This chapter examines whether spiritual struggles were uniquely associated with health-related quality of life (HRQoL) and mental health outcomes, after accounting for negative secular coping, and whether changes in spiritual struggles over time were associated with changes in these psychosocial outcomes among urban adolescents with asthma. Adolescents (N = 151 at Time-1; N = 132 at Time-2) completed multiple self-report measures. Descriptive statistics, difference scores, and hierarchical multiple regressions were calculated. Results indicated that more spiritual struggles were associated with greater depressive and anxiety symptoms and worse psychosocial HRQoL at baseline; changes in spiritual struggles were significantly associated with changes in depressive symptoms longitudinally; and spiritual struggles significantly accounted for 4–9% of the unique variance in these outcomes. Findings suggested screening for spiritual struggles when caring for these adolescents. Keywords:anxiety; asthma; depressive symptoms; health-related quality of life (HRQoL); mental health outcomes; secular coping; spiritual struggles; urban adolescents
