Research literature suggests that there are age and gender effects on numinous constructs, but little is known about how spirituality and religiousness evolve over time and differ between genders. The purpose of this study was to determine whether observed gender and age effects would be evidenced on the Assessment of Spirituality and Religious Sentiments (ASPIRES) and whether the underlying factor structure of the ASPIRES was consistent across age and gender groups. These sample data (N = 1,534 women and 697 men) demonstrated that (a) there are significant age and gender effects on the ASPIRES scales, and (b) the underlying factor structure of the scales remains unchanged in all groups, suggesting that the groups appear to understand and experience spirituality and religiousness in a similar manner. The results of this study demonstrate that although the expression of spirituality and religious sentiments may vary across age and between genders, the fundamental meaning of these constructs remains the same.

Hospitalization for a sudden cardiac event is a frightening experience, one that is often marked by uncertainty about health status, fear of recurrent cardiac problems, and related existential, religious, and spiritual concerns. Religious struggle, reflecting tension and strain regarding religious and spiritual issues, may arise in response to symptoms of acute coronary syndrome (ACS). The present study examined the prevalence and types of religious struggle using the Brief RCOPE, as well as associations between religious struggle, psychological distress, and self-reported sleep habits among 62 patients hospitalized with suspected ACS. Fifty-eight percent of the sample reported some degree of religious struggle. Questioning the power of God was the most frequently endorsed struggle. Those struggling religiously reported significantly more symptoms of anxiety, depression, and sleep disturbance. Non-White participants endorsed greater use of positive religious coping strategies and religious struggle. Results suggest that patients hospitalized for suspected ACS experiencing even low levels of religious struggle might benefit from referral to a hospital chaplain or appropriately trained mental health professional for more detailed religious and spiritual assessment. Practical means of efficiently screening for religious struggle during the often brief hospitalization period for suspected ACS are discussed.

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Rural cultures and nonrural cultures are distinctive in numerous ways, including how religion and spirituality are lived and experienced (Aten et al., 2012;Campbell & Gordon, 2003;Hastings & Cohn, 2013). Culturally competent mental health care in rural settings necessitates addressing the uniqueness of life in rural cultures, which includes the role of religion and spirituality in clients' lives. This study utilized interpretative phenomenological analysis (IPA), a qualitative research method, in an effort to uncover the lived experiences of 10 counselors in rural Iowa and their experience of religion and spirituality in clinical practice. Two superordinate themes emerged. Participants described how the culture of rural Iowa impacts mental health care and counseling. The results indicate specific barriers counselors face in addressing clients' religious and spiritual beliefs, values, and practices in counseling. These results were analyzed through the lens of multicultural competence in counseling, and implications for counselors given. Suggestions for the future research are posited.

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