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Daily Spiritual Experiences Before and After Near-Death Experiences

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People who have near-death experiences (NDEs) often report a subsequently increased sense of spirituality and a connection with their inner self and the world around them. In this study, we examined daily spiritual experiences, using Underwood and Teresi's (2002) Daily Spiritual Experience Scale, among 229 persons who had come close to death. Frequency of daily spiritual experiences before the close brush with death did not differentiate participants who had NDEs (n = 204) from those who did not (n = 25). However, participants who described having had NDEs reported more daily spiritual experiences after their brush with death than those who did not, and frequency of daily spiritual experiences after the brush with death was positively correlated with depth of NDE. We discussed the implications of these findings in light of other reported aftereffects of NDEs and of daily spiritual experiences among other populations.
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Daily Spiritual Experiences Before and After Near-Death Experiences
Surbhi Khanna and Bruce Greyson
University of Virginia Health System
People who have near-death experiences (NDEs) often report a subsequently increased sense of
spirituality and a connection with their inner self and the world around them. In this study, we examined
daily spiritual experiences, using Underwood and Teresi’s (2002) Daily Spiritual Experience Scale,
among 229 persons who had come close to death. Frequency of daily spiritual experiences before the
close brush with death did not differentiate participants who had NDEs (n 204) from those who did
not (n 25). However, participants who described having had NDEs reported more daily spiritual
experiences after their brush with death than those who did not, and frequency of daily spiritual
experiences after the brush with death was positively correlated with depth of NDE. We discussed the
implications of these findings in light of other reported aftereffects of NDEs and of daily spiritual
experiences among other populations.
Keywords: near-death experience, daily spiritual experience, spirituality, religion, spiritual change
The term “spirituality” is used in multiple ways. In a religious
context, it generally refers to the more intrinsic aspect of religious
life; in other contexts, it generally refers to aspects of personal life
that include the “transcendent,” something beyond the usual senses
(Underwood, 2006). Spirituality can also be understood as a search
for the sacred, a process through which people seek to discover,
hold on to, and when necessary, transform whatever they hold
sacred in their lives (Pargament, 1997, 1999). The sacred is a
common denominator between religious and spiritual life and
represents a vital destination sought by a person, and it is inter-
woven into the pathways many people take in life (Hill & Parga-
ment, 2008).
For most people, spiritual development is neither distinct from
nor antithetical to religious affiliation, identification, or involve-
ment (Day, 2010). In contemporary American society, many peo-
ple distinguish between “religion” and “spirituality” (Rambo &
Haar Farris, 2012). Religion usually connotes specific behavioral,
doctrinal, and institutional features whereas spirituality is typically
used to represent an individual’s subjective experiences in attempt-
ing to understand life’s ultimate questions and find meaning and
purpose that transcend the concerns of mundane life (Currier, Kim,
Sandy, & Neimeyer, 2012; Rambo & Haar Farris, 2012).
The United States in particular has witnessed a polarization of
religiousness and spirituality, with the former representing an
institutional, formal, outward, doctrinal, authoritarian, inhibiting
expression and the latter representing an individual, subjective,
emotional, inward, unsystematic, and freeing expression (Koenig,
King, & Carlson, 2012). Americans seem to be more comfortable
with the freedom associated with spirituality, and implied in this
distinction is the emphasis on personal choice and independence
from the constraints of religious ideology (Rambo & Haar Farris,
2012). In 2005, 24% of the U.S. population said they would
describe themselves as “spiritual, but not religious,” 9% indicated
the opposite, and 55% said they were religious and spiritual
(Schultz, 2005). These results are consistent with the concept of
spirituality as an inner attitude different from religiosity, which
relies on an outer institution and/or practices (Rowold, 2011).
Daily Spiritual Experience
Connection with the divine or transcendent is important in
Eastern and Western traditions and in people’s notions of spiritu-
ality in a more generic way (Underwood, 2006). Daily spiritual
experience, encompassing constructs such as awe, gratitude,
mercy, compassionate love, and sense of inner peace, was con-
ceived as an indicator of spiritual experiences of connection with
the transcendent playing out in the experiential and emotional
details of daily life; it was intended to operationalize one major
aspect of spirituality, but it does not capture the full construct
(Underwood, 2006, 2011). Although it has been used as a proxy
for spirituality (Underwood, 2011), in studies in which additional
measures of religiousness or spirituality are also used, daily spir-
itual experience can function differently than religiousness or
overall spirituality, such as in their association with marital satis-
faction (Fincham, Ajayi, & Beach, 2011).
Daily spiritual experiences have been shown to enhance the
lives of persons having them, having been linked to various pos-
itive outcomes in psychological state and relationships. A relation-
ship with the transcendent appears to be enriching and important in
and of itself, independent of any religious association. Hospital-
This article was published Online First August 18, 2014.
Surbhi Khanna and Bruce Greyson, Department of Psychiatry and Neu-
robehavioral Sciences, University of Virginia Health System.
At the time of this work, Surbhi Khanna was a Visiting Research Scholar
at the Division of Perceptual Studies, University of Virginia School of
Medicine. She is currently a psychiatric resident in the Department of
Psychiatry and Neurobehavioral Medicine at the University of Virginia
Health System.
Bruce Greyson is the Chester Carlson Professor of Psychiatry and
Neurobehavioral Sciences and Director of the Division of Perceptual
Studies at the University of Virginia Health System.
Correspondence concerning this article should be addressed to Bruce
Greyson, Division of Perceptual Studies, University of Virginia Health
System, 210 10th Street NE, Charlottesville, VA 22902-4754. E-mail:
cbg4d@virginia.edu
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2014, Vol. 6, No. 4, 302–309 1941-1022/14/$12.00 http://dx.doi.org/10.1037/a0037258
302
ized patients who reported more frequent daily spiritual experi-
ences have better social support, cognitive function, and cooper-
ation with medical staff as well as less depression and need for
long-term care (Koenig, George, Titus, & Meador, 2004).
Near-Death Experience
The term “near-death experience” (NDE) was coined by Moody
(1975) to describe a collection of 15 elements that seemed to recur
during a close brush with death. These elements were a sense of
ineffability, hearing oneself pronounced dead, a feeling of peace,
hearing unusual noises, seeing a dark tunnel, being out of the body,
meeting spiritual beings, encountering a bright light or being of
light, a panoramic life review, a realm where all knowledge exists,
cities of light, a realm of bewildered spirits, a supernatural rescue,
a border or a boundary, and coming back into the body (Moody,
1975). He defined NDEs as “profound spiritual events that happen,
uninvited, to some individuals at the point of death” (Moody &
Perry, 1988). A recent review of the accumulated findings from 30
years of research since Moody’s seminal work has essentially
confirmed his original description; it noted that NDEs are typically
conceptualized as profound perceptions suggestive of a transcen-
dent reality occurring during a close bush with death, in turn
conceptualized as a serious threat of imminent death (Zingrone &
Alvarado, 2009).
An analysis of incidence of NDEs among critically ill patients as
documented in nine prospective studies in four countries yielded
an average estimate of 17% (Zingrone & Alvarado, 2009). With
advancements in medical resuscitation techniques, the frequency
of NDEs has increased; thus, approximately 9 million people in the
United States alone have reported this kind of experience (van
Lommel, 2011). In the last 30 years, the near-death phenomenon
has been investigated extensively (Holden, Greyson, & James,
2009). Popular and academic curiosity about this topic have also
escalated. A recent review of scholarly journals analyzed 829
peer-reviewed articles by 629 authors (Loseu, Holden, Kinsey, &
Christian, 2013), and the search engine Google Scholar yields
440,000 articles about NDE, many of which relate to spirituality
(Cant, Cooper, Chung, & O’Connor, 2012).
NDE and Spirituality
Many near-death experiencers (NDErs) report having had a
transcendent experience involving travel to otherworldly realms,
encountering mystical beings or a “being of light,” and assistance
by spirits (Greyson, 2006). This kind of dramatic mystical expe-
rience is distinct from the more mundane kind of spiritual expe-
rience that the Daily Spiritual Experience Scale (DSES) was
developed to measure (Underwood, 2006, 2011). However, people
who have these more unusual and more intense NDEs often go on
to seek meaning in their daily lives by incorporating a sense of awe
and wonder in every moment of existence (Greyson, 2006; Noyes,
Fenwick, Holden, & Christian, 2009). The spiritual awakening that
often follows NDEs may reflect an attempt to relive and reexpe-
rience the overwhelming positive emotions felt during the NDE
and appreciate the precious gift of life in search for the sacred.
NDEs and other transcendent experiences are often associated
with radical and permanent transformations of experiencers’ atti-
tudes, beliefs, and lifestyle. The aftereffects typically reported are
increases in spirituality, concern for others, and appreciation of life
as well as decreases in the fear of death, materialism, and com-
petitiveness (Greyson, 2006). A recent review of research into the
characteristic changes after NDEs found the most commonly re-
ported to be loss of fear of death; strengthened belief in life after
death; feeling specially favored by God; a new sense of purpose or
mission; heightened self-esteem; increased compassion and love
for others; lessened concern for material gain, recognition, or
status; greater desire to serve others; increased ability to express
feelings; greater appreciation of and zest for life; increased focus
on the present; deeper religious faith or heightened spirituality;
search for knowledge; and greater appreciation for nature (Noyes
et al., 2009).
Overview of Study
The goal of this study was to explore the relationship between
NDE and daily spiritual experience. Although NDEs and daily
spiritual experiences involve a sense of transcendence, the extreme
and dramatic features of NDEs do not overlap significantly with
the more mundane daily spiritual experiences as described by
Underwood and Teresi (2002). The hypothesis to be tested in this
study was whether extremely intense NDEs are associated subse-
quently with a more moderate spiritual appreciation of everyday
events.
We used the Near-Death Experience Scale (Greyson, 1983)to
identify and quantify NDE and the DSES (Underwood & Teresi,
2002) to assess the frequency of daily spiritual experience. To
clarify the nature of the relationship between NDE and daily
spiritual experience, we asked participants to rate their frequency
of daily spiritual experience with regard to the period before their
NDE and with regard to the period after their NDE. We hypoth-
esized that frequency of daily spiritual experience before a close
brush with death would not predict occurrence and depth of NDE,
but that occurrence and depth of NDE would predict frequency of
subsequent daily spiritual experience.
Method
Participants
Participants were 229 individuals who had previously contacted
the authors to share their accounts of their experiences when they
had come close to death. Of those 229 participants, 204 (89%)
reported experiences that qualified as NDEs by scoring 7 or higher
on the NDE Scale (see NDE) whereas 25 (11%) reported experi-
ences that did not.
Table 1 lists demographic variables and parameters of the close
brush with death for the NDErs and nonexperiencers. In terms of
demographic variables, the two groups were statistically indistin-
guishable in gender; ethnicity; and religious identification, which
was categorized as Catholic, Protestant, “other” religious identifi-
cation (including various non-Christian denominations and “spir-
itual but not religious”), and agnostic or atheist. In terms of details
of the close brush with death, the two groups were statistically
comparable in age at the time of the near-death event, years
elapsed since that experience, and self-reported closeness to death.
However, the overall emotional tone of the experience was signif-
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DAILY SPIRITUAL EXPERIENCES BEFORE AND AFTER NDE
icantly more pleasant among those who reported NDEs and more
neutral or unpleasant among those who did not.
Procedure
Participants were mailed or e-mailed a brief questionnaire about
their demographic background and details of their close brush with
death as well as two standardized, self-rated questionnaires: the
NDE Scale and the DSES. They were asked to complete the DSES
twice: once with regard to the retrospective period before the close
brush with death and a second time with respect to the concurrent
period since the close brush with death. Participants completed
these questionnaires at a time and place of their choosing and
returned them by mail or e-mail.
Measures
NDE. The NDE Scale (Greyson, 1983), a self-rated, 16-item,
multiple-choice questionnaire, was used to assess NDEs. It has
been shown to differentiate NDEs from other close brushes with
death (Greyson, 1990); to correlate highly with the Weighted Core
Experience Index (Ring, 1980), an earlier measure of NDEs (r
.90, p .001); and to have high internal consistency (Cronbach’s
␣⫽.88), split-half reliability (r .84, p .001), and test–retest
reliability over a short-term period of 6 months (r .92, p .001;
Greyson, 1983) and over a long-term period of 20 years (r .83,
p .001; Greyson, 2007). A Rasch rating-scale analysis estab-
lished that the NDE Scale yields a unidimensional measure, in-
variant across gender, age, intensity of experience, or time elapsed
since the experience (Lange, Greyson, & Houran, 2004). Although
the NDE Scale was developed as an ordinal scale without quanti-
fied anchor points, the fact that it satisfactorily fits the Rasch
model suggests that for all practical purposes, there do appear to be
equal distances between the points of measurement that give the
scale interval-level measurement properties (Wright & Masters,
1982).
The 16 items on the NDE Scale explore cognitive changes
during the experience, such as an altered sense of time; affective
changes, such as intense feelings of peace; purportedly paranormal
experiences, such as a sense of separation from the physical body;
and purportedly transcendental experiences, such as an encounter
with a mystical being or presence. Scores on the NDE Scale can
range from 0 to 32; a score of 7, 1 SD below the mean of 15, is
generally used as a criterion for considering an experience to be a
NDE (Greyson, 1983).
Daily spiritual experience. The DSES was developed by
Underwood and Teresi (2002) to measure ordinary spiritual expe-
riences of connection with the transcendent in daily life (Under-
wood, 2006, 2011; Underwood & Teresi, 2002). It was constructed
to be one module in a multidimensional measure of religiousness/
spirituality, funded by the National Institute on Aging and the
Fetzer Institute, to assess the health implications of religiousness
and spirituality (Idler et al., 2003). Subsequent analysis has found
that the DSES forms a useful and psychometrically valid single
factor within the larger Multidimensional Measurement of Reli-
giousness/Spirituality (Stewart & Koeske, 2006).
The DSES was constructed as a scale equally acceptable to
those comfortable with theistic language and those who are not
(Underwood, 2011). The DSES includes constructs such as awe,
gratitude, mercy, sense of connection with the transcendent, com-
passionate love, awareness of discernment or inspiration, and
sense of deep inner peace. Perhaps because the experiences tapped
by this scale are feelings and sensations, rather than specific
cognitive beliefs (Underwood, 2011), items on the DSES resonate
with many people who do not identify themselves as religious but
do feel a connection with something unseen that transcends the
individual (Currier et al., 2012; Underwood, 2011).
Table 1
Demographic and Brush-With-Death Characteristics of the Participants
Variable NDErs Non-NDErs Test Statistic p
Gender
2
0.90 (df 1)
ns
Male 55 (27%) 9 (36%)
Female 149 (73%) 16 (64%)
Ethnicity
2
0.31 (df 1)
ns
Caucasian 180 (88%) 12 (92%)
Other 24 (12%) 2 (8%)
Religious identification
2
4.56 (df 3)
ns
Catholic 32 (17%) 3 (13%)
Protestant 58 (31%) 7 (29%)
Other, non-Christian 88 (47%) 10 (42%)
Atheist or agnostic 10 (5%) 5 (17%)
Age at time of brush with death 28.8 ( 13.0) 33.0 ( 17.5) t –1.48 (df 225) ns
Years since brush with death 35.6 ( 15.4) 37.2 ( 18.3) t –0.48 (df 214) ns
Closeness to death
2
4.01 (df 2)
ns
Loss of vital signs or declared
dead 55 (32%) 3 (17%)
Life threatened without loss of
vital signs 56 (33%) 10 (56%)
Life not threatened 61 (36%) 5 (28%)
Emotional tone of experience
2
41.55 (df 2)
.001
Pleasant 179 (89%) 10 (40%)
Neutral or mixed 11 (6%) 10 (40%)
Unpleasant 11 (6%) 5 (20%)
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KHANNA AND GREYSON
The DSES is a 16-item self-report modified Likert-type instru-
ment administered together with a brief introduction. Cronbach’s
values for the scale have consistently been 0.89 and higher with
adequate item distribution and skew as well as good test–retest
reliability on the order of 0.85 (Underwood, 2011). Despite some
trait-like consistency over time, the DSES also demonstrates state-
like variability over time, and repeated administrations have been
used to document change over time in various health-care, sub-
stance abuse, education, and religious studies (Underwood, 2006,
2011).
Some studies have factored the DSES into two components
comprising nine “God-items,” referred to as the Theistic factor,
and five “non-God-items,” referred to as the Self-Transcendent
factor, although the specific items loading on each factor may
differ from one study to another and scores on the two factors were
highly correlated (Currier et al., 2012; Zemore & Kaskutas, 2004).
Self-identified theists and nontheists do not generally respond to
the two factors differently (Underwood, 2011). The original article
on the scale’s psychometric properties demonstrated a single factor
(Underwood & Teresi, 2002), and translations of the DSES into
Chinese, Spanish, French, Brazilian Portuguese, and German have
shown loading on a single factor, suggesting that the single factor
solution is the preferred one at this point (Underwood, 2011),
although there are suggestions that the scale items may cluster
meaningfully within certain populations based on their theistic
assumptions (Underwood, 2006).
For the purposes of this study, mean per-item scores were
calculated as the most useful measure for analysis rather than total
score, and the DSES was scored with higher scores indicating
more frequent daily spiritual experiences, as recommended to
reduce confusion (Underwood, 2011). In addition, ratings on the
final item, which has a four-point Likert scale, were spread over a
six-point spectrum, as recommended to facilitate calculation of a
total mean per-item score (Underwood, 2006).
Statistical Analysis
Pearson correlation coefficients were used to assess the associ-
ations of DSES scores with NDE Scale scores, and the association
between DSES scores before and since the close brush with death;
t tests were used to assess the association of DSES scores with
having or not having a NDE during the close brush with death. All
data analyses were performed using SPSS 20 (IBM, Armonk, NY).
Results
NDE
Scores on the NDE Scale ranged from 0 to 32, with a mean of
15.01 (SD 6.73); Cronbach’s was .82. Among those partici-
pants who had NDEs, NDE Scale scores ranged from 7 to 32, with
a mean of 16.40 (SD 5.87), and among those participants who
did not have NDEs, NDE Scale scores ranged from 0 to 6, with a
mean of 4.28 (SD 1.72). The difference between the two groups
was statistically significant (t 10.24, df 229, p .001).
Daily Spiritual Experience Before and Since the Close
Brush With Death
For the retrospective period before the close brush with death,
mean per-item score on the DSES was 2.71 (SD 1.08). It should
be noted that 11 (5%) of the NDErs and 3 (12%) of the non-NDErs
did not complete the DSES for the period before the close brush
with death because that event had occurred during early childhood.
For the concurrent period since the close brush with death, mean
per-item score on the DSES was 4.35 (SD 1.17). DSES scores
for the periods before and since the close brush with death were
positively correlated (r .40, p .001). Cronbach’s for the
DSES in this sample was .95.
Daily Spiritual Experience Before the Close Brush
With Death and NDEs
For the retrospective period before the close brush with death,
the mean DSES score for the NDErs was 2.72 (SD 1.08) and for
those who did not have NDEs it was 2.62 (SD 1.07). As shown
in Figure 1, scores on the DSES before the close brush with death
were statistically indistinguishable between those participants who
reported NDEs than those who did not (t 0.43, df 212; NS).
Likewise, depth of NDE as measured by continuous NDE Scale
score was not significantly associated with scores on the DSES for
the period before the close brush with death (r .05, ns).
Daily Spiritual Experience Since the Close Brush With
Death and NDEs
For the concurrent period since the close brush with death, the
mean DSES score for NDErs was 4.50 (SD 1.05), and for those
who did not have NDEs it was 3.16 (SD 1.38). As shown in
Figure 2, scores on the DSES since the close brush with death were
significantly higher for those participants who reported NDEs than
for those who did not (t 5.81, df 227, p .001). Likewise,
depth of NDE as measured by continuous NDE Scale score was
positively associated with scores on the DSES for the period since
the close brush with death (r .46, p .001).
Scores for 15 of the 16 individual items on the DSES were
significantly higher for those participants who reported NDEs than
for those who did not, the exception being “I feel thankful for my
blessings,” which was the item most frequently endorsed by the
non-NDErs. Scores on each individual item were significantly
associated with scores on the NDE Scale, with correlation coeffi-
cients ranging from .18 for “I feel thankful for my blessings” to .43
for “During worship, or at other times when connecting to God, I
feel joy, which lifts me out of my daily concerns.”
An exploratory factor analysis of the DSES for the period after
the NDE yielded one factor with an eigenvalue of 9.475 that
explained 59% of the variance. All 16 items loaded significantly
onto this single factor, with factor loadings ranging from .47 to .89,
and all were statistically significant at p .001. No other com-
ponent extracted had an eigenvalue greater than 1.
Change in Daily Spiritual Experience and NDEs
The mean change in DSES score for the entire sample from before
to after the close brush with death was 1.70 ( 1.20). This increase
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305
DAILY SPIRITUAL EXPERIENCES BEFORE AND AFTER NDE
in daily spiritual experience was statistically significant (t 20.29,
df 213, p .001) and was positively correlated with depth of NDE
as measured by the NDE Scale (r .36, p .001). The increase in
DSES score from before to after the close brush with death for NDErs
was 1.81 (SD 1.18) and for those who did not have NDEs it was
0.65 (SD 0.88). As shown in Figure 3, the difference between the
two groups was statistically significant (t 4.48, df 214; p .001).
Discussion
Data from this study suggest that NDEs are associated with an
increase in daily spiritual experiences as measured by the DSES
and that this increase varied proportionally with the “depth” of the
NDE. Frequency of daily spiritual experience was significantly
higher after the close brush with death than before the close brush
Figure 1. Scores on DSES before the close brush with death.
Figure 2. Scores on DSES since the close brush with death.
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306
KHANNA AND GREYSON
with death. Further, frequency of daily spiritual experience after
the close brush with death was significantly higher for those
participants who reported NDEs than for those who did not. In
addition, among those who did have NDEs, depth of NDE as
measured by continuous NDE Scale score was positively associ-
ated with frequency of daily spiritual experience since the close
brush with death. It is plausible that deeper NDEs may promote a
stronger connection with the inner spiritual self, which translates
into significantly more frequent daily spiritual experiences com-
pared with people who come close to death and do not experience
an NDE. However, it should be noted that even participants who
did not have NDEs reported an increase in daily spiritual experi-
ences since their close brush with death, albeit significantly
smaller than that of NDErs.
The association between depth of NDE and increase in daily
spiritual experience raises the question of whether some under-
lying personality factor mediating perception might influence
reports of NDEs and daily spiritual experiences. However, 30
years of investigation into possible personality traits influenc-
ing NDE incidence or content have failed to identify any such
factor (Holden, Long, & MacLurg, 2009). Furthermore, the
absence of any difference in daily spiritual experience between
NDErs and non-NDErs before the close brush with death makes
the influence of a predisposing personality factor a less tenable
hypothesis.
Prior research has established that NDErs often report a greater
appreciation for life, a renewed sense of purpose, greater confi-
dence and flexibility in coping with life’s vicissitudes, increased
values of love and service, greater compassion for others, a height-
ened sense of spiritual purpose, decreased concern with personal
status and material possessions, and a greatly reduced fear of death
(Greyson, 2006; Noyes et al., 2009). This study extends those
findings to suggest that NDErs also report significantly more daily
spiritual experiences. It is possible that the increase in daily spir-
itual experiences noted after NDEs is related not to the NDE itself
but rather to the previously noted changes in spiritual attitudes and
practices, which might function as intervening variables mediating
the association shown here between NDEs and subsequent in-
crease in daily spiritual experience.
An exploratory factor analysis of the DSES among participants
who had NDEs resulted in one meaningful factor that included all
16 items. This result was compatible with several prior studies
suggesting that a one-factor solution was preferred (Underwood,
2011), although in certain populations the scale yielded distinct
factors that seemed to reflect Theistic and Self-Transcendent ele-
ments. Currier et al. (2012) suggested that theistic items were more
often endorsed by those with a more formal religious orientation,
whereas self-transcendent items seemed unrelated to religiousness.
Those with a greater sense of internalized religiousness seemed to
equally engage theistic and nontheistic approaches (Currier et al.,
2012). NDEs have been shown previously to be associated with a
decrease in allegiance to formal religious organizations and prac-
tices and an internalized sense of relationship to the transcendent
(Greyson, 2006). Data from this study were consistent with those
findings in that NDErs endorsed all of the theistic and all but one
of the self-transcendent items more frequently than nonexperienc-
ers, more frequently than they had before their NDEs, and in direct
proportion to the depth of their NDE. Thus, NDErs do not seem to
be a group for which the distinction between theistic and nonthe-
istic items is meaningful.
Limitations
The self-selection of participants in this study may have limited
the generalizability of these findings. We have no guarantee that
participants were comparable to NDErs who did not choose to
Figure 3. Change in DSES scores from before to since the close brush with death.
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DAILY SPIRITUAL EXPERIENCES BEFORE AND AFTER NDE
participate in the study. It is conceivable that NDErs who had a
subsequent increase in daily spiritual experience were more likely
to participate than those who did not. However, our study sample
did include participants who reported a wide range of daily spir-
itual experience frequencies.
In addition, our reliance on retrospective self-reports of experi-
ences may limit confidence in our findings. Any retrospective
report of subjective experience may be vulnerable to memory
decay, distortion, or fabrication. A prior study of the consistency of
NDE Scale scores over a period of decades suggested that passage
of time did not materially influence memories of the experience
(Greyson, 2007). However, there are no comparable data bearing
on the reliability of DSES scores over a period of many years. The
DSES was originally developed to focus on daily spiritual expe-
riences in the present and the recent past, and it has not previously
been used to assess experiences in the remote past. There is no
empirical or theoretical basis for suspecting the DSES to be any
more or less prone to retrospective bias than any other instrument
(L. Underwood, personal communication, February 11, 2013).
However, one might expect that if memory bias were playing a
role in the present study, NDErs, who reported more frequent daily
spiritual experiences that non-NDErs in the present, might also
report more frequent daily spiritual experiences in the past because
of their increased attention to the transcendent in life. However,
that was not the case.
In addition, a post hoc analysis of the effect of years elapsed
since the close brush with death did not show any consistent bias
in reports of either NDE or daily spiritual experience. Number of
years elapsed since the brush with death (range 481 years) was
not significantly associated with scores on the NDE Scale
(r ⫽⫺.11), DSES scores for the retrospective period before the
close brush with death (r .05), or DSES scores for the concur-
rent period since the brush with death (r .01).
This study assumed that NDEs are unitary phenomena, and
indeed a Rasch rating-scale analysis of the NDE Scale lends
statistical support to that unidimensional approach (Lange et al.,
2004). However, it is conceivable that different types of NDE
might be differentially associated with subsequent spiritual
growth. The possibility of differential effects of different types of
NDE might further limit the generalizability of these findings and
suggest future research aimed at elucidating the particular NDE
features that may be associated with subsequent increase in daily
spiritual experience. For example, it may be helpful in future
research to distinguish among (a) pleasurable versus distressing
NDEs; (b) NDEs that involve specific phenomenological features,
such as apparent out-of-body experiences or apparent visits to
other realms; (c) NDEs associated with different kinds of near-
death crises; and (d) NDEs occurring in the setting of specific
religious or spiritual rituals (Hood & Williamson, 2011). This
study showed that deeper NDEs are associated with quantitatively
more daily spiritual experiences; it may also be fruitful to look for
qualitative differences in daily spiritual experience with increasing
NDE depth.
Finally, participants from different cultural or faith back-
grounds may differ in their understanding of the items pertain-
ing to spiritual experience, and to the extent that that problem
exists, it may be obscured by the mass distribution of standard-
ized questionnaires as in this study (Chen, Yang, Hood, &
Watson, 2011).
Conclusion
The data from this study suggest that NDEs may be considered
a form of spiritual awakening in that individuals have subsequently
more daily spiritual experiences. These data also provide addi-
tional support for the utility of the DSES and provide additional
evidence for the one-factor solution among populations without a
specific formal theistic orientation. We hope that further investi-
gation into NDEs may provide access to aspects of consciousness
that have been to this date difficult to evaluate in scientific terms
but that may illuminate ways of enhancing quality of life. Under-
standing the mechanisms behind the association between NDE and
daily spiritual experience may provide insight into fundamental
questions of the quest for meaning.
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Received April 20, 2013
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Accepted May 12, 2014
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309
DAILY SPIRITUAL EXPERIENCES BEFORE AND AFTER NDE
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ZET Amaç: Kardiyak arrest (KA) geçiren ve kardiyopulmoner resüsitasyon uygulanan hastaların kognitif süreçler yaşayabileceği, bazılarının ise arrest süresince yaşadıkları olayları bilincin varlığını gösterecek şekilde ve doğru olarak anlatabildikleri belirtilmektedir. Bu araştırmada kardiyak arrest sonrası yaşama dönenlerde ölüm eşiğine yakınlaşma deneyimlerinin incelenmesi amaçlandı. Gereç ve Yöntem: Araştırma niteliksel tipte yapıldı. Özel bir hastanenin kardiyoloji yoğun bakım kliniklerinde yatışı yapılmış ve bu süreçte arrest olup başarılı resüstasyon ile yaşama geri dönmüş 12 hasta örneklemi oluşturdu. Örneklem seçiminde amaçlı örnekleme yöntemi kullanıldı. Bu kliniklerin alınma nedeni araştırmacılardan birinin bu kurumda çalışıyor olması ve bu hastalara başarılı resüstasyon yaparak yaşama geri döndürmüş olmasıdır. Veriler yüz yüze derinlemesine görüşme yöntemi ile Mart-Mayıs 2019 tarihleri arasında toplandı. Derinlemesine görüşmede; literatür incelemesi ve uzman görüşü alınarak belirlenen anahtar sorular ve her bir anahtar soruyu açıcı rehber soruların bulunduğu " Yapılandırılmamış Soru Formu", "Bireysel Bilgi Formu ile Bilgilendirme ve Onam Formu kullanıldı. Literatüre dayalı olarak oluşturulan taslak form üzerinde iki akademisyen ve alandan bir uzman hekim ile görüşüldü, anlam bozuklukları ve eksiklikler giderildi. Görüşmeler hastanenin toplantı odasında gerçekleştirildi. Yapılan görüşmelerin her biri yaklaşık 40-50 dakika sürdü ve görüşmeler hem katılımcılar hem de araştırmacılar tarafından yeni bir bilgi kalmayıncaya kadar devam edildikten sonra sonlandırıldı. Görüşmelerde; gizlilik esasına dayalı olarak katılımcılara kod verildi (Kod: K.1, E.1) ve ses kaydı alındı. Araştırmada görüşmeler sonunda elde edilen veriler ses kayıt cihazından bilgisayara aktarıldı. Verilerin analizinde kodlamaya dayalı içerik analizi kullanıldı. Bu analizde birbirine benzeyen veriler belirli kavramlar ve temalar altında sınıflandırıldı ve anlaşılır biçimde düzenlenerek yorumlandı. Bireysel bilgilerin frekans ve yüzdeleri hesaplanıp ifade edildi. Elde edilen veriler ayrıntılı olarak raporlaştırıldı ve doğrudan alıntılara yer verilerek araştırmanın geçerliliği sağlandı. Bulgular: Araştırmadan elde edilen bulgulara göre katılımcıların %75'i erkek, yaş ortalaması 63, %50'si üniversite mezunu, dini eğilim olarak %41,7'si Deist, %50'si, Dindar olarak kendilerini tanımladı. Araştırmaya katılanların %75'i bunu bir ölüm deneyimi olarak değerlendirdi. Katılımcıların görüşme sorularına verdikleri yanıtlar genel olarak incelendiğinde bu süreçte "rahatlama" ve "huzur hissi" nin olduğu, "zamanın hızla geçtiği", "derin bir karanlıktan ışığa çıkıldığı", "ağrı ve acının hissedilmediği", hayata ikinci kez dönmenin "mutluluğunu" yaşamın çok değerli olduğunu ifade ettikleri belirlendi. Sonuç: Kardiyak arrest sonrası yaşama dönenlerde ölme eşiğine yaklaşma deneyimlerinin incelendiği bu çalışmada katılımcıların büyük kısmı bu süreci "ölüm deneyimi" olarak kabul ettiklerini belirtti. Ayrıca görüşme yapılan hastaların kardiyak arrest sürecinde yaşadıkları olayları tanımlama şekilleri ve ifadeleri bilincin varlığını gösterecek şekilde; "huzur hissi", "derin bir karanlıktan ışığa çıkış" ifadeleri ile açıkladıkları belirlendi. Araştırmanın daha geniş örneklemle tekrarlanmasının yanı sıra, arrest sürecinde görev alan sağlık profesyonellerinin bu konuda bilgilendirilmeleri önerilmektedir. ABSTRACT Objectıves: Patients with cardiac arrest (CA) who undergo cardiopulmonary resuscitation may experience cognitive processes, and some may accurately describe the events experienced during the arrest, indicating the presence of consciousness. The aim of this study was to investigate the approaches to near death experiences in patients who returned to life after cardiac arrest. Materials and Methods: The study was conducted in qualitative type. The sample consisted of 12 patients hospitalized in the 6 cardiology intensive care clinics of a private hospital who were arrested and returned to life with successful resuscitation. Purposeful sampling method was used in sample selection. The reason for these clinics is that one of the researchers is working at this institution and has successfully resuscitated these patients and returned them to life. Data were collected between March and May 2019 by face-to-face interview method. In-depth interview; Key questions determined by literature review and expert opinion and forms containing guiding questions for each key question were used. These forms were Semi-Structured Questionnaire, Individual Information Form and Informing and Consent Form. Two academicians and one specialist physician were interviewed on the draft form based on the literature, meaning disorders and deficiencies were resolved. Interviews were held in the meeting room of the hospital. Each of the interviews lasted approximately 40-50 minutes and was terminated after the interviews were continued by both participants and researchers until there was no more information available. Interview; On the basis of confidentiality, participants were given a code (Code: K.1, E.1) and audio recording was taken. The data obtained from the interviews were transferred from the voice recorder to the computer. Coding-based content analysis was used for data analysis. In this analysis, similar data were classified under certain concepts and themes and interpreted in a comprehensible manner. Frequency and percentages of individual information were calculated and expressed. The data obtained were reported in detail and the validity of the study was ensured by direct quotations. Results: According to the findings of the study, 75% of the participants were male, the average age was 63, 50% were university graduates, as religious tendency, 41.7% Deist and 50% as religious. 75% of the respondents evaluated this as a death experience. When the answers given by the participants to the interview questions were examined in general, it was determined that there was "a feeling of relaxation and serenity", "time passed rapidly, light emitted from a deep darkness", "pain and pain were not felt", and the happiness of returning to life for a second time was very valuable. Conclusion: In this study where the experience of approaching the threshold of dying was examined in those who returned to life after cardiac arrest, most of the participants stated that they accepted this process as a "death experience.. In addition, the forms and expressions of the interviewed patients describing the events they experienced during the cardiac arrest process indicate the presence of consciousness; The feeling of peace, from a deep darkness to light with expressions were identified. In addition to repeating the study with a larger sample, it is recommended that health professionals involved in the arrest process be informed about this issue.
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In recent times, religiosity and spirituality have received much attention towards mental health, but very few investigations worked on their role on life satisfaction within the gender perspective. The present study, however, investigates the relationships between religiosity, spirituality, and life satisfaction among individuals residing in Haripur, Khyber Pakhtunkhwa (KPK) Pakistan, with special reference to gender. For this purpose, a sample of 150 adults (71 men and 79 women) were selected by convenient sampling technique and was evaluated using validated versions of three scales: Religious Orientation Scale (ROS), Spirituality Scale (SS), and Satisfaction with Life Scale (SLS). Results indicate that religiosity and spirituality have a significant positive correlation with life satisfaction. Results of linear regression showed that religiosity and spirituality significantly predict life satisfaction. Women reported more religious orientation and spirituality as compared to men in the sample studied. The study is useful for both men and women, highlighting the importance of one's orientation towards religion.
Chapter
Near-death experiences (NDEs) have been reported across time and cultures and more recently with increased frequency, in part due to improved survival rates from near-fatal encounters. As anomalous psychological phenomena often occurring in near-death situations, NDEs represent a radical departure from everyday normative experiences and are typically characterized by their transcendence of space, time, and perceptual boundaries. Although consensus regarding a definition of NDEs is yet to be achieved, less disputed is the profound impact such experiences effect in the lives of those who have them, particularly in regard to notions of religiosity and spirituality. This chapter will consider NDEs and their influence. After defining NDEs, considering causal explanations, and identifying cultural and motivational factors influencing the social reporting of NDEs, the chapter will explore the impact of NDEs on religious faith and spirituality and provide some explanatory propositions for reflection.
Presentation
Background: Spirituality and religiosity are salient among young adults and are associated with several positive physical and mental health outcomes. Prior research suggests that these constructs should be assessed multidimensionally in order to gain a full understanding of these phenomena. Informed by the Meaning Making Model, the current study examined patterns of spirituality and religiosity and their associations with meaning-making and sociodemographic factors. Method: Racially diverse, non-university attending young adults (N=199; 74.5% Black, 11.1% White, 10.6% Multiracial, 2% Latinx, 1.5% Other; 49% female) were recruited from a vocational program in the Midsouthern US. Participants completed measures of sociodemographics, spirituality, religiosity, and meaning-making. Latent profile analysis was used to identify profiles of spirituality and religiosity and examine associations between these profiles and meaning-making and sociodemographics. Results: Four profiles emerged, including Class 1 (Average Spirituality/Religiosity, Higher Negative Religious Coping), Class 2 (High Religiosity, Mixed Spirituality), Class 3 (Low Religiosity, Low to Average Spirituality), and Class 4 (Highest Spirituality/Religiosity and Lower Negative Religious Coping). Members of Class 4 had higher meaning-making scores. Identifying as White and identifying as male were significant predictors of class membership. Conclusion: Nuanced patterns of spirituality and religiosity were identified. Results highlight the potential salience of meaning making among young adults with high spirituality and religiosity and low negative religious coping. Findings have potential implications for future work examining mechanisms across spirituality and religiosity and meaning-making. Interventions aimed at improving meaning-making among this population may be enriched by incorporating elements of spirituality and religiosity.
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According to Google Scholar, the 1st edition of the Handbook, published in 2001, is the most cited of any book or research article on religion and health in the past forty years (Google 2011). This new edition is completely re-written, and in fact, really serves as a second volume to the 1st edition. The 2nd edition focuses on the latest research published since the year 2000 and therefore complements the 1st edition that examined research prior to that time. Both volumes together provide a full survey of research published from 1872 through 2010 -- describing and synthesizing results from over 3,000 studies. The Second Edition covers the latest original quantitative scientific research, and therefore will be of greatest use to religion/spirituality-health researchers and educators. Together with the First Edition, this Second Edition will save a tremendous amount of time in locating studies done worldwide, as well as provide not only updated research citations but also explain the scientific rationale on which such relationships might exist. This volume will also be of interest to health professionals and religious professionals wanting to better understand these connections, and even laypersons who desire to learn more about how R/S influences health.
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