A Scoping Review Of Religion, Spirituality And Youth Mental Health Outcomes

University of Wollongong

Ereni Tadrus

Word Count: 3059

Abstract

This scoping review explored how religion and spirituality (R/S) influences mental health outcomes in young people aged 10–24 years. Guided by the JBI Manual for Evidence Synthesis and PRISMA-ScR criteria, thirteen studies published between 2006 and 2025 were reviewed, including longitudinal, cross-sectional, qualitative, and intervention designs. Across diverse cultural contexts, intrinsic religiosity and spiritual wellbeing were consistently associated with improved resilience, greater life satisfaction, and reduced depression and anxiety. Three core mechanisms (meaning-making, adaptive coping, and social connectedness) emerged as mechanisms through which R/S support positive mental health. Conversely, extrinsic religiosity and negative religious coping (e.g., guilt, exclusion, or rigid belief systems) were occasionally linked to poorer outcomes. Contextual factors such as culture, gender, and inclusivity within faith communities moderated these relationships. While most evidence supports the protective influence of intrinsic spirituality, inconsistent operationalisation of R/S constructs and reliance on self-report measures limit causal interpretation. Overall, R/S appear to function as complex psychosocial resources that promote wellbeing when internalised authentically and practiced within supportive environments. These findings highlight the need for culturally sensitive, spiritually informed approaches in youth mental-health promotion and for longitudinal research to clarify causal mechanisms and developmental trajectories.

A Scoping Review Of Religion, Spirituality And Youth Mental Health Outcomes

Globally, one in seven adolescents aged 10–19 years experiences a mental disorder, contributing to 15% of the total burden of all diseases in this age group (WHO, 2024). Depression, anxiety, and behavioural disorders are leading causes of illness among adolescents, whilst suicide remains the third leading cause of death amongst young people aged 15–29 years (Institute for Health Metrics and Evaluation [IHME], 2024). Despite the high prevalence, many adolescent mental health conditions remain undiagnosed and untreated, resulting in long-term consequences that extend into adulthood, including impaired social functioning, physical health difficulties, and limited life opportunities (Mullens, 2018).

Adolescence represents a critical developmental period characterised by significant physical, emotional, and social change. Exposure to risk factors such as poverty, family conflict, violence, and social pressure can increase vulnerability to psychological distress. Conversely, protective factors — such as supportive relationships, coping skills, positive identity formation, and safe communal environments — can buffer against poor mental health outcomes and foster resilience (Tietbohl-Santos et al., 2024).

Religion & Spirituality (R/S) have emerged as potential psychosocial protective factors (Garssen et al., 2020). Religion refers to an organised system of beliefs and practices that provide a shared framework for understanding the world and seeking meaning (Guthrie, 1996). It often involves communal worship, faith traditions, and moral guidance, but can also include individual practices such as prayer or meditation (Rosmarin et al., 2016). Spirituality, while closely related, is a broader and more personal construct defined by an individual’s search for connection, purpose, and transcendence (Wink & Dillon, 2008; Schnall et al., 2014). Although religion and spirituality overlap, not all religious individuals identify as spiritual, and not all spiritual individuals adhere to a formal religion.

This scoping review aims to explore how R/S influence mental health outcomes in young people. The population of interest is adolescents aged 24 years and under from both clinical and general populations. The concept focuses on the role of R/S as psychosocial factors that may enhance positive mental health outcomes, such as life satisfaction, resilience, coping strategies, and reduced psychological distress. The context encompasses studies conducted in diverse cultural, social, and healthcare settings that examine R/S as potential protective or moderating factors in youth mental health. Specifically, the review seeks to (1) map existing research on the relationship between R/S and mental health outcomes in youth; (2) distinguish between the roles of religion and spirituality; and (3) identify conceptual, methodological, and population gaps to inform future research and youth mental health practice.

Method

Search Strategy

A systematic search was conducted across electronic databases including PubMed, and CINAHL, covering literature from January 2015 to August 2025. The full search strategy, including complete search terms and Boolean combinations, is provided in Appendix 1 to enable replication. The eligibility criteria were structured using the Population, Intervention Comparison, and Outcome (PICO) framework. The review focused on young people aged 24 years and under from clinical/high risk or general populations. The intervention or exposure of interest included religion — defined as formal adherence to organised doctrines, practices, and institutions such as service attendance or religious affiliation — and spirituality — defined as personal or subjective experiences of connection, meaning, or transcendence, such as spiritual wellbeing, prayer, or a perceived closeness to a higher power. Eligible outcomes included positive mental health indicators such as increased life satisfaction, hope, resilience, effective coping strategies, or reductions in depression, anxiety, and psychological distress.

Only peer-reviewed studies published in English between 2015 and 2025 were included, while studies focusing solely on adult populations or outcomes unrelated to mental health were excluded. Reference lists of selected articles were also screened to identify additional relevant literature. Grey literature was included to reduce publication bias and capture emerging evidence not yet represented in peer-reviewed journals.

Selection of Evidence

All search results were imported into Covidence software for management, duplication removal, and screening. Titles and abstracts were screened for eligibility before full-text review. As the review was completed by a single reviewer, all screening decisions were recorded within Covidence to maintain transparency and replicability.

Data Extraction and Synthesis

This scoping review was conducted in accordance with the JBI Manual for Evidence Synthesis (Aromataris & Munn, 2020) and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist (Tricco et al., 2018). The checklist guided all stages of screening, data extraction, synthesis, and reporting to ensure transparency and replicability (see Appendix 3).

All screening and appraisal processes were completed independently by the reviewer. Each included study was assessed for methodological quality and relevance using structured tools appropriate to its design, such as the JBI Critical Appraisal Checklists for qualitative, cross-sectional, or cohort studies. Data accuracy was verified through repeated checking at extraction and synthesis stages to minimise bias. Extracted variables included author, year, country, study design, sample characteristics, measures of religion and spirituality, mental health outcomes, and key findings.

Findings were summarised narratively, with consideration given to methodological diversity, strengths, and limitations of the included studies. Data was synthesised thematically to identify key patterns and gaps in the evidence. Please refer to Appendix 2 for a summary of the included studies.

Results

Selection of Sources of Evidence

A total of 98 records were identified through database searching. After removal of 3 duplicates, 95 titles and abstracts were screened for relevance. Of these, 53 full-text articles were assessed for eligibility, resulting in 13 studies meeting the inclusion criteria for this scoping review. Reasons for exclusion at full-text stage included adult-only samples, absence of religious or spiritual variables, or lack of mental-health outcomes. The selection process is summarised in Fig. 1.

Fig. 1

PRISMA Flow Diagram

Characteristics of Sources of Evidence

A total of 13 studies published between 2006 and 2025 were included, encompassing diverse methodological approaches. Samples represented youth aged 10–24 years across multiple cultural contexts, including the United States, United Kingdom, Canada, Iran, and multi-country cohorts. A detailed overview of each study including design, population, R/S constructs, outcomes, and principal findings is presented in Table 1 and further elaborated in the Table of Included Source of Evidence Characteristics in Appendix 2 The table was adapted from the JBI Manual for Evidence Synthesis (Appendix 10.1) to capture the diversity of study designs and contextual features (Peters et al.,2020).

Religious and spiritual constructs examined included intrinsic (personal faith) and extrinsic (institutional participation) religiosity, spiritual wellbeing, faith importance, spiritual coping, and faith-based interventions. Mental-health outcomes predominantly involved depression, anxiety, subjective wellbeing, resilience, and treatment-seeking behaviour.

Critical Appraisal Within Sources of Evidence

All included studies were appraised using the relevant JBI Critical Appraisal Checklists to assess methodological quality and potential bias. The overall quality of evidence was moderate-high. Common strengths included clearly defined research objectives and validated outcome measures, while limitations frequently involved small sample sizes, self-report bias, and inconsistent operationalisation of spirituality versus religiosity. Appraisal results informed interpretation but were not used as exclusion criteria.

Synthesis of Findings

Thirteen studies met inclusion criteria, examining how R/S relate to positive mental health outcomes in young people aged ≤ 24 years. Collectively, longitudinal, cross-sectional, qualitative, and intervention research published between 2015 and 2025 across 12 countries demonstrated that R/S generally enhances resilience, reduce depression and anxiety, and promote wellbeing, though effects vary according to type of religiosity (intrinsic vs. extrinsic), cultural context, and nature of stressors (see Appendix 2).

Aggarwal et al. (2023) found that spiritual wellbeing consistently protected against depressive symptoms, whereas negative religious coping (e.g., guilt or divine punishment) predicted poorer outcomes. Earlier work by Cotton et al. (2006) reinforced these findings, distinguishing between spirituality and external religiosity, and showing that intrinsic spiritual engagement correlated with greater emotional stability and lower risk-taking behaviour among adolescents.

Empirical studies reinforced these associations. Tsomokos and Dunbar (2023) reported that religiosity moderated the link between interpersonal distrust and depression among UK adolescents, while Fruehwirth et al. (2019) found an 11% reduction in depression among highly religious U.S. youth, independent of social supports. VanderWeele and Ouyang (2025) demonstrated that service attendance and intrinsic spiritual meaning predicted greater flourishing and slower growth of depressive symptoms. Complementing these, Tietbohl-Santos et al. (2024) highlighted spirituality and faith engagement as moderators of resilience in high-risk youth, and Al-amer et al. (2024) confirmed that religious coping strategies reduced stress in collectivist adolescent samples.

Qualitative and intervention studies provided contextual depth. Breland-Noble et al. (2015) found that prayer and faith nurtured hope among African American youth, though stigma sometimes hindered help-seeking. Naghmeh et al. (2023) described spirituality among Iranian adolescents as a source of self-control and optimism. In India, Pandya (2017) demonstrated through a randomised trial that structured spiritual-development programs significantly enhanced happiness and psychological wellbeing.

Several studies introduced nuance. Ji et al. (2011) distinguished intrinsic religiosity, which predicted reduced depression and substance use, from extrinsic religiosity, which correlated with maladaptive outcomes. Lekwauwa et al. (2022) showed that inclusive spirituality improved wellbeing for transgender adolescents, whereas exclusionary religious environments heightened distress. Shaver et al. (2022) reported that while spiritual connectedness buffered bullying effects for boys, excessive introspection among girls occasionally intensified distress.

Across studies, intrinsic spirituality consistently moderated the relationship between adversity and mental health outcomes, fostering meaning, belonging, and adaptive coping (Aggarwal et al., 2023; Fruehwirth et al., 2019; VanderWeele & Ouyang, 2025; Tsomokos & Dunbar, 2023). Qualitative and experimental findings (Breland-Noble et al., 2015; Naghmeh et al., 2023; Pandya, 2017) illustrated that spirituality promotes emotional regulation and pro-social orientation, complementing quantitative results linking faith practices to flourishing (VanderWeele & Ouyang, 2025; Al-amer et al., 2024).

Cultural and contextual factors shaped these outcomes. In collectivist societies (Naghmeh et al., 2023; Al-amer et al., 2024), spirituality emphasised communal harmony, whereas Western contexts (Cotton et al., 2006; Shaver et al., 2022; Tsomokos & Dunbar, 2023) framed it around personal meaning and autonomy. Among marginalised youth (Lekwauwa et al., 2022), the protective value of faith depended on inclusion within faith communities. While largely beneficial, some studies (Breland-Noble et al., 2015; Shaver et al., 2022) cautioned that spirituality may amplify distress when intertwined with guilt or stigma.

Overall, the synthesis indicates that religion and spirituality function as moderators of stress and predictors of positive coping in youth, with the strongest effects when faith is intrinsic, inclusive, and self-determined, and weakest when characterised by rigidity or exclusion. These findings underscore the need for culturally sensitive, spiritually informed approaches to youth mental-health promotion and intervention.

Table 1

Summary of Included Studies on Religion and Spirituality (R/S) and Youth Mental Health
Article	Study Design	Sample/Demographic	Key Results	Critical Appraisal Comments
Aggarwal et al. (2023)	Systematic review & meta-analysis	74 longitudinal + 29 intervention studies of youth < 24 yrs	Spiritual wellbeing reduced depressive symptoms; negative religious coping predicted poorer mental health.	High-quality systematic review with clear aims, comprehensive search, and rigorous dual-review process. Methods for synthesis and bias assessment were appropriate. Limited discussion of policy implications, but strong research recommendations. Included due to methodological rigor and relevance to review questions.
VanderWeele & Ouyang (2025)	Longitudinal cohort	U.S. adolescents & young adults	Religious attendance and intrinsic meaning predicted greater flourishing and lower depression.	Limited cultural diversity: Strong causal modelling (adjusted for confounders); robust design; aligns with inclusion.
Tsomokos & Dunbar (2023)	Longitudinal quantitative	11,045 U.K. adolescents	Religiousness buffered link between interpersonal distrust and depression.	Self-report bias; cross-sectional analysis within broader cohort. Excellent control for confounders. Strong internal validity.
Fruehwirth et al. (2019)	Longitudinal quantitative	U.S. secondary-school students	Religiosity reduced depression probability by 11% after adjusting for confounds.	Possible unmeasured peer-influence factors. Strong control for confounding; longitudinal robustness; significant protective association.
Pandya (2017)	Randomised controlled trial	5,339 Indian adolescents	Spiritual-development program increased happiness and wellbeing.	Short follow-up; cultural specificity limits generalisation. Data-driven and relevant; ethical rigor present.
Tietbohl-Santos et al. (2024)	Systematic review	High-risk youth (≤ 24 yrs)	Multiple protective factors against youth depression, highlighting intrinsic religiosity and spirituality as significant buffers promoting resilience and wellbeing.	Strong methodological rigor with a clear research question – adherence to all the JBI standards. Variability in how spirituality was defined and assessed across included studies limited the consistency and comparability of findings.
Al-amer et al. (2024)	Cross-sectional quantitative	1344 participants, aged 14 to 18 years	Religious coping correlated negatively with stress (r = − 0.097, p < .001).	Correlational design; single cultural context.
Naghmeh et al. (2023)	Qualitative interviews	Iranian adolescents aged 14–18 years	Spirituality promoted self-control, purpose, and optimism.	Small, homogeneous sample; limited transferability. High congruity between methodology and aims; reflexivity limited but rich participant voice.
Breland-Noble et al. (2015)	Qualitative thematic analysis	African American adolescents with depression	Prayer and faith fostered agency and hope, but stigma hindered help-seeking.	Non-generalisable; potential researcher bias.
Cotton et al. (2006)	Systematic review	Adolescents 10–18 years (multi-country)	Intrinsic spirituality linked to emotional stability and lower risk-taking.	Broad scope; includes physical and moral outcomes; partial alignment to inclusion criteria. Outdated evidence base; limited cultural scope.
Ji et al. (2011)	Quantitative survey	US adolescents	Intrinsic religiosity lowered depression and substance use; extrinsic linked to maladaptive outcomes.	Restricted to one faith tradition. Non-generalisable; potential researcher bias.
Lekwauwa et al. (2022)	Systematic review	Transgender adolescents (18 studies)	Intrinsic spirituality improved wellbeing: external stigma increased distress.	Few high-quality studies; Western bias.
Shaver et al. (2022)	Cross-sectional quantitative	12,593 Canadian adolescents 11–15 years	Spiritual connectedness buffered bullying impact but intensified distress for highly self-focused girls.	Self-report bias; gender-specific effects unclear. High-quality sample; strong analytic design.

Discussion

This scoping review synthesised studies examining the relationship between R/S and mental health outcomes in young people aged 24 years and under. The findings indicate that R/S are not peripheral influences but central psychosocial constructs shaping adolescents’ emotional development, coping capacity, and identity formation. Adolescence is a formative stage marked by increasing cognitive and moral sophistication and a growing search for meaning; making it a crucial period for understanding how faith, spirituality, and existential frameworks influence wellbeing. Within this developmental context, R/S can offer structure, belonging, and hope ; key factors that help young people navigate stress and adversity. These findings are particularly relevant given the rising global burden of adolescent mental health disorders and the increasing recognition that clinical frameworks often overlook spiritual dimensions of care. Understanding the role of R/S therefore extends the scope of mental health promotion, particularly in culturally and religiously diverse settings.

Across diverse study designs, R/S consistently emerged as protective or moderating factors in youth mental health. Intrinsic religiosity and spiritual wellbeing were associated with reduced depression and anxiety, improved life satisfaction, and stronger resilience (Aggarwal et al., 2023; VanderWeele & Ouyang, 2025). Conversely, extrinsic religiosity, rooted in obligation or conformity, was sometimes linked with maladaptive outcomes such as guilt or avoidance (Ji et al., 2011; Cotton et al., 2006). Three interrelated mechanisms consistently explained these relationships: meaning-making, adaptive coping, and social connectedness. Meaning making allowed adolescents to frame stressful experiences within a broader narrative of purpose or moral coherence, while adaptive coping involved using prayer, meditation, or spiritual reflection to regulate emotions and maintain hope. Social connectedness, facilitated through faith communities or shared belief systems, reduced isolation and provided relational support, often serving as a buffer against psychosocial stressors such as bullying or family conflict (Fruehwirth et al., 2019; Tsomokos & Dunbar, 2023).

Operationalisation and measurement of “religiosity” and “spirituality” varied considerably across studies, ranging from behavioural indicators such as institution attendance and prayer frequency to psychological dimensions like meaning, transcendence, or perceived connection to a higher power. This heterogeneity complicates direct comparisons and likely accounts for inconsistent findings, particularly when intrinsic (personal faith) and extrinsic (institutional participation) religiosity were conflated. Only a few studies employed validated multidimensional measures to capture the complexity of R/S constructs, reducing construct precision and cross-study reliability. Moreover, most included studies were conducted in Judeo-Christian or Muslim populations, reflecting the dominant religious orientations of the countries represented. This limits generalisability to non-religious, minority-faith, Indigenous, and Eastern spiritual traditions, which remain underrepresented in the literature.

Cultural, gender, and contextual factors consistently shaped the direction and magnitude of R/S effects. In collectivist societies, spirituality was embedded in family and communal structures, emphasising interdependence, moral duty, and social harmony (Al-amer et al., 2024). In contrast, Western studies framed spirituality as an individualised pursuit of authenticity and personal growth (Cotton et al., 2006; Tsomokos & Dunbar, 2023). Gendered patterns were also evident: faith-based belonging appeared particularly protective for males, whereas females reported greater vulnerability to guilt or exclusion when exposed to rigid or punitive religious teachings (Shaver et al., 2022). Among marginalised groups, such as transgender adolescents, inclusive faith settings enhanced wellbeing, while exclusionary or discriminatory religious environments exacerbated distress (Lekwauwa et al., 2022). Collectively, these findings underscore that R/S are not universally protective but operate as context-dependent psychosocial systems that can either mitigate or intensify vulnerability depending on inclusivity, authenticity, and community climate.

The quality of the available evidence was mixed. High-quality longitudinal and meta-analytic studies (e.g., Aggarwal et al., 2023; VanderWeele & Ouyang, 2025) provided the strongest support for temporal and causal links between R/S and improved wellbeing. These designs suggest that faith-based engagement can exert a sustained protective effect on depressive trajectories and general flourishing. However, most studies were cross-sectional and reliant on self-report measures, limiting causal inference and increasing susceptibility to social desirability bias. Sample diversity was also limited: participants were typically school-based, Western, or religiously affiliated, with few studies including secular or multi-faith cohorts. Small sample sizes, insufficient statistical power, and inconsistent control for confounding variables (e.g., family cohesion, socioeconomic status) further constrain interpretation.

Methodological limitations also exist within this review. Conducted by a single reviewer, there is an inherent risk of selection and interpretation bias, despite the use of Covidence software to ensure procedural transparency and adherence to JBI appraisal frameworks. Restricting inclusion to English-language studies may have excluded relevant non-English research potentially skewing findings toward Western perspectives. Furthermore, heterogeneity in study design and outcome measurement precluded quantitative synthesis, necessitating a narrative approach that emphasises thematic patterns over statistical precision. Nevertheless, the use of structured JBI tools and PRISMA guidelines enhanced methodological rigour and consistency throughout the screening and extraction process.

Despite these constraints, several key implications emerge for practice and policy. R/S should be recognised as legitimate dimensions of youth mental health assessment and intervention, particularly in multicultural clinical settings. When internalised authentically and practiced within inclusive, supportive contexts, R/S can strengthen emotional regulation, foster hope, and enhance identity coherence — core developmental goals during adolescence. Clinicians, educators, and youth workers should approach R/S as potential strengths, integrating spiritual dialogue or meaning-based frameworks into care where appropriate. However, practitioners must remain attentive to circumstances where R/S may contribute to guilt, stigma, or exclusion. Building partnerships with faith leaders, school chaplains, and culturally specific services may enhance accessibility and cultural safety, ensuring that spiritual support complements evidence-based care rather than competing with it.

Future studies should adopt longitudinal and mixed method designs to clarify developmental pathways and causal mechanisms through which R/S influence mental health. Standardised, multidimensional measurement tools are essential to distinguish between intrinsic and extrinsic aspects of religiosity and to enhance comparability across cultural settings. Research should intentionally include underrepresented populations, such as Indigenous, Eastern, and secular youth, to expand the cultural scope of existing findings. Furthermore, integrating psychophysiological and behavioural indicators alongside self-report measures may yield a more comprehensive understanding of how R/S engagement manifests in daily functioning and resilience.

In conclusion, this review demonstrates that religion and spirituality are powerful yet context-sensitive determinants of adolescent mental health. When expressed inclusively and self-determinedly, they enhance meaning, belonging, and coping, serving as vital protective factors in the face of adversity. Conversely, when imposed rigidly or accompanied by exclusion, they can contribute to psychological distress. Importantly, religion and spirituality, though related, play distinct roles: religion often operates as a social and institutional system providing structure, values, and community, while spirituality reflects an individual’s personal search for meaning, transcendence, and connection. The evidence reviewed suggests that spirituality tends to exert a more consistent protective effect on mental health, whereas the impact of religion varies depending on inclusivity, authenticity, and cultural context. The findings advocate for a balanced, culturally responsive approach to integrating R& S dimensions into youth mental health promotion and early intervention frameworks. Doing so not only aligns with holistic models of care but also acknowledges the diverse ways in which young people seek meaning, connection, and healing in an increasingly complex world.

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Appendix 1

Boolean Search Strategy

A systematic search was conducted across electronic databases including PubMed and CINAHL, covering the period January 2015 to August 2025. The following Boolean operators and search strings were used to identify relevant studies. Search terms were adapted to each database’s syntax and controlled vocabulary. Filters were applied to include peer-reviewed articles, English language, and participants aged ≤ 24 years. Grey literature and unpublished works were excluded.

PubMed Search String

("religion"[Title/Abstract] OR "religiosity"[Title/Abstract] OR "spirituality"[Title/Abstract] OR "spiritual well-being"[Title/Abstract]) AND ("mental health"[Title/Abstract] OR "psychological distress"[Title/Abstract] OR "wellbeing"[Title/Abstract] OR "depression"[Title/Abstract] OR "anxiety"[Title/Abstract] OR "coping"[Title/Abstract]) AND ("youth"[Title/Abstract] OR "adolescents"[Title/Abstract] OR "teenagers"[Title/Abstract] OR "children"[Title/Abstract] OR "young people"[Title/Abstract])

CINAHL Search String

("religion" OR "religiosity" OR "spirituality" OR "spiritual well-being") AND ("mental health" OR "psychological distress" OR "wellbeing" OR "depression" OR "anxiety" OR "coping") AND ("youth" OR "adolescents" OR "teenagers" OR "children" OR "young people") Limiters: English language; Peer reviewed; Publication date: 2015–2025; Age groups: All child, adolescent, young adult (≤ 24 years)

Appendix 2

Table of Included Sources of Evidence

Author (Year)	Country	Study Design	Participants / Population	Focus / Exposure	Key Findings	Relevance to Review Question
Cotton et al. (2006)	USA	Systematic Review	Adolescents aged 10–18 years	Spirituality vs external religiosity	Intrinsic spirituality associated with emotional stability and reduced risk behaviour	Indicates intrinsic spirituality moderates wellbeing more than external religiosity
Fruehwirth et al. (2019)	USA	Longitudinal Quantitative	Adolescents aged 13–18 years	Religiosity and depressive symptoms	Higher religiosity reduced likelihood of depression by 11%, even after adjusting for confounds	Empirically supports the buffering (moderating) role of religiosity
Ji et al. (2011)	USA	Quantitative	Evangelical adolescents	Intrinsic vs extrinsic religiosity	Intrinsic religiosity predicted reduced depression and substance use; extrinsic predicted maladaptive outcomes	Differentiates positive vs negative religious internalization in moderating mental health
Lekwauwa et al. (2022)	Global	Systematic Review	18 studies, transgender adolescents	Religion/spirituality and psychological wellbeing	Intrinsic spirituality correlated with wellbeing; religious stigma linked to distress	Shows conditional moderating role of spirituality depending on acceptance context
Naghmeh et al. (2023)	Iran	Qualitative	Adolescents aged 14–18 years	Spiritual health perceptions	Spirituality promoted self-control, purpose, and optimism	Demonstrates spirituality as a mechanism of resilience and meaning making
Pandya (2017)	India	Randomized Controlled Trial	5,339 adolescents	Spiritual development program	Spiritual training increased happiness and psychological wellbeing	Experimental evidence for spirituality as a developmental protective factor
Rasmieh Al-amer et al. (2024)	Jordan	Cross-sectional Quantitative	Adolescents aged 14–18 years	Coping strategies (religious coping)	Religious coping inversely correlated with stress (r = − 0.097, p < .001)	Confirms religion as a positive coping mechanism and moderator of stress
Shaver et al. (2022)	Canada	Cross-sectional Quantitative	12,593 adolescents aged 11–15 years	Spiritual health and bullying victimization	Strong self-connection buffered bullying impacts for boys, but amplified distress for highly self-connected girls	Highlights nuanced moderation effects of spirituality depending on gender and context
Aggarwal et al. (2023)	Global	Systematic Review & Meta-analysis	74 longitudinal + 29 intervention studies	R/S and youth depression/anxiety	Spiritual wellbeing protected against depression (r = − 0.153); negative religious coping worsened outcomes	Meta-analytic confirmation of moderating effects of spiritual wellbeing
Tsomokos & Dunbar (2023)	UK	Longitudinal Quantitative	11,045 adolescents	Religiousness, distrust, and depression	Religion moderated the relationship between distrust and depression; religious youth less affected by social threat	Direct evidence of faith as a moderator of social-psychological stress
Tietbohl-Santos et al. (2024)	Brazil	Systematic Review	38 studies of high-risk youth	Protective factors against depression	Faith and spirituality emerged as consistent moderators fostering emotional resilience	Synthesizes evidence for spirituality as a protective factor in high-risk youth
VanderWeele & Ouyang (2025)	USA	Longitudinal	Adolescents and young adults	Religious service attendance, prayer, meaning	Attendance and intrinsic meaning predicted lower depression and higher life satisfaction; evidence supports causality	Confirms religion’s causal moderating role on positive mental health outcomes

Appendix 3

PRISMA-ScR Checklist

A A SECTION	ITEM	PRISMA-ScR CHECKLIST ITEM	REPORTED ON PAGE #
TITLE
Title	1	Identify the report as a scoping review.	1
Structured summary	2	Provide a structured summary that includes (as applicable) background, objectives, eligibility criteria, sources of evidence, charting methods, results, and conclusions that relate to the review questions and objectives.	2
INTRODUCTION
Rationale	3	Describe the rationale for the review in the context of what is already known. Explain why the review questions/objectives lend themselves to a scoping review approach.	4
Objectives	4	Provide an explicit statement of the questions and objectives being addressed with reference to their key elements (e.g., population or participants, concepts, and context) or other relevant key elements used to conceptualize the review questions and/or objectives.	4
METHODS
Protocol and registration	5	Indicate whether a review protocol exists; state if and where it can be accessed (e.g., a Web address); and if available, provide registration information, including the registration number.	4–7
Eligibility criteria	6	Specify characteristics of the sources of evidence used as eligibility criteria (e.g., years considered, language, and publication status) and provide a rationale.	4–7
Information sources*	7	Describe all information sources in the search (e.g., databases with dates of coverage and contact with authors to identify additional sources), as well as the date the most recent search was executed.	4–7
Search	8	Present the full electronic search strategy for at least 1 database, including any limits used, such that it could be repeated.	4–7
Selection of sources of evidence†	9	State the process for selecting sources of evidence (i.e., screening and eligibility) included in the scoping review.	4–7
Data charting process‡	10	Describe the methods of charting data from the included sources of evidence (e.g., calibrated forms or forms that have been tested by the team before their use, and whether data charting was done independently or in duplicate) and any processes for obtaining and confirming data from investigators.	Table 1
Data items	11	List and define all variables for which data were sought and any assumptions and simplifications made.	6
Critical appraisal of individual sources of evidence§	12	If done, provide a rationale for conducting a critical appraisal of included sources of evidence; describe the methods used and how this information was used in any data synthesis (if appropriate).	6 and Table 1
Synthesis of results	13	Describe the methods of handling and summarizing the data that were charted.	6
RESULTS
Selection of sources of evidence	14	Give numbers of sources of evidence screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally using a flow diagram.	6–7
Characteristics of sources of evidence	15	For each source of evidence, present characteristics for which data were charted and provide the citations.	Appendix
Critical appraisal within sources of evidence	16	If done, present data on critical appraisal of included sources of evidence (see item 12).	Table 1
Results of individual sources of evidence	17	For each included source of evidence, present the relevant data that was charted that relates to the review questions and objectives.	Appendix 2
Synthesis of results	18	Summarize and/or present the charting results as they relate to the review questions and objectives.	9–11
DISCUSSION
Summary of evidence	19	Summarize the main results (including an overview of concepts, themes, and types of evidence available), link to the review questions and objectives, and consider the relevance to key groups.	16–17
Limitations	20	Discuss the limitations of the scoping review process.	20
Conclusions	21	Provide a general interpretation of the results with respect to the review questions and objectives, as well as potential implications and/or next steps.	20–21
FUNDING
Funding	22	Describe sources of funding for the included sources of evidence, as well as sources of funding for the scoping review. Describe the role of the funders of the scoping review.	N/A

JBI = Joanna Briggs Institute; PRISMA-ScR = Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

* Where sources of evidence (see second footnote) are compiled from, such as bibliographic databases, social media platforms, and Web sites.

† A more inclusive/heterogeneous term used to account for the different types of evidence or data sources (e.g., quantitative and/or qualitative research, expert opinion, and policy documents) that may be eligible in a scoping review as opposed to only studies. This is not to be confused with information sources (see first footnote).

‡ The frameworks by Arksey and O’Malley (6) and Levac and colleagues (7) and the JBI guidance (4, 5) refer to the process of data extraction in a scoping review as data charting.

§ The process of systematically examining research evidence to assess its validity, results, and relevance before using it to inform a decision. This term is used for items 12 and 16 instead of "risk of bias" (which is more applicable to systematic reviews of interventions) to include and acknowledge the various sources of evidence that may be used in a scoping review (e.g., quantitative and/or qualitative research, expert opinion, and policy document).

Yes