People facing difficulties in their faith are more likely to have symptoms of illness — and new research in the Journal for the Scientific Study of Religion suggests that a person’s socioeconomic status plays a role.

The difficulties that a person faces with his or her faith is linked to illness — and new research suggests that a person’s socioeconomic status plays a role.

“There is a good deal of research on the relationship between religiousness and physical as well as mental health. However, most of this work focuses on the ways in which religious involvement may bolster health and well-being,” said study author Neal Krause of the University of Michigan. “My colleagues and I are interested in spiritual struggles because it provides a way of providing a more balanced view of these relationships by suggesting that religious involvement may not always be beneficial.”

The study analyzed data collected in the Landmark Spirituality and Health Survey (LSHS). The nationwide face-to-face survey of 3,010 U.S. adults was completed in 2014 and collected information regarding spiritual struggles, among other things.

To assess spiritual struggles, the survey asked participants if they felt angry with God or organized religion, worried that the problems they faced were the work of the devil or evil spirits, felt guilty for not living up to their moral standards, or had concerns about whether there was any ultimate purpose to existence.

The researchers found that having more spiritual struggles was associated with more symptoms of illness.

“There are two takeaway messages from our work. First, being involved in religion is not always easy and sometimes, religion may be a source of stress,” Krause told PsyPost. “Second, if spiritual struggles are strong enough, they may lead to mental and physical health problems.”

Previous research has found that psychological factors, such as personality traits, are associated with spiritual struggles.

But the new research also found evidence that social factors were linked to spiritual struggles. People with lower levels of education were more likely to face financial troubles, while those with financial troubles were more likely to live in run down neighborhoods. Furthermore, living in run down neighborhoods was linked to feelings of anger, which in turn was linked to experiencing more spiritual struggles.

The study used a cross-sectional design, meaning the researchers cannot draw any strong conclusions about cause and effect.

“Two key issues remain largely unexplored,” Krause explained. “First, although a number of studies show that spiritual struggles are associated with greater mental health problems, we don’t know which came first. Do spiritual struggles ’cause’ mental health problems or do mental health problems ’cause’ spiritual struggles.”

“Second, spiritual struggles may not always have undesirable consequences. Sometimes, spiritual struggles are necessary for spiritual growth. Religious doubt provides a good example. Religious doubt is widely recognized as one form of spiritual struggle. A number of researchers argue that doubt is a necessary part of learning and growth. After all, you cannot grow if you do not question.”

The study, “Spiritual Struggles and Health: Assessing the Influence of Socioeconomic Status“, was co-authored by Kenneth I. Pargament and Gail Ironson.