































Graduate Student Journal of Psychology          Copyright 2012 by the Department of Counseling and Clinical Psychology 
2012, Vol. 14               Teachers College, Columbia University 

22 
 

 
Religious Change and Depressive Symptoms among Youth in Foster Care 

With or Without a History of Sexual Abuse
 

Steven Pirutinsky 
Teachers College, Columbia University 

 
Research suggests that trauma, such as childhood sexual abuse (CSA), disrupts key social-cognitive 
assumptions including religious beliefs.  Limited previous studies examined adult reports and 
compared group means on measures of religiosity.  Yet CSA may both increase and decrease 
religiosity, and, therefore, group means may be deceptive.  The current study explored religious 
change and depression among adolescents in foster care with and without CSA over a two-year 
period (n = 407).  Results indicated that youth with a history of CSA were no more likely to report 
changes in religious affiliation or belief over the study period, as compared to youth without a 
history of CSA.  Among youth without a history of CSA, changes in religious affiliation and beliefs 
were associated with increased depression.  For youth with a history of CSA, religious changes 
were unrelated to depressive symptoms.  It appears that the impact of religious change is context-
dependent, and further research using longitudinal designs appears warranted and necessary. 

 
 
 Research and theory suggest that trauma can disrupt 
basic assumptions about the world and oneself in key social-
cognitive areas such as safety, trust, power, and self-esteem, 
leading to distress (McCann & Pearlman, 1990; Resick, 
Monson, & Rizvi, 2008).  For some, these basic assumptions 
are linked to religious and spiritual beliefs.  Therefore, many 
hypothesize that trauma may disrupt religion and spirituality 
(Falsetti, Resick, & Davis, 2003; Walker, Reid, O’Neill, & 
Brown, 2009).  Considerable research has documented the 
negative impact of childhood sexual abuse (CSA) on multiple 
indices of psychological functioning (Jumper, 1995; Paolucci, 
Genuis, & Violato 2001), and qualitative studies indicate that 
CSA survivors report negative images of God (Imbens & 
Jonkers, 1992), lower religious practices and beliefs (Hall, 
1995; Lawson, Drebing, Berg, Vincellette, & Penk, 1998), 
and spiritual disconnection (Flaherty, 1992).  On the other 
hand, religion and spirituality can be protective, as other 
studies have found that they help survivors reduce distress 
(Weber & Cummings, 1999), maintain resilience (Valentine 
& Feinauer, 1993), and construct meaning (Glaister & Abel, 
2001).   
 Quantitative research has been limited and results mixed, 
with some studies reporting less belief among adults with a 
history of CSA and others more belief (see Falsetti et al., 
2003 and Walker et al., 2009 for reviews). Previous studies 
have almost exclusively utilized retrospective reports of 
adults, comparing those with a history of CSA to those 
without such history on mean level of religiosity and 
spirituality.  Yet the influence of CSA on religiosity and 

                                                 
Steven Pirutinsky, M.S., Teachers College, Columbia 

University. 
Correspondence concerning this article should be addressed to 

Steven Pirutinsky; Department of Clinical and Counseling 
Psychology; Teachers College, Columbia University; Box 303, 525 
West 120th St., New York, NY 10027. Email: 
sp2813@columbia.edu.  

spirituality is likely bi-directional; while some seek new 
sources of spiritual support and significance to cope, others 
may find their beliefs shattered (e.g., “God would not have 
allowed this to happen”) and renounce them (Pargament, 
Desai, & McConnell, 2006).  As demonstrated by Bonanno 
and colleagues (2002), aggregating data obscures divergent 
patterns of response to trauma, as cross-sectional designs 
examining group means cannot capture individual increases 
and decreases.  Consequently, longitudinal research 
examining individual trajectories of change is necessary. 
 
Religious Change and Distress 

 The psychological impact of CSA-related religious and 
spiritual change remains unclear.  A large body of research 
suggests that religion plays a pivotal role in helping patients 
adjust and cope with stress, grief, and trauma (Koenig, 
George, & Siegler, 1988; Pargament, 1997).  Common 
religious coping strategies include seeking a supportive 
relationship with God, benevolent religious reappraisals (e.g., 
seeing one’s situation as part of God’s plan), and obtaining 
interpersonal religious support (Pargament, 1997).  Meta-
analytical research suggests that positive forms of religiosity 
(e.g., intrinsic religiosity and positive religious coping) 
decrease distress (Smith, McCullough, & Poll, 2003).  With 
regard to CSA, there is some evidence that religion can 
moderate the development of Axis I disorders among 
survivors of CSA (Walker et al., 2009).   

However, it is widely recognized that religion and 
spirituality can also have a negative influence on 
psychological functioning (see Exline & Rose, 2005 for a 
review).  For example, religious coping may take a negative 
form, including anger at God, passive religious deferral (e.g., 
not doing anything and expecting God to solve one’s 
problems), religious doubts, and interpersonal religious 
struggles (Pargament, Smith, Koenig, & Perez, 1998).  Thus, 
while religion generally correlates with decreased 



PIRUTINSKY 
 

23 
 

psychological distress, spiritual struggles such as religious 
doubt and change are related to increased distress (Ano & 
Vasconcelles, 2005; Smith et al., 2003).   

The vast majority of these studies have been cross-
sectional (Paloutzian, Richardson, & Rambo, 1999), and the 
long-term outcome of spiritual struggles remains unclear.  For 
example, spiritual struggles may lead to religious 
transformations with long-term positive effects (James, 
1902).  This may be particularly apparent where traumatic 
events, such as CSA, have damaged existing beliefs, since 
spiritual struggles leading to the transformation of these 
damaged beliefs may be beneficial.  As suggested by 
cognitive therapies for traumatic stress (Resick et al., 2008), 
recovery from trauma-related psychopathology includes 
reinterpretation of the event and restructuring of trauma-
induced cognitions.  Religious change may be an important 
avenue through which some survivors of CSA transform 
distressful beliefs about the world and themselves. 

The current research aimed to address the limitations of 
previous research by exploring CSA, religious change, and 
depressive symptoms over a two-year period.  Although the 
terms religion and spirituality often have distinct meanings—
spirituality a broad term encompassing anything regarded as 
sacred, and religion a specific term referring to culture-based 
forms of relating to the sacred (Hill & Pargament, 2003)—the 
current study uses both terms loosely, reflecting the broad 
measures utilized to measure religious and spiritual change.  
The study was conducted among older adolescents in foster 
care, as recent research suggests that adolescence may be a 
particularly sensitive period for enduring religious change and 
development (Good & Willoughby, 2008).  Our hypotheses 
were twofold.  First, we predicted that youth with a history of 
CSA would report greater religious change over the study 
period.  Second, we predicted that religious changes would 
increase depression among youth without a history of CSA 
(reflecting spiritual struggles), while among CSA survivors, 
depression would decrease as they transform beliefs to more 
adaptive views. 
 

Method 
 
Participants 
 Participants were 407 youths in foster care residing in 
Missouri, 178 (44%) males and 226 (56%) females, ranging 
in age from 16 to 17 years (M = 16.33, SD = .47) at Time 1.  
Ethnicity varied with 1% (n = 3) American Indian, 51% (n = 
206) African-American, 44% (n =  178) Caucasian, and 4.1% 
(n = 12) Other.  Average age of entry to foster care was 10.85 
years (SD = 4.48), and average length of current placement 
was 20.5 months (SD = 36.91).  Current living situations 
included 8% residing with their biological parent(s) after a 
stay in out-of-home care, 19% in kin foster care, 29% in non-
kin family foster care, 41% in congregate care, and 3% in 
semi-independent living situations.  Religious affiliation at 
Time 1 included 7.7% (n = 31) Catholic, 53.7% (n = 217) 
Protestant, 2% (n =  1.2) Muslim, 31.7% (n =  128) None, and 
6.7% (n =  27) Other. 

Procedure 
The current study analyzed data from the Mental Health 

Service Use of Youth Leaving Foster Care Survey 
(McMillen, 2010) conducted from December 2001 to May 
2003. The Missouri Children’s Division identified 647 youth 
in their custody who resided in one of eight Missouri counties 
and were turning 16 years and nine months of age (see 
Larrabee-Warner and McMillen (2010) for a full description).  
Approximately 30% of these youths were excluded from the 
study because they (a) were no longer in custody; (b) had a 
reported IQ below 70; (c) did not speak English; (d) lived 
outside the study area; or (e) had runaway status.  Of the 
resulting 451 (70%) youths, 39 (8%) declined to participate, 4 
(1%) could not be contacted, and one interview was not 
completed, resulting in a final sample of 407 youths.  
Interviews were conducted near each youth’s 17th birthday 
(Time 1) and again 24 months later (Time 2) at their 
residence.  Although phone interviews were conducted in the 
intervening period, religious variables were only assessed in 
the initial and final interviews, and the current study used data 
from those waves exclusively.  Wherever statistically 
feasible, missing data was imputed using IVEware 
(Raghunathan, Solenberger, & Van Hoewyk, 2002).  Missing 
data unable to be imputed was deleted case-wise for each 
analysis.  The Human Subjects Committee of Washington 
University’s Institutional Review Board approved all 
procedures. Consent was provided by each youth’s custodial 
case manager and the youths assented to participate. 
 
Measures 

Childhood sexual abuse.  History of sexual abuse was 
assessed through three previously used items (Auslander, 
McMillen, Elze, Thompson, Jonson-Reid, & Stiffman, 2002), 
which read: (a) “Has anyone ever made you touch their 
private parts, against your wishes?” (b) “Has anyone ever 
touched your private parts (breasts or genitals) against your 
wishes?” and (c) “Has anyone ever had vaginal sex, oral sex, 
or anal sex with you against your wishes?” Youths who 
responded “yes” to any of these were defined as having a 
history of CSA, and youths who responded “no” to all three 
were defined as having no history of CSA. 

Religious affiliation.  At Time 1 and Time 2, youths 
were asked, “What is your religious preference?” Response 
choices were Catholic, Protestant, Jewish, Muslim, None, or 
Other.  They were then assigned a religious change category 
based on the discrepancy between their affiliation at Time 1 
and Time 2.  Those reporting identical affiliations at each 
time were assigned to either “remained religious” or 
“remained irreligious,” while those reporting different 
affiliations were assigned to one of three change categories: 
“none to religion,” “religion to none,” and “religion to 
religion.” 

Religious belief.  Belief was measured using the 
Multidimensional Measure of Religiousness/Spirituality 
(Fetzer Institute & National Institute on Aging, 1999).  It 
contained seven items rated on a four-point scale ranging 
from strongly disagree to strongly agree. Items included “I 



RELIGIOUS CHANGE AMONG YOUTH 
 

24 
 

have faith in a power greater than me” and “I am not a 
religious person.” Internal consistency was adequate (Time 1 
α = .87, Time 2 α = .87). 

Depressive symptoms.  Depressive symptoms were 
measured using the Depression-Arkansas Scale, which has 
demonstrated adequate reliability and validity in previous 
studies in adult samples (Smith et al., 2002; Walter, 
Meresman, Kramer, & Evans, 2003).  It consists of 11 items, 
drawn from DSM-IV-TR criteria for depression, that asked 
how often youths experienced depressive symptoms on a 
four-point scale ranging from “not at all” to “nearly every day 
for at least 2 weeks.” Items were summed to form a 
continuous measure of depressive symptoms (Time 1 α = .84, 
Time 2 α = .81). 
 
Statistical Analysis 

To examine the relationship between CSA and religious 
change, a chi-square test was conducted comparing those with 
a history of CSA to those without a history of CSA on the 
religious affiliation change categories described above.  An 
independent groups t-test comparing these groups on mean 
change in religious beliefs over the study period was also 
conducted.  Because change scores in opposite directions may 
average out, squared change in religious beliefs was also 
examined.  To assess the relationship between religious 
change and depression, we conducted a hierarchical 
regression predicting depression at Time 2, controlling for 
depressive symptoms at Time 1.  Model 1 included change in 
affiliation, CSA, and interaction terms.  Model 2 assessed 
change in religious beliefs (linear and quadratic), CSA, and 
interaction terms.  Model 3 was a combined model that 

included both change in religious affiliation and belief, CSA, 
and interaction terms.   

 
Results 

 
 Change in self-reported religious affiliation was common 

in the sample (45%, n = 171), with 15% (n = 58) reporting a 
change of “none to religion,” 12% (n = 45) reporting a change 
of “religion to none,” and 14% (n = 68) reporting a change of 
“religion to religion.”  Many youths also reported variation in 
the strength of religious beliefs with 313 (79.8%) reporting a 
change of less than 1 SD, 49 (12.5%) reporting a change of 1-
2 SDs, and 21 (21%) reporting a change of greater than 2 
SDs. Preliminary analyses comparing youths reporting a 
history of CSA (n = 138, 35%) to youths reporting no history 
of CSA (n = 254, 65%) revealed that religious affiliation at 
Time 1 (χ2(4, N = 388) = 3.14, p = .55) and mean religious 
belief over the two time-periods (t(391) = 1.71,  p = .19) did 
not differ significantly between these groups.  Zero-order 
correlations between religious belief and depression at Time 1 
were not significant (r = .01, p = .73).  However, consistent 
with previous research, higher religious belief at Time 2 was 
significantly correlated with lower depression at Time 2 (r = -
.12, p = .02) while religious affiliation was unrelated to both 
depression at Time 1 (t(390) = 0.61, p = .54) and 2 (t(390) = 
1.60, p = .11). 

With regard to Hypothesis 1, results indicated that 
affiliation change (χ2(4, N = 388) = 2.32, p = .68), change in 
belief (t(392) = 0.18, p = .86), and squared change (t(392) = 
0.71, p = .48) were unrelated to CSA.  This suggests that, 
contrary to our predictions in Hypothesis 1, CSA may be 
unrelated to religious change.  Hierarchical regression testing  

 
Table 1 
 
Model 1: Religious affiliation change, CSA, and depressive symptoms 
 

Variable 
Step 1 Step 2 Step 3 

B SE B β B SE B β B SE B β 
Time 1 Depressive Symptoms .32*** .04 .37 .32*** .04 .36 .32*** .04 .36 
CSA .16 .26 .03 .14 .25 .03 .11 .27 .02 
Religious change          
Change vs. no change    .76*** .19 .19 .57** .20 .14 
Change: to R1 vs. to N2    .02 .24 .01 .07 .24 .01 
Change: N to R vs. R to R    -.91* .42 -.10 -.73 .43 -.08 
Remaining: R vs. N    -.01 .33 -.002 -.24 .36 -.04 
Religious change X CSA          
Change vs. no change       -.53** .20 -.14 
Change: to R vs. to N       .14 .24 .03 
Change: N to R vs. R to R       .66 .43 .07 
Remaining: R vs. N       -.44 .36 -.07 
ΔR2 .14 .18 .02       
F for ΔR2 31.90*** 6.13*** 2.66*       
 
Note.  1R = religion; 2N = none; *p < .05; **p < .01; ***p < .001. 
 
 



PIRUTINSKY 
 

25 
 

Hypothesis 2 indicated that changes in religious affiliation 
from Time 1 to 2 were related to increased depressive 
symptoms, but CSA significantly moderated this relationship 
(Model 1, Table 1).  A plot of predictions (Figure 1) and post-
hoc tests suggested that among youth with a history of CSA,  
religious change was unrelated to depressive symptoms (B = 
.04, t(370) = 0.12, p = .90).  In contrast, among youth with a 
history of CSA, change in religious affiliation was associated 
with increased depressive symptoms (B = 1.10, t(370) = 4.78 , 
p < .001).  Categories of change (e.g., “none to religion,” 

“religion to none”) did not differ significantly on depressive 
symptoms, suggesting that the impact was equivalent 
regardless of the direction of religious changes.  

Model 2 examined the influence of change in belief on 
depressive symptoms at Time 2, controlling for depressive 
symptoms at Time 1.  Results indicated that change in 
religious belief was quadratically related to depressive 
symptoms (Table 2), such that those with the greatest change 
(positive or negative) reported increased depressive 
symptoms at Time 2 (Figure 2). This was moderated by CSA 

 
Table 2 
 
Model 2: Religious belief change, CSA, and depressive symptoms 

 

Variable 
Step 1 Step 2 Step 3 

B SE B β B SE B β B SE B β 

Time 1 Depressive Symptoms .33*** .04 .37 .32*** .04 .36 .33*** .04 .37 

CSA .16 .26 .03 .22 .25 .04 .52 .29 .10 

Change in beliefs (linear)    -.26 .22 -.06 -.20 .24 -.04 

Change in beliefs (quadratic)    .51*** .14 .17 .39* .15 .13 

CSA x beliefs (linear)       .05 .24 .01 

CSA x beliefs (quadratic)       -.31* .15 -.12 

ΔR2 .14 .03 .01       

F for ΔR2 31.88*** 7.56*** 4.18*       
 
Note. *p < .05; **p < .01; ***p < .001. 
 
 

15

17

19

21

23

25

Religion to None None to Religion Religion to Religion Remained Religious Remained Irreligious

D
e

p
re

ss
io

n
 T

im
e 

2
 (

P
re

d
ic

te
d

)

non-CSA

CSA

Figure 1. Depression at Time 2 by CSA and Religious Affiliation Change 
 
Note. Adjusted for depression at Time 1. 

 



RELIGIOUS CHANGE AMONG YOUTH 
 

26 
 

history.  That is, for youth without CSA, change in religious 
beliefs (quadratic) was related to significantly increased 
depression at Time 2 (B = .70, t(386) = 4.13, p < .001), while 
among youth with CSA these were unrelated (B = .08, t(386) 
= 0.31, p = .76). 

The results of Model 3 indicated that religious belief and 
affiliation remained significant predictors of depression even 
controlling for each other’s effect. In terms of interactions 
between changes in affiliation and changes in belief, 
increased religious beliefs among those who changed 
affiliation from “religion to none” was significantly related to 
sharply increased depression (B = .96, t(364) = 3.36, p = 
.001).  No other interactions were significant, including three-
way interactions with history of CSA (∆R2 = .01, F(8, 352) = 
0.56, p = .85).  In summary, results indicated that religious 
change of any type was related to increased depression among 
youths without a history of CSA, but was unrelated to 
depression among youth with a history of CSA. 

 
Discussion 

 
Research suggests that CSA relates to both increased and 

decreased religiosity and spirituality (Falsetti et al., 2003; 
Walker et al., 2009).  However, these studies have been 
primarily retrospective, and CSA can have bi-directional 
influences on religion and spirituality.  Therefore, only 
examining the average level of religiosity in those with and 
without CSA likely obscures important changes.  

Furthermore, the impact of religious change on psychological 
functioning remains unclear.  The current research therefore 
explored CSA, religious change, and depressive symptoms 
among foster-care youth over a two-year period.  We 
hypothesized that youth with a history of CSA would report 
greater religious change over the study period, as compared to 
youth without a history of CSA (Hypothesis 1).  We also 
expected that these changes would relate to increased 
depressive symptoms among youth without CSA and 
decreased symptoms among those with CSA (Hypothesis 2). 

Contrary to expectations, in the present study, youths 
with a history of CSA were no more likely than those without 
a history of CSA to report changes in religious affiliation or 
belief over the study period.  This suggests that CSA does not 
systematically influence religious change.  However, our 
sample was comprised of older foster care youths who were 
transitioning from foster care to independent living, and there 
was a high degree of religious change in the entire sample 
(47% reported change in affiliation, and 21% reported 
changes of at least 2 SDs in religious belief).  Consequently, 
the specific impact of CSA may not be apparent in youth 
experiencing such high levels of environmental changes.  In 
addition, only superficial measures of religiosity (affiliation 
and belief) were available, and these may not capture more 
nuanced changes in religion and spirituality resulting from 
CSA (Gall, Basque, Damasceno-Scott, & Vardy, 2007).  
Furthermore, the age at which CSA occurred was not reported 
and important religious changes may have occurred prior to 

Figure 2. Depression Symptoms at Time 2 by Change in Religious Beliefs and CSA   
 
Note. Adjusted for depression at Time 1. 
 

15

17

19

21

23

25

 -2 SD  -1 SD  No change  +1 SD  +2 SD

Religious Belief Change

D
e

p
re

s
s

io
n

 T
im

e
 2

 (
P

re
d

ic
te

d
)

Non-CSA

CSA



PIRUTINSKY 
 

27 
 

the collection of Time 1 data.  The nature and timing of CSA 
may alter its influence as well, as repeated sexual abuse at an 
early age may have very different effects on religious 
development and change than a single isolated incident at age 
16. 

The present study results further suggest that among 
youth without a history of CSA, change in religious affiliation 
and beliefs was associated with increased depressive 
symptoms, likely reflecting spiritual and religious struggles 
(Exline & Rose, 2005).  This was equally true of those 
experiencing an increase or decrease in religious belief and of 
those relinquishing or acquiring an affiliation.  Inconsistent 
changes, such as increased belief and affiliation change from 
“religion to none,” were related to sharply increased 
depression.  These results parallel previous cross-sectional 
findings (Exline & Rose, 2005) and suggest that religious 
change is related to increased distress longitudinally.  This 
may be due to intra-psychic factors such as loss of meaning 
(Park, 2005), insecure attachment to God (Kirkpatrick, 2005), 
or negative religious coping (Pargament, 1997), or may 
reflect psychosocial changes such as loss of religious social 
support and community (Putnam, 2009).  In contrast, for 
youth with a history of CSA, religious changes were 
unrelated to depressive symptoms, perhaps because, as 
hypothesized, religious change included positive 
transformations of their meaning-system (Park, 2005).  
Further research should consider using prospective 
longitudinal designs and statistical techniques such as growth 
modeling (e.g., Bonnano et al., 2002) that allow consideration 
of individual trajectories and the nuanced processes supported 
by our results. 

Beyond theoretical implications and directions for future 
research, these findings have applications in the treatment of 
youth with a history of CSA.  In particular, religious and 
spiritual change, although potentially distressful to caregivers 
and involved adults, may be a normative and health-
promoting process of transformation that can have positive 
mental health consequences and may be a component to 
healing from trauma.  Consequently, foster parents, 
caseworkers, parole officers, and clergy should support and 
encourage youth to adjust their meaning system in adaptive 
ways.  Moreover, explicit incorporation of religious, spiritual, 
and existential themes in psychotherapeutic treatment of CSA 
survivors may be indicated and helpful. 

However, although the study of the relationship between 
religion and mental health has generated considerable recent 
interest (e.g., Smith et al., 2003), integrating religious and 
spiritual struggles into treatment presents challenges, since 
individuals may be hesitant to bring these issues to 
professionals (Pirutinsky, Rosmarin, & Pargament, 2009), 
and clinicians receive little training (Walker, Gorsuch, & Tan, 
2004) and can be reluctant to explore these issues (Turner-
Essel & Waehler, 2009).  One possible reason for this gap is 
the lack of empirical research integrating spiritual struggles 
into current conceptualizations of mental illness and clinical 
treatment (Pirutinsky, Rosmarin, Pargament, & Midlarsky, 
2011).  There is, however, a small body of research 

demonstrating that positive aspects of religion and spirituality 
can be successfully integrated into existing treatments (e.g., 
McCullough & Larson, 1999), suggesting that negative 
aspects of spirituality can be similarly addressed.   

One promising treatment for this integration in the 
context of childhood sexual abuse is Cognitive Processing 
Therapy (CPT; Resick, Monson, & Rizvi, 2008).  The 
fundamental focus of this treatment is to reintegrate prior 
beliefs and new beliefs, thereby reconstructing a coherent and 
positive worldview.  To achieve theses aims, TFP 
incorporates a number of techniques.  First, patients are asked 
to write an impact statement focusing on how the traumatic 
event has impacted their beliefs about themselves and others.  
This statement is used to conceptualize how the event has led 
to distorted or overgeneralized attributions of meaning.  
These faulty ideas are then challenged through Socratic 
questioning, disputing thoughts, worksheet exercises, and the 
development of alternative, more balanced beliefs.  Religious 
struggles and doubts involve similar processes whereby an 
individual’s previous worldview is challenged and disturbed 
in some way, resulting in distress.  Similar techniques such as 
writing down the implications of these changes in worldview, 
identifying distorted or exaggerated conclusions, challenging 
these ideas, and developing more balanced and integrated 
alternatives, may be a fruitful avenue to address trauma-
related religious and spiritual doubts, struggles, and 
transformations. 

 
Limitations 

This research has several limitations. There were no 
prospective pre-CSA reports on religion or depressive 
symptoms available, and information concerning the nature of 
CSA (e.g., age of occurrence, repetition, violence, perpetrator 
identity) was not available.  It also relied on cursory measures 
of religiosity, which may not reflect the particular beliefs, 
behaviors, and emotions relevant to CSA and mental health.  
Furthermore, spirituality, conceptualized as any manner of 
relating to the sacred, can be distinct from culture-based 
religiosity (Hill & Pargament, 2003), and the measures 
utilized did fully explore these constructs.  Future research 
should utilize more nuanced and proximal measures of 
religiosity and spirituality.  In addition, the sample was 
subject to an overall high degree of stress and change, and 
those disruptions may have been confounded with religious 
change.  However, given the difficulty of conducting 
longitudinal research of this type, these data give a much-
needed glimpse into the impact of CSA and religious change 
on youth.  As discussed above, further carefully designed 
research appears warranted and necessary. 

 
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