The study, published in SSM – Mental Health, drew on the Nurses’ Health Study II COVID-19 substudy, an offshoot of one of the longest-running and most influential women’s health cohorts in the world. The parent cohort began in 1989, enrolling 116,429 U.S. female registered nurses aged 25 to 42, who have completed biennial questionnaires ever since. In May 2020, as the pandemic surged, researchers invited roughly 56,000 active participants to join a dedicated substudy tracking mental health through monthly and then quarterly surveys. More than 39,000 women, with a mean age of about 65, enrolled. From this framework, the research team identified 6,868 women who reported having lost a loved one or someone important to them since March 1, 2020, and who had answered questions about religious coping.

The exposure of interest was captured with two deceptively simple items drawn from the Brief COPE inventory: whether, in the past seven days, the participant had tried to find comfort in her religion or spiritual beliefs, and whether she had prayed. Responses ranged from “not at all” to “a lot,” and the researchers constructed several versions of the exposure, including a composite measure, separate binary and continuous indicators for religious practice and prayer, and a high-religiosity subgroup of women who reported engaging in both activities frequently. The outcomes were assessed with the PHQ-4, a validated four-item screening instrument that yields a composite psychological distress score along with separate depression (PHQ-2) and anxiety (GAD-2) subscales, averaged across two follow-up waves in early 2021.

One of the study’s most eye-opening findings came before any outcome analysis: religious coping is astonishingly common in this population. Nearly 88 percent of bereaved women reported engaging in it, with prayer being the more prevalent form. Women who used religious coping also tended to report higher gratitude, hope, flourishing, mindfulness, community belongingness, and use of other coping strategies, painting a picture of faith as part of a broader resilient profile rather than an isolated behavior. Yet their baseline psychological distress scores were essentially identical to those of women who did not turn to religion, hinting that the apparent advantages of the religious group might reflect who they were rather than what their faith did for them.

That distinction is precisely where the study’s methodological ambition lies. Rather than simply comparing outcomes between groups, the researchers deployed inverse probability of treatment weighting, a causal inference technique that estimates each woman’s propensity to engage in religious coping based on a rich set of pre-exposure covariates, then reweights the sample so that the two groups are statistically balanced. The covariate set was unusually comprehensive, spanning demographics, neighborhood-level income, occupational status, social connectedness, loneliness, gratitude, sleep, physical activity, other coping methods, and critically, baseline mental health, including a pre-pandemic depression index built from 2017 cohort data using CES-D scores, physician diagnoses, and antidepressant use. Missing data were addressed through multiple imputation with chained equations, and the analysis was repeated under three different timing specifications to guard against reverse causality.

After all that statistical machinery, the headline result was null. Religious coping showed no significant association with subsequent overall distress (a beta coefficient of 0.01, with a confidence interval spanning zero), depression, or anxiety. The pattern held whether coping was treated as a binary yes-or-no behavior, a continuous frequency measure, or analyzed separately for prayer and religious practice. It held among women grieving immediate family members, extended family, and friends alike, and it held among the nearly 2,000 women who reported high religiosity. Sensitivity analyses using complete cases, separately analyzed timepoints, and alternative covariate windows all converged on the same conclusion: within the limits of what frequency-based measures can capture, religious coping neither protected nor harmed the average bereaved woman’s mental health.

But the stratified analyses revealed a wrinkle that complicates the tidy null. When the researchers split the sample by baseline depression severity, they found that among women with no depressive symptoms at baseline (PHQ-4 scores of 0 to 2), religious coping predicted a small but statistically significant increase in subsequent distress, with an overall PHQ-4 coefficient of 0.16. Among women with mild depression, the association flipped direction but was not significant, and among those with moderate to severe symptoms it was essentially null. A formal interaction test confirmed that the effect of religious coping differed meaningfully between women with and without baseline depression. The authors suggest several interpretations: for previously undepressed women, a sudden turn toward intensive religious coping might itself signal emerging distress, or it might displace more habitual and better-matched coping strategies, a possibility consistent with prior work linking coping inflexibility to worse outcomes.

The null findings in the most distressed subgroup echo one of the few prior prospective studies, an eight-week follow-up of university students in which baseline positive religious coping failed to buffer the effect of stress on later depression. The researchers also point to a conceptual limitation that may underlie much of the mixed literature: religious coping is not one thing. Decades of research, notably Kenneth Pargament’s work on the Brief RCOPE, distinguish positive religious coping, reflecting a secure relationship with the sacred, from negative religious coping, or spiritual struggle, marked by anger toward God, feeling abandoned, or questioning. These two dimensions are only weakly correlated and show divergent mental health associations, with positive coping generally linked to growth and well-being and negative coping to heightened distress. The current study could only measure how often women prayed or sought comfort, not the tone, content, or purpose of that engagement, leaving open the possibility that beneficial and harmful forms of religious coping canceled each other out in the aggregate.

There are other caveats worth weighing. The bereavement question captured any loss since March 2020 without pinpointing timing, so some women may have been surveyed long after their loss while others were in acute grief. The measure could not distinguish ongoing grief-related distress from more resolved mourning, and the sample, drawn from a cohort of predominantly white, highly educated nurses, limits generalizability. The authors also note that even positive religious coping may backfire under conditions of extreme, overlapping stress: conservation of resources theory suggests that when people invest coping resources such as prayer and hope without experiencing relief, the mismatch can amplify rather than relieve suffering, a dynamic that may have been especially relevant during the prolonged uncertainty of the pandemic.

For clinicians, grief counselors, and spiritual care providers, the practical message is one of calibrated expectations rather than dismissal. Religious coping is nearly universal among older women facing loss, and it may well provide meaning, community, and comfort that frequency-based survey items cannot detect. But the evidence here suggests it should not be assumed to be a protective intervention for mental health symptoms, particularly for women who were not depressed to begin with, in whom it may even mark or foreshadow emerging distress. Severe grief-related depression, the findings imply, likely requires more intensive support than faith practices alone can supply. The authors call for future research using instruments that separately capture positive and negative religious coping, along with the motivations behind prayer, so that spiritual and psychological support can be tailored to what each grieving person actually needs rather than to what tradition assumes helps.

Subject of Research: Religious coping and depression and anxiety outcomes among bereaved older women during the COVID-19 pandemic

Article Title: Religious coping and mental health outcomes among bereaved older women in the Nurses Health Study II

Article References: Sung, M., Cowden, R., Kang, J. H., & Denckla, C. (2026). Religious coping and mental health outcomes among bereaved older women in the Nurses Health Study II. SSM – Mental Health, 10, Article 100698. https://doi.org/10.1016/j.ssmmh.2026.100698

Image Credits: AI Generated

DOI: 10.1016/j.ssmmh.2026.100698

Keywords: religious coping, bereavement, grief, depression, anxiety, Nurses' Health Study II, COVID-19, mental health, prayer, older women, epidemiology, causal inference

The research draws on the National Study of Catholic Priests, a collaboration between the Catholic University of America and Gallup that constitutes the largest nationally representative survey of American Catholic priests in more than half a century. The baseline wave was collected between February and June 2022 from a stratified random sample of priests drawn from the Official Catholic Directory, a comprehensive listing of the U.S. priesthood. From a sampling frame of 26,807 priests, 10,000 were selected and 3,516 completed the first survey. A follow-up wave, fielded by Gallup between May 12 and June 30, 2025, recontacted those priests and produced 1,164 usable responses, yielding a final analytic sample of 1,056 priests with valid data at both time points. Because predictors were measured in 2022 and loneliness was measured in 2025, the design allows genuinely lagged analysis, a substantial advance over the cross-sectional and qualitative studies that have dominated research on clergy well-being.

Loneliness was measured using the widely validated three-item UCLA Loneliness Scale, which asks how often respondents feel they lack companionship, feel left out, and feel isolated from others. On average, priests reported relatively low to moderate loneliness, but with meaningful variation across the sample. The study’s central premise is that this variation is patterned and predictable. Priests represent what researchers call a paradigmatic case of relational asymmetry: their ministry is intensely social, filled with pastoral care, sacramental duties, and congregational leadership, yet their vocational commitments, including celibacy, frequent parish reassignment, and hierarchical constraints, limit access to the intimate and reciprocal relationships that buffer against emotional loneliness. A priest can be surrounded by hundreds of parishioners each week and still feel profoundly alone.

The first major set of findings concerns psychological well-being. Priests who scored higher on the Harvard Flourishing Index in 2022, a composite measure capturing life satisfaction, happiness, physical and mental health, sense of purpose, and the quality of their relationships, reported significantly lower loneliness three years later. A one-unit increase in flourishing on the ten-point scale corresponded to a 0.19-point decrease in loneliness, a meaningful shift given the compressed range of the outcome. This pattern is consistent with the broaden-and-build theory of positive emotions, which holds that people with higher well-being are better equipped to build and sustain social resources over time. Flourishing priests may interpret interactions more positively, invest more in relationships, and remain more emotionally available to others, creating a virtuous cycle of connection.

The reverse also holds, and with striking force. Priests reporting greater psychological distress at baseline, measured with the Kessler-6 screening tool covering nervousness, hopelessness, restlessness, depression, and worthlessness, showed the largest increase in subsequent loneliness of any predictor in the study, with a coefficient of 0.37. Burnout, assessed with items adapted from the Maslach Burnout Inventory, also predicted higher loneliness. This makes sense given the emotional labor inherent to priesthood: priests are expected to comfort the grieving, mediate conflicts, and embody spiritual authority, often while suppressing their own emotional needs. Emotional exhaustion erodes the capacity for empathy and engagement, while depersonalization fosters detachment and cynicism, gradually hollowing out the relational quality of a priest’s interactions until withdrawal follows. Notably, demographic characteristics such as age, race, nativity, and years in the diocese showed little consistent association with loneliness, suggesting that psychological conditions matter far more than background factors.

Institutional support emerged as a second crucial pillar, but its protective power depended dramatically on the source. Support from fellow priests proved to be the most consequential social resource: priests reporting strong peer support reported loneliness levels substantially lower than those with little or no support, with the association growing steadily stronger at each level of support. Peer relationships offer something that relationships with bishops and parishioners cannot: a space free of role asymmetry where priests can be vulnerable, share the particular struggles of their vocation, and receive understanding from people who live the same reality. The author suggests that variation in collegial networks may represent a central axis of inequality within the priesthood, with well-integrated priests enjoying durable protection while isolated colleagues face heightened risk.

Support from bishops also predicted lower loneliness, though with smaller effect sizes, likely because hierarchical power dynamics constrain openness and genuine emotional exchange. Support from parishioners showed the weakest and least consistent associations, with only strong parish support reaching statistical significance. Priests may feel constrained in expressing vulnerability to the people they lead, limiting how deeply these relationships can alleviate isolation. The pattern carries a practical message: horizontal bonds among peers appear more protective than vertical or role-bound relationships, and dioceses seeking to reduce clergy loneliness may do well to invest in structures that foster genuine peer connection rather than relying on formal supervisory relationships.

The spiritual findings were equally nuanced. Over 91 percent of the priests affirmed that the Eucharist is the center of their lives, and those who did so reported significantly lower subsequent loneliness, a reduction of 0.25 points compared to priests who did not affirm Eucharistic centrality. The Eucharist, which Catholic theology describes as the source and summit of Catholic life, is an inherently communal and embodied ritual involving physical presence, shared participation, and repeated coordination with a community of believers. For priests, who act as officiants mediating between the divine and the congregation, the Eucharist may provide a dual defense against loneliness: a sense of transcendent connection and a reinforced collective identity within the Church. In contrast, time spent in private prayer, whether fifteen minutes or more than an hour daily, showed no significant association with future loneliness. Private devotion may offer emotional comfort, but it apparently cannot substitute for the relational and communal dimensions of spiritual life.

The broader implication is that loneliness is best understood not as a static condition but as a temporally unfolding process shaped by the accumulation of psychological, institutional, and spiritual experiences. Two men entering the priesthood under identical structural constraints, celibacy, mobility, and demanding workloads, may follow very different trajectories depending on their psychological resources, the strength of their peer networks, and the depth of their engagement with communal ritual. This reframing matters for policy and formation. Seminaries and dioceses that cultivate flourishing, monitor for early distress and burnout, and deliberately build peer-support structures may be acting on some of the most powerful known predictors of long-term well-being among clergy. The findings also resonate beyond the Church, suggesting that in any highly relational occupation where emotional labor is intense and intimate support is constrained, communal and embodied forms of engagement, not solitary coping, are what keep isolation at bay. Loneliness among those who shepherd others, the study concludes, is not inevitable; it is contingent on the social and spiritual architecture surrounding them.

Subject of Research: Longitudinal predictors of loneliness among Catholic priests in the United States

Article Title: Lonely Shepherds? A Longitudinal Study of the Social, Psychological, and Spiritual Predictors of Loneliness among Catholic Priests in the United States

Article References: Upenieks, L. (2026). Lonely Shepherds? A Longitudinal Study of the Social, Psychological, and Spiritual Predictors of Loneliness among Catholic Priests in the United States. Pastoral Psychology. https://doi.org/10.1007/s11089-026-01373-0

Image Credits: AI Generated

DOI: 10.1007/s11089-026-01373-0

Keywords: loneliness, Catholic priests, clergy well-being, social support, burnout, psychological distress, flourishing, Eucharist, prayer, longitudinal study, pastoral psychology, mental health