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Article

The Daily Spiritual Experience Scale: Empirical Relationships to Resiliency-Related Outcomes, Addictions, and Interventions

by
Lynn G. Underwood
1,* and
Kaitlyn M. Vagnini
2
1
Inamori International Center for Ethics, Case Western Reserve University, Cleveland, OH 44106, USA
2
Department of Psychology, University of Colorado Denver, Denver, CO 80204, USA
*
Author to whom correspondence should be addressed.
Religions 2022, 13(3), 237; https://doi.org/10.3390/rel13030237
Submission received: 3 February 2022 / Revised: 7 March 2022 / Accepted: 7 March 2022 / Published: 10 March 2022
Versions Notes

Abstract

:
The Daily Spiritual Experience Scale (DSES) is a 16-item self-report measure designed to assess a set of experiences that may occur in the context of daily life for many different kinds of people. These include awe, a merciful attitude, giving other-centered love, deep inner peace, finding strength, guidance, or consolation from a transcendent source, among others. The DSES includes theistic and non-theistic language and alternatives, and has proven useful for those from many religions and for the unaffiliated. Since its original publication, it has been translated into over 40 languages, used in hundreds of published studies, and adopted for use in many practical settings. Empirically, the DSES predicts greater resilience, stress buffering, post-traumatic growth, and a sense of meaning in the face of illness, trauma, and daily stressors, as well as less substance abuse and burnout. Intervention studies using the DSES show that a variety of interventions can increase the frequency of these experiences. In this article, we will provide a brief overview of the scale and review its use in the empirical literature with respect to resilience and related outcomes. Findings suggest that the experiences measured by the DSES may serve as a resource for those experiencing distress of various kinds.

1. Introduction

The goal of this paper is to provide a narrative review of empirical studies investigating the relationship between daily spiritual experiences (DSEs), measured by the Daily Spiritual Experience Scale (DSES; Underwood and Teresi 2002; Underwood 2006) and resilience, stress buffering, post-traumatic growth, sense of meaning in the face of life stressors, substance abuse, and burnout. We also report on studies showing changes in DSEs over time in response to a variety of interventions and in other longitudinal studies. These results offer potential avenues for providing resources to those experiencing distress.

Overview of the DSES

The DSES consists of 16 quantitative self-report questions. It measures the frequency with which respondents have a variety of experiences that many describe as spiritual (Underwood 2006). The experiences captured in the scale include those of awe, a merciful attitude, giving other-centered love, receiving compassionate love, finding strength, guidance or consolation from a transcendent source, a sense of deep inner peace or harmony, a sense of desire for closeness to a divine source in life, a sense of being blessed even in tough times, and a sense of joy that lifts a person above momentary troubles, among others. Daily spiritual experiences (DSEs) are reported on a frequency scale from 1 to 6 (Never to Many times a day), with researchers usually scoring the scale so that higher average scores reflect more frequent DSEs. Collectively, the items (e.g., “I have experienced a connection to all of life”, “I desire to be closer to God or in union with the divine”) reflect experiences beyond those of psychological wellbeing (Underwood 2006; Ellison and Fan 2008).
The scale was developed by Lynn Underwood in the mid-1990s using extensive international structured qualitative interviewing and quantitative testing among diverse religious, ethnic, cultural, and social groups (Underwood 2005, 2006; Underwood and Teresi 2002). The DSES is designed so that the respondent grounds their answers in the specifics of everyday life. “Daily” in the title of the scale was initially selected by Underwood because the items were designed to assess aspects of day-to-day spiritual experience for an ordinary person rather than extraordinary experiences such as near-death or out-of-body experiences, hearing voices, having visions, or other more dramatic mystical experiences. Scores on the scale and frequencies of individual items can vary widely from one person to another. However, it is important to note that many different kinds of people do have these experiences frequently as reported in the many studies cited in this paper and, for example, a large random sample of U.S. adults in the General Social Survey (Ellison and Fan 2008).
Many of the scale’s questions assess a person’s perception of the transcendent “more than” as embedded in daily life (i.e., “more than” one can see, hear, or touch). Many characterizations of spirituality involve such an inner dimension (McGinn 1993; James [1902] 1994) and during initial scale development and testing, most participants described the experiences captured in the scale as “spiritual” in nature (Underwood 2006). There has been no consensus on a meaning for the word “spirituality” currently agreed upon across the social science, medical, and religious literature. Thus, some may label the DSES experiences as “spiritual”, and others may not. In this paper, we do not try to claim such a definitive label for the DSES, but rather aim to review empirically verified correlations of DSES scores to a variety of outcomes.
The DSES uses a combination of both theistic language (with non-theistic alternatives offered) as well as non-theistic language. Consistent with Hill et al.’s overlapping constructs model of religiousness/spirituality, which posits that religiousness and spirituality are not mutually exclusive (Hill et al. 2000), the DSES is applicable to those for whom spirituality is religiously grounded, as well as to those for whom it is not (Dong et al. 2017; Underwood 2006). Importantly, although some of the items use the word “God”, the introductory sentences of the DSES encourage participants to substitute for that word language that is applicable to them: “A number of items use the word ‘God’. If this word is not a comfortable one for you, please substitute other words which calls to mind the divine or holy for you”. Many researchers have enriched this with “If this word is not a comfortable one for you, please substitute other words which call to mind the divine or holy for you such as: Higher Power, Allah, Creator, Ultimate Reality, Goddess, Lord, Tao, G_d, Supreme Consciousness, Great Spirit”. Online formats may allow for electronic substitution of the respondent’s word choice for each item. In addition, the checklist version, which is suitable for use in intensive longitudinal methodologies, offers alternative wording within the items (Vagnini and Masters 2020). Offering alternative language continues to be important in our contemporary environment where the word “God” can be uncomfortable, alienating, or inapplicable for some as religious affiliation continues to decline in some areas of the world (Pew Research Center 2017).
The DSES has been used in over 400 peer-reviewed studies (https://rb.gy/aneijc, accessed on 6 March 2022) and has been translated into 40 languages, including Arabic, Croatian, Czech, Danish, Dutch, Filipino, Flemish, French, Greek, Hebrew, Hungarian, Italian, Japanese, Korean, Latvian, Malay, Malayalam, Nepalese, Persian, Polish, Portuguese, Romanian, Russian, Serbian, Slovenian, Thai, Turkish, Ukrainian, and Urdu. Papers have been published on the psychometric validation of translations of the full 16-item DSES in Mandarin Chinese (Ng et al. 2009), Korean (Kim et al. 2021), Indonesian (Qomaruddin and Indawati 2019), Slovak (Soósová and Mauer 2020), Hindi (Husain and Singh 2016), Spanish (Sierra Matamoros et al. 2013; Mayoral Sánchez et al. 2014), Portuguese (Kimura et al. 2012), and a number of other languages, and psychometric validation is also included in some of the papers cited in this review. Psychometric properties for translated versions of the DSES are strong, with Cronbach’s alphas ranging from 0.86 to 0.98 among those cited above.
There is an abbreviated version of the scale that was used in the Brief Multidimensional Measure for Religiousness and Spirituality (BMMRS; Idler et al. 2003). This short form correlates highly with the full scale, but because it was developed ad-hoc rather than psychometrically, lacks breadth, and does not usually include the introductory sentences suggesting alternative language, Underwood recommends using the full 16-item scale whenever possible (Underwood 2011). Items from the full 16-item DSES are also included in the baseline Spirituality Survey (SS-1) in the Study on Stress, Spirituality, and Health and other longitudinal studies (Warner et al. 2021). Additional details on the theoretical background, the development and psychometrics of the scale, its applicability across populations, and other versions of the scale, can be found elsewhere (www.dsescale.org, accessed on 6 March 2022; Underwood 2006, 2011; Underwood and Teresi 2002).

2. Empirical Evidence

Originally developed for use in health studies, the DSES has been increasingly used for program evaluation, personal reflection, examining changes in an individual’s spiritual experiences over time, and social science research. It has been used in counseling, addiction treatment settings, and various secular and religious organizations (Underwood 2013). In the following sections, we will provide a narrative review of findings from selected areas of research: (1) stress buffering and resilience (health and illness, exposure to violence and trauma, enhanced sense of meaning in life, post-traumatic growth, and encounters with daily stressors), (2) substance use and addictions, (3) burnout and compassion fatigue, and (4) intervention studies. This review can provide a better understanding of the predictive and associative value of the DSES that can be of use for future research and in practical applications.

2.1. Stress Buffering and Resilience

The following sections describe some of the studies that look at how DSEs buffer stress and promote resiliency and growth following difficult life circumstances, in the face of illness, and during daily life. A basic reason that more frequent DSEs can lead to various positive outcomes, even in the midst of tough times, is that they can enable a person to be more resilient, which the following research review demonstrates. These experiences can also buffer stress. Stress results from both our experience of a stressful event as well as our response to it (Cohen et al. 1995). Resiliency is our ability to quickly recover from stressful events or circumstances. Resilience has some trait qualities, meaning that some people tend to be more resilient than others, but it can also vary over time within individuals. The accumulating evidence described here indicates that DSEs may enhance resilience during or in the aftermath of difficult life experiences, or even in the face of day-to-day stressors. DSEs, such as finding strength from a transcendent source, feeling thankful for blessings, or finding comfort from sensing divine help, can buffer stress. DSEs may also promote a sense of meaning when facing adversity. Personal growth can also sometimes follow tough times such as chronic or acute disease, disability, disasters, or loss (Tedeschi and Calhoun 2004). This growth—often referred to as post-traumatic growth—is associated with more frequent DSEs. These different experiences of connection with the transcendent in daily life can provide support and help individuals to make sense of and find meaning in challenging times.

2.1.1. Health and Illness

A number of studies furnish evidence that DSEs provide resilience in the face of significant illness, often reflected in health behaviors and indicators of physical and mental health. DSEs predicted a stronger sense of being able to cope with illness and a sense of self-efficacy in older adults living with congestive heart failure (Park et al. 2009b). DSEs were also linked with higher existential well-being and predicted less subsequent spiritual strain in those with advanced congestive heart failure (Park et al. 2014). In 127 Italian hospice patients with a life expectancy of a few weeks, DSEs were positively associated with dignity enhancement, whereas self-blame coping style, poor emotional and physical well-being, and depression predicted loss of dignity (Bovero et al. 2018). Among a sample of 128 hospitalized older adults, those with more frequent DSEs reported greater quality of life and satisfaction with life (Okuno et al. 2021). Najihah et al. (2020) found that more frequent DSEs were associated with less psychological distress in a sample of 64 hemodialysis patients in Malaysia, and Oliveira et al. (2021) found that more frequent DSEs were associated with greater resilience in patients receiving dialysis. Among a sample of 120 women with infertility, those with more frequent DSEs had less infertility stress and feelings of failure (Rezaei et al. 2020). Moehling et al. (2021) found that DSEs buffered the negative impact of poor quality of life on physical frailty among a sample of 110 community-dwelling adults aged 50 years and older.
Several studies investigate DSEs in the context of cancer. In cancer survivors between 18 and 55 years old, 1–3 years post-diagnosis, Park et al. (2013) examined predictors of emotional (worry) and cognitive (perceived risk) dimensions of fear of recurrence and their relationships with psychological well-being. Among several psychosocial variables, DSEs were the only predictor of perceived risk independent of the effect of race, even when worry about general health was controlled for. A study of 167 younger adult survivors of a variety of cancers revealed that DSEs were related to greater performance of health behaviors whereas religious attendance had little impact on engagement in health behaviors (Park et al. 2009a). In a large-scale prospective longitudinal study of cancer survivors, Rudaz et al. (2019) found that DSEs enhanced life satisfaction over time, especially in those with low life satisfaction at baseline. Regression analyses, controlling for age, educational attainment, and religious/spiritual coping, showed that DSEs moderated the association between life satisfaction and positive affect at baseline and follow-up. In a sample of 234 cancer patients in Iran, those who had more frequent DSEs reported more resilience (Savaryand and Savary 2019).
The COVID-19 pandemic has presented new threats of illness and mortality on a global scale, and bereavement has added a significant burden to people’s lives during this time. A number of researchers are conducting ongoing studies assessing the DSES in relation to the COVID-19 pandemic. Gülerce and Maraj (2021) studied 546 Turkish community members during the pandemic and found that those with more frequent DSEs had greater resilience and less hopelessness. Rias et al. (2020) found that, among a sample of 1082 community members of 17 provinces in Indonesia, those with more DSEs had less anxiety regarding the virus than those who had fewer DSEs. Finally, in a U.S. sample of 127 adults, those with more frequent DSEs reported greater resilience during the COVID-19 pandemic (Roberto et al. 2020).

2.1.2. Exposure to Violence and Trauma

Many researchers have investigated the role that DSEs may play in buffering the adverse effects of trauma and exposure to violence. One study found that more frequent DSEs predicted higher resilience during emerging adulthood following childhood exposure to violence (Howell and Miller-Graff 2014). In another study, DSEs reduced the effects of exposure to violence in the community on psychological well-being for urban African American adolescents and also significantly contributed to satisfaction with life and positive affect over and above demographic factors and perception of family support (Shannon et al. 2013). A study of 162 children aged 9–12 in Indonesia found that more frequent DSEs were associated with increased resilience after being exposed to flooding (Syukrowardi et al. 2017), and a study of 332 student earthquake survivors in Pakistan found that more frequent DSEs were associated with a greater sense of coherence and less stress (Zafar et al. 2019). Relatedly, a study of 303 randomly selected Nepalese older adult earthquake survivors found that more frequent DSEs were associated with higher resilience (Timalsina et al. 2021).
In 223 Latino adolescents residing in poor, urban neighborhoods, personal victimization and witnessing violence were associated with higher depression and posttraumatic stress disorder (PTSD) symptoms at low and average levels of DSEs, but not at high levels of DSEs (Jocson et al. 2020). More frequent DSEs in young adults buffered the negative effects of having a depressed parent (Rounding et al. 2011) and DSEs were associated with a lower risk of depression among early childhood education staff regardless of the adverse childhood experiences they were exposed to early in life (Whitaker et al. 2021). In addition to investigating childhood and young adult exposure to violence or trauma, some studies have investigated the role of DSEs in PTSD among veterans of war. For example, more frequent DSEs predicted less suicidal thoughts in a group of Veterans diagnosed with PTSD (Kopacza et al. 2016).

2.1.3. Enhanced Sense of Meaning in Life and Post-Traumatic Growth

When people experience challenges, they can become overwhelmed or they can quickly recover. The previous sections highlighted research that explored how DSEs can help individuals recover when faced with difficulties. Growth can also follow difficult times such as chronic disease, acute disease, disability, disasters, or loss. Sometimes this growth, often called post-traumatic growth (PTG), enhances an individual’s sense of meaning or coherence in life, which can add much to the quality of their lives. The following studies using the DSES demonstrate how more frequent DSEs can contribute to positive change and growth as a response to difficult circumstances.
In samples of heart failure patients and cancer survivors, higher baseline DSEs predicted more positive change in meaning over time (i.e., 6 months later for heart failure patients and 12 months later for cancer survivors), supporting the notion that DSEs can provide increased meaning in life among individuals dealing with substantial adversity (George and Park 2017). These authors also found, in a sample of 167 cancer survivors, that baseline DSEs predicted a greater sense of meaning in life one year later, and that meaning was positively correlated with PTG at that time (George and Park 2013). Similarly, more frequent DSEs predicted more PTG in bereaved people (Currier et al. 2013), in patients with leukemia in Iran (Karami and Kahrazei 2018), in parents who lost young children in India (Khursheed and Shahnawaz 2020), and among online and community samples of U.S. Muslims (Saritoprak et al. 2018). More frequent DSEs have also predicted a greater sense of meaning in life in students in Poland (Wnuk and Marcinkowski 2014) and a greater sense of coherence in Catholic pastoral workers in Germany (Kerksieck et al. 2017).

2.1.4. Daily Stressors

The DSES can have trait-like consistencies over time, meaning that some people tend to experience DSEs more frequently than others, but it can also have state-like characteristics as the number of DSEs experienced can vary over time within individuals. This lends the DSES well to examinations of change over time. Intensive longitudinal designs, such as experience sampling methods (ESM), allow for more nuanced investigations of the relationships between DSEs and day-to-day stress. A 2012 study of 244 older adults sought to investigate the day-to-day processes underlying the stress-buffering effect of the DSES. Participants completed daily assessments for 56 days assessing perceived stress, DSEs, positive affect, and negative affect. Findings revealed a stress-buffering effect such that DSEs buffered the negative effect of perceived stress on same-day negative affect. Findings also revealed a positive direct effect of DSEs on positive affect (Whitehead and Bergeman 2012). Similarly, a recent smartphone-based, ESM study of 1691 participants also demonstrated stress-buffering effects of DSEs. Increased stressors predicted a reduction in attitudes of love for others. However, more frequent DSEs moderated the negative effect of stressors on love, indicating a buffering effect (Brelsford et al. 2020). In another analysis utilizing ESM, researchers found support for a moderating role of both state and trait DSEs on the relationship between stressors and well-being. Notably, state scores of DSEs were associated with positive outcomes above and beyond more general trait scores, indicating that intensive longitudinal methodologies may serve as a fruitful avenue for future research and may allow for more precise investigations of the relationship between DSEs and various health outcomes (Kent et al. 2020). These authors also found that DSEs are associated with psychosocial benefits (i.e., reduced depressive symptoms and more flourishing) regardless of whether the items were explicitly theistic or non-theistic. Overall, the results from these studies indicate that DSEs positively contribute to well-being in a direct and immediate way; even controlling for general tendencies in individuals’ own DSES scores, short-term increases or decreases in DSEs significantly predict positive or negative outcomes, respectively.

2.2. Substance Abuse and Addictions

The relationship between DSEs and addiction is particularly relevant given the increasing incidence of addictive behaviors and their impact on our societies (Mattson et al. 2021). Addiction can be found in relation to activities as varied as cellphone use, online gaming, social media, gambling, as well as abuse of various substances such as alcohol, opioids, and other drugs. Results from a growing body of literature suggest that DSEs may play an important role in the treatment and recovery from addiction. As described earlier, DSEs can act as a stress buffer, and many seek out addictive substances as a response to stress, seeking to ease the discomfort (Lindenberg et al. 1993). Feelings of loneliness and alienation can also contribute to addiction (Ingram et al. 2020), and the experience of spiritual connection may relieve some of those feelings. The following studies are a few of those investigating the relationship between DSEs and substance abuse or addictions.
In a study of 195 youths court-referred to a 2-month addiction treatment program, an increasing frequency of DSEs over the course of treatment was associated with a greater likelihood of abstinence from alcohol or drugs, increased pro-social behaviors, and reduced narcissistic behaviors (Lee et al. 2014). Another study investigated the outcomes of 364 alcohol-dependent individuals both in treatment and not in treatment and found that six-month increases in DSEs predicted less drinking at nine months (Robinson et al. 2011). One study followed 123 alcoholics for six months after entry into treatment and found that increases in DSEs (but not positive religious coping or forgiveness) were associated with an increased likelihood of no heavy drinking at six months, regardless of gender and Alcoholics Anonymous (AA) involvement (Robinson et al. 2007). AA involvement itself may be helpful in increasing the frequency of DSEs. In a sample of 364 individuals with alcohol dependence, greater AA involvement was associated with more frequent DSEs after controlling for drinking (Krentzman et al. 2017). Wnuk (2021) also found, in a sample of Polish AA participants, that greater AA involvement was associated with more frequent DSEs. There also appears to be a reciprocal relationship between recovery and DSEs, such that DSEs promote abstinence, and that recovery then increases the frequency of DSEs (Zemore and Kaskutas 2004).
Collectively, the results of these studies indicate a link between DSEs, as measured by the DSES, and a variety of alcohol- and drug-related outcomes, such as reduced alcohol and drug use, increased likelihood of sobriety and recovery, and increased prosocial behaviors. It appears that experiencing more day-to-day connections with the transcendent may be an important aspect of recovery from alcohol and drug dependency. DSEs may also be associated with other types of addictive behaviors. For example, Charzyńska et al. (2021) found that DSEs were inversely associated with shopping addiction among 430 Polish students. After reviewing 10 measures of religiousness/spirituality for use in addiction research, Shorkey et al. (2008) concluded by regarding the DSES that “the usefulness of this scale for assessing the spiritual experience of a person in treatment and recovery may be profound” (p. 291). These studies indicate that enhancing the frequency of DSEs may provide an additional resource for those struggling with addictions.

2.3. Burnout and Compassion Fatigue

Burnout is becoming a prevalent issue in contemporary life. The World Health Organization has recently included a diagnostic category of burnout in the workplace. The characteristics of burnout include physical fatigue, cognitive weariness, and reduced professional efficacy (World Health Organization 2019). It is especially common in the caring professions and those working with people in the midst of traumas or crises (Bridgeman et al. 2018; Dzau et al. 2018). People in these situations are often said to experience “compassion fatigue”. Because the situations that bring on burnout often cannot be changed, techniques to increase various DSEs may be a way to attenuate burnout and compassion fatigue. It makes sense that experiences of spiritual connection might be helpful, building on the previous discussion of stress buffering and resilience. DSEs may be able to replenish people when stretched to their limits, making the experience of giving of self to others less draining.
Medical students who have more frequent DSEs described themselves as more satisfied with their life in general, while medical students with low scores on the DSES had higher levels of psychological distress and burnout (Wachholtz and Rogoff 2013). Health care workers in Hong Kong with more frequent DSEs experienced less burnout, less depression, and less anxiety (Ng et al. 2009; Hung Ho et al. 2016; Ng 2014). More frequent DSEs were correlated with less physical, cognitive, and emotional forms of burnout in professionals working in palliative care or end-of-life settings (Holland and Neimeyer 2005). Similarly, in 113 nursing home staff with high exposure to death and dying, Frey et al. (2018) found that more frequent DSEs were associated with less burnout.
Studies also indicate that DSEs are protective against compassion fatigue among mental health providers (Patel 2018; Newmeyer et al. 2014). In a sample of counselors, Browning et al. (2019) found that gratitude and DSEs were associated with reduced burnout. More frequent DSEs also predicted greater resilience among university teachers (Capelo 2021) and less compassion fatigue among 147 Israeli residential child-care workers for children and youth at risk (Zerach 2013). In 8574 German pastoral professionals (48% priests, 22% parish expert workers, 18% pastoral assistants, 12% deacons), DSEs buffered the negative effects of stress on health (Frick et al. 2016). Relatedly, a study of Protestant ministers in Germany showed that more frequent DSEs were correlated with diminished burnout (Voltmer et al. 2010). These studies lend support to DSEs as buffers to burnout and compassion fatigue among those caring for others, and as a possible supportive resource for caregivers.

2.4. Intervention Studies

Considering that DSEs appear to influence a variety of psychological and physical health outcomes, developing interventions aimed at increasing DSEs in daily life is a logical next step for consideration. Some studies have already found specific interventions to be efficacious in increasing DSEs. Various forms of meditation, it appears, may be one avenue by which individuals can deliberately foster the experience of connection with the transcendent and increase the frequency of DSEs. For example, in a 2004 study in which participants were randomly assigned to learn either (a) relaxation techniques, (b) secular meditation, or (c) spiritual meditation, those in the Spiritual Meditation group reported significantly more DSEs than those in the Secular Meditation group or the Relaxation group (Wachholtz and Pargament 2005). Similarly, in a 2021 study, university students who engaged in a 12-week Sufi meditation intervention reported significantly more DSEs following the intervention, whereas those in a waitlist group or standard-practice stress management control group did not. The Sufi meditation intervention was effective at increasing DSEs even when over half of the participants in the experimental group were atheists, agnostics, or had no religious preferences (Bahadorani et al. 2021). There is also evidence that mindfulness-based interventions can increase DSEs and that DSEs mediate some of the beneficial effects of mindfulness (Geary and Rosenthal 2011; Greeson et al. 2011, 2015).
Certain other practices (prayer, reading scripture, seeking guidance, and being in solitude) may also increase DSEs more than attending religious services and meetings, as demonstrated in a repeated-measures smartphone study (Wright et al. 2017). In another study, nursing students and RNs completed a self-study program designed to teach them how to talk with patients about spirituality and reported more frequent DSEs after completion of the program relative to the baseline (Taylor et al. 2009). In a 2017 study, a spiritual program was effective at increasing DSEs among a sample of 5339 adolescents (aged 13–15) from 60 schools across 15 countries, lending support to the effectiveness of some interventions in increasing DSEs cross-culturally (Pandya 2017). Similarly, in a two-week, two-armed randomized controlled trial, researchers investigated an online contemplative prayer program for Christians with daily stress. DSEs increased over time in the intervention group in a dose-responsive manner (Knabb and Vazquez 2018). A multi-faith, spiritually based intervention in Canada also increased DSEs over time and helped patients with generalized anxiety disorder (Koszycki et al. 2010). A one-month Mind–Body–Spirit intervention in Hong Kong increased DSEs among staff who provide services for the elderly (Ng 2014), and an eight-session, peer-led spirituality-based group increased DSEs from pre- to post-intervention among a sample of Black individuals living in the Bronx, New York City (Ali et al. 2021). Interventions may also be used to increase DSEs in illness populations. A randomized controlled trial of hemodialysis patients examined changes in DSEs among patients receiving eight spiritual care counseling sessions compared to those in a control group receiving no intervention. Patients receiving spiritual care during dialysis reported significantly more DSEs three months following intervention relative to the control group (Asadzandi et al. 2021). The section on substance abuse summarized a number of intervention studies looking at changes in DSEs following participation in addiction interventions.
Goldstein (2007) devised a clinical intervention aimed at deliberately cultivating sacred moments in daily life. The intervention (which consisted of a combination of mindfulness techniques, placing attention on a sacred or meaningful object, and opening oneself up to experiencing sacredness in the moment) successfully resulted in participants experiencing more frequent DSEs relative to baseline. Similarly, Koenig et al. (2016) sought to assess whether religiously integrated cognitive behavioral therapy (RCBT) increased DSEs in a sample of participants with major depressive disorder and chronic medical illness. The authors found that DSEs significantly increased after receiving RCBT, and that RCBT was more effective than conventional cognitive behavioral therapy with regard to increasing DSEs, especially in those with low religiosity.
Finally, it appears that having more frequent DSEs at baseline can help achieve the goals of interventions intended to affect other outcomes. For example, in a sample of 532 U.S. veterans in a residential treatment program for combat-related PTSD, those who reported more frequent DSEs at intake showed lower levels of PTSD symptomatology at discharge (Currier et al. 2015). DSEs may also mediate the relationship between prayer as a spiritual intervention and well-being in some faiths (Albatnuni and Koszycki 2020). Collectively, these studies show that various interventions can increase the frequency of DSEs and that more frequent DSEs may facilitate enhanced intervention outcomes.

3. Conclusions

The DSES measures experiences that include those of awe, a merciful attitude, giving other-centered love, receiving compassionate love, finding strength, guidance, or consolation from connection with a transcendent source, a sense of deep inner peace or harmony, a sense of joy that lifts a person above their momentary troubles, a sense of desire for closeness to a divine source in life, and a sense of being blessed even in tough times, among others. The questions were developed using in-depth interviews with many religious and ethnic groups, socio-economic groups, and ages, with the religiously unaffiliated, and with people from many countries.
This review indicates that scores on the DSES are associated with stress buffering, increased resilience, increased posttraumatic growth or meaning in the face of challenge, and reduced burnout, substance abuse, and addictive behaviors. There are a variety of resources that individuals can draw on in challenging times to build resiliency, buffer stress, and encourage growth or meaning in the face of difficulty. The empirical studies described in this paper indicate that DSEs may be one of those resources, and we encourage the reader to explore the studies described here in more detail by reading the original articles.
The religious and spiritual landscape is changing in many areas of the world (Pew Research Center 2017). Regardless of an individual’s religious or spiritual orientation, many people have the kinds of experiences that the DSES describes. These experiences can be nurtured by various religious or spiritual practices or in ways compatible with a more secular worldview. When embodied in everyday living, DSEs can result in greater resilience, growth, and meaning, even in tough times.

Author Contributions

Original draft preparation and review and editing, and formal analysis, L.G.U. and K.M.V. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

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Underwood, L.G.; Vagnini, K.M. The Daily Spiritual Experience Scale: Empirical Relationships to Resiliency-Related Outcomes, Addictions, and Interventions. Religions 2022, 13, 237. https://doi.org/10.3390/rel13030237

AMA Style

Underwood LG, Vagnini KM. The Daily Spiritual Experience Scale: Empirical Relationships to Resiliency-Related Outcomes, Addictions, and Interventions. Religions. 2022; 13(3):237. https://doi.org/10.3390/rel13030237

Chicago/Turabian Style

Underwood, Lynn G., and Kaitlyn M. Vagnini. 2022. "The Daily Spiritual Experience Scale: Empirical Relationships to Resiliency-Related Outcomes, Addictions, and Interventions" Religions 13, no. 3: 237. https://doi.org/10.3390/rel13030237

APA Style

Underwood, L. G., & Vagnini, K. M. (2022). The Daily Spiritual Experience Scale: Empirical Relationships to Resiliency-Related Outcomes, Addictions, and Interventions. Religions, 13(3), 237. https://doi.org/10.3390/rel13030237

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