Spiritual Well-Being Scale

1. Abstract

The Spiritual Well-Being Scale (SWBS), originally developed by Craig W. Ellison and Raymond F. Paloutzian in 1982, represents one of the most prominent, extensively validated, and widely cited psychometric instruments designed to assess the subjective quality of life from a multidimensional spiritual perspective. Constructed to evaluate spirituality as a nonsectarian, wholistic psychological construct rather than a strictly theological or doctrinal one, the SWBS conceptualizes spiritual well-being along two distinct yet reciprocal axes: a vertical, theological dimension designated as Religious Well-Being (RWB) and a horizontal, psychosocial dimension termed Existential Well-Being (EWB). Comprising 20 self-report items evenly distributed across these two 10-item subscales, the instrument employs a 6-point forced-choice Likert rating format devoid of an ambivalent neutral midpoint, ranging from 1 ("Strongly Disagree") to 6 ("Strongly Agree"), with approximately half of the items reverse-coded to minimize affirmative response set bias.

Over four decades of empirical investigation across diverse clinical, medical, psychiatric, and normative cohorts have demonstrated robust psychometric credentials for the SWBS. Internal consistency reliability estimates consistently range from moderate to excellent, with Cronbach’s alpha coefficients across published literatures typically spanning 0.82 to 0.94 for Religious Well-Being, 0.78 to 0.86 for Existential Well-Being, and 0.89 to 0.94 for the composite Spiritual Well-Being total score. Test-retest reliability over intervals extending from 1 to 10 weeks demonstrates high temporal stability, yielding coefficients between 0.73 and 0.99. Validity analyses—including extensive exploratory and confirmatory factor analyses, convergent correlations with psychological hardiness, self-esteem, and intrinsic religiosity, as well as divergent relationships with chronic loneliness, depression, and systemic anxiety—underscore its clinical and empirical diagnostic utility. While ceiling effects have been documented in devout theological populations, the scale is exceptionally sensitive at detecting spiritual distress, existential demoralization, and psychological alienation across diverse medical and therapeutic environments.

2. Keywords

Spiritual Well-Being Scale, religious well-being, existential well-being, psychometrics, quality of life, purpose in life, spiritual distress, health psychology, subjective well-being, intrinsic religiosity, factor analysis, existential psychology

3. Authors

The Spiritual Well-Being Scale was conceptualized and standardized through the collaborative psychometric research of two American psychologists:

• Craig W. Ellison, Ph.D.: Former Professor of Urban Studies and Psychology at the Alliance Theological Seminary (Nyack College) in Nyack, New York. Dr. Ellison was a pioneering researcher in the intersection of urban sociology, clinical pastoral counseling, and psychological well-being.
• Raymond F. Paloutzian, Ph.D.: Professor Emeritus of Experimental Social Psychology at Westmont College in Santa Barbara, California, and former visiting professor at Katholieke Universiteit Leuven, Belgium. Dr. Paloutzian is widely recognized internationally as a prominent theorist and scholar in the psychology of religion, having served as the longtime editor of the International Journal for the Psychology of Religion and co-editor of the landmark Handbook of the Psychology of Religion and Spirituality.

The scale was formally made commercially accessible and cataloged through Life Advance, Inc. (Nyack, NY), established by the original authors to supervise instrument licensing, psychometric manual dissemination, and institutional research permissions.

4. Purpose

The primary purpose of the Spiritual Well-Being Scale is to provide empirical researchers, clinical psychologists, behavioral scientists, and healthcare practitioners with an objective, standardized measure of an individual’s subjective perception of spiritual quality of life. During its developmental inception in the late 1970s and early 1980s, psychological research into religion and personal adjustment was largely encumbered by idiosyncratic, unstandardized operationalizations, doctrinal dogmatism, and an over-reliance on external behavioral proxies—such as church attendance frequency or denominational affiliation—which often failed to reflect an individual’s interior, subjective psychological experience. Ellison and Paloutzian sought to overcome these methodological limitations by designing a parsimonious psychometric instrument capable of distinguishing between theological engagement and psychological vitality.

Importantly, the SWBS was purposely designed not to evaluate doctrinal orthodoxy, ecclesiastical obedience, or canonical spiritual maturity. Because the criteria for spiritual maturity vary substantially across theological confessions and religious traditions, the scale focuses instead on the functional psychological outcomes of an individual’s personal philosophy of life and transcendence. It serves two distinct theoretical and clinical imperatives: capturing how individuals perceive the vertical quality of their communion with a divine or transcendent other (God), alongside how they evaluate the horizontal existential trajectory of their lived experience, characterized by a sense of life purpose, personal meaning, and environmental satisfaction.

In applied clinical contexts, the instrument has achieved widespread adoption across oncology, palliative medicine, gerontology, substance abuse rehabilitation, and psychotherapy. Medical professionals utilize the SWBS to screen for spiritual distress—a condition characterized by profound alienation, loss of meaning, and unresolved existential anguish—which has been repeatedly demonstrated to exacerbate somatic symptoms, complicate pain management, elevate clinical depression, and compromise treatment adherence. In psychiatric and outpatient psychological services, the instrument aids clinicians in delineating whether a patient’s psychological crisis stems from severed interpersonal/existential integration or acute theological alienation, thereby informing integrative psychotherapeutic interventions, existential therapy, and pastoral care pathways.

5. Psychological Construct

The psychological construct underlying the Spiritual Well-Being Scale is framed as a global, wholistic phenomenon composed of two structurally distinct yet mutually reinforcing dimensions: the vertical dimension of Religious Well-Being (RWB) and the horizontal dimension of Existential Well-Being (EWB). Spiritual well-being is defined within this paradigm as an individual’s subjective perception of wellness in relation to that which transcends the immediate, localized ego.

Religious Well-Being (Vertical Dimension)

The vertical dimension, operationalized via the Religious Well-Being subscale, captures the individual’s subjective psychological appraisal of their personal relationship with God or a supreme transcendent being. This dimension is explicitly theistic in its linguistic construction, with all 10 items incorporating the specific referent "God." Rather than evaluating adherence to complex theological dogma, liturgical compliance, or metaphysical propositions, the RWB items target the experiential, affective, and relational quality of this divine connection. Key phenomenological themes addressed within this subscale include:

• Perceived Divine Benevolence and Care: Exemplified by items such as "I believe that God loves me and cares about me" and "I believe that God is concerned about my problems." These items capture an internal working model of the transcendent as loving, accessible, and protective.
• Relational Satisfaction and Communion: Reflected in items such as "I have a personally meaningful relationship with God" and "I feel most fulfilled when I’m in close communion with God."
• Spiritual Resourcefulness and Coping: Examined through statements concerning the reception of internal fortitude, resilience, and solace during times of distress, as evaluated in "My relationship with God helps me not to feel lonely" and negatively reflected in "I don’t get much personal strength and support from my God."

Existential Well-Being (Horizontal Dimension)

The horizontal dimension, operationalized through the Existential Well-Being subscale, evaluates an individual’s subjective adjustment to self, community, cultural surroundings, and the broader temporal trajectory of their life. By intentional psychometric design, the 10 EWB items are entirely devoid of religious language, theological nomenclature, or references to divine entities. Instead, this subscale captures core humanistic and existential concerns, evaluating the extent to which an individual experiences their existence as meaningful, purposeful, coherent, and satisfying. The phenomenological facets comprising the EWB subscale include:

• Life Purpose and Meaning: Addressed directly by items such as "I believe there is some real purpose for my life" and negatively operationalized by "Life doesn’t have much meaning." This reflects the human need for teleological coherence and significance.
• Life Satisfaction and Hedonic Adjustment: Captured by statements evaluating global affective contentment, such as "I feel very fulfilled and satisfied with life" and "I feel that life is a positive experience," contrasted against dysphoric alienation in "I don’t enjoy much about life."
• Future Orientation and Self-Identity: Evaluated through cognitive appraisals of one’s personal destiny and existential security, including "I feel good about my future" versus profound ontological disorientation, as seen in "I don’t know who I am, where I came from, or where I’m going."

The theoretical synthesis of these two components asserts that genuine, integrated spiritual well-being involves both a transcendent anchor (whether vertical/theistic or internalized) and a constructive, functional engagement with the phenomenological realities of everyday life.

6. Theoretical Framework

The conceptual scaffolding of the Spiritual Well-Being Scale draws extensively from existential psychology, humanistic psychology, and contemporary social-cognitive psychology of religion. Most prominently, the construct reflects the logotherapeutic principles formulated by Viktor Frankl in his seminal work on the "will to meaning." Frankl posited that the fundamental human motivational drive is the pursuit of purpose and significance, and that a failure to realize subjective meaning precipitates an "existential vacuum," characterized by profound aimlessness, boredom, and psychological distress. Paloutzian and Ellison operationalized this existential imperative within the EWB subscale, conceiving human adjustment as intrinsically bound to whether an individual can articulate a coherent life narrative and teleological purpose.

Concurrently, the scale integrates the theoretical framework of Gordon Allport concerning religious motivation and psychological maturity. Allport established the classic dichotomy between intrinsic religiosity—wherein an individual interiorizes their faith as an end in itself, providing a master motive for living—and extrinsic religiosity, in which faith is utilized instrumentally for utilitarian gains, social status, or self-protection. The Religious Well-Being subscale reflects an intrinsic theological orientation, treating the divine relationship not as a transactional or social mechanism, but as an experiential source of personal identity, relational solace, and ontological security.

Furthermore, the horizontal/vertical dimensional architecture of the SWBS was informed by the conceptual writings of David O. Moberg, who argued that sociological and psychological inquiries into spiritual wellness must avoid reductionist paradigms. Moberg hypothesized that spiritual well-being operates as a two-dimensional continuum: a vertical relationship transcending mundane existence toward God, and a horizontal relationship unfolding across space, community, and time. Paloutzian and Ellison formalized Moberg’s theoretical taxonomy into a structured psychometric tool. The foundational assumption posited by this framework is that while vertical and horizontal well-being can and do influence one another—often exhibiting moderate positive empirical correlations—they are structurally separable. Consequently, an individual may maintain high existential purpose in the absence of theistic belief, or conversely, profess strong religious commitments while experiencing acute existential despair and demoralization.

7. Validity

The psychometric validity of the Spiritual Well-Being Scale has been thoroughly substantiated across hundreds of empirical investigations spanning diverse clinical, academic, and community populations.

Content and Face Validity

Initial content validation was conducted by panels of psychometricians, clinical theologians, and behavioral scientists who reviewed item candidate pools to ensure that the vertical items represented theistic relational affect without referencing specific sectarian dogmas (such as baptism, salvation theories, or canonical scripture), and that the horizontal items maintained a purely secular, existential focus. Face validity is immediately evident upon review of the 20 items, which clearly reflect personal satisfaction, divine interaction, existential purpose, and affective adjustment.

Construct and Convergent Validity

Construct validity has been demonstrated through robust correlations with theoretically related psychological constructs. In their seminal validation studies, Paloutzian and Ellison (1982) demonstrated that higher composite scores on the SWBS, as well as on both individual subscales, were significantly and negatively correlated with scores on the UCLA Loneliness Scale (Russell et al., 1980), indicating that spiritual well-being acts as a robust psychological buffer against social and existential alienation. Furthermore, total SWB, RWB, and EWB correlate positively and robustly with Crumbaugh and Maholick’s Purpose in Life (PIL) test, providing powerful empirical confirmation that the instrument accurately captures existential coherence and teleological direction.

Subsequent investigations across health psychology literature have demonstrated that higher SWB is positively associated with psychological hardiness, self-esteem (as measured by the Rosenberg Self-Esteem Scale), intrinsic religious orientation (Allport & Ross, 1967), and adaptive emotional coping strategies. In medical research, Carson and Green (1992) confirmed that spiritual well-being significantly predicted hardiness and emotional resilience in patients living with acquired immunodeficiency syndrome (AIDS). Similarly, Kaczorowski (1989) identified substantial negative associations between SWBS scores and state-trait anxiety among adult oncology patients undergoing active treatment.

Discriminant and Criterion Validity

Discriminant validity is supported by the capacity of the SWBS to differentiate between clinical and non-clinical cohorts. In comparative standardization studies (Bufford, Paloutzian, & Ellison, 1991), distinctly varied baseline profiles emerged across divergent demographic groups:

• Devout, conservative religious college samples demonstrated elevated baseline means (RWB ≈ 51–56; EWB ≈ 48–53; SWB ≈ 99–109).
• Nonreligious sociopathic incarcerated individuals yielded substantially depressed baseline means (RWB ≈ 35; EWB ≈ 40; SWB ≈ 76).
• Clinical psychiatric outpatients presenting with histories of sexual abuse, severe eating disorders, and mood dysregulation displayed marked spiritual distress (RWB ≈ 44; EWB ≈ 38; SWB ≈ 83).

Ceiling Effects and Clinical Sensitivity

A well-documented psychometric phenomenon of the SWBS is the occurrence of ceiling effects on the Religious Well-Being subscale within highly religious or evangelical populations, wherein distributions exhibit negative skewness and clustering near the maximum score of 60. While this characteristic limits the subscale’s discriminative sensitivity among devout individuals with uniformly elevated religious commitments, the scale displays profound psychometric sensitivity at the lower score spectrum, making it an exceptional diagnostic instrument for identifying individuals experiencing profound spiritual crisis, existential demoralization, and functional alienation.

8. Reliability

The reliability of the Spiritual Well-Being Scale has been evaluated comprehensively across four decades of research, demonstrating high internal consistency and exceptional temporal stability across varied test intervals.

Internal Consistency Reliability

In the original normative studies reported by Ellison (1983) and Paloutzian and Ellison (1991), internal consistency was calculated across multiple cohorts totaling over 900 subjects across seven independent empirical investigations. The resulting Cronbach’s alpha coefficients demonstrated high homogeneity within each subscale:

• Religious Well-Being (RWB): Cronbach’s $\alpha$ coefficients typically ranged from 0.82 to 0.94 across diverse cohorts.
• Existential Well-Being (EWB): Cronbach’s $\alpha$ coefficients ranged from 0.78 to 0.86, reflecting solid internal cohesion for a multidimensional existential measure.
• Total Spiritual Well-Being (SWB): Cronbach’s $\alpha$ coefficients for the full 20-item composite scale ranged from 0.89 to 0.94.

Test-Retest Stability

Temporal stability of the SWBS has been confirmed through repeated test-retest reliability designs across student and adult populations. In four distinct baseline samples evaluated across differing longitudinal intervals, Pearson product-moment stability coefficients remained remarkably high:

• 1-Week Interval: Test-retest correlation coefficients reached 0.93 for RWB, 0.98 for EWB, and 0.99 for total SWB.
• 4-Week Interval: Stability coefficients remained solid at 0.92 for RWB, 0.86 for EWB, and 0.91 for total SWB.
• 6-Week Interval: Reliability estimates demonstrated coefficients of 0.88 for RWB, 0.73 for EWB, and 0.82 for total SWB.
• 10-Week Interval: Extended temporal tracking yielded coefficients of 0.99 for RWB, 0.98 for EWB, and 0.99 for total SWB.

Collectively, these psychometric indices verify that the scale possesses strong score consistency, making it well-suited for longitudinal research, pre- and post-intervention evaluations, and epidemiological tracking over time.

9. Factor Analysis

The dimensional structure of the Spiritual Well-Being Scale has been the subject of extensive psychometric investigation utilizing both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Exploratory Factor Structure

During the initial development of the scale, Ellison (1983) conducted principal component and exploratory factor analyses with orthogonal and oblique rotations. The mathematical extraction reliably confirmed a robust two-factor conceptual solution mapping cleanly onto the vertical (Religious) and horizontal (Existential) structural axes:

• Factor 1 (Religious Well-Being): All 10 RWB items loaded heavily on a single primary factor, with factor loadings uniformly exceeding 0.60. These items cleanly clustered around communion with God, theological satisfaction, and divine presence.
• Factor 2 (Existential Well-Being): The 10 EWB items demonstrated clear separation from the religious items, clustering together on a distinct dimension. However, secondary sub-clustering was observed within the EWB item pool, revealing two distinct semantic facets: one reflecting Life Direction and Purpose (e.g., items 2, 6, 10, 14, 20) and another reflecting Life Satisfaction and Contentment (e.g., items 4, 8, 12, 16, 18).

Confirmatory Factor Analysis and Structural Controversies

Subsequent psychometric scrutiny using Confirmatory Factor Analysis (CFA) by Ledbetter et al. (1991), Genia (1996), and other independent investigators revealed that while the two-factor model provides an adequate theoretical approximation, a three-factor oblique model often provides a statistically superior fit to empirical data. In these structural equation models, the SWBS is represented by:

1. A primary, unified Religious Well-Being factor comprising all 10 theistic items;
2. An Existential Satisfaction factor capturing affective fulfillment and positive life experience; and
3. An Existential Direction / Purpose factor capturing future orientation, identity, and existential goals.

Fit indices across several CFA evaluations have yielded Root Mean Square Error of Approximation (RMSEA) values ranging between 0.05 and 0.07, and Comparative Fit Indices (CFI) hovering around 0.90 to 0.93 when modeling either the correlated two-factor model with method effect parameters (accounting for reverse-worded items) or the three-factor specification. Although a more nuanced three-factor solution is statistically supported in specific populations, the conventional two-subscale scoring model (RWB and EWB) remains the standardized, universally accepted framework for clinical scoring, norm comparison, and psychometric interpretation.

10. Instrument / Measurement Tool

• Full Instrument Name: Spiritual Well-Being Scale (SWBS)
• Authors: Craig W. Ellison, Ph.D., and Raymond F. Paloutzian, Ph.D.
• Publication Year: 1982 (Initial academic presentation); 1991 (Official standardized user manual)
• Administration Format: Self-administered paper-and-pencil or secure digital survey
• Completion Time: Approximately 10 to 15 minutes
• Item Composition: 20 items divided equally into two distinct 10-item subscales:
  • Religious Well-Being (RWB): Odd-numbered items (Items 1, 3, 5, 7, 9, 11, 13, 15, 17, 19). Every item explicitly includes the word "God."
  • Existential Well-Being (EWB): Even-numbered items (Items 2, 4, 6, 8, 10, 12, 14, 16, 18, 20). Contains no religious or theological terminology.
• Response Scale: 6-point forced-choice Likert scale with no neutral midpoint:
  • SA = Strongly Agree
  • MA = Moderately Agree
  • A = Agree
  • D = Disagree
  • MD = Moderately Disagree
  • SD = Strongly Disagree
• Scoring and Directionality:
  • Each item is scored from 1 to 6, where higher aggregate scores denote greater well-being.
  • Directly Scored Items (11 items): Positively phrased statements where agreement indicates higher well-being are scored as: SA = 6, MA = 5, A = 4, D = 3, MD = 2, SD = 1. (Items: 3, 4, 7, 8, 10, 11, 14, 15, 17, 19, 20).
  • Reverse Scored Items (9 items): Negatively phrased statements where agreement indicates lower well-being are reversed prior to scoring such that: SA = 1, MA = 2, A = 3, D = 4, MD = 5, SD = 6. (Items: 1, 2, 5, 6, 9, 12, 13, 16, 18).
• Subscale and Total Score Ranges:
  • Religious Well-Being (RWB) Score: Sum of items 1 through 19 (odd numbers). Possible range: 10 to 60.
  • Existential Well-Being (EWB) Score: Sum of items 2 through 20 (even numbers). Possible range: 10 to 60.
  • Total Spiritual Well-Being (SWB) Score: Sum of all 20 items (RWB + EWB). Possible range: 20 to 120.
• Standard Score Interpretation Ranges (Bufford et al., 1991):
  • Religious and Existential Subscales: Low (10–20), Moderate (21–40), High (41–60).
  • Total Spiritual Well-Being: Low (20–40), Moderate (41–99), High (100–120).

11. Permissions & Fee and Test Year

The Spiritual Well-Being Scale was originally conceptualized and presented in empirical literature in 1982, with the comprehensive psychometric standardization manual officially published in 1991. The instrument is a proprietary, copyrighted psychological test owned by the authors, Craig W. Ellison and Raymond F. Paloutzian.

Commercial dissemination, research licensing, test booklet distribution, and scoring permissions are administered through Life Advance, Inc. (81 Woodcrest Drive, Nyack, NY 10960, USA). While the scale items have frequently been reproduced in academic literature for scholarly examination and peer review, formal institutional use—including clinical trials, sponsored medical studies, funded academic research, and healthcare facility screenings—requires obtaining an official research specimen set and standardized scoring manual from the copyright holders or authorized testing distributors. Modest licensing fees or academic discounts are typically applied per administration protocol depending on whether the application is student-led dissertation research or an externally sponsored institutional project.

12. References

Allport, G. W., & Ross, J. M. (1967). Personal religious orientation and prejudice. Journal of Personality and Social Psychology, 5(4), 432–443. https://doi.org/10.1037/h0021212

Bassett, R. L., Camplin, W., Humphrey, D., Dorr, C., Biggs, S., Distaffen, R., Doxtator, I., Flaherty, M., Hunsberger, P. J., Poage, R., & Thompson, H. (1991). Measuring Christian maturity: A comparison of several scales. Journal of Psychology and Theology, 19(1), 84–93. https://doi.org/10.1177/009164719101900109

Bufford, R. K., Paloutzian, R. F., & Ellison, C. W. (1991). Norms for the Spiritual Well-Being Scale. Journal of Psychology and Theology, 19(1), 56–70. https://doi.org/10.1177/009164719101900106

Carson, V. B., & Green, H. (1992). Spiritual well-being: A predictor of hardiness in patients with acquired immunodeficiency syndrome. Journal of Professional Nursing, 8(4), 209–220. https://doi.org/10.1016/8755-7223(92)90083-d

Ellison, C. W. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology and Theology, 11(4), 330–340. https://doi.org/10.1177/009164718301100406

Ellison, C. W., & Smith, J. (1991). Toward an integrative measure of health and well-being. Journal of Psychology and Theology, 19(1), 35–48. https://doi.org/10.1177/009164719101900104

Frankl, V. E. (1984). Man’s search for meaning: An introduction to logotherapy. Simon & Schuster. (Original work published 1959).

Genia, V. (1996). I, E, Quest, and Fundamentalism as predictors of psychological and spiritual well-being. Journal for the Scientific Study of Religion, 35(1), 56–64. https://doi.org/10.2307/1386395

Kaczorowski, J. M. (1989). Spiritual well-being and anxiety in adults diagnosed with cancer. The Hospice Journal, 5(3–4), 105–115. https://doi.org/10.1080/0742-969x.1989.11882658

Ledbetter, M. F., Smith, L. A., Fischer, J. D., Vosler-Hunter, W. L., & Chew, G. P. (1991). An evaluation of the construct validity of the Spiritual Well-Being Scale: A confirmatory factor analytic approach. Journal of Psychology and Theology, 19(1), 94–102. https://doi.org/10.1177/009164719101900110

Paloutzian, R. F., & Ellison, C. W. (1982). Loneliness, spiritual well-being and quality of life. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research and therapy (pp. 224–237). John Wiley & Sons.

Paloutzian, R. F., & Ellison, C. W. (1991). Manual for the Spiritual Well-Being Scale. Life Advance, Inc.

Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39(3), 472–480. https://doi.org/10.1037/0022-3514.39.3.472

13. Items of the Scale