Table 2 Study characteristics of intervention studies
Study name & year | Country | Study design | N (INT, CONT) | Follow-up points | Study population | %F | Mean age in years (SD), range | Description of intervention | Intervention length | Comparison condition & description | Mental health outcomes | Quality rating | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Anxiety | Depression | ||||||||||||
Anastasi [66], 2008 | USA | Quasi-experimental | 30 (12,18) | post | College students | NR | NR | Recitation of the Rosary in a campus chapel | 30 min | Watched 30 min video of religious content | STAI: ↓ (State), NS (Trait) | NA | Moderate risk of bias |
Armento [67], 2012 | USA | RCT | 50 (25,25) | 1-month | Undergraduate students with > 14 BDI-II score | 62%F | 20(2.75) | Single session of modified Behavioral Activation treatment and post-session activation completing religious activities | 60 min + 2 week activation | Single session of supportive therapy | BAI: ↓ (Somatic) STAI: ↓ (Trait) (Maintained at follow-up) | BDI-II: ↓ (Maintained at follow-up) | Moderate risk of bias |
Charkabi [68], 2014* | Iran | RCT | 60 (30,30) | post | Secondary school students | NR | 14.93(INT) 14.82(CONT) | Spiritual intelligence training to solve problems in everyday life | 7-weekly sessions | No intervention | SCL-90-R: NS (INT only) | SCL-90-R: NS (INT only) | High risk of bias |
USA | RCT | 177 (90,87) | 1-month | College students | 59%F | 19.5(2.48) | Written exercise on an experience of trauma from a religious or spiritual perspective | 3 writing sessions over one week | Written exercise on an experience of trauma | IES-R: NS (PTSD symptoms) | NA | High risk of bias | |
Chen [70], 2009 | USA | RCT | Total = 215, Religious writing = 90 Conventional trauma writing = 87 CONT = 38 | 1-month | College students | 57%F | 19.3 (2.36) | Written exercise on an experience of trauma from a religious or spiritual perspective | 3 writing sessions over one week | Written exercise on an experience of trauma (CTW) Written exercise on a trivial experience (CONT) | NA | CES-D: NS | High risk of bias |
Chen [71], 2018 | Taiwan | RCT | 105 (52,53) | 1-month | College students | 54%F | 20.7(3.47) | Written exercise on an experience of trauma from a religious or spiritual perspective | 3 writing sessions over one week | Written exercise on an experience of trauma | IES-R: NS (PTSD symptoms) | NA | High risk of bias |
Dami [72], 2019 | Indonesia | Quasi-experimental | 64 (32,32) | post, 5-weeks | Christian Religious Education Study Program students | 69%F | 18–30 | Group counselling with a spiritual approach with sessions based on spiritual intelligence book and an emphasis on biblical principles | 7 60-min sessions | NR | DASS-21 anxiety sub-scale: ↓ | DASS-21 depression sub-scale: ↓ | Moderate risk of bias |
Ebrahimi [73], 2015 | Iran | Quasi-experimental | 40 (20,20) | Post | Male high school students | 0%F | 16.48(1.10) | Group cognitive-behavioural therapy with spiritual intelligence training component | 8 sessions | NR | DASS-42 anxiety sub-scale: ↓ | DASS-42 depression sub-scale: ↓ | Moderate risk of bias |
Hajra [74], 2021 | Pakistan | Pre-post | 60 Low religiosity: 30 High religiosity: 30 | Post | University students with mild to moderate DASS-21 scores and low/high religiosity levels | 61.7%F | 18–30 | Islamic art therapy involving completing patterns from an Islamic adult colouring book and free-hand calligraphy | 14 daily 35-45min sessions | NA | DASS-21 anxiety sub-scale: ↓ | DASS-21 depression sub-scale: ↓ | Moderate risk of bias |
Heidari [75], 2019 | Iran | Quasi-experimental | 60 (30,30) | Post | Individuals admitted to hospital for a suicide attempt | 62%F | Predominantly emerging adults (80%) | Spiritual care counselling | 8 sessions | NR | NA | BDI-II: ↓ | High risk of bias |
Kadafi [76], 2021 | Indon esia | Quasi-experimental | 14 (7,7) | Post | High school students with high anxiety | 64%F | 16–18 | Islamic counselling sessions | 3 40-min sessions | Individual counselling including Covid-19 information and advice | CAS: ↓ | NA | Moderate risk of bias |
Khaki [77], 2021 | Iran | Quasi-experimental | 152 (76,76) | Post | Female university students | 100%F | NR | Religious and spiritual teachings | 15 sessions | NR | GHQ-28 anxiety component: ↓ | GHQ-28 depression component: ↓ | High risk of bias |
Khubalkar [78], 2009 | India | Pre-post | 12 | Post | University graduate psychology students | 50%F | 21.58(NR), 21–23 | Single integral meditation session | 20 min | NA | STAI: ↓ (State), ↓ (Trait) | NA | Moderate risk of bias |
Klawonn [79], 2019 | USA | Quasi-experimental | 21 | Post | Graduate healthcare students with < = 16 on BDI | 67%F | 25(4), 23–29 | Seminars on meditation with reading, breathing techniques, education on the kosha model, mindful movement/modified asana, and supine guided meditation | 5 weekly 60-min seminars | 5-week baseline control period | BAI: ↓ | BDI: ↓ | Moderate risk of bias |
Lolla [80], 2018 | India | Pre-post | 52 | Post | College students | NR | 17–20 | Listening to mantras at home | 40-min at least four days per week over 60 days | NA | PGWBI anxiety dimension: ↓ | PANAS negative affect subscale: ↓ PGWBI depressed mood dimension: NS | Moderate risk of bias |
Maddix [81], 2018 | USA | Quasi-experimental | 60 (38,22) | Post | Undergraduate university students | NR | 23(NR), 17–42 | Spiritual disciplines taught and practiced in a history of spiritual practices and neuroscience course | 7 weekly sessions | Not enrolled in course | STAI: NS (State and trait) | BDI: NS | Moderate risk of bias |
Mastropieri [82], 2015 | USA | Pre-post | 13 | Post | Emerging adult men from a homeless shelter transitional living program | 0%F | 22.38 (1.03), 20.27–23.38 | Group psychotherapy with spiritual visualization | 16 weekly 90-min sessions | NA | GAD-7: NS | PHQ-12: ↓ | Low risk of bias |
GHQ-12: ↓ (Psychological distress) | |||||||||||||
Pandya [83], 2021 | India, Kenya, Nepal, South Africa | RCT | 96 (48,48) | Post | Deaf and hard-of-hearing university students | 37.5%F | INT: 21.48 (2.63) CONT: 21.34 (2.08) | Online spiritual counselling program | 50 weekly 1-h sessions | Online relaxation sessions | GAD-7: ↓ | NA | Low risk of bias |
Penberthy [84], 2017 | USA | Pre-post | 205 | Post | Undergraduate college students | 68.1%F | 20.7(1.6), 18–36 | Buddhism Meditation and Modernity course covering knowledge and practice | 13 bi-weekly lectures | NA | STAI: ↓ | PANAS negative affect sub-scale: NS | Low risk of bias |
Rickhi [85], 2015 | Canada | RCT | 62 (31,31) | Post, 16-weeks, 24-weeks | Adolescents and young adults with mild-to-moderate MDD | 71%F | 12–24 | Online modules on spiritually informed principles (e.g., forgiveness, gratitude, compassion) | 8 2-3h weekly modules | Waitlist | NA | CES-D (adolescents): ↓ HAMD (young adults): ↓ | Low risk of bias |
Safara [86], 2012 | India, Iran | Quasi-experimental | 64 (32,32, 32) | Post | Iranian female university students residing in Iran and India | 100%F | 18–45 | Spiritual therapy | 5 bi-weekly sessions | Cognitive therapy (CT) No intervention control (CONT) | NA | BDI: ↓ (INT vs CT; INT vs CONT) | Moderate risk of bias |
Scott Richards [87], 2006 | USA | RCT | 122, (43, C: 35, ES: 44) | Post | Women receiving in-patient eating disorder treatment | 100%F | 21.2(6.6), 13–52 | Read and participated in group discussion on Spiritual Renewal: A Journey of Faith and Healing, a self-help workbook on non-denominational spiritual readings and Judeo-Christian education materials | Reading + weekly 60-min group | Cognitive group: Read and participated in weekly group discussion on a CBT self-help workbook and attended Emotional support group: Weekly “open-topic” support group | OQ-45 anxiety subscale: ↓ | OQ-45 depression subscale: ↓ | High risk of bias |
Singh 2021 [88], (Study 1) | India | Pre-post | 42 | Post, 21-days | Undergraduate college students | 14.2%F | 21.17(1.53), 19–27 | Multi-component wellbeing program covering topics on mindfulness and meditation and videos of Indian spiritual leaders imparting psychological messages | 14 25–40 min sessions | NA | DASS-21: ↓ (post), NS (follow-up) | Low risk of bias | |
Singh 2021 [88], (Study 2) | India | Pre-post | 308 | Post | Undergraduate college students | 31.8%F | 19.26(1.49), 18–26 | Multi-component wellbeing program covering topics on mindfulness and meditation and videos of Indian spiritual leaders imparting psychological messages | 14 25–40 min sessions | NA | DASS-21: NS | Low risk of bias | |
Singh 2021 [88], (Study 3) | India | Pre-post | 112 | Post | College freshman | 28.6%F | 18.24 (0.60), 18–20 | Multi-component wellbeing program covering topics on mindfulness and meditation and videos of Indian spiritual leaders imparting psychological messages | NR | NA | DASS-21: NS | Moderate risk of bias | |
Smith [89], 2011* | USA | Quasi-experimental | 81 (INT: 33, exercise yoga: 15, cont: 32) | Post | Undergraduate students with mild-to-moderate depression, anxiety and stress | 50.5%F | 21.15 (4.15) | Hatha yoga with a meditation based on one of the yamas or niyamas of yogic philosophy | Bi-weekly 60-min sessions for 7 weeks | Yoga-as-exercise: Hatha yoga only No intervention control | DASS anxiety sub-scale: ↓ (INT only) | DASS depression sub-scale: ↓(INT only) | Low risk of bias |
Vazifeh Doust [90], 2020* | Iran | RCT | 40 (20,20) | Post | Children undergoing hospital treatment | 52.5%F | NR | Training program on spiritual care covering topics on trust, coping, prayer, thanksgiving, and patience | Five 45–60 min sessions over 4 weeks | Disease and care in chemotherapy pamphlets | MASC: ↓ (INT only) | NA | High risk of bias |
Wachholtz [91], 2008 | USA | RCT | 92 (spiritual med: 25, Internal secular med: 22, External secular med: 23, Relaxation: 22) | Post | Meditation naïve psychology university students meeting criteria for vascular headache | 90.4%F | 19.1 (1.10) | Spiritual meditation involving aloud soft repetition of one of four spiritual meditation phrases (e.g., “God is peace”) to help with focus | 20-min daily for one month | (1) Internal secular meditation, (2) External secular meditation, (3) Progressive muscle relaxation | STAI: ↓ (trait) | CES-D: NS PANAS negative affect sub-scale: ↓ | Moderate risk of bias |
Wachholtz [91], 2005 | USA | RCT | 84 (spiritual med: 25, Secular med: 21, Relaxation: 22) | 2-weeks | University students | 68%F | 19.1 (1.03) | Spiritual meditation involving aloud soft repetition of one of four spiritual meditation phrases (e.g., “God is peace”) to help with focus | 20-min daily for two weeks | (1) Secular meditation, (2) Relaxation | STAI: ↓ | PANAS negative affect sub-scale: NS | High risk of bias |