Aging & Mental Health

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Spirituality and wellbeing in later life: a

multidimensional approach

Rinat Lifshitz, Galit Nimrod & Yaacov G. Bachner

To cite this article: Rinat Lifshitz, Galit Nimrod & Yaacov G. Bachner (2018): Spirituality
and wellbeing in later life: a multidimensional approach, Aging & Mental Health, DOI:
10.1080/13607863.2018.1460743

To link to this article: https://doi.org/10.1080/13607863.2018.1460743

Published online: 18 Apr 2018.

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AGING & MENTAL HEALTH, 2018
https://doi.org/10.1080/13607863.2018.1460743

Spirituality and wellbeing in later life: a multidimensional approach

Rinat Lifshitza,b#, Galit Nimroda# and Yaacov G. Bachnerc#
a
Department of Communication Studies, Ben-Gurion Universuty of the Negev, Beer Sheva , Israel; bHerczeg Institute on Aging, Tel-Aviv University,
Tel-Aviv, Israel; cDepartment of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel

ABSTRACT ARTICLE HISTORY

Objectives: Previous studies pointed at positive associations between spirituality and Subjective Received 2 December 2017
Wellbeing (SWB) in later life, but were typically limited to one dimension of spirituality and/or one Accepted 29 March 2018
measure of SWB. Applying Fisher’s (2010) multidimensional approach to spirituality and measuring KEYWORDS
both positive and negative aspects of SWB, this study aims at providing deeper understanding of this Depression; life satisfaction;
association. older adults; spirituality
Method: The study was based on an online survey with 306 individuals aged 50 years and over. The
questionnaire included the SHALOM spirituality scale as well as measures of depression, satisfaction
with life, and personal background.
Results: Personal and communal spirituality were the most dominant domains reported by study
participants, followed by environmental spirituality. Transcendental spirituality was the least reported
domain. Personal spirituality was the only domain positively associated with SWB (lower depression
and higher life satisfaction), whereas communal and transcendental spirituality were associated with
more depression.
Conclusion: These findings demonstrate that not all spirituality domains are equally dominant in
people’s lives or positively associate with SWB. They also suggest that encouraging elderly people to
develop their personal spirituality and self-growth may contribute to their wellbeing.

Introduction religious life. Spirituality has been commonly used in refer-

ence to the experiential and subjective identification of reli-
Interest in spirituality in later life has recently increased, pri-
gious experience and has been considered personal,
marily due to empirical research demonstrating the benefits
something individuals define for themselves that may be free
of spirituality to various aspects of wellbeing (Lavretsky, 2010;
of the rules, regulations and responsibilities associated with
Reutter & Bigatti, 2014). Studies have also shown that the
religiosity (Hill & Pargament, 2003, 2008). Nonetheless, there
sense of spirituality tends to grow during later adulthood
is a large degree of variation in definitions of spirituality.
(Koenig, 1995; Wink & Dillon, 2002), even in today’s modern
Whereas much of this variation depends on scholarly disci-
society and despite the significant secularization of Western
plines (Lazar, 2010), it also results from the virtue of spirituality
societies (Gallup, 1999; Moberg, 2008). Consequently, finding
as complex, highly subjective and difficult to measure (Coyle,
and acknowledging the benefits of spirituality and under-
2002) as well as from its multidimensionality (Miller & Thore-
standing its contributions to coping with changes, losses and
sen, 2003; Seybold & Hill, 2001; Zinnbauer & Pargament,
adverse circumstances in later life should be at the forefront
2005).
of societal research. Existing studies, however, tend to ignore
Many of the definitions focused on the existential concept
the multifaceted nature of spirituality. Applying a multidimen-
defining spirituality as an internal evidence of one’s struggle
sional approach, this study aims at providing deeper under-
to assign meaning (Brady, Peterman, Fitchett, & Cella, 1999;
standing of the association between spirituality and
Csikszentmihalyi & Csikszentmihalyi, 2006), purpose (Waite,
wellbeing in later life.
Hawks, & Gast, 1999) and encompassed belief structure and
faith (Sherwood, 2000). Others definitions described spiritual-
ity in terms of relationship and connectedness with self, others,
Literature review nature, and higher being (Benzein, Norberg, & Saveman,
1998; Chiu, 2000; Sherwood, 2000). These four main domains
An extensive range of definitions has been employed within
are based on the framework definition of spiritual wellbeing
research under the umbrella of spirituality and religiosity.
proposed by the National Interfaith Coalition of Aging (NICA,
Although many studies confound these two constructs, vari-
1975). Recently, Fisher (2010) defined these domains as
ous authors concur they are not identical (Buck, 2006; Hill &
following:
Pargament, 2003; Hill et al., 2000; McCarroll, O’Connor, &
Personal—wherein one intra-relates with oneself with
Meakes, 2005; Moberg, 2002; Zinnbauer, Pargament, & Scott,
regards to meaning, purpose and values in life. Self-awareness
1999). Typically, religion was defined as a system of ideas or
is the driving force or transcendent aspect of the human spirit
ideological beliefs and commitments, and tended to refer to
in its search for identity and self-worth.
the external, institutionalized, formal and doctrinal aspects of

CONTACT Rinat Lifshitz rinatomer@013.net

#
All three authors contributed equally to the conceptualization of the study and the interpretation of the results. Rinat Lifshitz collected the data, analyzed it, and
wrote most of the manuscript. Galit Nimrod and Yaacov Bachner revised the manuscript and finalized it.
© 2018 Informa UK Limited, trading as Taylor & Francis Group
2 R. LIFSHITZ ET AL.
Communal—as shown on the quality and depth of inter-
personal relationships, between self and others, relating to
morality, culture and religion. These are expressed in love, for-
giveness, trust, hope and faith in humanity.
Environmental—care and nurture for the physical and bio-
logical world, including a sense of awe and unity with the
environment.
Transcendental—relationship of self with something or some-
one beyond the human level (i.e. ultimate concern, cosmic force,
transcendent reality or God). This involves faith towards, adora-
tion and worship of the source of mystery of the universe.
Fisher’s (2010) portrayal of spirituality was based on exten-
sive literature review, encompassing the various definitions
and multidimensional perception of spirituality in that litera-
ture. It was also validated by broad empirical research with
Australian educators (Fisher, 2010) and recently with Hebrew
speakers (Elhai, Carmel, O’Rourke, & Bachner, 2016).
Spirituality appears to flourish post midlife. Tornstam
(1994, 1999) found retrospective evidence for a self-perceived
shift toward a more spiritual view of the world in later years.
In a cross-sectional study, Fowler (1981) reported a positive
relation between age and higher stages of faith development
characterized by a sense of unity and personal transcendence.
Similarly, a longitudinal study in the United States that
applied semi-structured interviews at four points of adulthood
analysis demonstrated that spirituality increased significantly
from late-middle to older adulthood (Wink & Dillon, 2002).
Human development theories such as Erikson’s model of
psychological development (Erikson, 1982) explain this ten-
dency by the need for personal autonomy and awareness that
typically develops around midlife. Experiencing reduction in
external responsibility (e.g. childcare, work) middle-aged indi-
viduals both begin to face the challenges of aging and able to
devote more time to issues of spirituality (Jung, 1964; McFad-
den, 1996; Sinnot, 1994). Another explanation may be that spir-
itual perspective becomes increasingly important because of
the growing awareness to the likely shortness of life remaining
(Carstensen, Isaacowitz, & Charles, 1999). From the continuity
theory perspective (Atchley, 1995), greater spirituality in late
life is an evolutionary outgrowth and development of years of
seeking spiritual meaning. Yet, Gerotranscendence theory
(Tornstam, 1989; 1994; 1996) suggests that a ‘paradigm shift’
occurs as people age, in which they move from a materialistic
and rational perspective on life to one that is more cosmic and
transcendent. This theory echoes the disengagement theory
(Cumming & Henry, 1961) according to which elderly people
gradually withdraw from social activities and their roles of ear-
lier life, but the difference is that the theory of gerotranscend-
ence proposes a reorientation towards a more spiritual point
of view on life rather than a withdrawal from society.
The concept of wellbeing in old age is complex and elu-
sive. ‘Over the course of gerontological research, numerous
terminologies, including life satisfaction, quality of life, posi-
tive and negative affect, happiness and contentment, have
emerged in an attempt to capture and describe the concept’
(Poon & Cohen-Mansfield, 2011, p.46). Specifically, Subjective
Wellbeing (SWB) refers to ‘self-evaluation that people make
about their general life condition, usually in terms of a judg-
ment or affect that can be located on a positive-negative con-
tinuum’ (Shmotkin, 2011, p. 27–28). In other words, SWB
refers to the extent to which people perceived their lives as
favorable in terms of satisfaction and happiness (Eid & Larson,
2008; Kehneman, Diener, & Scwartz, 1999).
Numerous studies indicated a positive association between
spirituality and various aspects of SWB and some even demon-
strated that spirituality predicts SWB in later life (see Kirby,
Coleman, & Daley, 2004; Koenig, McCullough, & Larson, 2001;
Reutter & Bigatti, 2014). In spite of the growing understanding
that spirituality is a multidimensional phenomenon (Elhai et al.,
2016; Fisher, 2010; NICA, 1975), however, these studies tended
to regard spirituality as one-dimensional concept. An exception
is a study conducted among senior home residents in Iran that
found a positive correlation between individuals’ spiritual well-
being (measured as religious wellbeing and existential wellbe-
ing) and quality of life (Jadidi, Farahaninia, Janmohammadi, &
Haghani, 2015). Another example is a survey of community-
dwelling Spanish elderly that revealed that spirituality signifi-
cantly contributed to the explanation of life satisfaction. In this
study spirituality was measured by two different scales: ‘Spiri-
tual Wellbeing subscale of the Functional Assessment of
Chronic Illness Therapy’ (FACIT-Sp; Brady et al., 1999; Canada,
Murphy, Fitchett, Peterman, & Schover, 2008; Peterman, Fitch-
ett, Brady, Hernandez, & Cella, 2002) with three subscales:
meaning, peace, and faith, and ‘GES Questionnaire’ (Benito
et al., 2014) composed of items assessing three dimensions of
spirituality: intrapersonal, interpersonal, and transpersonal spiri-
tuality (Tomas, Sancho, Galiana, & Oliver, 2016).
Whereas most studies focused on positive aspects of SWB,
some explored negative aspects and showed that individuals’
greater perception of transcendent spirituality (God, the divine)
is associated with less depression (e.g. Lynch, Strom, Hernandez-
Tejada, & Egeda, 2012; Soo You et al., 2009). Only few studies
encompassed both positive and negative aspects of SWB. For
example, an intervention study applied in a retreat program for
American cardiac patients showed that high levels of spirituality
was positively associated with increased wellbeing, measured by
both positive affect (happiness) and negative affect (depression
and anxiety) (Kennedy, Abbot, & Rosenberg, 2002).
The present study aimed at further deepening the under-
standing of the association between spirituality and SWB in
later life by applying the multidimensional model of spiritual
wellbeing (Fisher, 1998, 2010, 2011) and simultaneously mea-
suring positive and negative aspects of SWB. Specifically, the
study was designed to answer the following questions:
Q1: How dominant are the four spirituality domains (personal,
communal, environmental and transcendental) in later life?,
which of them rank higher than the other?
Q2: Do the four spirituality domains vary among individuals
with different background characteristics?
Q3: To what extent do the four spirituality domains associate
with positive and negative aspects of SWB?
Combining the exploration of the four spirituality domains
with the two aspects of SWB and focusing on the personal
and subjective side of spirituality, rather than on its behavioral
elements, enabled probing individuals’ experience more
directly, and provided new insights regarding spirituality’s
relations with SWB in later life.
Method
Data collection
Data were collected within the framework of a research proj-
ect that explored well-being among individuals aged 50 years

and over residing in Isreal which is involved in an ongoing
military conflict with a neighboring county. This choice of this
age group resulted from the wish to explore wellbeing across
the later life course. The rationale for this choice lies in the
perception of aging as a continuous process rather than a life
stage (Neugarten, 1979).
Three hundred and six individuals aged 50 years and over
completed an online survey. In line with the project’s goal,
about half (144 participants) resided in a high-risk zone, con-
sisting of areas close to the border, while the remainder (162
participants) lived in a low-risk zone (For more information
see: (Lifshitz, Nimrod & Bachner, 2016)). This convenience
sample was derived from a commercial panel comprised of
50,000 registered participants. Two-hundred participants
were randomly sampled from each residential area (i.e. the
response rate was 306/400; 76.5%). Participants were reached
out using an email with a link to the survey. Although not rep-
resentative of the country’s population, this sample possessed
the advantage of allowing comparison of middle aged and
older adults living under different circumstances.
Measurement
The questionnaire included closed-ended questions relating
to the following topics:
Spirituality
The Spiritual Health And Life-Orientation Measure (SHALOM;
Fisher, 2010) was used to measure spirituality. This scale is
comprised of 20 items—five items for each domain, asking
respondents to evaluate how each item reflects their experi-
ence most of the time: personal (e.g. Sense of identity), com-
munal (e.g. Forgiveness towards other), environmental (e.g.
Connection with nature) and transcendental (e.g. Feeling
close to God). Each item requires the respondents to consider:
(a) How important the item is for optimal spiritual health, in
their opinion? And (b) how this item reflects their daily per-
sonal experience. In line with the current study’s goals, only
the second part of the SHALOM questionnaire—‘Experience
questionnaire’—was applied. The Experience questionnaire is
based on the Spiritual Wellbeing Questionnaire (Gomez &
Fisher, 2003). The SHALOM has been translated into Hebrew
and validated. Internal consistency found for the four dimen-
sions ranged from adequate to excellent (0.72 < a < 0.96;
(Elhai, Carmel, O’Rourke & Bachner, 2016)). In the currents
study the internal consistency of the four dimensions was
found to be very high (0.85 < a < 0.96).
Subjective wellbeing
In accord with the aim of simultaneously assessing positive
and negative aspects of SWB, two commonly used measures
were applied- depression and life satisfaction. Depressive
symptoms were measured by the Iowa short form (Kohout,
Berkman, Evans, & Cornoni-Huntley, 1993) of the Center for
Epidemiological Studies Depression Scale (CES-D; Radloff,
1977). This 11-items self-reporting instrument asks respond-
ents to describe their mood over the past week on a 3-point
scale (1 = rarely or almost none of the time, 2 = some or a lit-
tle of the time, 3 = most or all of the time). The questionnaire
includes items such as ‘In the past week I felt depressed,’ ‘In
the past week I felt lonely,’ and ‘In the past week, I enjoyed
life’ (reverse coded). The Cronbach’s alpha was found high
0.86.
AGING & MENTAL HEALTH 3
Life satisfaction was assessed using the Satisfaction with
Life Scale (SWLS, Diener, Emmons, Larson, & Griffin, 1985),
comprising of five statements on a Likert response scale rang-
ing from 1 (strongly disagree) to 7 (strongly agree). The ques-
tionnaire include items such as ‘in most ways my life is close
to my ideal,’ and ‘if I could live my life over, I would change
almost nothing.’ The Cronbach’s alpha was high 0.91.
Background questionnaire
The last part of the questionnaire included demographic and
sociodemographic questions ascertaining age, sex, marital
status, number of children, education, household income,
place of birth (country of study/other), being a holocaust sur-
vivor and religious orientation. Another question called for
self-rated health on a five-point Likert scale ranging from 1
(very bad) to 5 (very good). Place of residence (i.e. high/low
risk zones) was also used as a background variable.
Data analysis
Each of the four spirituality domains was assessed according
to means and standards deviations, as well as possible and
observed ranges. The means of the four spirituality scores of
each participant were compared by using one-way repeated
measures Analysis of Variance (ANOVA). The ANOVA evalu-
ated differences in the dominance of each domain followed
by multiple comparison tests (LSD post-hoc tests). Pearson
and t-tests were employed to examine associations between
background variables and each of the domains and between
spirituality domains and SWB (depression and life
satisfaction).
Two series of linear multiple regressions were conducted.
In the first series, the dependent variables were the reported
dominant of the various spirituality domains and the indepen-
dent variables were the sociodemographic characteristics
found to be significantly correlated with the dependent varia-
bles in bivariate analyses. In the second series, the dependent
variables were depression and life satisfaction and the inde-
pendent ones were the differentiating background variables
and spirituality domains. Significance level was set at p<0.05.
Data were analyzed using SPSS statistical software, PC version
23.0.
Results
Sample characteristics
Participants’ age ranged from 50 to 77 years (mean = 58.8, SD
= 6.0), 57% were female, 80% were married and 98% had chil-
dren (mean = 3.08, SD = 1.41). Most participants (63%) were
born in the country of study, and had at least some post-sec-
ondary education (mean number of years of education =
14.47, SD = 1.41). Seventy one percent reported that their
monthly income was higher than average, 63% classified
themselves as secular, 37% reported that they were first or
second generation of holocaust survivors (themselves, their
mother or father), and 75% rated their health as good, very
good or excellent.
Description of spirituality domains
Personal and communal spirituality were the most dominant
domains reported by participants, followed by environmental
4 R. LIFSHITZ ET AL.

Table 1. Mean level of reported spirituality per domain (N = 306). Table 4. Pearson Correlations between the reported spirituality per domain and
Domains Mean SD Potential range Observed range background characteristics (continuous variables).
Personal 3.76a 0.77 1–5 1–5 Domain Variable Personal Communal Environmental Transcendental
Communal 3.80b 0.69 1–5 1–5 Age ¡0.133** ¡0.151** ¡0.091 ¡0.100
Environmental 3.45b 0.85 1–5 1–5 Income 0.228** 0.155** 0.132* ¡0.117*
Transcendental 2.42c
1.30 1–5 1–5 Education 0.223** 0.173** 0.061 ¡0.268**
Note: Means that are significantly different are denoted by different letters. N. of children 0.124* 0.151** 0.151** 0.279**
Self-rated health 0.281** 0.206** 0.259** 0.112
*p<.05, **p<.01

Table 2. Correlations between spirituality domains.

Domains Personal Communal Environmental
Personal 1 a first or second generation of holocaust survivors. Higher
Communal 0.76** 1
Environmental 0.72** 0.60** 1
Transcendental 0.23** 0.18** 0.35**
**p<.01
spirituality. Transcendental spirituality was by far the least
reported domain (Table 1). The one-way repeated measures
ANOVA conducted to evaluate differences in spirituality levels
within each domain revealed significant differences among
the various domains (Wilks’ lambda = .47, F (3, 303) = 110.95,
p < .01, ƞ2 = .52). Follow-up multiple comparison test (LSD
post-hoc test) indicated that both personal and communal
spirituality were significantly more dominant than environ-
mental spirituality, and that the latter was significantly more
intense than transcendental spirituality (p < .01). In addition,
the correlations among all four spirituality domains were
found to be positive and significant (.18 < r < .76, p< .01; see
Table 2). Tests made to see if the data met the assumption of
collinearity indicated that multicollinearity was not a concern
(Personal spirituality, Tolerance = .28, VIF = 3.46; Communal
spirituality, Tolerance = .40, VIF = 2.48; Environmental spiritu-
ality, Tolerance = .43, VIF = 2.31; Transcendental spirituality,
Tolerance = .73, VIF = 1.35).
Associations between background characteristics and
spirituality domains
Tables 3 and 4 display the correlations between spirituality
domains and the background characteristics. Higher personal
spirituality was significantly correlated with younger age,
higher education and income, having more children, better
Transcendental self-rated health, birth not in country of study and not being
communal spirituality was associated with younger age,
1 higher education and income, having more children, better
self-rated health, birth not in country of study and living in a
high-risk zone. Significant correlations were found between
environmental spirituality and higher income, having more
children, better self-rated health, living in a high-risk zone
and not being a first or second generation of holocaust survi-
vors. Transcendental spirituality was associated with lower
education and income, and having more children, as well as
with being religious and living in a high risk zone. Sex and
marital status were not significantly associated with any of
the spirituality domains.
Multiple regression analyses were performed to determine
the extent to which background characteristics contributed
to the explanation of level of spirituality in each domain. Only
variables that were significantly correlated with the domains
in univariate analyses were included in the regression models
(see Table 5). Analysis indicated that number of children, edu-
cation, income and self-rated health were associated with per-
sonal spirituality (R2 = .174, F (7, 298) = 8.99, p<.01); number
of children, education, self-rated health and place of resi-
dence correlated with communal spirituality (R2 = .144, F (7,
298) = 7.14, p<.01); self-rated health, place of residence and
not being a first or second generation of holocaust survivors
associated with environmental spirituality (R2 = .122, F (5, 300)
= 8.31, p<.01); and number of children, education and religi-
osity correlated with transcendental spirituality (R2 = .401, F
(5, 300) = 40.11, p<.01). The explained variance was low for
the first three models, meaning that variables not examined
in this study may better explain level of spirituality in each
domain.

Table 3. Associations between reported spirituality per domain and background characteristics (nominal variables).
Domain Personal Communal Environmental Transcendental
Variable N M SD t M SD t M SD t M SD t
Sex
Male 131 3.74 0.71 ¡0.43 3.76 0.66 ¡1.06 3.38 0.81 ¡1.19 2.46 1.31 ¡0.53
Female 175 3.77 0.81 3.84 0.71 3.50 0.88 2.38 1.30
Marital status
Not married 65 3.72 0.83 ¡0.54 3.69 0.71 ¡1.45 3.28 0.90 ¡1.83 2.41 1.21 ¡0.05
Married 237 3.77 0.76 3.83 0.68 3.50 0.84 2.42 1.33
Country of birth
Country 111 3.60 0.83 ¡2.67** 3.69 0.73 ¡2.10* 3.38 0.94 ¡1.02 2.37 1.38 ¡0.47
Other 195 3.85 0.72 3.87 66 3.49 0.79 2.44 1.26
Religious orientation
Secular 194 3.75 0.78 ¡0.30 3.80 0.68 .00 3.39 0.87 ¡1.64 1.83 .99 12.88**
Religious 112 3.70 0.76 3.80 0.70 3.55 0.80 3.44 1.14
Place of residence
Low-risk 162 3.69 0.79 ¡1.68 3.71 0.71 ¡2.44* 3.33 0.82 ¡2.49* 2.21 1.16 ¡3.00**
High-risk 144 3.84 0.74 3.91 0.65 3.58 0.86 2.65 1.41
Holocaust survivor
No 193 3.83 0.76 2.15* 3.85 0.69 1.61 3.55 0.83 2.75** 2.46 1.33 0.71
Me, mother, father 113 3.63 0.78 3.72 0.69 3.27 0.87 2.35 1.25
*p<.05, **p<.01.
 AGING & MENTAL HEALTH 5

Table 5. Predictors of level of spirituality per domain.

Domains Personal Communal Environmental Transcendental
Variable B SE B b B SE B b B SE B b B SE B b
Age ¡0.011 0.007 ¡0.086 ¡0.012 0.006 ¡0.101
Number of children 0.056 0.029 0.103* 0.057 0.027 0.117* 0.060 0.033 0.099 0.118 0.043 0.128**
Education 0.059 0.017 0.193** 0.051 0.015 0.189** ¡0.068 0.025 ¡0.132**
Income 0.073 0.036 0.114* 0.035 0.033 0.061 0.072 0.039 0.103 ¡0.040 0.051 ¡0.037
Self-rated health 0.150 0.040 0.209** 0.094 0.036 0.147** 0.164 0.044 0.208**
Country of birth 0.120 0.088 0.074 0.157 0.085 0.109
Religious orientation 1.42 0.127 0.527**
Place of residence 0.253 0.280 0.182** 0.231 0.094 0.135* .189 0.119 0.072
Holocaust survivor ¡0.143 0.085 ¡0.089 ¡0.230 0.097 ¡0.130*
R2 0.174 0.144 0.122 0.401
F 8.99** 7.14** 8.31** 40.11**
*p<.05, **p<.01
Note: Dummy codes: Religious orientation, 1 = religious, 0 = secular; Country of birth, 0 = country, 1 = other; Place of residence, 0 = low risk zone, 1 = high risk
zone; Holocaust survivor, 0 = no, 1 = me, mother, or father

Associations between spirituality domains and
subjective wellbeing
Participants’ depression scores ranged between 11 and 33
(mean = 16.64,—lower than 21 - the cutoff for depression, SD
= 4.37), and their satisfaction with life scores ranged from 1 to
7 (mean = 4.86, SD = 1.30). A series of Pearson correlation tests
revealed significant negative correlations between depression
and three spirituality domains: personal (r = -.318, p < .01),
communal (r = -.153, p < .01) and environmental (r = -.221, p
< .01). Transcendental spirituality was positively associated
with depression (r = .132, p < .05). In addition, positive correla-
tions were found between life satisfaction and three spirituality
domains: personal (r = .439, p < .01), communal (r = .324, p <
.01) and environmental (r = .365, p < .01).
As the background characteristics associated with each of
the domains of spirituality may explain the associations
between these functions and SWB, all differentiating back-
ground variables (number of children, income, education,
self-rated health, religious orientation, place of residence and
being a first or second generation of holocaust survivors) as
well as the four spirituality domains were entered as indepen-
dent variables into two regression analyses – one with depres-
sion and the other with satisfaction with life as the dependent
variables. A summary of the analyses is provided in Table 6.
Higher self-rated health levels were associated with lower lev-
els of depression, as did three of the four spirituality domains
personal, communal and transcendental: The higher level of
personal spirituality and lower levels of communal and tran-
scendental spirituality the lower the depression level (for the
entire model R2 = .289, F (11, 294) = 10.877, p<.01).
Furthermore, a greater number of children, higher income
level, better self-rated health and living in a high-risk area cor-
related with greater life satisfaction. Personal spirituality was
the only domain that associated with higher life satisfaction
(for the entire model R2 = .356, F (11, 294) = 14.789, p<.01).It
should be noted that self-rated health and personal spiritual-
ity were the only variables that correlated with both positive
and negative aspects of SWB. .
Discussion
The multidimensional approach applied in the present study
as well as the simultaneous exploration of both positive and
negative aspects of SWB yielded new insights regarding the
association between spirituality and SWB among aging adults.
Specifically, our findings indicated that the four spiritualty
domains are not equally dominant in people’s lives. Moreover,
not all spiritualty domains were found to be positively associ-
ated with SWB, and some were even negatively correlated
with its measures.
Overall, the findings pointed at complex phenomenon,
according to which both personal and communal spirituality
were the most dominant domains reported by participants
but showed opposite associations with SWB. In fact, personal
spirituality was the only domain positively associated with
SWB (i.e. lower depression and higher life satisfaction). This
finding is consistent with previous research (e.g. Dein & Sty-
gall, 1997; Tomas et al., 2016), and may particularly befit indi-
viduals who have developed relatively novel and
nontraditional ways of embracing the sacred. This finding

Table 6. Predictors of subjective wellbeing.

Depression Life satisfaction
Variables B SE B b B SE B b
N. of children ¡0.135 0.161 ¡0.044 0.100 0.046 0.109*
Education ¡0.087 0.095 ¡0.051 0.011 0.027 0.021
Income ¡0.339 0.194 ¡0.094 0.276 0.055 0.256**
Self-rated health ¡1.209 0.214 ¡0.299** 0.274 0.061 0.226**
Religious orientation ¡0.504 0.568 ¡0.056 0.066 0.162 0.024
Place of residence 0.732 0.445 0.084 0.352 0.127 0.135**
Holocaust survivor 0.388 0.454 0.043 ¡0.049 0.129 ¡0.018
Personal ¡1.997 0.515 ¡0.354** 0.472 0.147 0.280**
Communal 1.287 0.490 0.204** ¡0.105 0.139 ¡0.056
Environmental ¡0.395 0.384 ¡0.077 0.124 0.109 0.081
Transcendental 0.820 0.232 0.245** ¡0.055 0.066 ¡0.055
R2 0.289 0.356
F 10.877** 14.789**
*p<.05, **p<.01.
Note: Dummy codes: Religious orientation, 1 = religious, 0 = secular; Country of birth, 0 = country, 1 = other; Sex, 0 = male, 1 = female; Marital status,
0 = not married, 1 = married; Place of residence, 0 = low-risk area, 1 = high-risk area
6 R. LIFSHITZ ET AL.
also supports Gerotranscendence theory (Tornstam, 1989;
1994; 1996) which claims that a reorientation towards a more
spiritual point of view on life may be followed by an increase
in life satisfaction. The overall positive effect of spiritual beliefs
on wellbeing is in accord with the view of spirituality as a
resource (Wong, 1998).
In the current study, higher education and income, num-
ber of children, and better perceived health were associated
with higher personal spirituality. These findings resemble pre-
vious research (e.g. Mystakidou et al., 2008) and suggest that
well-to-do middle-aged and elderly people are somewhat
more available, able and/or motivated to invest in their per-
sonal spirituality, growth and development. As suggested by
some human development theories (Erikson, 1982; Jung,
1964; McFadden, 1996; Sinnot, 1994), such individuals experi-
ence reduction in external responsibility and thus can devote
more time and energy towards other goals.
Communal spirituality, which was found to be the second
most dominant domain reported by participants, only associ-
ated with depression and in a paradoxical way: higher com-
munal spirituality correlated with higher depression. This
finding contradicts previous studies which report positive
association in late adulthood between spirituality expressed
in positive relations with others and wellbeing (Wink & Dillon,
2003). Moreover, this finding does not fit Erikson’s model
(1963), according to which mid to later life are a period of
generativity—a selfless concern for others that has its origin
in an unconditional valuing of the human species. According
to Erikson, the ability to maintain this trust in the meaningful-
ness of life helps the older adults confronts mortality and
enhances the confidence and social trust of younger
generations.
It was somewhat surprising to note that higher levels of
personal and communal spirituality were both significantly
correlated with younger age in the bivariate analysis, and the
association became non-significant in the regression models
that included other sociodemographic variables as indepen-
dent variables. This inconsistency with previous research (e.g.
Wink & Dillon, 2002) may be explained by the overlaps with
religion while defining spirituality (e.g. the place of religion in
participants’ lives, their church attendance habits) and the
diverse methods and numerous scales that were applied (e.g.
Moberg, 2008).
The positive correlation between communal spirituality
and depression should be interpreted cautiously, as it would
be reasonable to assume that it is bilateral in nature: It is pos-
sible that people with high depression and lower perceived
health tend to increase engagement in coping behaviors
(Bishop, 2011, p. 229–230) thus rely on their communal spiri-
tuality as a coping resource in a time of stressful situation
(Wink & Dillon, 2002; Wong, 1998). Furthermore, it was found
that higher communal spirituality was associated with living
in high-risk zone, which can contribute to developing a gen-
eral and broader perception of the world as dangerous and
threating (Lifshitz, Nimrod, & Bachner, 2016), and conse-
quently may activate an excessive Hostile-World Scenario
(Shmotkin, 2005, 2011). This could generate a disturbing
sense of precarious living in a disastrous world (Shmotkin,
2005, 2011), which may manifests itself in more depressive
symptoms, and consequently in higher communal spirituality.
Transcendental spirituality, which was the least dominant
domain by far, was also found to be positively associated with
depression. This finding is in contrast with previous research
that showed negative correlation between transcendent spiri-
tuality and depression (Lynch et al., 2012) or a non-significant
correlation between the two (Elhai et al., 2016). This can be
explained by the differences in the samples’ age characteris-
tics; both these studies did not focus on the elderly popula-
tion, as opposed to the current study. Another explanation
may be the possible difficulties of the respondents to distin-
guish, as shown in previous research, between spirituality and
religiosity (e.g. Bishop, 2011). In the current study, a significant
and strong association was found between religiosity and
higher transcendental spirituality which may reflect a possible
confusion in participants’ perception of these two concepts.
Moreover, participants with high transcendental spiritualty
were found to be poorer, less educated and had more chil-
dren. Since the current study is correlational in nature, these
characteristics could have led to higher depression among
participants and thus increase their engagement in religiosity
and transcendental spirituality as a coping strategy (Wink &
Dillon, 2002; Wong, 1998).
Environmental spirituality was not associated with wellbe-
ing at all. This contradicts previous research that found elderly
to be happier, less stressed and less depressed when exposed
to nature (e.g. Beyer et al., 2014). The current finding may be
explained by the sample characteristics of older Internet users
who were relatively young, healthy, highly educated and
well-to-do, than the older adults examined in previous stud-
ies. Furthermore, the study did not address participants’ work
status that may have a significant role in their spiritual lives
(e.g. less available time to invest in connecting with nature).
The overall positive effect of spiritual beliefs on wellbeing
is consistent with the view of spirituality as a resource (Elhai
et al., 2016; Wink & Dillon, 2002; Wong, 1998) and support pre-
vious research reporting somewhat the same dominance of
the spirituality dimensions in a wide range of setting (Fisher,
1998, 2010, 2010, 2011). It is also aligned with the conclusion
that spirituality may benefits the wellbeing of older adults
(see: Kirby et al., 2004; Koenig et al., 2001). It is likely, however,
that the contradicting findings of the current study to previ-
ous studies on spirituality and SWB can be attributed to differ-
entiated use of the concept of spirituality: multidimensional
versus one-dimensional concept and objective (behavioral
elements e.g. frequency of church visits) versus subjective
perception of spirituality. Exploring spirituality in various ways
may thus distort our understanding of the contribution of
spirituality to SWB in later life.
Conclusions
Our findings indicated that the four spiritualty domains are
not equally dominant in people’s lives: Personal and commu-
nal spirituality were the most dominant domains reported by
participants, followed by environmental spirituality, and tran-
scendental spirituality was the least reported domain. More-
over, not all spiritualty domains were found to be positively
associated with SWB, and some were even negatively corre-
lated with its measures.
One major conclusion of the present study is that applica-
tion of the multidimensional model of spiritual wellbeing may
increase the accuracy of the body of knowledge. Another con-
clusion, of a more practical nature, suggests that encouraging
elderly people to develop their personal spirituality and self-
growth can contribute to better wellbeing. These findings
suggest a new direction for public health practice, education,

and research. Spirituality is a pervasive factor among middle-
aged and elderly and may help to ensure positive health-pro-
moting behaviors, especially in times of stress and loss of
age-related resources.
Limitations and future research
Despite the advantages of the multidimensional model
applied, the study embodies several drawbacks. The sample
consisted of older Internet users who were relatively young,
healthy, highly educated and well-to-do. Considering these
characteristics and the sampling method employed, the sam-
ple could not be considered representative of the country’s
population aged 50 years and over. Additionally, as the data
were gathered in a country involved in a military conflict, gen-
eralization of results to peaceful countries may well be lim-
ited. Moreover, the survey was conducted during a time that
included periods of calm and confrontation alike, possibly
affecting participants’ psychosocial needs and consequent
Internet use. Finally, the study design was cross-sectional
which does not allow for casual interpretations.
Future research should further investigate the association
between spirituality and SWB in later life by exploring addi-
tional variables (e.g. living in residential/nursing homes) and
audiences (e.g. people from various cultural contexts and geo-
graphical areas). Application of longitudinal methods in such
studies will underscore causality. Finally, further research
should strive to generate a more stronger and nonambiguous
definitions and measures for spirituality that will unify
research efforts.
Compliance with ethical standards
All procedures performed in studies involving human partici-
pants were in accordance with the ethical standards of the
institutional and national research committee and with the
1964 Declaration of Helsinki and its later amendments or
comparable ethical standards.
Disclosure statement
No potential conflict of interest was reported by the authors.
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