Journal of Public Health: From Theory to Practice

https://doi.org/10.1007/s10389-019-01092-2

ORIGINAL ARTICLE

Spirituality as predictor of depression, anxiety and stress

among engineering students
Ajit Singh Negi 1 & Ashu Khanna 2 & Rajat Aggarwal 3

Received: 14 March 2019 / Accepted: 23 May 2019

# Springer-Verlag GmbH Germany, part of Springer Nature 2019

Abstract
Aim The purpose of present study is to examine the impact of aspects of spirituality on stress, anxiety, depression among
engineering students.
Subject and method Data were collected from 914 engineering students of Indian Institute of Technology Roorkee, India. A self-
administered questionnaire and DASS-21 scale were used to measure spirituality and depression, anxiety, stress in current study.
Pearson correlation is used to examine the relationship between spirituality dimensions and stress, anxiety, depression; multiple
regression is used to examine the most influencing spirituality dimension; independent sample t-test is used to examine the
gender difference in spirituality, stress, anxiety, depression among engineering students.
Result Findings of the study propagated the positive and significant relationship between universal consciousness and anxiety of
engineering students.
Conclusion The most influencing spirituality dimensions are relationship with self and relationship with others. The sense of
spirituality of female students is stronger than that of male students.

Keywords Spirituality . Depression . Anxiety . Stress . Correlation . Regression

Introduction
The most prevalent psychological distress among university
students are stress, anxiety and depression. Many research
studies have examined whether student’s performance are af-
fected by the symptoms of stress (Dusselier et al. 2005), anx-
iety (Anson et al. 1984) and depression (Stark and Brookman
1994). The main causes of depression among students are
homesickness, pressure of achieving higher academic grade,
hope for safe and better future (Buchanan 2012). These psy-
chological conditions generate unpleasant experiences which
* Ajit Singh Negi
ajit_prudent11@yahoo.co.in
1
Applied Science and Engineering Department, Indian Institute of
Technology Roorkee, Roorkee, India
2
Polymer and Process Engineering Department, Indian Institute of
Technology Roorkee, Roorkee, India
3
Management Studies, Indian Institute of Technology Roorkee,
Roorkee, India
impede the level of functioning and disrupt the mental state of
a student (Bayram and Bilgel 2008).
Although psychological health problems affect society as a
whole, young people are severely affected by psychological
distress in comparison to the general population (Adewuya
et al. 2006; Daniel 2013; Kumaraswamy 2013). Young stu-
dents frequently encounter multiple challenges associated to
their academics, personal and social life (Dyrbye et al. 2006).
Young adults face multiple stressors such as academic de-
mand, pressure to succeed, financial burden, workload, expec-
tation of parents and teachers and future worries are suscepti-
ble to psychological distress in students and adversely affect
their overall performance. Young people also experience be-
havioral, economic, sexual, social, academic and emotional
conflict in this stage of identity formation (Kaya et al. 2007).
Therefore, this challenge intensifies imbalance, loneliness,
self-centeredness, lack of commitment and degradation of hu-
man values in human beings.
A spiritually evolved youth can effectively moderate the
consequence of psychological distress. The unwavering guid-
ance of universal consciousness is essential for the younger
generation to negotiate the demanding uncertainties of the
materialistic world. Spirituality expresses as Bone’s ability to

tap the deepest resources within oneself and embrace the un-
seen and mysterious resources of the entire universe^; spiritual
intelligence is Ban ability to consciously seek the divine
knowledge, conscious of every moment and consciously nav-
igate one’s inner resources to the fullest^. The path of spiritu-
ality is important for everyone, but especially for those of the
younger generation as they are the future of their nation.
The need for spirituality is vital for engineering students to
enhance their awareness about true self-identity. It is essential
to explore the nature of spirituality and its effect in dealing
with the psychological distresses of one’s self. This study
examines the relationship between the categorical aspects of
our study regarding spirituality and stress, anxiety, depression
among the engineering students, with the main objective of
the study being to examine the impact of spirituality on stress
anxiety and depression among engineering students.
Consideration of engineering students
in the present study
To realize the research gap, the present study is an endeavor to
examine the relationship between spirituality and depression,
anxiety, stress among engineering students. Engineering stu-
dents who participated in the survey are from the Indian
Institute of Technology, Roorkee. All these students have
passed the IIT-JEE exam, which is held across the nation to
join prestigious engineering colleges. Every year engineering
entrance examination is conducted by the Indian Institutes of
Technology-Joint Entrance Examination (IIT-JEE), and is one
of the toughest examinations for consideration for admission
to the premier engineering institution in India. Likewise, for M
Tech and PhD to pass the graduate aptitude test in engineering
(GATE), the entrance examination is an essential criterion. It is
assumed that the IQ of engineering students of the leading
institution to be more than that of college students. The path
of spirituality is important for everyone, but especially for the
younger generation who are seen as the nation’s future.
Literature survey
Spirituality
The word Bspirit^ is originated from the Latin word Bspiritus^.
It is that animated energy that is full of life, vigor, energy,
passion and contributes reason for effective functioning in
one’s life. Spirituality is ubiquitous in all existential realities
of life. Definitions of spirituality have escalated over many
years but no universal consensus has appeared in the existing
literature (Hollins 2005). The elusive nature of spirituality still
prevails due to its multidimensional construct (Cook 2004;
Moberg 2002; Larson et al. 1998).
J Public Health (Berl.): From Theory to Practice
Different disciplines have defined spirituality in their own
perspective—for example, spirituality as a search for the sa-
cred (Pargament 1997), as Ba quality that goes beyond reli-
gious affiliation, that strives for inspirations, reverence, awe,
meaning and purpose, even in those who do not believe in any
God^ (Murray and Zentner 1989), as Ba subjective experience
of the sacred^ (Vaughan 1991), and Bthe way in which people
understand their lives in view of their ultimate meaning and
value^ (Muldoon and King 1995). Howard and Wellborn
(Howard and Welbourn 2004) state: BSpirituality helps us in
our struggle to determine who we are (our being) and how to
live our lives in this world (our doing)^. Spirituality is consid-
ered as a two-dimensional approach including: (1) vertical
dimension or theistic approach, (2) horizontal dimension or
nontheistic approach. Vertical dimension incorporating rela-
tionship with and faith in God, whereas the horizontal ap-
proach incorporates existential, secular and humanistic ele-
ments (McSherry and Cash 2004; Moberg 2002).
According to Lambert (2004), there is a severe decline in
church attendance and belief in a personal God in Europe.
More and more people experience spirituality outside religious
traditions and are also seeking for meaning and purpose in their
personal life (Heelas 2005). BQuest^ or Binward journeys^ are
the central dimensions of spirituality among youth. Today
many college youth are participating in a variety of events to
explore the dimension of inward self-reflection and self-
introspection (HERI 2004; Mooney 2005; Gallup 1998).
The data revealed by the Higher Education Research
Institute (HERI 2004) indicates the importance of spirituality
and religion among contemporary youth in shaping their be-
liefs, behavior and values. Findings of the study reveal that (1)
75% of the new entrants were searching for Bmeaning & pur-
pose in their life^ and 80% stated that they were fairly inter-
ested in spirituality, (2) 50% of the youth in the national sur-
vey were finding ways to enhance their spiritual quest in life
and need the support of the college in this endeavor, (3) 80%
of the students believe in BGod^ or a BHigher Power^ and
seek to strengthen themselves through belief in divine forces.
According to Sharon Parks (2000), contemporary youth are
searching for answers to some Bbig^ questions in life such
as: (1) Who am I? (2) Where am I going? (3) What can I
believe in? (4) How can I be happy? (5) Will my life
make a difference? To search for the answers to these
profound questions, youth are striving to explore the spir-
itual aspect of the inner life.
Previous studies indicate that, contemporary youth started
questioning, when they were not able to determine the scien-
tific evidence of omnipresent God who can help mankind.
Thus, youth do accept that ‘religious beliefs are abstract, in-
valid, and irrational (Hay and Nye 2006). They are searching
for real ‘existential’ questions of life. They believed that God
is indifferent and detached to their call. Consequently, they
enumerate their aggravation to God for causing their distress,
J Public Health (Berl.): From Theory to Practice
abandonment, challenges, tragedies and punishment. Thus,
these youth experience discontentment and ask questions re-
lated to the existence of God; hence, the youth have spawned a
troublesome relationship with God or Higher Power.
Spirituality is thus associated with numerous advantages
and also negatively associated with the divine struggle.
Spirituality improves quality of life, contentment (Abdel-
Khalek 2010), effective social support (Taliaferro et al.
2009), better adjustment with the college environment
(Kneipp et al. 2009), and is negatively associated with psy-
chological distress and promoting positive health behaviors
(Hsiao et al. 2010). Spirituality through religious beliefs helps
in managing better health and also acts as resistance to stress-
ful situations in those who recognized themselves as spiritual
but not religious (Graham et al. 2001). Spiritual/religious cop-
ing activities increases positive advantages in managing ad-
verse emotional state, physical and mental health of an indi-
vidual (Pargament 1997; Pargament et al. 1998). When a per-
son experiences a sense of care, reassurance, positive direction
with motivation, emotional concern are included in the pur-
view of perceived social support (Wang 2014).
The prevalence rate of depression among college students
between (18-24 years) is 16.5%. The level of depression
is more among engineering students than medical students.
Depression is severly affect those students whose parents are
not supportive and involved in frequent conflict (Kaur et al.
2014). In relation to gender difference, many previous studies
have suggested that a sense of spirituality in females is stron-
ger as compared to male college students. A study was con-
ducted by Bryant (2007) on 434 university students of coop-
erative institutional research programme. The survey includes
multiple topics about student’s attitude, self-assessment,
values and activities. The result of the study found that fe-
males were more spiritual than males.
A similar finding was observed by Hammermeister et al.
(2005), who measured the diverse dimensions of health of 435
college students. This survey consists of 176 questions related
to spiritual well-being and physical health. The results indicate
that female students have scored higher on three of the studied
aspects regarding spirituality as compared to male students. A
recent study was conducted on the gender difference on spir-
ituality, forgiveness, gratitude among school teachers. The
study suggested that the gratitude is higher in male teachers,
whereas forgiveness and spirituality is higher in female
teachers (Khan and Singh 2013).
Spirituality/religion
Spirituality is the multidimensional concept. Spirituality is the
apt expression preferred in the present study to avoid any con-
founding incongruity with the religion. Operationalization of
spirituality seems to encompass two approaches—one is a
religious, often a theistic approach; while the other is a mono-
theistic approach that is often based on secular, humanistic, and
existential elements (McSherry and Cash 2004). Spirituality
represents Bone’s striving for and experience of connection
with the essence of life^ which encompasses three main
dimensions—connectedness with oneself, connectedness with
others and nature, and connectedness with the transcendent.
Interest in spirituality has greatly increased in the past 25 years
and American religious life has moved to embrace more ele-
ments of spirituality (Roof 1993; Turner et al. 1995), while
there has been a drop in public confidence in religion and
religious leadership. According to Lambert (2004) the
number of people in Europe today who attend church
and believe in a personal God is dropping steadily, where-
as more and more people are looking for meaning and
purpose in their lives and in spiritual experiences outside
or across religious traditions (Brown 2007; Heelas 2005).
Stress
Stress is an undesirable emotional experience accompanied by
the anticipated cognitive, behavioral, biochemical and psy-
chological changes that are focused either towards altering
the stressors or regulating or accommodating with its reper-
cussions (Baum 1990). Stress poses a threat to our mental
health and well-being. It can further lead to depression, obe-
sity and heart diseases (Baum and Polsusnzy 1999). Stress is a
progression which requires more capacity to deal with exter-
nal situation, resultant in biological and psychological alter-
ations that may cause an individual at risk of illness (Cohen
et al. 1995). If the stress is persistent or continued, it can leave
negative effects on a person’s body (Anderson 1998).
Increased chronic stress can lead to severe disorders such as
anxiety, high blood pressure, muscle pain, weakened immune
system, and insomnia; thus, untreated stress can cause severe
depression (Richards et al. 2016).
Anxiety
Anxiety is a physiological and psychological state manifested
by cognitive, behavioral, somatic, and emotional elements.
These elements incessantly create an unpleasant emotion that
is usually accompanied by the characteristics of fear, worry
and uneasiness. Anxiety is a general emotional state which
prompts without any identifiable stimulus (Seligman et al.
2001). The characteristic of anxiety or nervousness is fre-
quently experienced by college students. The abrupt anxious
feeling of constant worry, fear, invariable overwhelm while
making an important decision, and during times of academic
urgency and worry before examinations are all associated with
the anxiety symptoms.

Depression
The symptoms of depression includes feeling of hopelessness,
worthlessness/or helplessness, feelings of guilt, restlessness,
loneliness, loss of interest (NIMH 2008). Depressive syn-
drome has an enormous effect on a person’s competence to
function at the work place, in relationships and affects all
dimensions of life. The leading psychological problem across
the globe is depression (Kessler et al. 2003). The World Health
Organization reports that major depression will be the world’s
second most debilitating condition after cardiovascular dis-
eases by the year 2020 (Murray and Lopez 1996). The main
causes of depression among students are homesickness, the
pressures of achieving a higher academic grade, and hope for a
secure and better future (Buchanan 2012).
Stress, anxiety, depression among male
and female students
The results of some previous studies reporting on gender dif-
ferences have shown that females were under more stress than
males due to their recurrent health issues (Hall et al. 2006). It
was observed that first-year college students faced more stress
than final year students (Bassols et al. 2015). Overall, it was
assessed that mental distress severely impinged the lives of
females as compared to males (Goebert et al. 2009).
Females were more prone to anxiety syndromes (Ojha
2002). It was identified that students who were facing
anxiety symptoms have lower academic achievement and
peer acceptance (Seligman and Wuyek 2007). It was de-
tected that anxious and depressive disorders were found
more in females as compared to males (Bryme 2000;
Kulsoom and Afsar 2015). It was also perceived that the
level of test anxiety for females was higher than that of
male students (Bandalos et al. 1995).
While males reveal better psychological health than fe-
males, more depressive and obsessive symptoms were shown
by female participants in late adolescence (Sharma 1979). The
prominence of depression and anxiety syndromes are
more prone to females than males (Fisher and Hood
1987; Carson et al. 1998). It was identified that first-
year college students were severely affected by psycho-
logical problems, interpersonal relationship issues and
depressive symptoms (Kitzow 2003).
There are different results produced by the various studies
conducted on the Malaysian population. It was propounded in
studies conducted by NHMS (2015) on Malaysian population
that 27.6% of males and 30.8% of females are affected by
mental health problems; thus, it is concluded that females
are more affected by mental health problems in Malaysian
population. It was found in one of the recent studies conducted
on the Malaysian population, that poor urban males are more
J Public Health (Berl.): From Theory to Practice
susceptible to depression as compared to females (Tan and
Yadav 2015), while no gender difference was identified in
only a few studies conducted there (Wong and Lua 2011).
Objectives of the study
1. The first objective of the research paper is to isolate the
categories of of our study of spirituality by using explor-
atory factor analysis (EFA).
2. The second objective is to examine the relationship be-
tween aspects of spirituality and stress, anxiety, and de-
pression of engineering students.
3. The third objective is to examine the impact of spirituality
on depression, anxiety and stress.
4. The fourth objective of the study is to find out the differ-
ence between the different catagories factoring into our
study of spirituality and depression, anxiety, stress among
male and female engineering students.
Research methodology
Sample size
In total, 1,000 questionnaires were distributed among engi-
neering students of various disciplines at Indian Institute of
Technology Roorkee India, in the academic year 2017–2018.
A total of 914 questionnaires were included in the final anal-
ysis, while 86 inappropriate questionnaires were deleted and
not used in the final analysis. The response rate of the partic-
ipants was 91.4%. The sample consist of 773 males (84.6%)
and 141 females (15.4%). Students of different disciplines
participated in the current study: 734 (80.3%) B. Tech stu-
dents, 102 (11.2%) M. Tech students and 78 PhD (8.5%)
scholars participated in the study.
Procedure
A simple random sampling was used in the current study. For
conducting research on campus, prior permission was given
by the dean of student welfare of Indian Institute of
Technology Roorkee, India. Students were asked to voluntar-
ily participate in the random survey and the students in the
classroom were given 25 min to fill out the questionnaire with
uttermost authenticity. A 5-point Likert scale (1-strongly dis-
agree, 2-disagree, 3-neutral, 4-agree, 5-strongly agree) was
used in the survey questions, while the SPSS version 20 used
for data analysis.
J Public Health (Berl.): From Theory to Practice

Measurement Results

Spirituality Objective 1 The first objective of the research paper is to

extract the categorical aspects of spirituality by using explor-
A self-administered questionnaire on spirituality was used in atory factor analysis (EFA).
the present study. Table 1 shows a brief breakdown of differ-
ent categorial aspects along with the statistical technique of
exploratory factor analysis, whereby a total of eight categories Validation of multidimensional questionnaire
were extracted after applying factor analysis. These aspects of spirituality
were further categorized into three main categories on the
basis of a strong correlation between variables. The total Content validity
Cronbach alphas of the extracted dimensions are 0.872, while
sub-aspects are 0.870–0.606. It was considered that all the items in this phase are included
from all the conceptualized domain areas. The languages of
items included are simple, readable, appropriate, upfront, and
DASS-21 unpretentious to the target population (Clark and Watson
1995). The literature on spirituality was extensively reviewed
There are many psychometric scale to measure the psycholog- to develop an exhaustive list of items, whereby 77 items (71
ical distress of the respondents. One of the scale to measure positive items and 6 negative items) were generated initially
depression and anxiety is Kessler Psychological Distress with the reference of existing spirituality instruments
Scale (K10) given by (Andrew & Slade 2001). It was found including—expression of spirituality inventory (MacDonald
in the present study that the internal consistency of DASS-21 2000); spirituality scale (Delaney 2003); Daily spiritual expe-
is better than Kessler Psychological Distress scale. A shorten rience scale (Underwood and Teresi 2002); spiritual assessment
version of (depression, anxiety, and stress) Scale-21 (DASS- inventory (Hall and Edward 1996); spiritual meaning scale
21; Lovibond and Lovibond 1995) is used in the present re- (Mascaro et al. 2004); The Spiritual Transcendence Index
search paper to evaluate the level of distress; i.e. the short (Seidlitz et al. 2002); spirituality intelligence self-report inven-
version of the long 42-item DASS. In this study, it is used to tory (SISRI-24; King 2008); Integrated Spirituality Intelligence
measure levels of distress on three subscales: depression, anx- Index (Amram 2007); spiritual attitude and involvement list
iety, and stress. A total of 21 items with 7 items per construct (SAIL; de Jager Meezenbroek et al. 2012); brief multidimen-
such as depression, anxiety, stress, recorded on a 4-point scale sional measure of religiousness/spirituality (Fetzer institute
from 0 (did not apply to me at all) to 3 (applied to me very 1999); Heartland forgiveness scale (HFS; Thompson et al.
much or most of the time). The total score of the different 2005); the gratitude disposition questionnaire (McCullough
constructs is mentioned in the following section. Distress is et al. 2002); self-compassion scale (Neff 2018), etc.
indicated by the higher score per construct, whereas The content and face validity of the pooled items was
Cornbach’s alphas for subscales ranged from 0.79 to 0.84. established with the help of three experts in the field of man-
agement, psychology and spirituality. Items were reviewed by
these experts for readability, clarity and suitability.
A total of 58 items (54 positive items and 4 negative items)
Table 1 Demographic profile of the participants rated relevant by the experts were retained. Retained items
N %
were discussed and exposed to 20 randomly selected young
students for their comprehensive understanding and clarity of
Gender words. All the students comprehended the meaning of these
Male 773 84.6 items clearly without any confusion and misinterpretation.
Female 141 15.4 Exploratory factor analysis (EFA) was conducted among 914
Branch engineering students to confirm the precision and accuracy of
B. Tech 734 80.3 the questionnaire. An exploratory factor analysis (EFA) with
M. Tech 102 11.2 extraction technique of principal component analysis (PCA)
PhD 78 8.5 and varimax rotation was used for data reduction. Minimum
Age recommended value of KMO is 0.50; between 0.50 to 0.70 is
18–21 734 80.3 mediocre; between 0.70 to 0.80 is good; between 0.80 to 0.90
22–25 102 11.2 is great and above 0.90 is superb (Hutcheson and Sofroniou
26–30 78 8.5 1999). The value of Kaiser-Meyer-Olkin was 0.872 and
Barlett test of sphericity was Chi-square = 10,524, p = 0.000.

All the factors whose Eigen value were greater than 1 were
extracted in the present study. These rules of eigen value was
proposed by Kaiser (1974) and Heppner et al. (2006). Average
variance extraction of six dimensions was 62.70%. The ideal
acceptable limit was 60% (Scherer et al. 1988). All the values
whose factor loading was greater than 0.60 were accepted in
the current study, with the rule of thumb being that factor
loading <0.40 is weak and factor loading greater than >0.60
is strong (Garson 2010).
Reliability was measured using Cronbach alpha (α) coef-
ficients. All values of the internal reliability were found to
exceed 0.60. The minimum accepted value of Cronbach alpha
is 0.60 to 0.70 (Nunnally 1978; Bryman and Cramer 2005;
Hair et al. 2006). It is also relevant to mention that Cronbach’s
alpha value of 0.60 is also accepted in cases of exploratory
research (Bagozzi and Yi 1988). The overall reliability of the
self-administered scale is 0.872. Items of the questionnaire
and Cronbach alpha are presented in Table 2.
Finally, eight dimensions were extracted after exploratory
factor analysis: (1) universal consciousness; (2) relationship
with others and environment; (3) relationship with self. These
dimensions were further condensed into three main dimen-
sions on the basis of highest correlation among these vari-
ables, literature survey, conceptual understanding and expert
opinion. These variables are incorporated into three main cat-
egories: (1) relationship with universal consciousness (Rwuc):
universal consciousness; (2) relationship with others (Rwo):
reverence, compassion, forgiveness to others; (3) relationship
with self (Rws): self-love, mindfulness, acceptance, gratitude.
Abbreviation used for in the current study
Rwuc Relationship with universal consciousness
Rwo Relationship with others
Rws Relationship with self
Uc Universal consciousness
Re Reverence
SL Self-love
For Forgiveness to others
Com Compassion
Acc Acceptance
Mind Mindfulness
Gra Gratitude
Objective 2 To examine the relationship between spiritual
aspects and stress, anxiety, depression among engineering
students. A Pearson correlation coefficient was computed
to investigate the association between spirituality aspects
and stress, anxiety, depression. Table 3. shows the associ-
ation between aspects of spirituality such as relationship
with universal consciousness (Rwuc), relationship with
others (Rwo), relationship with self (Rws) and stress, anx-
iety and depression.
J Public Health (Berl.): From Theory to Practice
Relationship with universal consciousness (Rwuc)
There is a positive but not statistically significant relationship
found between Rwuc and stress (r(914) = 0.026, P = 0.431); a
significant positive relationship found between Rwuc and
anxiety (r(914) = 0.085, P = 0.010); and a negative but not sig-
nificant relationship between Rwuc and depression (r(914) =
−0.039, P = 0.238).
Relationship with others (Rwo)
There is a negative and statistically significant relationship
between Rwo and stress (r(914) = −0.169, P = 0.000); Rwo
and anxiety (r(914) = −0.184, P = 0.000) and Rwo and depres-
sion (r(914) = −0.229, P = 0.000).
Relationship with self (Rws)
There is a negative and statistically significant relationship
between Rws and stress (r(914) = −0.204, P = 0.000); Rws
and anxiety (r(914) = −0.164, P = 0.000) and Rws and depres-
sion (r(914) = −0.279, P = 0.000).
Objective 3 To examine the impact of spirituality dimensions
on depression, anxiety and stress.
Instantaneous, multiple regressions was used between spir-
ituality dimensions and stress to examine statistically the best
predictor of stress. The values of multiple regressions are pre-
sented in Table 4.
All the categories under spirituality such as Rwuc,
Rwo, Rws, significantly predict the dependent variable
stress, F(3, 910) = 19.12, **P < 0.001. The beta coeffi-
cient value of Rwuc is 0.109, Rwo is −0.110 and Rws is
−0.186, which reveals that the impact of Rwo and Rws is
negative regarding stress, whereas the impact of Rwuc is
positive. The adjusted r2 is 0.056, i.e. that 5.6% of the
variance in stress is explained by the different aspects of
spirituality. It also means that the level of stress is mini-
mized by the highest contributing aspect of Rws followed
by Rwo.
Stress ¼ 14:48 þ ð−10:8Þ  Rws þ ð−:068Þ  Rwo
þ ð:059Þ  Rwuc
The spiritual aspects significantly predicting the dependent
variable anxiety, F(3,910) = 21.69, **P < .001. The beta coef-
ficient value of Rwuc is 0.091, Rwo is −0.100 and Rws is
−0.083, which reveals that the impact of Rwo and Rws is
negative regarding stress, whereas the impact of Rwuc is pos-
itive. The adjusted r2 is 0.064, meaning that 6.4% of the var-
iance in anxiety is explained by the spiritual categorical as-
pects in the current study. In the present study, the highest
J Public Health (Berl.): From Theory to Practice

Table 2 Results of reliability and factor analysis of spirituality

Construct Items Factor Cronbach

loading alpha (.872)

Universal consciousness Uc1: look to higher supreme consciousness for strength, support and guidance 0.819 0.882
Uc2: pray to God 0.756
Uc3: find inner strength and peace from my prayer or meditation 0.735
Uc4: there is a higher plane of consciousness or spirituality that binds all people 0.723
Uc5: feel the presence of higher superior consciousness 0.714
Uc6: feel higher supreme consciousness punishes me for my sins or lack of spirituality 0.710
Uc7: my faith in higher power/universal intelligence helps me to cope during challenges in my life 0.677
Uc8: I have had spiritual experience that cannot be expressed in words 0.658
Reverence Re1: respect the diversity of people 0.801 0.795
Re2: believe that nature should be respected 0.777
Re3: believe that all living creatures deserve respect 0.730
Re4: listen to both sides of the story 0.628
Self-love SL1: I love myself 0.782 0.770
SL2: I take good care of myself 0.744
SL3: I hope for the best 0.715
SL4: I feel I can improve myself, I hope for the best 0.663
Forgiveness For1: I continue to be hard on others who have hurt me 0.891 0.832
For2: If others mistreat me, I continue to think badly of them 0.838
For3: I continue to punish a person who has done something that I think is wrong 0.834
Compassion Com1: People whom I really admire are those who have sacrificed everything for the sake 0.763 0.781
of societal upliftment
Com2: I feel a deep sense of responsibility for reducing pain and suffering in the world 0.749
Com3: I try to make a meaningful contribution to society 0.621
Com4: I want to make the world a better place 0.607
Acceptance Acc 1: I happily accept all that life brings 0.788 0.646
Acc 2: I accept myself as I am with all my problems and limitations 0.697
Acc 3: I accept other people as they are 0.690
Mindfulness Mind 1: I have developed my own techniques for entering higher states of consciousness 0.716 0.607
or awareness
Mind 2: recognize aspects of myself that are deeper than my physical body 0.693
Mind 3: I use silence to get in touch with myself 0.648
Gratitude Gra 1: I have so much in life to be thankful for 0.789 0.772
Gra 2: I am grateful for what I have 0.768

Author’s own finding

contributing dimension is Rwo followed by Rws, which infers by the catagorical aspects of spirituality. It also infer that the
that the level of anxiety is minimized by the highest contrib- level of depression is minimized by the highest contributing
uting aspect of Rwo followed by Rws. dimension Rws followed by Rwo.

Depression ¼ 16:98 þ ð−:149Þ  Rws þ ð−:091Þ  Rwo

Anxiety ¼ 12:51 þ ð−:141Þ  Rws þ ð−:160Þ  Rwo
þ ð:039Þ  Rwuc
þ ð:167Þ  Rwuc

Aspects of spirituality significantly predict the dependent
variable depression, F(3, 910) = 31.73, **P < 0.001. The beta
coefficient value of Rwuc is 0.066, Rwo is −0.136 and Rws is
−0.237, thus revealing that the impact of Rwo & Rws is neg-
ative with the depression, whereas the impact of Rwuc is
positive with the depression. The adjusted R2 is 0.092, and
shows that 9.2% of the variance in depression is explained
Objective 4 To examine the difference between the different
spiritual aspects and depression, anxiety, stress among male
and female engineering students. Table 5 presents an indepen-
dent sample t-test, conducted to examine the gender difference
between male and female engineering students. There is a sig-
nificant mean difference between spirituality of male and fe-
male engineering students. The mean score for males (M =
 J Public Health (Berl.): From Theory to Practice

Table 3 Relationship between aspects of spirituality and stress, anxiety, Table 5 Difference between spirituality, stress, anxiety and depression
depression among male and female engineering student

Variables Rwc Rwo Rws Stress Anx. Dep. Variables Gender Mean SD T-value

1 Rwuc 1 0.244** 0.304** 0.026 0.085* −0.039 SI

2 Rwo 1 0.462** −0.169** −0.184** −0.229** M 114.76 14.04 −6.058**
3 Rws 1 −0.204** −0.164** 0.279** F 112.34 11.33
4 Stress 1 0.718** 0.707** Stress
5 Anx. 1 .687** M 8.23 3.66 2.15*
F 7.58 3.16
6 Dep. 1
Anx.
**P < 0.001, *P < 0.05 M 6.89 3.69 0.155
F 6.94 3.25
Dep.
114.76, SD = 14.04) and females (M = 122.34, SD = 11.33), t = M 7.31 4.01 2.66**
−6.053, P = 0.000; P < 0.001, indicates that the level of spiritu- F 6.51 3.09
ality is different in both male and female engineering students.
An independent sample t-test, conducted to examine the **P < 0.001, *P < 0.05
gender difference between male and female engineering stu- SI spiritual intelligence; Anx. anxiety; Dep. depression
dents showed there is a significant mean difference present
between the levels of spirituality of male and female engineer- engineering students. Thirdly, there is a no significant mean
ing students. The mean score of males (M = 114.76, SD = difference present between the anxiety of male and female
14.04) and females (M = 122.34, SD = 11.33), t = −6.053, engineering students. The mean score of male (M = 6.89,
P = 0.000; P < 0.001 indicates that the spirituality level is dif- SD = 3.69) and female (M = 6.84, SD = 3.25), t = 0.155, P =
ferent in both male and female engineering students. 0.87; P > .05, indicates that the anxiety level is not different in
Secondly, there is a significant mean difference present be- male and female engineering students. Fourthly, there is a
tween the stress of male and female engineering students. significant mean difference present between anxiety of male
The mean score of males (M = 8.23, SD = 3.66) and females and female engineering students. The mean score of males
(M = 7.58, SD = 3.16), t = 2.15, P = .032; P < 0.05, indicates (M = 7.31, SD = 4.01) and females (M = 6.51, SD = 3.09),
that the stress level is different in both male and female t = 2.66, P = 0.008; P < 0.001 indicates that the level of de-
pression is different in both male and female engineering
students.
Table 4 Impact of spiritual aspects on stress, anxiety and depression

Variables B SEB β T-value Sig.

Discussion
Stress
Constant 14.48 This section covers the observation of subsequent findings of
Rws −0.108 0.022 −0.186 −5.01 0.000 the present study. At the first stage, the three main aspects of
Rwo −0.068 0.023 −0.110 −3.00 0.003 spirituality such as Rwuc, Rwo, Rws were isolated. In the
Rwuc 0.059 0.018 0.109 3.21 0.001 second stage, a positive and significant relationship between
r = 0.244, r2 = 0.059, Adj. r2 = 0.056, F(3,910) = 19.12, P = 0.000 universal consciousness and anxiety was observed. It was
Anxiety found in the third stage that Rws and Rwo act as important
Constant 12.51 aspects of spirituality which influence the level of stress, anx-
Rws −0.083 0.022 −0.141 −3.81 0.000 iety and depression among students. It was found in the fourth
Rwo −0.100 0.023 −0.160 −4.39 0.000 stage that the sense of spirituality of female students is more
Rwuc 0.091 0.018 0.167 4.91 0.000 pronounced than that of male students. In the fifth stage it is
r = 0.258, r2 = 0.067, Adj. r2 = 0.064, F(3,910) = 21.69, P = 0.000 seen that the stress, anxiety and depression of male students is
Depression higher than that of the female students.
Constant 16.98
Rws −0.149 0.023 −0.237 −60.49 0.000 Relationship with universal consciousness (Rwuc)
Rwo −0.091 0.024 −0.136 −3.78 0.000
Rwuc 0.039 0.019 0.066 1.99 0.040 ‘God’ or ‘Universal Consciousness’ exists in different forms
r = 0.308, r2 = 0.095, Adj. r2 = 0.092, F(3,910) = 31.73, P = 0.000 and shapes in all of us but in a true sense God resides within
us. A realization of soul-consciousness is a true connection
J Public Health (Berl.): From Theory to Practice
with God or Universal Consciousness. These spiritual experi-
ences are difficult to explain, but are realized and felt by ev-
eryone. This is the state of connection with one’s inner-self
and to the entire universe. BSpirituality expresses as one’s
ability to tap the deepest resources within oneself and embrace
the unseen and mysterious resources of the entire universe^.
Both the inward and outward journey gives us the opportunity
to discover and articulate our personal meaning and purpose
in life. It is only possible to get the absolute truth by accepting
the presence of something larger than the physical. A spiritual
person has a deep faith in God or a ‘supreme power. A strong
faith in a supreme power can help a person to cope with the
challenges of life. A strong faith helps an individual to
strengthen the core spiritual qualities of meaning and purpose,
hope, love and faith that allows for stability and the experience
of fulfillment (Rovers and Kocum 2010). Thus, true connec-
tion with the universal consciousness helps in cultivating the
quality of life and also in providing greater contentment
(Abdel-Khalek 2010), effective social support (Taliaferro
et al. 2009), better adjustment with college environment
(Kneipp et al. 2009), is negatively associated with psycholog-
ical distress and promotes positive health behaviors (Hsiao
et al. 2010).
Relationship with others (Rwo)
A person feels connection with society; they appreciate
that the whole universe is helping them. The greater the
trust among diversified cultures, the faster the growth of
whole society. Holistic vision will develop when we are
able to see the world from the viewpoints of others. A
spiritual person can see everyone equally with no one in
the entire universe appearing superior to another. All hu-
man beings are just performing their duties as dispensed
by the supreme consciousness. Spiritual knowledge shows
the true path of respect and virtue from other point of
views. Spirituality develops and nurtures the feeling of
sensitivity and respect towards society and our environ-
ment. It was found in the research study conducted on
36,000 adolescents in United States that family connect-
edness, school connectedness and spiritual connectedness
act as a defensive mechanism against many social indis-
positions (Resnick et al. 1993).
Relationship with self (Rws)
Self-love means caring for one’s own emotion, cultivation
of self-compassion and kindness for oneself, respecting
one’s well-being and taking responsibility for one’s life
consciously. Self-love is not replicated as a quality of
self-centeredness, arrogance or egoism. It is an indispens-
able realization of connection with one’s true inner-self
and disseminates the interconnection with others and with
the universal consciousness in search for true meaning
and purpose of life. Therefore, it is rightly said that BIf
you do not love yourself, you will be unable to love
others^ (Branden 1994). It was identified that higher
self-esteem shows a strong correlation with optimism, el-
evating the sense of achievement (Heinonen et al. 2005).
Relationship and impact of Rwuc and stress, anxiety
and depression
In the current study, the relationship found between universal
consciousness (Ruc) and stress is positive but not significant,
while the relationship between universal consciousness (Ruc)
and anxiety is positive and significant and the Ruc and depres-
sion is negative but not significant; hence, the emphasis is
given to the positive relationship between universal con-
sciousness (Ruc) and anxiety.
It is also relevant to mention that the impact of universal
conscious is positive on stress, anxiety and depression, which
means that engineering students stress, anxiety and depression
is increasing along with the involvement with the concept of
universal consciousness or supreme power. Relationship with
self (Rws) and relationship with others (Rwo) has a negative
impact on stress, anxiety and depression, which means that
engineering student’s levels of stress, anxiety, depression re-
garding Rws and Rwo.
A positive and significant relationship
and impact was found between relationship
with universal consciousness (Rwuc)
and anxiety
A positive relationship between universal consciousness and
anxiety was identified in the present study. This relationship
was increasing because contemporary youths are searching for
Bexistential realities^ of life, while at the same time they are
confounded about the true meaning and purpose of their life.
Many youths criticize the omnipresent God for spawning pain
and suffering in the society. These conventional events forced
a younger generation to ask questions related to God’s exis-
tence. Some people show their aggravation to God for
abandoning and punishing them, causing distress, challenges
and calamities in their life. As the younger generation have
inquired persistently about the existence of Universal
Consciousness or God, these youths are struggling and
experiencing trouble in accepting the abstract nature of uni-
versal mysticism.
This type of relationship with the supreme power cre-
ates a struggle with the divine force. It was found in the
previous studies that divine struggle was related to the
negative relationship with well-being. In the meta analysis
of 49 studies examined on 13,512 participants, the

findings of the study reveal that spiritual struggles were
interrelated with negative psychological adjustment such
as anxiety, social dysfunction and suicidality, guilt, hope-
lessness, depression, and hostility (Ano and Vasconcelles
2005). One of the studies was conducted on a sample of
1,629 participants in United States and it was observed
that spiritual struggles were connected with anxiety, de-
pression, obsessive-compulsiveness, and somatization,
paranoid ideation (McConnell et al. 2006). Another
meta-analysis of more than 100 studies also exposed that
this form of spiritual struggle is positively related with
depressive symptoms (Smith et al. 2003). Spiritual strug-
gles have been connected with greater emotional distress,
anxiety, depression, neuroticism, and psychosomatic
symptomatology, as well as lower levels of self-esteem
(Pargament et al. 1998a; Pargament et al. 1998b; Exline
et al. 1999, 2000; Wood et al. 2010).
Rws and Rwo act as an important dimension
of spirituality which influences the level
of stress, anxiety and depression
among students
It is clearly manifested in the current study that Rws and Rwo
are the dominating aspects which are operative in diminishing
the effect of stress, anxiety and depression. It can be inferred
from the results that connection with self and others helps an
individual in attaining ultimate peace, comfort and content-
ment. Rws can be strengthened by regular internal practices
of self-acceptance, self-compassion, gratitude and mindful-
ness. Likewise, participation in community services enhances
one’s sense of belonging and connection with others. It man-
ifested the following traits such as unconditional love, com-
passion for others and forgiveness to others, etc. Thus, youn-
ger generations are consciously developing the relationship
with self and others to minimize the effect of stress, anxiety
and depression.
Therefore, subjective well-being and worthiness positively
increases with the experience of self-love or high self-esteem.
Higher self-esteem shows a strong correlation with optimism,
elevation in the experience of achievement (Heinonen et al.
2005). Both hope and optimism refer to the positive future
expectation (Peterson and Seligman 2004). It was also found
that the high self-compassion reduces the level of depression,
anxiety and stress syndrome (MacBeth and Gumley 2012).
One study reveals that the adults who participated in once a
week community services are happier as compared to their
previous controlled condition (Mongrain et al. 2011). It was
also observed that spirituality is associated with one’s quality
of life, interconnectedness, well-being and harmony among
people (karakas 2010).
J Public Health (Berl.): From Theory to Practice
The strong sense of spirituality of female
students and the high levels of stress, anxiety
and depression of male students
It is found in the present study that the sense of spirituality for
female students is stronger than that in male students. The
results of the study are coherent with the past findings: female
students felt daily connection with the supreme power through
regular prayer, seeking directions of spiritual leaders to face
difficult situations of life (Buchko 2004; Ozorak 2003; Smith
and Denton 2005). These findings determine that females are
more inclined towards spirituality/religiosity than men.
Stress, anxiety, depression are more
pronounced in male students than female
students
It was observed in the current study that the symptoms of
stress, anxiety and depression are more in male students than
female students. Much of the previous research was not found
to be similar with the present study. It was concluded in the
previous studies that female students were more prone to
stress as compared to their male counterparts (Ruby
Brougham et al. 2009; Misra and McKean 2000; Dusselier
et al. 2005). It was also found that female students’ mathemat-
ical anxiety was higher in comparison to male students
(Hembree 1990; Maloney et al. 2012) and that the prevalence
rates of depression were higher in female than male popula-
tion (Cyranowski et al. 2000).
Implementation
Integrating aspects of spirituality in the lives of college stu-
dents via educational programs helps students with the devel-
opment of essential qualities such as love, hope, faith, mean-
ing in life, peace and comfort, leading to contentment and
satisfaction in their lives. Institutions should start some theo-
retical motivational courses to explore the degree of spiritual-
ity among engineering students. These are elective courses
accessible for the engineering students. Additionally, some
regular exercise like surya namaskar, silent meditation, and
self-reflection should be taught to the students by some qual-
ified and experienced faculty member.
Moreover, technical institutions should encourage stu-
dents to participate in extracurricular activities with spe-
cific emphasis on social services such as feeling empathy
and compassion for others, offering respect to others, love
and care for self, enhancing one’s self-efficacy and facing
challenging situation by retaining inner resilience and
tranquility. Regular workshop, seminars, lectures on the
subject of incorporating the relationship with self, others
J Public Health (Berl.): From Theory to Practice
and higher self and its influence in the life of students,
should be conducted on the college premises to strengthen
the inner potential of engineering students. Students
should be assessed continuously on the college premises
by counselors, psychologist and social workers. Students,
who score low on the spirituality and self-efficacy scale,
should be encouraged, and a progressive strategy for these
students should be made. Students should contribute to
social activities and also participate in team-building ex-
ercises which will improve their self-efficacy and social
support. Some more strategies are required to investigate
the relationship with family members, friends and society
as a whole.
Limitation and future work
In the current study, spiritual aspects are extracted by
preforming exploratory factor analysis. It is recommended
that a confirmatory factor analysis be conducted on a new
group of students, as the present study only included a
large group of engineering students whose intelligence
quotient is high in comparison to other university stu-
dents. All participating students are only from one pre-
mier institution and most of them are from a background
in Hindu religion; therefore, the generalization of the
study is not applicable to students of other backgrounds,
although the self-administered spirituality questionnaire
may be suitable for other geographic regions.
Conclusion
It is concluded in the present study that students should
connect with self, others and universal consciousness by
participating in the various programs which strengthen
their mind. Thus, the college administration of the pre-
mier engineering institution should motivate students to
participate in national social service (NSS) programs to
enlarge the vision of students so that they learn and con-
tribute to nation building. Consistent training of mind and
thought management should be given to the students.
Yoga and meditation programs benefit students to manage
a certain level of self-awareness and self-realization. This
will bring internal transformation and increases a sense of
overall well-being of the students. Finally, it was stated in
the previous research that overall contentment and happi-
ness of life is not merely dependent on general basic re-
quirements such as housing, health and finances, but it
also requires social support, religious/spiritual commit-
ment and integration of society’s values and principle
(John et al. 2011).
Funding Authors have not received fund from any source.
Compliance with ethical standards
Conflict of interest The authors declare that they have no conflict of
interest.
Ethical approval This article does not contain any studies with human
participants or animals performed by any of the authors.
Informed consent Informed consent was obtained from all individual
participants for whom identifying information is included in this article.
Approval of college ethical committee To conduct an ethical research, a
written consent from the Dean of Student Welfare, wellness wardens and
professors employed by the Indian Institute of Technology, Roorkee was
undertaken in the present study. Students participated voluntarily in the
study without any compensation.
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