emotional bonds with those who have died and on giving back to the community. Given the issue of confound-
ing, we don’t recommend the use of this scale to assess spirituality.
A third scale often used to measure spirituality is a subscale of the Self-Transcendence Scale called the
Spiritual Acceptance Scale, a section of Cloninger’s widely used Temperament and Character Inventory
(Cloninger et al., 1993 ). This measure consists of questions about the ability to predict the future, personal experi-
ences having to do with telepathy, and belief in paranormal phenomena. These items, in our opinion, do not
serve to identify the deeply spiritual person (at least not in the way that spirituality has been traditionally under-
stood in the past).
We have already discussed the Daily Spiritual Experiences (DSE) Scale (Underwood & Teresi, 2001). While sev-
eral items that assess mental health may contaminate the scale (#2, 3, 5, 6, 11 /C014), this problem can be handled by
examining health outcomes with and without those items included (see Koenig, 2011 , pp. 204 /C0205). If results are
the same, then this will demonstrate that contamination is minimal. The Spiritual Well-being Scale (SWBS)
(Paloutzian & Ellison, 1982) is another commonly used scale, and while we consider the 10-item religious well-
being (RWB) subscale a valid measure, the 10-item existential well-being (EWB) subscale is simply a measure of
well-being or good mental health. If researchers decide to use the SWBS, relationships with RWB and EWB sub-
scales should be analyzed and reported separately (and modeled correctly, i.e., RWB leading to EWB, which in
turn leads to better mental health).
In summary, definitions are crucial to measurement. Constructs must be clear and distinct from one another.
This is particularly important when dealing with constructs such as religion, spirituality, secular humanism, and
mental health, where construct overlap has been a serious concern. To avoid such problems when undertaking
research on religion/spirituality and health, we recommend that researchers use the traditional definition of spir-
ituality that conceptualizes those who are spiritual as the deeply religious. Religious involvement has many
dimensions, and we have described 10 of them in this chapter. Measures to assess each of these dimensions are
presented and critiqued and psychometric characteristics are provided. A brief section is also devoted to com-
monly used measures of spirituality. Although most measures of religiosity have been developed in Christian
populations, many of these instruments work well in other religious groups, particularly Jews and Muslims.
However, given differences in the content of belief between faith traditions, we recommend in non-Christian
populations both the use of religion-specific scales and the use of more established measures of religiosity devel-
oped in largely Christian populations (for comparison). Finally, we make recommendations on the best scales to
use depending on the researchers’ specific aims, the religious composition of their samples, and the space avail-
able in their questionnaires, ensuring the assessment of both religious beliefs/practices and religious coping
behaviors.
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V. VICES AND VIRTUES