Psychology Statistics data report project

RESEARCH

A Preliminary Construct Validation of the Multidimensional Measurement of Religiousness/Spirituality Instrument:

A Study of Southern USA Samples

Chris Stewart and Gary F. Koeske School of Social Work

University of Pittsburgh

The Multidimensional Measurement of Religiousness/Spirituality (MMRS) survey was administered to 515 respondents from the southeastern United States, 355 gradu- ate and undergraduate students in Social Work, and 160 clients undergoing alcohol- ism or drug treatment. Exploratory factor analysis and reliability analyses resulted in retaining 59 of 81 MMRS items measuring 3 primary factors (Meaning, Spirituality, Religious Practices and Organized Religiousness) and 2 secondary factors (Guilt vs. God’s Grace, and Loving/Forgiving God). The primary factors were highly internally consistent and showed acceptable stability reliability for a subsample of clients; they also largely replicated intended dimensions of the MMRS. Convergent, discriminant, and theoretical construct validity were generally supported for the factors in correlational analyses, but the Guilt dimension, in particular, should be reevaluated in future research. Various limitations were discussed. It was suggested that the 3 pri- mary factors could be reliably assessed with 10 items, and that this 30-item scale could be a very useful multidimensional research tool.

There appears to be an increasing interest in the subject of religiosity and spiritual- ity in human behavioral research. Numerous articles investigate the possible bene- fits of religious and spiritual domains for health and mental health (Cooper-Patrick

THE INTERNATIONAL JOURNAL FOR THE PSYCHOLOGY OF RELIGION, 16(3), 181–196 Copyright © 2006, Lawrence Erlbaum Associates, Inc.

Correspondence should be sent to Chris Stewart, University of Pittsburgh, School of Social Work, 2117 Cathedral of Learning, Pittsburgh, PA 15260. E-mail: [email protected]

et al., 1997; Ming, Williams, Simpson, & Lyons, 2002; Russinova, Wiewiorski, & Cash, 2002; Thompson, 2002; Thoreson & Harris, 2002). Similarly, the contribu- tion of religiosity and spirituality has been the focus of work in the addiction treat- ment arena (Cancellaro, Larson, & Wilson, 1982; Connors, Tonigan, & Miller, 1996; Koenig, George, Meador, Blazer, & Ford, 1994; Miller 1998). Despite the lack of conclusive results, sufficient evidence suggests that these constructs con- tribute to positive outcomes (Hackney & Sanders, 2003).

The psychology of religion has made great advances in conceptualizing and operationalizing many dimensions of religiosity and spirituality so that, currently, the creation of new instruments is generally discouraged (Gorsuch, 1984, 1990). In one volume alone Hill and Hood (1999) reviewed over 120 measures of religiosity, including often-utilized measures, such as the Spiritual Well-Being Scale (SWB) and the Religious Orientation Scale (ROS).

Despite the vast array of measures, there is room for improvement in measuring both religiosity and spirituality, particularly in relation to health and mental health outcomes (Hill & Pargament, 2003). One suggestion from the literature is to in- clude both religiosity and spirituality domains in a single measure that might be conceptualized as an individual’s global spirituality (Miller & Thoreson, 1999).

Spirituality, as thus defined, is a complex construct generally thought to be best defined as multidimensional, encompassing every individual’s beliefs concerning reality beyond the sensory, material world (Larson, Swyers, & McCullough, 1998; Miller 2003). The exact number and nature of dimensions has been the subject of some debate in the literature, although some have suggested components, includ- ing self-identification or affiliation, formal practice, private practice, recognition of importance or centrality, belief, and spiritual experience (Hill & Hood, 1999; Hood, Spilka, Hunsberger, & Gorsuch, 1996; Miller & Thoreson, 1999). Addi- tionally, there is general agreement that religiosity and spirituality are distinct but related constructs that should be considered collectively, particularly in assessing the impact of global spirituality on outcomes of interest (Hill & Pargament, 2003; Miller, 1998, 2003).

Some proven and accepted instruments may tap particular dimensions of spiri- tuality as exemplified by the Spiritual Assessment Inventory (SAI) and SWB; many measures tend to focus primarily on aspects of religiosity, such as the ROS (Hall & Edwards, 1996; Hill & Hood, 1999). Because the domains are signifi- cantly related it seems important to try and capture an overall spiritual construct by including both domains in one measure. A further concern is the inclusion of spiri- tual expressions that are outside the Judeo–Christian tradition as many current measures were normed without such considerations (Hill & Pargament, 2003).

A consortium of religiosity, spirituality and health specialists (Fetzer Institute, 1999) collaborated to compile a multidimensional measure of religiousness and spirituality (MMRS) that included multiple domains of both religiosity and spiri- tuality related to an individual’s overall or global spirituality that might be used in

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health and mental health research. Conceptual and methodological issues in re- searching spirituality, religiosity, health, and aging were explored (Underwood & Teresi, 2002). This ambitious exercise resulted in a full-length, 88-item measure and a short form with domains, including daily spiritual experiences, religious be- liefs, life meaning, religious practice, forgiveness, and other elements. This elabo- rate instrument may have utility for studies dedicated to the examination of religi- osity and spirituality as preeminent variables and attempts to holistically capture global spirituality.

As of September 2004 the Fetzer Institute reported on its Web site that 23 pub- lished studies have utilized either the complete measure or the brief form of the MMRS and provides a list of 58 publications that cite the measure. The first author has utilized both forms of the MMRS in published research involving student atti- tudes concerning religiosity in social work practice and treatment of addictions (Stewart & Koeske, in press-a, in press-b). Despite the interest in the measure and an increase in its use, little psychometric evidence is currently available for the MMRS.

Some of the longer subscales have psychometric evaluation. For example, Underwood and Teresi (2002) reported on the reliability and validity of the Daily Spiritual Experiences Scale. This scale has undergone significant psychometric study with three different samples demonstrating good reliability and internal con- sistency greater than .90. Similarly, the domain tapping religious coping has been extensively tested (Pargament, 1999; Pargament, Koenig, & Perez, 2000). The full RCOPE has demonstrated good validity and reliability with two different samples. Further, factor analysis was largely consistent with a priori conceptualization (Pargament, Koenig, & Perez, 2000). The Brief RCOPE, utilized by the MMRS also demonstrated strong internal consistency and validity (Pargament, 1999).

This project is a beginning effort into validating the complete MMRS instru- ment as a comprehensive measure of global spirituality. Exploratory factor analy- sis was used to examine the structure of the MMRS and to compare the derived fac- tors to the a priori or intended item clusters. Homogeneity and test–retest reliabilities are reported for all subscales. Construct validity evaluations are pro- vided, including convergent, discriminant, and theoretical validity.

METHODS

Samples

Two samples responded to the MMRS and related instruments. The first sample was composed of 355 undergraduate and graduate social work students from three universities in the southeastern United States. The second sample was composed of 160 clients receiving treatment for alcoholism at centers also located in the southeast. The clients received traditional 12-step treatment in a 28-day inpatient setting. Seventy of the treatment clients responded to the MMRS and related scales

VALIDATION OF THE MMRS 183

a second time, approximately one month after the first testing. For the exploratory factor analysis, the student and client samples were combined into one larger sam- ple, N = 515. The students responded anonymously in classroom groups of various sizes; the clients responded to the confidential survey shortly after intake and (for those responding to the posttest) about one month later after completing treatment.

In the Student sample, 317 (89%) were females, the median age was 25 years, and 54% were White, 21% African American, 13% Hispanic American, and the remainder were “other” racial categories of 1% or lower representation. Their reli- gious identification was predominantly Protestant (47%) and Catholic (22%), with other affiliations accounting for 18% of the sample. Of this 18% slightly less than 3% were Jewish, and slightly greater than 7% was nonreligious, Buddhist, or exis- tentialist. The Client sample was older (median age = 38), largely male (67.5%), and predominantly African American (52%) or White (44%), with only 2% His- panic. One half had experienced previous treatment. The primary drugs of choice were alcohol (34%), marijuana (24%), and cocaine or crack cocaine (27%).

Measures

The full-length MMRS was administered with standard instructions to both sam- ples. The 88 MMRS questions are organized into 12 labeled subsections with k items per section: Daily spiritual experiences (k = 16), Meaning (k = 20), Beliefs (k = 7), Forgiveness (k = 10), Private religious practices (k = 4), Religious/spiritual coping (k = 11), Religious/spiritual history (k =5), Organizational religiousness (k = 7), Commitment (2), Religious preference (k = 1), Values (k = 3), and Overall ranking (k = 2). Our psychometric evaluation of the measure excluded the religious preference and history sections as well as the monthly or yearly dollar contribution item. This left 81 items, which were rated on 3-, 4-, 5-, 6-, 8-, and 9-step ordinal metrics. Each a priori labeled subsection with three or more items was assessed as a separate subscale and potential construct.

In addition to the MMRS, the Student sample responded to a number of mea- sures of religious/spirituality and social work practice developed by Sheridan (1992, 1999). These included the following:

1. A 19-item Likert-type scale measuring the attitude toward infusing a reli- gious or spiritual element in social work practice.

2. A 15-item (yes or no) scale for perceived appropriateness of various reli- gion-relevant practice behaviors.

3. A summed rating of whether the respondent had personally used the listed practice behavior.

4. A single-item 8-step report of frequency of current participation “in reli- gious services.”

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5. A single-item 6-step report of current participation in “religious or spiritual practices.”

6. A single-item 5-step report of “present relationship to an organized reli- gion or spiritual group,” from “active participation, high level of involve- ment” to “disdain and negative reaction to religion or spiritual tradition.”

7. A reported choice among six religious ideological positions, which we scored as “1” for endorsement of “There is a personal God or transcendent existence and power whose purpose will ultimately be worked out in his- tory” and “0” for endorsement of any of the other 5 positions.

8. Reports of having had graduate training in religion or theology and participa- tion in workshops or conferences on religion or spirituality in the last 5 years.

These measures were used to assess convergent and theoretical validity of the MMRS.

The Client sample respondents completed, along with the MMRS, two addi- tional multi-item measures of religiosity: the Allport and Ross (1967) 26-item Re- ligious Orientation Scale (ROS) and spirituality, the 20-item Spiritual Well-being Scale (SWB; Ellison 1983). These scales are scored by summation of the items rated on 1–5 (ROS) and 1–6 (SWB) agree–disagree scales. These measures were also used to assess convergent and theoretical validity of the MMRS.

RESULTS

Internal Consistency of the MMRS “A Priori” Section Subscales

Prior to exploring the factor structure of the MMRS, we estimated the homogene- ity of the eight item sets of “a priori” subscales that had three or more items. The coefficient alphas are reported in Table 1 for the eight subscales for the Student and

VALIDATION OF THE MMRS 185

TABLE 1 Homogeneity (Alpha) Reliabilities for MMRS “A Priori” Section Scales

Students (N = 355) Clients (N = 160) Merged (N = 515)

Daily Spiritual Experiences .93 .93 .93 Meaning .96 .95 .96 Beliefs .83 .78 .81 Forgiveness .56 .44 .50 Religious Practices .83 .81 .81 Religious/Spiritual Coping .79 .82 .79 Organizational Religiousness .84 .80 .83 Values .44 .36 .40

Client samples separately. The alphas are in the very good to acceptable range for 6 of the 8 subscales; they are, however, very low for the 3-item Values set and the 10-item Forgiveness set, for which none reach .60.

Exploratory Factor Analysis

Because exploratory factor analysis is a large sample procedure, the Student and Client samples were merged into one large sample of 515 cases. Although the 81-item MMRS is relatively new and may not be appropriate for a confirmatory factor analysis, we maintained the a priori subsections as one guide for the number of factors to extract, along with the scree test, imputation of meaningfulness, and a requirement of at least three items loading uniquely to a .40 criterion on a factor. A principal components analysis followed by an oblique rotation of the factors ex- tracted eight factors, while the scree test suggested five viable factors.

Table 2 shows the loadings for each of the five retained factors. Fifty-seven per- cent of the scale variance was attributable to the 8 factors, 52% to the 5 retained factors. The KMO diagnostic assessment of the item set’s suitability for analysis was .96, far exceeding the .70 criterion. All 20 Meaning items of the MMRS loaded uniquely on the first factor and accounted for 27% of the scale variance; all but two loaded above .50. One item that loaded .44 on this factor, an item from the Religious/Spiritual Coping section, was omitted because it was complex, loading beyond .35 on two other factors. The next largest factor (labeled Factor 3; 21% of variance) included 10 the 11 items from the Religious Practices and Organiza- tional Religiousness sections plus the overall religiosity item (To what extent do you consider yourself a religious person?), and the third largest factor (labeled Factor 3; 18% of the scale variance) included 14 of the 16 Spiritual Experiences items plus the overall spirituality item (To what extent do you consider yourself a spiritual person?). So, these three empirical factors replicated fairly well their cor- responding a priori item subsections.

Table 2 shows that the second factor after the oblique rotation (5.6% of the vari- ance) included 4 items from the Forgiveness section of the MMRS and 2 items from the Spiritual/Religious Coping section. The four former items each express a sense of having done wrong, but do not directly refer to forgiveness. The latter two items refer to receiving punishment from, and having been abandoned by, God. When scored in this “negative” direction the items of this factor seem to express a sense of guilt; it will, therefore, be labeled the Guilt dimension. The “positive” (or “proreligious”) end of this dimension might be regarded to represent the notion of God’s grace. This is the only dimension scored in a “nonreligious” direction, in the sense that high scorers report feeling abandoned by God and not forgiven. Because of possible ambiguity in this designation (i.e., high scorers may be implicitly ac- knowledging that there is a God that reviews their behavior and evaluates their lives), an exploratory analyses was conducted extracting between 5 and 9 factors to

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TABLE 2 Factor Loadings for Five Retained Factors for 59 MMRS Survey Items

Factor

MMRS Item & Number 1 2 3 4 5

Factor 1: Meaning 34. My feelings of spirituality add meaning to the events in my life. .81 –.05 –.02 .14 .02 36. My spirituality helps define the goals I set for myself. .79 –.05 –.04 .11 .06 23. My spiritual beliefs give my life a sense of significance and purpose .78 –.09 –.02 .08 .00 31. Looking at the most troubling or confusing events from a spiritual

perspective adds meaning to my life .76 –.10 –.01 .14 –.02

25. When I am disconnected from the spiritual dimension in my life, I lose my sense of purpose.

.71 .10 –.07 –.01 –.07

19. Without a sense of spirituality, my daily life would be meaningless. .70 .01 –.04 .02 –.04 28. What I try to do in my day-to-day life is important to me from a

spiritual point of view. .70 –.05 –.09 .18 .13

30. Knowing I am part of something greater than myself adds meaning to my life.

.69 .02 –.02 .10 –.12

17. My spiritual beliefs give meaning to my life’s joys and sorrows. .66 –.09 –.06 .04 .02 22. When I lose touch with God, I have a harder time feeling there is

purpose and meaning in life. .63 .15 –.09 –.12 –.08

21. My religious beliefs help me find a purpose in even the most painful and confusing events in my life.

.62 –.09 –.15 –.07 –.17

18. The goals of my life grow out of my understanding of God. .61 –.01 –.13 .00 –.04 35. God plays a role in how I choose my path in life. .60 .03 –.15 .04 –.25 32. My purpose in life reflects what I believe God wants for me. .59 .12 –.14 –.02 –.26 26. My relationship with God helps me find meaning the ups and downs

of life. .59 .02 –.10 .02 –.33

24. My mission in life is guided/shaped by my faith in God. .58 .05 –.19 .01 –.26 29. I am trying to fulfill my God-given purpose in life. .57 .06 –.08 .06 –.23 27. My life is significant because I am part of God’s plan. .52 .07 –.11 .01 –.39 33. Without my religious foundation, my life would be meaningless. .47 .26 –.23 –.02 –.18 20. The meaning in my life comes from feeling connected to other living

things. .47 –.13 .23 .03 .14

Factor 2: Guilt 63. I feel that stressful situations are God’s way of punishing me for my

sins or lack of spirituality. –.09 .73 .11 –.05 .07

47. I belief there are times when God punished me. –.13 .72 .07 .07 –.08 49. I often feel that no matter what I do now I will never make up for the

mistakes I have made in the past. .04 .63 –.01 –.01 .06

64. I wonder whether God has abandoned me. –.01 .59 .04 –.12 .39 53. I often feel like I have failed to lead the right kind of life. .13 .55 .01 –.07 –.02 45. If I hear a sermon, I usually think about things I have done wrong. .07 .49 –.16 .01 –.23

Factor 3: Religious Practices & Organized Religiousness 78. I feel at home in this church/synagogue. –.01 –.07 .86 –.06 –.09 76. How well do you feel you fit in your church/synagogue? .01 –.09 .81 –.01 –.09 77. If I had to change churches/synagogues, I would feel a great sense of

loss. –.06 –.06 .79 –.08 –.00

(Continued)

evaluate its stability. Though it is a “small” factor, it appeared in each exploratory analysis performed.

The last (fifth) factor (accounting for 13% of the variance) included 4 items from the Beliefs section, 1 from the Forgiveness section, and 2 from the Spiri-

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TABLE 2 (Continued)

Factor

MMRS Item & Number 1 2 3 4 5

80. The church/synagogue matters a great deal to me. .06 –.03 .78 –.05 –.08 74. How often do you attend religious services? .07 –.01 .77 .05 .09 75. Besides religious services, how often do you take part in other

activities at a place of worship? .12 –.05 .65 .12 .25

87. To what extent do you consider yourself a religious person? .08 .05 .56 .05 –.05 56. How often do you read the Bible or other religious literature? .10 .12 .56 .18 .15 55. How often do you watch or listen to religious programs on TV or radio? –.05 .37 .46 .16 .09 57. How often are prayers or grace said before or after meals in your home? .04 .22 .43 .21 –.10 81. I try hard to carry my religious beliefs over into all my other dealings

in life. .26 .02 .41 .10 –.06

Factor 4: Spirituality 2. I experience a connection to all life. .09 –.07 .14 .70 .08 11. The beauty of creation spiritually touches me. .14 –.02 –.02 .67 .03 6. I feel deep inner peace or harmony. –.11 .01 –.04 .66 .05 12. I feel thankful for my blessings. .00 .07 .02 .64 –.25 13. I feel a selfless caring for others. –.08 –.08 –.10 .59 –.03 5. I find comfort in my religion or spirituality. .24 .00 –.14 .57 –.05 4. I find strength in my religion or spirituality. .25 –.01 –.15 .57 –.05 1. I feel God’s presence. .17 –.02 –.09 .53 –.21 14. I accept others even when they do things I think are wrong. –.10 .07 –.13 .50 .08 3. During worship, or at other times when connecting with God, I feel joy

which lifts me out of my daily concerns. .11 .15 –.23 .47 –.19

7. I ask for God’s help in the midst of daily activities. .07 .10 –.24 .45 –.20 8. I feel guided by God in the midst of daily activities. .14 .14 –.18 .45 –.22 88. To what extent do you consider yourself a spiritual person? .26 –.25 –.05 .44 .26 10. I feel God’s love for me through others. .15 .06 –.16 .44 –.20 9. I feel God’s love for me directly. .18 .05 –.20 .41 –.30

Factor 5: Loving/Forgiving God 66. I question whether God really exists. .26 –.14 –.11 .06 .56 39. God’s goodness and love are greater than we can possibly imagine. .26 .09 –.18 .01 .53 41. When I am faced with a tragic event I try to remember that God still

loves me and that there is hope for the future. .29 .12 –.05 .03 .52

65. I try to make sense of the situation and decide to do without relying on God.

.10 –.23 –.10 .19 .48

43. I think that everything that happens has a purpose .12 .18 .06 .08 .44 42. I feel that it is important for my children to believe in God. .21 .15 –.28 –.06 .44 46. I believe that God has forgiven me for things I have done wrong. .13 –.01 –.11 .10 .40

tual/Religious Coping section. These items seem to reflect a firm belief in a loving and forgiving God that provides purpose to one’s life and it was also relatively sta- ble across exploratory analyses. This set includes the item “I question whether God exists,” for which high scorers were more likely to answer “not at all.”

The remaining three factors in this solution were not regarded as viable. The sixth factor included three items from different sections, and one of these items was complex, having a loading to criterion on the fifth factor as well. No items loaded to criterion on the seventh factor. The last factor included four items from the Forgiveness section, which referred to interpersonal, but not God-granted, for- giveness. It did not, therefore, appear to reflect a dimension of religiosity.

This central analysis supported the integrity of two of the a priori MMRS sec- tions (Meaning and Spiritual Experiences) and folded two others (Religious Prac- tices and Organizational Religiousness) into a single dimension, Organized Reli- gion and Religious Practices. Fifty-nine items loaded uniquely on one of the five factors; 22 items did not load on a viable factor, loaded below criterion, or loaded on more than a single factor (i.e., they were complex items).

Factor Score Distributions

Each of the distributions was skewed in the direction of lower religiosity/spiritual- ity scores (i.e., there were a small number of respondents with very low scores). The skew was minimal for Organized Religion and Practices (sk = –.23) and not excessive for Spirituality (sk = –.70) and Guilt scores (sk = .71). The skewness of the Meaning scores exceeded 1.0 (sk = –1.09), but could be corrected to –0.46 with a square transformation. The Loving and Forgiving God scores were highly skewed (sk = –2.12) and nontransformable. It is likely that similar non-normality will be found for Meaning and Loving God scores in other samples, including het- erogeneous/representative samples. Therefore, transformations may be needed for multivariate analysis of Meaning scores and scores on the Loving and Forgiving God dimension may need to be dichotomized.

Factor Score Intercorrelations

The factor scores were generally not correlated providing support for the unique- ness of each derived factor. The factor intercorrelations ranged between .45 for Meaningfulness with Spirituality to 0.00 for God’s Grace with Spirituality.

Homogeneity and Test–Retest Reliabilities of the Empirical Dimensions of Religiosity/Spirituality

We used the saved standardized factor scores to measure the five retained dimen- sions, partly due to the several metric lengths used in the MMRS. It would be use-

VALIDATION OF THE MMRS 189

ful, however, to know the conventional alpha reliability estimates for the items that are identified with each factor, based on the factor loadings exceeding the .40 crite- rion. Table 3 shows these estimates for the merged sample of 515, as well as for the separate Student and Client samples. The alphas reported are the standardized item alphas, because the items may have been rated on scales of different length. These alphas were quite high, ranging from the high 80s to the 90s, with the exception of the Guilt set, which .73 in the merged file, .72 in the Student sample, and .56 in the Client sample.

The sample of 70 clients that responded to the MMRS survey twice was used to provide an estimate of stability reliability. Because these respondents were in alco- holism treatment, their true religiosity/spirituality scores might be expected to change at varying rates. Consequently, these estimates may underestimate the reli- ability of the measured dimensions. Table 3 includes these stability coefficients. Pearson coefficients were used for four of the tests; a Spearman rho was used for the Loving/Forgiving God dimension, which was markedly negatively skewed. Given that these clients had undergone an intervention, the estimates are quite high for Meaning, Spirituality, and Religious Practices and Organized Religion, but modest for Loving/Forgiving God (rho = .61) and Guilt (.57).

Convergent and Discriminant Validation of the MMRS Empirical Dimensions

Four questions about religiousness and spirituality asked of the students might be expected to relate to the factor scores derived from the MMRS. These relationship tests reflect on convergent validity, albeit dimly, as these are exclusively self-report measures. Table 4 presents the nonparametric intercorrelations of the factor scores with endorsement of the statement “There is a personal God or transcendent exis- tence and power whose purpose will ultimately be worked out in history,” and with frequency of participation “in religious services,” frequency of participation in

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TABLE 3 Alpha Reliabilities for Empirically-Derived Scales in Separate and Merged

Samples and Stability Coefficients for 70 Clients

Sample

Scale Students

(N = 355) Clients

(N = 160) Merged

(N = 515) Prepost Stability

(N = 70)

Meaning .96 .95 .96 .67 Spirituality .92 .93 .92 .78 Religious Practices & Organized Religion .92 .89 .91 .84 Guilt .72 .56 .73 .57 Loving/Forgiving God .88 .80 .87 .61

“personal religious or spiritual practices,” and extent of “relationship to an orga- nized religion or spiritual group.” Excluding the Guilt dimension, we see that the factor scores are significantly and often substantially related to these single-item measures of religion and spirituality. Consistent with discriminant validity, the or- ganized religion dimension was particularly highly related to frequency of partici- pation in religious services and to report of a deeper involvement in organized reli- gion, whereas the correlation of the frequency of spiritual practices item was somewhat more highly related to the Spirituality dimension than to the organized religion factor. Although the correlations with Guilt were very low, this factor was significantly related to participation in religious services (rho = .19, p < .001) and endorsement of personal God ideology (rho = .12, p = .04).

Table 4 also shows the correlations of the factor scores with the scores on the Religious Orientation Scale and the Spiritual Well-Being Scale for the 160 respon- dents in the Client sample. These correlations range between .40 and .64 for the MMRS factors, excluding Guilt. Low Guilt, which might be construed as a belief in God’s grace, was related more modestly, but significantly, to the two independ- ent measures of religiosity and spirituality.

Theoretical Construct Validity

Beyond support for the rather obvious expectation that people who do not identify themselves with religious group should score lower on dimensions of religiosity and spirituality, the Student sample permits the assessment of construct validity through the administration of the Sheridan (1999) measures of attitude of inclusion

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TABLE 4 Spearman Correlations of Factor Scores With Religious Involvement

Questions in Student Sample and With Religious Orientation Scale (ROS) and Spiritual Well-Being (SWB) Scale in Client Sample

Item/Scale

Factor Scale

Participation In Religious

Services

Personal Spiritual Practices

Personal God

Ideology

Involvement Organized Religion ROS SWB

Meaning .53** .45** .38** .47** .51** .62** Spirituality .52** .53** .27** .44** .40** .59** Religious Practices & Organized Religion

.83** .47** .42** .72** .54** .55**

Guilt .19** –.05 .12* .07 –.23** –.32** Loving/Forgiving God

.51** .37** .41** .41** .55** .64**

*p < .05. **p < .01

of religious-based practices in social work practice, the appropriateness of specific exemplary religious practices, and the actual use of such practices. Many of these students, particularly the graduate students, had fieldwork or employment experi- ence in which these practice behaviors may have been utilized. As would be ex- pected (see Table 5), respondents with a more positive attitude, those who deemed more religious-based practices “appropriate,” and those who had personally prac- ticed more of these behaviors scored significantly higher on Meaning, Spirituality, Religious Practices and Organized Religiousness. Guilt scores were not related to any of the three measures, and the Loving/Forgiving God score was only signifi- cantly related to Attitudes and use of practice behaviors.

Finally, based on the Client data, we might expect that valid scores on religi- osity/spirituality would be sensitive to exposure to a 12-step treatment interven- tion, which emphasizes relationship to a transcendent spiritual power. We would predict, therefore, that clients undergoing such an intervention would score higher on dimensions of religiosity following exposure to 12-step-oriented alco- holism or drug treatment. Wilcoxin signed ranks tests showed that clients’ religi- osity factor scores were higher at the posttest, compared to the pretest, for each of the comparisons. The probabilities achieved were .09 for Meaning, .006 for Spirituality, .001 for Organized Religiosity, .04 for Loving/Forgiving God, and .001 for Guilt. In the case of the Guilt scores, the results showed that the clients reported lower guilt scores or, conversely, a higher belief in God’s grace follow- ing treatment.

DISCUSSION

The 81 ordinal items of the Multidimensional Measurement of Religious- ness/Spirituality survey are organized a priori into eight sections or item sets

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TABLE 5 Spearman Correlations of Factor Scores With Attitude Toward Religious

Intervention Practices, Appropriateness of Various Practices, and Use of Various Practices

Measure

Factor Scale Attitude Appropriateness Use in Practice

Meaning .46** .30** .23** Spirituality .33** .18** .24** Religious Practices & Organized Religion .28** .24** .28** Guilt –.06 .00 .02 Loving/Forgiving God .21** .10 .18*

*p < .05. **p < .01

which might be expected to emerge as eight empirical factors in a factor analy- sis. We found, however, that 59 of the items loaded uniquely to a criterion on only five viable factors in our analysis of the responses of regionally southeast- ern United States. respondents. Twenty-two or 27% of the items loaded below criterion or could not be identified with any empirical construct. The sections on Meaning, Daily Spiritual Experiences, Religious Practices, and Organiza- tional Religiousness were represented in the empirically derived factors, though the latter two sections combined into one factor. Despite being inter- nally consistent as separate a priori sets, the Beliefs and Religious/Spiritual coping sections did not emerge empirically in the factor analysis, which is sup- ported in other research (Kendler et al., 2003). Values and Forgiveness were nonhomogenous sections that failed empirically. Consequently, the “multidi- mensional” quality was supported, but its a priori character or structure re- ceived only limited support.

Two empirical factors not designated a priori emerged: a sense of guilt versus God’s grace and a firm belief in a loving and forgiving God. These factors had only 6 and 7 items, respectively, with loadings exceeding the .40 criterion, and the Guilt factor had both homogeneity and test–retest reliabilities below .70 in one of the samples. The Guilt factor may be considered a “weak” factor or sec- ondary import, but it was robust, in the sense that it emerged regardless of the number of factors extracted in early explorations. In validation analyses, Guilt consistently correlated least with other measures, although it appears to corre- spond with the Instability subscale of the Spiritual Assessment Inventory (Hall & Edwards, 1996). Future research on different, larger, and more diverse samples will be needed to determine if this factor should be regarded as a genuine mea- sure of an element of religiosity. If the Guilt score is tapping a genuine and useful element of religious experience, it may be one with considerable psychological and health import.

The dominant factors of Meaning, Spirituality, and Religious Practices and Or- ganized Religion might be regarded as reflecting cognitions, experiences or affect, and behaviors, respectively. This represents a useful conceptual mix, even if the secondary factors of Guilt and Loving God fail to survive in repeated testing or are not used. The Guilt factor seems inherently affective, while the Loving God factor is primarily cognitive or belief-oriented. The affect expressed in the Guilt factor items, unlike that of the Spirituality items, is typically a negative affect. The beliefs expressed in the Loving God items seem to assume a more personal, active, and be- neficent God than presented in the Meaning items.

The reliability and validity evidence for the three primary scales is quite persua- sive. Both stability and homogeneity reliability were good, as was structural or fac- torial validity. In addition, convergent and discriminant validity was supported by correlations with other accepted religion-relevant measures, such as the ROS and SWB, including patterns of lower and higher correlations corresponding to the

VALIDATION OF THE MMRS 193

specific content of the associated measures. Theoretical construct validity was supported by analyses in the student data showing that the primary religion/spiritu- ality factors “predicted” specific practice attitudes and behaviors of social workers in training. In the client study construct validity could be inferred from the ability of the primary factors to document expected increases in religiosity following tra- ditional treatment for alcohol and drug problems.

Recommendations and Conclusions

We are unaware of previous published research on the MMRS survey, which ap- pears to be the most comprehensive measure of religiosity and spirituality recently developed. The character of its dimensionality was untried, prior to the current study, and much more must be done to evaluate the potential the measure has in health, mental health, and behavioral research in general.

Based on the current findings, researchers in immediate need of a fairly com- prehensive measure of religiosity/spirituality might proceed with the reduced 59-item set we found to measure three primary and two secondary factors. Given that the primary factors tap cognitive, affective or experiential, and behavioral ele- ments of religiosity, which are often suggested by the literature, it would be feasi- ble to select 10 items measuring each primary factor (Hill & Hood, 1999; Hood, Spilka, Hunsberger, & Gorsuch, 1996; Miller & Thoreson, 1999). In addition to being serviceable as a comprehensive measure for the study of health–religion re- lationships, the 30-item measure might be subjected to an assessment using confir- matory factor analytic procedures.

To achieve comparability across different samples a scoring system must be de- veloped for MMRS dimension scores that can handle the different scale lengths. This is complicated by the fact that the factor analytic results revealed that, for some dimensions, not all the items loading on the factor share the same scale length. The use of standardized factor scores is a fine solution within a single study, but disallows between study or sample comparisons. An item-weighting system driven by the number of alternatives for each item could be implemented and communicated as a system of scoring rules to scale users. Such a scoring sys- tem would also allow comparisons between the factor/dimension scores within a sample. Then, one could make statements, for example, about the amount of spiri- tuality versus organized religion emphasis in the religiosity of a particular sample of respondents.

Implementation of some of the research paths suggested here should soon re- veal if the MMRS scale effort has realized the potential that its founders imagined for it. Studies of religiosity and the fields of the psychology and sociology of reli- gion would benefit greatly from a comprehensive measure of religion and spiritu- ality used across disciplines in numerous studies.

194 STEWART AND KOESKE

Limitations

The sample used for the primary factor analysis in this study was diverse, in that it in- cluded both clinical and nonclinical respondents; it was also individuals of three major ethnic or racial groupings, males and females, and respondents of various ages. It was not a random or representative sample, nor was its composition as diverse or heteroge- neous as a large representative sample. Particularly the secondary or smaller factors may not be replicated on samples from different geography. This sample included very few Jewish respondents and many Protestant believers from more conservative denomina- tions. On the other hand, minor empirical factors that may be interesting to some observ- ers may have been obscured in a sample with a more heterogeneous mix. We might ex- pect, however, that the dominant factors of Meaning, Spirituality, and Religious Practices and Organized Religion would emerge in even very different samples.

Another concern is that the high reliability coefficients found for the a priori section scales and the primary derived factor scales may be partly attributable to item contiguity (i.e., the items were placed together in the survey instrument and given a separate heading for each section). This item contiguity might, in part, ex- plain why the Beliefs and Religious/Spiritual Coping sections had satisfactory alphas, but did not emerge as empirical factors in the primary factor analysis. It may also have helped bind the Spiritual Experiences and Meaning item sets to- gether in their respective factors. Future methodological research might involve the random scrambling of the items to assess if they cohere as expected independ- ent of the assist provided by strategic ordering.

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