Spirituality and Depressive Symptoms in a Multiethnic Sample of Cancer Survivors

Objective: This study aimed to (a) examine the relationships of 3 facets of spirituality (i.e., meaning, peace, faith), and their interaction, with depressive symptoms among Black, Latino, and White cancer survivors; and (b) test fear of cancer recurrence (FCR) and social support (SS) as mediators of these relationships. Method: Data were analyzed from the American Cancer Society's Study of Cancer Survivors-I, a longitudinal population-based study of cancer survivors' quality of life. A national sample of Black (n = 194), Latino (n = 90), and White (n = 2,775) survivors of the top 10 incident cancers completed measures 1 year (Time 1, T1), 2 years (Time 2, T2), and 9 years (Time 3, T3) postdiagnosis. Results: After controlling for T1 depressed mood and demographic and medical characteristics, T1 lower meaning and lower peace, but not faith, predicted greater depressive symptoms at T3 in the total sample. A significant interaction showed that higher faith predicted greater depressive symptoms specifically in the context of lower meaning. Race/ethnicity did not affect these relationships. FCR at T2 partially mediated the relationships of T1 meaning and peace with T3 depressive symptoms, and SS partially mediated the relationship between T1 meaning and T3 depressive symptoms. Conclusions: Cancer survivors with greater meaning and peace appear better able to integrate the cancer experience into their lives. An interaction between T1 meaning and faith on T3 depressive symptoms replicated previous findings. Future research should treat spirituality as a multidimensional construct and focus on identifying and influencing malleable mechanisms of the associations between spirituality and mental health.