Examining the impact of spirituality religious strength on behavioral and emotional health among youth with multiple adverse childhood experiences

Purpose: Although spiritual/religious strengths (SRS) are widely believed to be a protective factor for youth physical and mental wellness, scant evidence is available regarding how much and in what direction a person's past adverse experiences can affect the said protection. The study aims to validate the overall protective effect of SRS on health and investigate the mutual effect modification of SRS and accumulated adverse experiences exposure. Methods: The study is a cross-sectional design utilizing the Child and Adolescent Needs and Strengths (CANS) administered to foster care youth aged between 5 and 17 in a large, mid-western state from July to December 2020. Logistic regressions were used on a gender-balanced working sample of 4,802 youths to model the odds of physical and mental unwellness measured by 12 behavioral and emotional needs (BEN) items in CANS and the combined multi-BENs (MBE) as 4 or more BEN items, given the presence of (a) SRS identified by CANS, (b) past trauma as having 4 or more out of 10 adverse childhood experiences (ACEs) items on the CANS, denoted as multi-ACEs (MAC), and (c) co-occurring SRS and MAC. Results: Primarily, the study found supported the protective benefits of SRS as the presence was associated with lower levels of BEN. However, the higher levels of adverse experiences exposure were associated with an attenuation of the relationship between SRS and BEN. Secondarily, females were found to have higher SRS and lower BEN than males; adolescents between 13 and 17 had disproportionally more ACES, greater BEN and lower SRS; Black youth had disproportionally more trauma exposure and higher BEN, but had higher SRS. Conclusion: The findings imply that having spiritual/religious strength helps promote wellbeing among foster care youth. However, it appears the greater levels of traumatic experiences exposure can overwhelm this positive impact. These findings are consistent with the complex literature on the role of spiritual/religious strength in mental health and may help clarify this complex relationship. Trauma-informed intervention should be considered nuanced approaches to address SRS among children and youth who present with these strengths.