Modeling the Relationships between Discrimination, Depression, Substance Use, and Spirituality with Muslim Americans: A National Sample

Abstract

Background: This study sought to examine the relationship between discrimination and two health outcomes of critical importance to social work educators-depression and substance use-in tandem with the protective effects of spirituality. Drawing from stress/coping theory, a theoretically based model was developed and tested using structural equation modeling (SEM) with a national sample of self-identified Muslims (N = 265). In addition to demographic items, the self-report survey included measures of perceived discrimination, developed by the Pew Research Center (2011); depression, assessed with the short form of the Center for Epidemiological Studies Depression Scale (CES- D); substance use; and spirituality. After pilot testing, the survey was placed online and various Islamic organizations were contacted. Methods: Based upon prior related research, it was hypothesized that higher levels of discrimination would predicts higher levels of both depression and substance use, and spirituality would mediate the relationship between discrimination and both health outcomes. Structural equation modeling (SEM) was conducted using AMOS. Preliminary analyses indicated that some variables were highly skewed (e.g., substance use). Mardia’s test of multivariate normality was not supported, violating a key assumption upon which Maximum Likelihood estimation is based. Accordingly, the asymptotically distribution free estimator was used. Results: Findings show partial support for the study hypotheses. Discrimination predicted higher levels of depressive symptoms. Discrimination did not, however, predict higher levels of substance use. Spirituality did not function as a mediator. Rather, spirituality exhibited an independent effect on both depression and substance use. In other words, higher levels of spirituality predicted lower levels of depression and substance use, apart from the effects of discrimination. Discussion: The results regarding the protective effects of spirituality on depression and substance use underscore the importance of incorporating Islam’s spiritual strengths into direct practice content. For instance, courses featuring training in cognitive behavioral therapy (CBT) might include content on adapting CBT protocols on cultural sensitivity a strategy to increase the cultural relevance and effectiveness of the intervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved) (Source: journal abstract)