Subtitle: A groundbreaking longitudinal study of over 1,600 adolescents and parents reveals that identifying as both religious and spiritual is associated with the best mental health outcomes, while “spiritual but not religious” youth show the highest levels of anxiety and depression.
In an era of rising mental health crises among young people—with adolescent depression rates increasing by 35% between 2016 and 2023—researchers are urgently seeking factors that protect psychological well-being. A study offers compelling evidence that one such factor may be the combination of religious practice and spiritual belief.
The study, titled “Mental Health Across Religious and Spiritual Categories: A Longitudinal Study Among Parents and Their Children,” followed over 1,600 parent-child dyads from Utah, Arizona, and California across eight years. The findings are striking: adolescents who identified as both religious and spiritual (RAS) had the lowest levels of depression, while those who identified as “spiritual but not religious” (SBNR) had the highest levels of both anxiety and depression.
The difference between these two groups—RAS and SBNR—was significant across every baseline measurement. This research challenges popular narratives that spirituality alone is sufficient for mental well-being and suggests that religious community, practice, and structure may provide unique protective benefits.
The Four Categories of Religious/Spiritual Identity
The study classified participants into four distinct groups based on their self-identification:
- Religious and Spiritual (RAS): Individuals who practice organized religion and also have personal spiritual beliefs and experiences.
- Spiritual but not Religious (SBNR): Individuals who believe in a higher power or have spiritual experiences but do not participate in organized religion.
- Religious but not Spiritual (RBNS): Individuals who participate in religious practices and community but do not identify as personally spiritual.
- Neither Religious nor Spiritual (NRNS): Individuals who have no religious affiliation or spiritual beliefs.
This four-category framework is crucial because most previous research has lumped “religiosity” and “spirituality” together, missing the nuanced differences between these groups. The study’s authors note that “it has become progressively popular to identify as ‘spiritual but not religious,'” with 22% of U.S. adults now holding this identity.
Baseline Findings: A Clear Hierarchy of Mental Health
In 2020 (the baseline year of the study), researchers measured depression and anxiety levels using validated clinical scales (CESD-10 for depression, Spence Anxiety Scale for children, Burns Anxiety Scale for parents). The results revealed a clear and consistent pattern:
For Adolescents (Children):
- RAS youth had the lowest depression levels—significantly lower than every other group.
- SBNR youth had the highest depression levels—significantly higher than every other group.
- SBNR youth also had the highest anxiety levels—significantly higher than every other group.
- RAS youth had lower anxiety than SBNR, though not significantly different from RBNS and NRNS.
For Parents:
- RAS parents had significantly lower depression than RBNS and SBNR groups.
- RBNS and SBNR parents had significantly higher anxiety than NRNS parents.
- RAS parents had lower anxiety than SBNR and RBNS.
Baseline (2020) Mental Health Across Religious/Spiritual Categories
| Group | Child Depression | Child Anxiety | Parent Depression | Parent Anxiety |
|---|---|---|---|---|
| Religious & Spiritual (RAS) | Lowest | Low | Lowest | Low |
| Religious Only (RBNS) | Medium | Low | High | Highest |
| Spiritual Only (SBNR) | Highest | Highest | High | Highest |
| Neither (NRNS) | Medium | Low | Medium | Low |
| Key Finding | RAS significantly lower than all others; SBNR significantly higher than all others | SBNR significantly higher than all others | RAS lower than RBNS and SBNR | RAS and NRNS lower than SBNR and RBNS |
Longitudinal Findings: Changes Over Eight Years
The study followed participants across three waves: 2020 (baseline), 2022, and 2024. This longitudinal design allows researchers to see how mental health changes over time within each group.
Child Depression Over Time:
- SBNR youth started with the highest depression levels but showed a significant decrease over time (slope = -0.0312, p = 0.000). By 2024, they were only slightly (though not significantly) higher than RBNS youth.
- RAS youth started with the lowest depression levels and maintained this advantage, though they did not show significant change over time (likely because they already had low levels).
- RBNS and NRNS youth showed no significant change in depression over time.
The researchers note that the SBNR decrease “may represent a ceiling effect”—meaning they had so much room for improvement that any change was detectable. Still, this finding suggests that even SBNR youth may experience some improvement in depression over time, potentially as they develop coping mechanisms or find meaning.
Child Anxiety Over Time:
- SBNR youth started with the highest anxiety levels and did not significantly change over time. They remained high.
- All other groups (RAS, RBNS, NRNS) showed significant increases in anxiety over time (p = 0.017, p = 0.001, and p < 0.001, respectively).
- RAS youth had the smallest increase in anxiety (slope = 0.0158), which was significantly lower than the NRNS increase.
This is a crucial finding. While all groups except SBNR saw their anxiety rise over the eight-year period (which included the COVID-19 pandemic and its aftermath), SBNR youth did not get worse—but they also did not get better. They remained at high levels.
Longitudinal Changes in Depression and Anxiety (2020–2024)
| Group | Child Depression Change | Child Anxiety Change | Parent Depression Change |
|---|---|---|---|
| Religious & Spiritual (RAS) | No significant change (already low) | Increased (smallest increase) | Decreased (p = 0.000) |
| Religious Only (RBNS) | No significant change | Increased | No significant change |
| Spiritual Only (SBNR) | Decreased (p = 0.000) | No significant change (remained high) | Decreased (p = 0.000) |
| Neither (NRNS) | No significant change | Increased | Decreased (p = 0.014) |
| Key Finding | SBNR improved in depression; RAS maintained low levels | RAS had smallest anxiety increase; SBNR remained high | All except RBNS improved in depression |
Parent Depression Over Time:
- All groups except RBNS showed significant decreases in depression over time.
- SBNR parents had the largest decrease (slope = -0.0347, p < 0.001), followed by RAS (slope = -0.0218, p < 0.001) and NRNS (slope = -0.0217, p = 0.014).
- RBNS parents showed no significant change in depression over time.
This finding is particularly interesting. While SBNR adolescents struggled, SBNR parents improved significantly. The researchers suggest that “adults may be particularly affected by the cognitive dissonance that may result from participating in religious practices without internalizing them spiritually.” In other words, going through the motions of religion without genuine spiritual connection (RBNS) may be uniquely distressing for adults.
Why Might RAS Identity Be Protective?
The study’s authors review several mechanisms that may explain why combining religious practice with spiritual belief benefits mental health:
1. Social Support: Religious communities provide social connection, belonging, and practical support. The study notes that “religious social support” is a key mechanism. For adolescents, youth groups, religious camps, and intergenerational relationships within congregations offer protective social networks.
2. Positive Emotions: Religious and spiritual practices generate positive emotions: love, awe, trust, compassion, gratitude, forgiveness, and hope. These emotions directly counter the negative affect characteristic of depression and anxiety.
3. Healthy Behaviors: Religious involvement is associated with decreased substance abuse, healthier lifestyle choices, and better self-care.
4. Meaning-Making and Coherence: Religious worldviews provide a framework for understanding suffering, adversity, and life’s challenges. This “sense of coherence” is especially supportive during difficult times. The authors cite Pargament’s work on religious coping, which shows that positive religious coping (trusting in a benevolent God, seeking spiritual support) predicts better mental health outcomes.
5. Structure and Routine: Religious practices (prayer, worship attendance, study of sacred texts) provide daily and weekly structure, which is particularly beneficial for adolescents who are still developing self-regulation skills.
Why Might SBNR Identity Be a Risk Factor?
The study’s findings on SBNR youth are consistent with previous research. King (2014) found that “those with a spiritual life view were at an elevated risk” for common mental disorders. The authors offer several possible explanations:
1. Yearning Without Direction: A desire for transcendent connection, without the structure, doctrines, or social support of organized religion, may leave individuals feeling confused and downhearted. They are “looking for transcendent connection without direction, having questions without faith claims to answer.”
2. Lack of Social Support: SBNR individuals may not have the same access to religious communities that provide belonging, practical help, and crisis support.
3. Negative Religious Coping: While the study did not directly measure religious coping, the literature shows that individuals who feel abandoned by God or angry at God have worse mental health. SBNR individuals may still hold spiritual beliefs but lack the positive religious coping strategies taught in religious communities.
4. Isolation and Individualism: The SBNR identity is inherently individualistic. While this appeals to modern Western values, it may also lead to isolation. The authors note that SBNR individuals may be “devoid of the structure, doctrines, or social support of organized religious practices.”
The Impact of COVID-19
The study’s timeline (2020–2024) includes the COVID-19 pandemic and its aftermath. The researchers note that “Wave 3 data were gathered in 2020; the impacts of the COVID-19 pandemic may have resulted in the higher baseline depression levels.” The general increase in anxiety across time “may also represent the stresses related to a post-COVID reintegration into society.”
Importantly, religious communities faced unique challenges during the pandemic, with many closing their doors or moving to online services. The researchers suggest that “SBNR individuals may contain individuals who were unable to practice their religion at the time when the baseline levels were measured due to social distancing and church closures.” This may have contributed to the higher baseline distress in this group.
Limitations and Cautions
The study has important limitations that readers should keep in mind:
- Geographic and demographic limitations: The sample was drawn from Utah, Arizona, and California, with a predominantly white, middle-to-upper-class population. Many participants belonged to The Church of Jesus Christ of Latter-day Saints (Mormon). Results may not generalize to other religious traditions, regions, or more diverse populations.
- No measurement of religious coping: The study only examined main effects of identity categories, not the content of religious beliefs (e.g., views of God as benevolent vs. punishing) or coping styles (positive vs. negative religious coping). Previous research shows that negative religious coping is associated with worse mental health, even among religious individuals.
- No examination of identity shifts: The study did not track individuals who changed their religious/spiritual identity over time (conversion, deconversion, apostasy). Future research should examine mental health changes associated with such shifts.
- Correlation, not causation: The study cannot determine whether RAS identity causes better mental health or whether individuals with better mental health are more likely to adopt or maintain RAS identity. The bidirectional relationship is well-documented: depression can reduce religious attendance, and religious attendance can reduce depression.
- Parent anxiety not analyzed longitudinally: The underlying structure of parent anxiety changed over time, making growth curve modeling inappropriate. Thus, longitudinal data on parent anxiety are not available.
Implications for Families, Clinicians, and Educators
Despite these limitations, the study’s findings have practical implications:
For Parents: If your adolescent is struggling with anxiety or depression, consider the role of religious and spiritual community. The RAS identity was associated with the lowest depression levels and the smallest increases in anxiety. Encouraging religious practice (not just private spirituality) may be protective.
For Clinicians: Assess both religious and spiritual dimensions of your clients’ lives. The study shows that “if one is high and the other low, the client may be at risk for difficulties.” Clients who are “religious but not spiritual” may benefit from exploration of their personal beliefs and spiritual experiences. Clients who are “spiritual but not religious” may benefit from connection to supportive communities.
For Educators: Schools can provide space for students’ spiritual lives without teaching specific religious doctrines. Allowing time for reflection, meditation, and exploration of meaning may benefit all students, particularly those who lack religious community.
For Religious Leaders: The study underscores the mental health benefits of religious community and practice. This is not just about “saving souls” but about promoting human flourishing. Consider partnering with mental health professionals to support congregants.
A Final Word of Hope
The study’s findings are both sobering and hopeful. Sobering because they reveal that adolescents who identify as “spiritual but not religious” are at significantly higher risk for anxiety and depression. Hopeful because they show that religious and spiritual identity—the combination of community, practice, and belief—is associated with the best mental health outcomes.
The researchers conclude: “Religion and spirituality are found to be impactful to humans worldwide, and thus, must be psychologically and representatively studied. With the recent increase in those who are spiritual but not religious, it is important to better understand how this may relate to well-being.”
This study is a significant step in that direction. It challenges simplistic narratives that religion is inherently harmful or that spirituality alone is sufficient. Instead, it suggests that the combination of religious community, practice, and personal spiritual belief may be uniquely protective for mental health.
For the millions of young people struggling with anxiety and depression, this is good news. There is a pathway to better mental health that includes faith, community, and meaning. The science now supports what many religious traditions have taught for millennia: we are not meant to navigate life alone. We need each other, and we need something greater than ourselves.
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