The Daily Spiritual Experience Scale: Development, Theoretical Description, Reliability,Exploratory Factor Analysis, and Preliminary Construct Validity Using Health-Related Data

Lynn G. Underwood, Ph.D.Fetzer Institute

Jeanne A. Teresi, Ed.D., Ph.D.Hebrew Home for the Aged at Riverdale and Columbia University Stroud Center

ABSTRACTSpirituality and religiousness are gaining increasing atten-

tion as health research variables. However, the particular as-pects examined vary from study to study, ranging from churchattendance to religious coping to meaning in life. This fre-quently results in a lack of clarity regarding what is being mea-sured, the meaning of the relationships between health variablesand spirituality, and implications for action. This article de-scribes the Daily Spiritual Experience Scale (DSES) and its de-velopment, reliability, exploratory factor analyses, and prelimi-nary construct validity. Normative data from random samplesand preliminary relationships of health-related data with theDSES also are included. Detailed data for the 16-item DSES areprovided from two studies; a third study provided data on a sub-set of 6 items, and a fourth study was done on the interrater reli-ability of the item subset. A 6-item version was used in the Gen-eral Social Survey because of the need to shorten the measurefor the survey. A rationale for the conceptual underpinnings anditem selection is provided, as are suggested pathways for link-ages to health and well-being. This scale addresses reported or-dinary experiences of spirituality such as awe, joy that lifts oneout of the mundane, and a sense of deep inner peace. Studies us-ing the DSES may identify ways in which this element of life mayinfluence emotion, cognition and behavior, and health or waysin which this element may be treated as an outcome in itself, aparticular component of well-being. The DSES evidenced goodreliability across several studies with internal consistency esti-mates in the .90s. Preliminary evidence showed that daily spiri-tual experience is related to decreased total alcohol intake, im-proved quality of life, and positive psychosocial status.

(Ann Behav Med 2002, 24(1):2233)

INTRODUCTIONThe inner experience of spiritual feelings and awareness are

an integral part of the everyday religious and spiritual lives of

many individuals. As far back as Jamess The Varieties of Reli-gious Experience: A Study in Human Nature (1), there has beeninterest in this experience of the individual from a psychologicalperspective. This article presents the development of a DailySpiritual Experiences Scale (DSES), the items of which attemptto measure everyday ordinary experience rather than particularbeliefs or behaviors; although developed for the predominatelyJudeo-Christian U.S. population, it is intended to transcend theboundaries of particular religions.

Spirituality and religiousness have received increasing at-tention as potential health research variables. Frequent refer-ence has been made to the body of data linking religious vari-ables to mental and physical health outcomes (25). TheNational Institute on Alcohol Abuse and Alcoholism justfunded a set of seven proposals after a request for applications tosolicit research examining the relationship of spirituality to al-coholism. However, the particular aspects of religiousness andspirituality that have been examined vary across studies, whichhas resulted in a lack of clarity regarding the construct measuredand an accompanying lack of clarity as to the implications eachstudy has for action. The results of a recent meta-analysis ofstudies examining the relationship between religiousness andmedical outcomes (6) have underscored the need for adequatemeasurement. Aligned with the concern that studies of this sub-ject need more rigor and thoughtfulness, the National Instituteon Aging and the Fetzer Institute cosponsored a meeting at theNational Institutes of Health in March 1995, where participantsexamined conceptual and methodological issues at the interfaceof religion, health, and aging. After the meeting, a workinggroup received support to develop a multidimensional approachto the measurement of religious and spiritual variables thatcould be used in health studies (7). This approach was particu-larly helpful due to the plethora of ways that exist to measurethese variables, often with little or no justification given for theparticular method used. Conceptual overlap was the rule, withscales that measured religious preference (8), attendance (re-viewed in 9), or intrinsic versus extrinsic religiosity (10) andmultidimensional sections of surveys (11). Also, scales eitherhave tended to be solidly based in a single religious tradition(12) or, in trying to avoid that approach, have examined issuessuch as meaning and values from an existential perspective (13).

The working group identified daily spiritual experience(DSE) as one aspect of religiousness and spirituality that hadnever been fully addressed despite its anecdotal importance inindividuals lives and its potential connection to health. Under-wood, in response to that recommendation, developed the

22

This research was funded, in part, by the Fetzer Institute. We thank Dr.Frank Keefe, Dr. Jeanne Zechmeister, Leila Shahabi, Dr. Lynda Powell,and Dr. Scott Tonigan for data collection and use of that data in this arti-cle, and Katja Ocepek-Welikson for data programming. We thankWayne Ramsey and Heidi Matteo for their help with the article.

Reprint Address: L. G. Underwood, Ph.D., Fetzer Institute, 9292 WestKL Avenue, Kalamazoo, MI 49009. E-mail: info@fetzer.org

2002 by The Society of Behavioral Medicine.

DSES. After the development of the instrument, the scale wasincluded, with the authors permission, in a variety of studies.The data were made available to the author. The main purpose ofthis article is to describe the development of the DSES, includ-ing its reliability, exploratory factor analyses (EFAs), and pre-liminary construct validity. The relationship of DSE tohealth-relevant data is examined.

Theoretical Orientation and Definition of DSEThis scale is intended to measure a persons perception of

the transcendent (God, the divine) in daily life and his or her per-ception of his or her interaction with or involvement of the tran-scendent in life. The items attempt to measure experience ratherthan particular beliefs or behaviors; therefore, they are intendedto transcend the boundaries of any particular religion. Manycharacterizations of spirituality involve such an inner dimension(14). Development of this measure began by the examination ofwhat constitutes the substantive feelings and thoughts that de-scribe the interface of faith with daily life. It appeared that heremight lie some of the proximal connections of spirituality withhealth. Through reflection on the aspects of the spiritual or reli-gious perspective that weave through thought processes andfeelings in daily events, an attempt was made to develop ques-tions that would elicit those inner qualities as they express them-selves at specific moments in the midst of daily life events. Theintention was to determine the extent to which spiritual feelingsand inner experiences might constitute an integral part of the lifeof the ordinary person and, ultimately, to examine the relation ofthese factors to health and well-being.

The decision was made at the outset to use the word spiri-tual rather than religious in the definition of the collection ofitems in this measure. Although there are different understand-ings of the distinction between religiousness and spirituality, thefollowing clarifying statement has been useful in a variety ofmedical research settings:

Religiousness has specific behavioral, social, doctrinal, anddenominational characteristics because it involves a systemof worship and doctrine that is shared within a group. Spiritu-ality is concerned with the transcendent, addressing ultimatequestions about lifes meaning, with the assumption thatthere is more to life than what we see or fully understand.Spirituality can call us beyond self to concern and compas-sion for others. While religions aim to foster and nourish thespiritual lifeand spirituality is often a salient aspect of reli-gious participationit is possible to adopt the outward formsof religious worship and doctrine without having a strong re-lationship to the transcendent. (7, p. 2)

The spiritual, for the ordinary person, is most often and mosteasily described in language that has religious connotations. Re-ligious language can be stated in such a way that it is more ame-nable to translation; for example, the word God, although notacceptable for some, can be interpreted by a person respondingto a questionnaire to include various notions of the divine or atranscendent aspect of life, without losing its meaning to thosefor whom it has significance.

In preparation for a meeting on the role of spirituality andreligiousness in disability at the National Institute of ChildHealth and Human Development in 1994, a model was devel-oped (15) to reflect the integration of the variety of aspects of anindividuals life. In addition to an integrative core, the modelhad four different dimensions of life: the vital (physical andemotional), the functional (intellectual and physical), the inter-personal (social and cultural), and the transcendent. The modelexamined how we influence others and they influence us; howwe are shaped by our physical endowment, our environment;our emotional dispositions; and our orientation to the transcen-dent. Drawing from this model, the DSES assesses features thatcan affect physical and mental health, social and interpersonalinteractions, and functional abilities. In turn, the physical andemotional can have effects on DSE, as do intellectual interpreta-tions of meaning and belief, cultural environment and experi-ences, and interpersonal interactions.

Recent developments in cognitive neuroscience have en-couraged the adoption of such an integrative model. For exam-ple, the issue of an integrative core is compatible with a varietyof neuroscientific understandings, whether the core is seen as re-siding within a specific neural network (16) or as not necessarilysynonymous with a physical location (17). Work by Damasio(18) has shown the incorrectness of our common assumptionthat if only we could get the emotions out of the way, our intel-lect could function more clearly. People with neurological defi-cits in the emotional area are actually incapacitated in much de-cision making. The driving force for decision making issomehow dependent on an integrative activity using emotionsand more rational thought. In the same way, it is very possiblethat the integration of the transcendent sphere also may be cru-cial to decision making, behaviors, and attitudes. The DSES as-sesses features that, in this model (15), pass through the core ofthe person to affect physical and mental health, social and inter-personal interactions, and functional abilities.

The DSE construct represents those aspects of life thatmake up day-to-day spiritual experience for many people, amore direct assessment of some of the more common processesthrough which the larger concepts of religiousness and spiritual-ity are involved in everyday life, grounding them in specifics.The items are designed to assess aspects of day-to-day spiritualexperience for an ordinary person and should not be confusedwith measures of extraordinary experiences (e.g., near-death orout-of-body experiences and other more dramatic mystical ex-periences) that may tap something quite different and have a dif-ferent relation to health outcomes. This choice was deliberate.Scales exist that measure these more extraordinary experiences(19). The experiences reflected in the DSES may be evoked by areligious context or by other events of daily life or by the indi-viduals religious history or religious or spiritual beliefs. Under-hill (20), a British theologian of the early 1900s, referred to thiskind of experience as practical rather than what usually isthought of as mystical, emphasizing the ordinariness of theseexperiences. The scale differs from other measures of religious-ness such as religious coping (21), as it is not necessarily dealingwith stressful life events. It also differs from religious motiva-

Volume 24, Number 1, 2002 Daily Spiritual Experience Scale 23

tion measures (10,22) that tap whether people are motivated byintrinsic or more socially driven religious factors and from theSpiritual Well-Being Scale (23,24), which examines existentialand religious quality of life issues. Religious commitment or sa-lience items tap the importance of religion and cognitive assess-ment of application of religious principles in daily life (25).

An important point is that there is no assumption that themore of these daily spiritual experiences (DSEs) you have, thebetter you are in spiritual terms. The intent is to capture a set ofexperiences that may play a strong role in the lives of many;such measures, to date, have been absent from our attempts toassess what factors might play important roles in the lives of in-dividuals and their actions, thoughts, and attitudes.

Implicit in the model presented here is the assumption thatthere is a type of DSE that can contribute positively to health andthat can be defined broadly to include spiritual, psychological,and social well-being as well as physical health. Analogously,although psychological stress has been extensively linked tohealth problems through specific physiologic effects, emotionaland physical dispositions can buffer this stress (26). Positiveemotional experiences have also been connected with positiveeffects on the immune system, independent of the negative ef-fects of stress (27). Likewise, positive expectations for out-comes have been linked to positive immune effects (28,29).There may also be overlap between the endorsement of a senseof deep peace and the condition that leads to or emanates fromdirect neurologic and endocrine effects similar to those identi-fied during meditation (30).

Despite work linking church attendance with health out-comes (31,32), this association has many potential confoundingand mediating factors, such as social support effects, need forreasonable health to participate in public activities, and linkswith behavioral dictums of religious groups. Very little empiri-cal work has sought to link the spiritual experiences of daily lifewith health outcomes. One suggestive study was that of Oxman,Freeman, and Manheimer (33), in which one of the items moststrongly predictive of positive health outcome in cardiovasculardisease was I obtain strength and comfort from my religion(elements that were incorporated into the DSES). The inclusionof the DSES in health studies has the potential for the establish-ment of a pathway by which religiousness and spirituality mightinfluence physical and mental health.

METHODSDevelopment of the DSES

Content validity. To begin development of the scale, LynnG. Underwood held in-depth interviews and focus groups withindividuals from many religious perspectives. This process pro-vided basic qualitative information regarding the spiritual expe-riences of a wide range of individuals. She also conducted a re-view of scales that attempt to measure some aspects of spiritualexperience (19,32,34) and drew as well on a variety of theologi-cal, spiritual, and religious writings (3540 are representative).The writings helped to categorize experiences to develop a con-cise set of items.

Refinement of the instrument involved several stages. First,Underwood elicited individual interpretations of the questionsthrough semistructured interviews and refined the items in thelight of the responses. Then, individual, open-ended interviewswere conducted to confirm what the items actually meant topeople responding to them. In this process, efforts were made toground the questions in the specific whenever possible, althoughstill keeping them broad enough to encompass a variety of per-spectives and situations. Finally, she further revised the itemsbased on a review of the instrument by representatives of a vari-ety of spiritual orientations at a meeting of the World HealthOrganization Working Group on Spiritual Aspects of Qual-ity-of-Life. This group included agnostics, atheists, Buddhists,Christians, Hindus, Jews, and Muslims. (Details of the qualita-tive methodology used in instrument development can be ob-tained from Underwood by request.)

The development process can be illustrated by the consider-ation of how to handle the question whether to include the wordGod in some of the items. Initial interviews with Christians,Jews, Muslims, agnostics, and atheists indicated a variety ofwords used to refer to the transcendent or divine, but the domi-nant word used was God. Although some aspects of spiritual ex-perience could be addressed without this word, for many spe-cific aspects a single word for the divine was necessary. In thesubsequent testing of the instrument, in which Underwood ex-plored with the respondents what they took the items to mean,most found the word God to be easily understood and the bestword for them. Those outside the Judeo-Christian orientation,including Muslims, people from indigenous religious perspec-tives, and agnostics, were generally comfortable with the word,being able to translate it into their concept of the divine. Theonly group for which this wording did not translate easily wasthe Buddhists. There are a number of other items that do addressBuddhist spiritual experience. The introduction to the instru-ment was subsequently designed to encourage people who arenot comfortable with the word God to substitute another ideawhich calls to mind the divine or holy for you.

Conceptual orientation and rationale for specific items. DSEis composed of a variety of concepts. It was expected that someaspects of DSE would be more important for some people thanfor others and that it was possible that specific componentswould be particularly important for mental and physical health.The interviews revealed that connection was an important con-cept. Western spirituality emphasizes a personal connectionwith God, whereas Eastern and Native American spirituality, forexample, place more emphasis on a connection with all of lifeand on connection as being part of a greater whole (41). Twoitems were developed to address both people whose experienceof relationship with the transcendent is one of personal intimacy(I feel Gods presence) and those who describe a more generalsense of unity as their connection with the transcendent (I ex-perience a connection to all of life).

Many people experience frequent interaction with the tran-scendent as a fundamental part of life, an active involvement ofthe divine in the nitty-gritty of life, and not only in moments of

24 Underwood and Teresi Annals of Behavioral Medicine

Volume 24, Number 1, 2002 Daily Spiritual Experience Scale 25

stress. Social support from the divine can be experienced asinstrumental or emotional. Perception of a supportive interac-tion with the transcendent is measured in this instrument in threeways. The first way is that of strength and comfort (I findstrength in my religion or spirituality and I find comfort in myreligion or spirituality). These were initially separated into twoitems; however, they were highly intercorrelated so that, al-though conceptually different, a case can be made for use ofonly the strength item. Second, perceived divine love (I feelGods love for me directly and I feel Gods love for methrough others). These items measure whether the individualexperiences Gods love rather than whether one just believesthat God loves people generically or that God and love are re-lated conceptually. Feeling loved may prove important in seek-ing to quantify the relation of religious or spiritual issues tohealth outcomes. The quality of love imputed to God can be dif-ferent from the many kinds of love shared by people, with a par-ticular kind of love from others that many attribute to God. Di-vine love, directly and through others, can be experienced asaffirming and can contribute to self-confidence and a sense ofself-worth, independent of actions. The third aspect of interac-tion with the transcendent is when support from the divine maybe experienced as inspiration or discernment (I ask for Godshelp in the midst of daily activities and I feel guided by God inthe midst of daily activities). These items address the expecta-tion of divine intervention or inspiration and a sense that a divineforce has intervened or inspired. The guidance item was mostoften described similar to a nudge from God and more rarelyas a more dramatic action.

The perception that life consists of more than physicalstates, psychological feelings, and social roles may help one intranscending the difficulties of present physical ills or psycho-logical situations. (During worship, or at other times when con-necting with God, I feel intense joy which lifts me out of mydaily concerns). The language of this item translates frommetaphysical terminology into more practical lay language byfocusing on concrete examples that might occur in the context ofa lively worship service or a walk in nature. This has been de-scribed by many as an important feature in dealing with chronicdisease, pain, and disability (15).

A sense of wholeness and internal integration is reflectedfrequently in the spiritual literature of both Eastern and Westerntraditions, with an accompanying sense of inner harmony (Ifeel deep inner peace or harmony). During interviews, personswho had experienced depression insisted that they could havethis experience even in the midst of feeling very distressed. Thissense of peace has a transcendent dimension that may be af-fected but not determined by events and affect, and this questionwas designed to elicit something other than positive mood orpsychological well-being.

Van Kaam (41) suggested that awe is the central quality ofspiritual life and has an ability to elicit experience of the spiri-tual that crosses religious boundaries and affects people with noreligious connections (I am spiritually touched by the beauty ofcreation) (41).

Gratefulness (I feel thankful for my blessings) is consid-ered a central component of spirituality by many (42). Because

of the potential connections between gratitude and circum-stances of life, external life circumstances or stressors maymodify a respondents feelings of gratefulness; however, somepeople find blessings even in the most dire circumstances.

The attitudes of compassion and mercy are more active andless passive than the qualities of experience just mentioned, butthey still result in inner spiritual experience and, therefore, areincluded in this measure. Unconditional love, agape or compas-sionate love, is central to many spiritual traditions (41). The itemI feel a selfless caring for others, which may seem unwieldy,was easily understood by individuals representing a spectrum ofeducational levels. It describes a love centered on the good ofthe other and did not generally connote self-abnegation in the in-terviews assessing content validity. An excellent examination ofthis concept is found in Vacek (43). Mercy, giving others thebenefit of the doubt, dealing with others faults in light of onesown, and being generous of heart, describe inner experiences inwhich the spiritual can be evident in everyday life. The item Iaccept others even when they do things I think are wrong ad-dresses the felt sense of mercy rather than the mere cognitiveawareness that mercy is a good quality. This fundamental accep-tance of others is not the same as forgiveness, which is based onresponse to a particular act. Vaniers writings (44), which use theexample of attitudes toward those with developmental disabili-ties, address this concept thoughtfully.

The final two items assess spiritual longing (I desire to becloser to God or in union with the divine). This is a key conceptin the Muslim tradition (45) and may be more relevant for thosewho are seeking interaction with the divine. The final item(How close do you feel to God?) was originally included as away of calibrating the previous question.

Item format. The measure includes 16 items described inthe following paragraphs; the first 15 are scored using a modi-fied Likert scale, in which response categories are many times aday, every day, most days, some days, once in a while, and neveror almost never. (Use to date as reflected in this article has beensuch that lower scores reflect more frequent DSE: e.g., manytimes a day = 1, never or almost never = 6.) The introduction tothe items states that

The list that follows includes items which you may ormay not experience, please consider how often you di-rectly have this experience, and try to disregardwhether you feel you should or should not have theseexperiences. A number of items use the word God. Ifthis word is not a comfortable one for you, please sub-stitute another idea which calls to mind the divine orholy for you.

Each item is cast in positive terms. Initially, some items werecast in negative terms, but it became clear that this mode of as-sessment measured something other than the opposite to theconcept being addressed, perhaps anomie or alienation. The16th item, In general, how close do you feel to God?, has fourresponse categories: not close at all, somewhat close, very close,and as close as possible.

In addition to the 16-item scale, a 6-item version was de-veloped for incorporation into surveys. The 6-item version ofthe scale, used in the Brief Multidimensional Measure of Reli-giosity and Spirituality (7), was developed by selection ofitems representing a few key aspects of DSE from the 16-itemversion. (This is not a recommended short form for this instru-ment.) The selection of these items was developed in conjunc-tion with inputs from the National Institute on Aging/Fetzerworking group, the goal being to have a set of items to com-plement other domains in the multidimensional instrument.The main reason for the presentation here of these 6 items isthat they were embedded in the General Social Survey (GSS)for 19971998 (46) and therefore allowed us to examine somenormative population data for a subset of DSES items. Thestrength and comfort questions were combined to read I find

strength and comfort in my religion, as the psychometricproperties of the combined item were known, and it has beenextensively used with some predictive data for health. The 2items regarding love directly from God and love from Godthrough others were also combined into 1 item, although it isrecognized that it would be preferable to maintain the 2 sepa-rate items, as correlations with social support may vary be-tween the 2. The additional items are those on presence,touched by beauty, and desire to be in union. Examination ofthe 6-item version in this article provides a basic measure ofspiritual experience and allows us to examine the distributionsof some of these experiences in the general population. Onlyextensive testing of the 16-item version in health studies willpermit identification of the shorter list of items most predictiveof positive health outcomes. See Table 1 for a list of items.

26 Underwood and Teresi Annals of Behavioral Medicine

TABLE 1Summary Statistics for the Daily Spiritual Experience Scale Across Four Sites: Item Means, Standard Deviations,

Scale Alphas, and Intraclass Reliability Coefficients

ChicagoSWANa

LoyolaUniversityb GSSc

Corrected Item-TotalCorrelations

Item Content M SD M SD M SDChicagoSWANd

LoyolaUniversitye GSSf

ICC Reliability(Ohio)g

1. I feel Gods presence. 2.76 1.66 3.00 1.35 3.23 1.67 .86 .79 .77 .712. I experience a connection to all

life.2.96 1.48 3.03 1.17 .69 .83

3. During worship, or at othertimes when connecting withGod, I feel joy, which lifts meout of my daily concerns.

3.48 1.64 3.39 1.22 .85 .76

4. I find strength in my religion orspirituality

2.76 1.54 2.94 1.31 3.23 1.66 .88 .82 .82 .74

5. I find comfort in my religion orspirituality.

2.79 1.51 2.83 1.32 3.23 1.66 .88 .82 .82 .74

6. I feel deep inner peace orharmony.

3.22 1.47 3.38 1.00 3.26 1.40 .81 .67 .70 .64

7. I ask for Gods help in the midstof daily activities.

2.91 1.70 3.39 1.39 .83 .75

8. I feel guided by God in the midstof daily activities.

3.22 1.73 3.60 1.26 .89 .82

9. I feel Gods love for me,directly.

3.06 1.74 3.33 1.37 3.11 1.59 .89 .83 .83 .67

10. I feel Gods love for me, throughothers.

3.03 1.57 3.22 1.28 3.11 1.59 .83 .76 .83 .67

11. I am spiritually touched by thebeauty of creation.

2.58 1.34 2.51 1.26 2.71 1.51 .68 .57 .63 .75

12. I feel thankful for my blessings. 1.97 1.01 2.27 1.08 .73 .66 13. I feel a selfless caring for others. 2.94 1.26 2.80 1.05 .37 .49 14. I accept others even when they

do things I think are wrong.2.85 .99 2.70 1.04 .33 .36

15. I desire to be closer to God or inunion with Him

2.63 1.50 2.75 1.35 3.14 1.62 .72 .75 .80 .78

16. In general, how close do you feelto God?

2.69 .89 2.24 .97 .72 .76

Note. For the GSS site, Items 4 and 5 are equivalent to Item 14b from the Short Form, and Items 9 and 10 are equivalent to Item 14e, also from the ShortForm. SWAN = Study of Women Across the Nation; GSS = General Social Survey; ICC = Intraclass Correlation Coefficient.

an = 233. bn = 122. cn = 1,445. dScale = .95. eScale = .94. fScale = .91. gn = 50.

Samples. Data from several samples are included in this ar-ticle, as follows:

1. Rush-PresbyterianSt. Lukes Medical Center, Chicago,conducted a series of psychometric analyses of the 16-itemDSES as part of the Study of Women Across the Nation(SWAN), a multisite, multiethnic, mulifactorial study of midlife(L. Shahabi & L. Powell, personal communication, March 2,1999). The Chicago site contributed 233 cases for these analy-ses. All were women; 60% were White, 53% were Catholic,18% were Protestant, 21% were Baptist, and 8% belonged toother religions. The mean age was 46.76 (SD = 2.74).

2. The Ohio University Medical Center examined the spiri-tual and religious dimensions of daily life of 45 patients with ar-thritis pain (47). The Ohio study contributed the interrater reli-ability estimates for the six DSES items contained in the GSS.

3. Loyola University (J. Zechmeister, personal communi-cation, March 24, 1999) administered the 16-item DSES to asample of 122 individuals from the University of Chicago area;58% were full-time students. The sample was female (61%),male (49%), White (72%), non-White (28%), Catholic (49%),and non-Catholic (51%). Although the range in age was from 15to 88, the mean was 27.7 (SD = 13.4).

4. The GSS for 19971998 (46) used the 6-item version ofthe DSES among 1,445 individuals nationally. This survey wasdesigned to constitute a random, representative sample of theU.S. population geographically, socioeconomically, and ra-cially. The sample was 79% White and 45% female, with a reli-gious distribution representative of the U.S. population. Themean age was 45.64 (SD = 17.06).

Approach to the analyses. Presented next are (a) descrip-tive and normative data for the DSES, (b) estimates of reliabil-ity, (c) results of EFAs, and (d) preliminary evidence for con-

struct validity. Scale and item means and standard deviations arepresented for several samples and within each sample for differ-ent sex, racialethnic, and religion subgroups. Estimates of in-ternal consistency (Cronbachs ) are presented across threesamples; a fourth study contributed estimates of interrater reli-ability for a subset of DSES items, with the intraclass correla-tion coefficient. Estimates of testretest reliability were alsoprovided for the six items contained in the GSS version of theDSES. The results of EFAs are presented, and preliminary evi-dence for construct validity is discussed in terms of differencesin DSES scores for different demographic and religion sub-groups and correlations of DSE with psychological and otherhealth-related variables.

RESULTSDescriptive Statistics for the DSES

Table 1 shows means and standard deviations for the 16DSES items across three studies: Chicago SWAN, Loyola Uni-versity, and the GSS (the Ohio study provided interrater reliabil-ity estimates with respect to items contained in the GSS but noitem frequencies). From a psychometric standpoint, most items,although somewhat skewed toward the more frequent tail of thedistribution, demonstrate adequate variability. However, few re-spondents endorsed the never or almost never category for Items11 through 14.

Examination of item frequencies (available from Under-wood) and means (Table 1) showed that several statements weremore frequently endorsed across sites. These were I am spiritu-ally touched by the beauty of creation, I am thankful for myblessings, and I desire to be closer to God or in union withhim. Those items less frequently endorsed were During wor-ship, or at other times when connecting with God, I feel joywhich lifts me out of my daily concerns, I feel guided by Godin the midst of daily activities, and I feel Gods love for me, di-rectly.

Correlations Among ItemsExamination of the zero-order correlations among items

(not shown here) for the SWAN study showed that most itemswere moderately to highly intercorrelated (average range of cor-relations = .60.80). Two items, I feel a selfless caring for oth-ers and I accept others even when they do things I think arewrong, had lower correlations (in the .20s) with all other items.However, two items, finds strength in religion, spirituality andfinds comfort in religion, spirituality were collinear. The cor-relation was .96; all responses were almost identical for bothitems. The item wording of the two items is very similar, and re-spondents did not appear to distinguish between the terms com-fort and strength. If this pattern is observed in other samples, it isrecommended that in future work one of the two collinear itemsbe omitted. Although the GSS (46) version combines the items,from a psychometric standpoint, double-barreled items are to beavoided. Because of the problems of collinearity in this data set,EFAs were conducted for both a 16-item version and a 15-itemversion; however, results are shown only for the 15-item version(see Table 2) of the DSES.

Volume 24, Number 1, 2002 Daily Spiritual Experience Scale 27

TABLE 2Exploratory Factor Analyses of the Daily Spiritual Experience

Scale: Factor Loadings from the Structure Matrix

Short Item Wording Factor 1 Factor 2

1. Presence .90 .332. Connection .69 .623. Joy when connecting .88 .394. Strength in R/S 5. Comfort in R/S .89 .386. Deep inner peace .82 .487. God for help .88 .268. Guided by God .93 .299. Love through others .87 .33

10. Love directly .93 .3311. Touched by beauty .68 .6012. Thankful for blessings .74 .5213. Selfless caring .33 .7714. Accept others .27 .7815. Desires to be in union .77 .2616. Close .77 .27

Note. R/S = Religiousness/Spirituality.

Psychometric Analyses of DSES:Classical Test Theory Results

Testretest of six items. It is expected that DSE is rela-tively stable over the short term. However, because this con-struct measures perceptions and feelings, scores may vary ac-cording to external stressors and emotional state. Therefore,assessing response stability over a relatively brief period is ap-propriate. Testretest reliability currently is being assessed withthe entire 16 items; however, the 6 items were incorporated intoa testretest of separate subscales of the Brief MultidimensionalMeasure of Religiousness/Spirituality, the results of which fol-low (48). Forty-seven treatment-seeking substance users weretested for 2-day response stability. The Spiritual Experiencesubscale had good response stability (Pearson productmomentcorrelation = .85; intraclass correlation coefficient =.73). TheCronbachs alpha estimate of internal consistency was .88 fortest and .92 for retest.

Interrater reliability. Interrater reliability is not a concernfor most applications of the DSES because it is usually self-ad-ministered. However, if administered by an interviewer, say, to afrail or very old population, interrater reliability would be ofconcern. Table 1 presents interrater reliability estimates calcu-lated by the Ohio site, with the intraclass correlation coefficientfor 6 items representing 8 of the 16 DSES items (2 DSES itemswere combined in two analyses). As shown, the reliability coef-ficients were adequate, ranging from .64 to .78.

Internal consistency reliability. The internal consistencyreliability estimates with Cronbachs alpha were very high, .94and .95 for the 16-item version of the scale and .91 for the 6-itemscale used in the GSS (46).

EFA. Several EFAs were performed for the Chicago SWANstudy. An exploratory principal components analysis was firstperformed to examine the dimensionality of the DSES. The itemset tended to be unidimensional for this sample. This interpreta-tion was supported by the fact that the first eigenvalue was about10 times that of the second; this can be demonstrated graphicallybythescree test, aplotof theeigenvaluesagainst thefactor rank.

An EFA with an oblique rotation was then performed. Asshown in Table 2, nearly all items loaded highly on the first fac-tor, with loadings ranging from .69 to .93, except for two items,which loaded at .33 and .27; these items loaded more highly on asecond factor (these items were feels selfless caring for othersand accepts others even when they do wrong things). How-ever, a 2-item scale is generally undesirable and, in this case, notmeaningful in terms of explained variance (about 8%). It is alsoto be noted that the items with explicit reference to God did notfactor out separately from those without such reference.

Two other EFAs (not shown here) were performed with thedichotomization of items at two different points: (a) the combi-nation of never and once in a while versus some days to manytimes a day and (b) the combination of never, once in a while,and some days versus most days to many times a day. The resultsof these analyses indicated that the second dichotomization per-

formed somewhat more consistently and yielded results moresimilar to those with the continuous response format. The inter-nal consistency for this latter dichotomous version of the16-item scale was .93. Additional exploratory analyses of twoways of dichotomizing items provided preliminary evidencethat the items could be treated as binary if necessary for popula-tions in which a Likert-type response continuum may be prob-lematic (e.g., the frail or the very old). Details of these analysesare available from Underwood.

Preliminary Construct Validity: Differencesin DSES Scores for Different Demographicand Religion Subgroups

Summary statistics for the DSES were examined acrossseveral samples and subgroups (see Table 3). Means on theDSES 16-item version are about 47 for both the SWAN (SD =18.69) and Loyola (SD = 13.81) studies. The mean score for the6-item GSS version was 18.68 (SD = 7.91). Of note are the lowermean scores for African American women in the SWAN study(37.78, SD = 14.87) in contrast to Whites (52.79, SD = 18.58), t= 6.82, p < .01. This indicates that the responding AfricanAmerican women reported a significantly greater degree of DSEthan did Whites. This pattern was repeated for the GSS (46)6-item version of the scale, t = 8.44, p < .01. This was consistentwith other findings from the GSS (46) data and with studies in-dicating high levels of religiousness among African Americanwomen as measured by religious involvement (both organiza-tional and nonorganizational) and subjective ratings (49).

As would be expected, the GSS (46) data showed that thosewho reported no religion had the highest GSS mean scores(25.91, SD = 7.30), that is, the least frequent daily spiritual expe-riences. Comparison of those with no religion with those whoclaimed to be either Protestant or Catholic showed that the for-mer had significantly different mean scores, reflecting less fre-quent DSEs, F = 126.60, p < .01. Scheff multiple range tests in-dicated that individuals with no religion had significantly lessfrequent daily spiritual experiences than did those who claimedto be Catholic or Protestant. (The score for those ofself-proclaimed Jewish faith showed high frequency daily spiri-tual experiences; however, the subsample size was too small[26] to permit reliable inferences.) Women also reported signifi-cantly more frequent daily spiritual experiences than did men, t= 6.26, p < .01. This was also consistent with other GSS (46)data, with women scoring significantly higher than men on vir-tually every item in the other domains of religiousness or spiri-tuality: public activity, private activity, coping, religious inten-sity, forgiveness, and beliefs.

Correlations With Psychosocial and OtherHealth-Related Variables

In the Chicago SWAN study, frequency of DSE (scoredpositively for this analysis) was significantly negatively corre-lated with a variety of psychosocial factors: anxiety assessedwith the StateTrait Anxiety Inventory (50), depression mea-sured with the Center for Epidemologic StudiesDepression F(51), and the Cohen Perceived Stress Scale (52) (see Table 4). It

28

29

TABL

E3

Mea

nSc

ores

on

the

Dai

lySp

iritu

alEx

perie

nce

Scal

efo

rD

iffere

ntD

emog

raph

icSu

bgro

ups

bySi

te

Sex

Ethn

icity

Relig

ion

Fem

ale

Mal

eW

hite

Afric

anAm

eric

anH

ispa

nic

Oth

erPr

ote

stan

tCa

thol

icJe

wis

hBa

ptis

tCh

ristia

nNo

neO

ther

Chic

ago

SWA

Na

M46

.87

52

.79

37.7

8

46

.79

49.0

9N

Ab

37.9

4

NA

bN

Ab

SD18

.69

18

.58

14.8

7

19

.99

17.0

4N

A15

.61

N

AN

An

233

14

193

3911

7N

Ab

47

NA

bN

Ab

%c

100

60

.339

.7

17

.753

.2N

A21

.4

NA

NA

Loyo

laU

niver

sityd

M46

.45

48.6

548

.85

NA

b40

.00

40

.65

43.7

5

NA

b46

.93

SD13

.48

14.5

114

.17

NA

12.4

0

10.0

214

.25

N

A7.

04n

7446

88N

Ab

12

1360

N

Ab

14%

c60

.737

.772

.1N

A9.

8

10.7

49.2

N

A11

.5G

SSe

M17

.49

20.1

419

.28

14.9

3

19.2

416

.53

19.9

625

.08

16

.35

25.9

117

.06

SD7.

428.

257.

916.

37

8.59

7.10

7.45

8.39

6.

797.

307.

37n

791

654

1,14

319

8

104

783

370

26

2319

817

%c

54.7

45.3

79.1

13.4

7.

255

.326

.11.

8

1.6

14.0

1.2

Note

.In

divid

uals

ampl

esiz

esdo

nots

um

toto

tals

ampl

esiz

ebe

caus

eso

me

sam

ple

sizes

wer

eto

osm

allf

orin

clus

ion.

SWA

N=

Stud

yofW

om

enA

cros

sthe

Nat

ion;

GSS

=G

ener

alSo

cial

Surv

ey.

a n=

233;

theo

retic

alra

nge

=16

94,

obs

erve

dra

nge

=17

89;

b Sam

ples

izew

asto

osm

allf

orth

isgr

oup

(