The Mediating Role of Spiritual Health in Explaining the Relationship between Distress Tolerance and Irrational Beliefs in Women: A Structural Equation Modeling Study
Journal of Pizhūhish dar dīn va Salāmat (i.e., Research on Religion & Health),
Vol. 12 No. 3 (2026),
6 October 2026
https://doi.org/10.22037/jrrh.v12i3.50164
Abstract
Background and Objective: Despite their critical role in social development, women are vulnerable to psychological disorders due to occupational and familial pressures. Irrational beliefs, distress tolerance, and spiritual health are among the key factors influencing their mental health; however, the mediating role of spiritual health in the relationship between distress tolerance and irrational beliefs has been less investigated in Iranian women. This study aimed to examine the mediating role of spiritual health in the relationship between distress tolerance and irrational beliefs in women.
Methods: This applied research employed a descriptive-correlational design with structural equation modeling. The statistical population included 2,128 female teachers in District 9 of Tehran during the 2022-2023 academic year, with a final sample of 285 participants selected through multi-stage cluster sampling. Data was collected using three standardized questionnaires: the Paloutzian and Ellison Spiritual Health Questionnaire, the Simons and Gaher Distress Tolerance Scale, and the Jones Irrational Beliefs Questionnaire. All ethical considerations, including informed consent and data confidentiality, were observed.
Results: Data analysis revealed that spiritual health significantly mediated the relationship between distress tolerance and irrational beliefs (β = -0.06, P<0.01). Correlations indicated a positive relationship between distress tolerance and spiritual health (r = 0.31) and a negative relationship between both variables and irrational beliefs (r = -0.36 and r = -0.45, respectively). The final model demonstrated good fit (CFI = 0.90, RMSEA = 0.06), showing that 30% of the effect of distress tolerance on irrational beliefs was explained through spiritual health.
Conclusion: This study demonstrated that spiritual health mediates the relationship between distress tolerance and irrational beliefs in women. The findings suggest that enhancing spiritual health and distress tolerance can reduce irrational beliefs, with significant implications for designing psychological interventions. These results highlight the importance of incorporating spiritual dimensions into mental health promotion programs.
- Distress tolerance
- Irrational beliefs
- Spiritual health
- Structural equation modeling
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References
1. Giuliano P. The Role of Women in Society: from Preindustrial to Modern Times. CESifo Economic Studies. 2015;6(1):33–52.
2. Giuliano P. The Role of Women in Society: from Preindustrial to Modern Times. CESifo Economic Studies. 2015;61(1):33–52.
3. Khorsandpour T, rezakhani S, Sharifi H. The structural pattern of irrational beliefs based on personality traits and self-esteem in students: the mediating role of critical thinking. Journal of Psychological Science. 2021;20(101):775–86. (Full Text in Persian)
4. Roozbeh B, Azimi M, Pourmovahed Z. Spiritual health of mothers of children with cancer and other chronic diseases: A comparative study. Journal of Pizhūhish dar dīn va Salāmat. 2023;9:38–49. (Full Text in Persian)
5. Sedeqi S. Factors and Effects of Depression on Individuals’ Mental and Physical Health. Journal of Social Sciences - Kabul University. 2022; 4(3):127–41.
6. Garcia-Zavala G, Schoebi D, Osorio A, de Irala J. Relationship beliefs and relationship satisfaction: Perceived relationship power imbalance as a mediator. The Family Journal. 2025: 10664807251333757.
7. Puteikis K, Jasionis A, Mameniškienė R. Metacognitive beliefs in epilepsy: What is their contribution to quality of life in the context of anxiety, depression and cognitive functioning? Epilepsy & Behavior. 2025;166:110356.
8. Keough ME, Riccardi CJ, Timpano KR, Mitchell MA, Schmidt NB. Anxiety symptomatology: The association with distress tolerance and anxiety sensitivity. Behavior therapy. 2010;41(4):567–74.
9. Sung JY, Mumper E, Schleider JL. Empowering anxious parents to manage child avoidance behaviors: Randomized control trial of a single-session intervention for parental accommodation. JMIR Mental Health. 2021;8(7):e29538.
10. Farris SG, DiBello AM, Zvolensky MJ. Development and validation of a contextual behavioral distress intolerance task in cigarette smokers. Addictive behaviors. 2018;87:260–6.
11. Shahabi A. Predicting life expectancy based on spiritual health and psychological toughness in unaccompanied women in Gachsaran city. Faculty of Humanities: Islamic Azad University, Gachsaran Branch; 2019.
12. Garcia AN, Goins T, Eubanks B, Joseph VE, English A. Integrating spirituality into physical therapy: Exploring its emerging role as a recognized determinant of health. Archives of Physiotherapy. 2024;14:189–95.
13. de Oliveira Maraldi E. The Meeting of Psychoanalysis and Feminism in the Study of Mediumship 1. The Journal of Parapsychology. 2019;83(2):279–82.
14. Homayuni A, Abedini S, Hosseini Z, Etemadifar M, Ghanbarnejad A. Explaining the facilitators of quality of life in patients with multiple sclerosis: a qualitative study. BMC neurology. 2021;21(1):193.
15. Mohsenzadeh F, Ghasemi Jobaneh R, Dargahi S, Nikoo SJ. Spiritual health, family hardiness and family satisfaction: A comparison between addicts and non-addicts. Journal of Research on Religion & Health. 2018;4(4):33–43. (Full Text in Persian)
16. Afshar S. Comparison of the spiritual health and irrational beliefs of male and female undergraduate, masters and Ph. D student in Kashan. Res Relig Health. 2016;2(3):25–34. (Full Text in Persian)
17. Khavari Z, Mohseni TAr. Sociological Analysis of women's alienation with using of Grounded theory method (Case Study: Woman 20 to 50 Years old in Masshad). Women’s Studies. 2021;12(2):1–32. (Full Text in Persian)
18. Sadri DE, Mojarrad A, Pirgholi kM. A Comparison of the Locus of Control, Unreasonable Beliefs and Religious Orientation in Divorce and Ordinary Women in Ardabil in 2016. Journal of Research on Religion and Health. 2020;5(4):73–87. (Full Text in Persian)
19. Teixeira MBM, Galvão LLdC, Mota-Santos CM, Carmo LJO. Women and work: film analysis of Most Beautiful Thing. Revista de Gestão. 2021;28(1):66–83.
20. Artiran M, Tinaz P, Simsek ÖF, Miller A, Vione KC, Turner MJ. The development and validation of an integrated assessment of irrational beliefs concerning basic psychological needs: the rational emotive self-determination scale for workers. Frontiers in Psychiatry. 2025;16:1571324.
21. Ghezelsaflo M. The mediating role of spiritual health in relation to distress tolerance and social emotional loneliness among female heads of households. Shahrood Branch: Islamic Azad University; 2019.
22. Cheng Q, Liu X, Li X, Wang Y, Mao T, Chen Y. Improving spiritual well-being among cancer patients: implications for clinical care. Supportive Care in Cancer. 2019;27(9):3403–9.
23. Cergetova IT, Maturkanič P, Hlad Ľ, Biryukova YN, Martín JG. Spirituality and irrational beliefs of movement activities in Slovaks and Czechs. Journal of Education Culture and Society. 2021; 12(2):539–49.
24. Pasandideh M, Tabli H. Investigating the Relationship between Spiritual Health and Irrational Beliefs: The Moderating Role of Personality Traits. The Second International Symposium on Management Science with a focus on sustainable development2015. p. (Full Text in Persian)
25. Kanter RL, Hoffman KR, Hassija CM. Moral Injury: Religious and Spiritual Struggles Among Survivors of Intimate Partner Sexual Violence in the USA. Journal of religion and health. 2025;64(3):2101–17.
26. Kingdon GG. Education of women and socio-economic development. East Asia. 2002;80(96):79.
27. Moore MT, Fresco DM, Segal ZV, Brown TA. An exploratory analysis of the factor structure of the Dysfunctional Attitude Scale–Form A (DAS). Assessment. 2014;21(5):570–9.
Paloutzian RF, Ellison CW. Loneliness, spiritual well-being and the quality of life. Loneliness: A sourcebook of current theory, research and therapy. 1982;1(1):224–37.
29. Simons JS, Gaher RM. The Distress Tolerance Scale: Development and Validation of a Self-Report Measure. Motivation and Emotion. 2005;29(2):83–102.
30. Jones P. Design for care: Innovating healthcare experience: Rosenfeld Media; 2013.
31. Elminejad M, Dehghan S, Nasrtazhi M, Alavi S, Derazhi J. The Relationship between Spiritual Health and Emotional Distress Tolerance among Elementary School Principals in Saravan County. The 7th National Conference on Modern Research In the field of Educational Science and Psychology of Iran. 2022. p. (Full Text in Persian)
32. King DB. Personal meaning production as a component of spiritual intelligence. International Journal of Existential Psychology and Psychotherapy. 2010;3(1):1–5.
33. Lee EC. The mediating effect of spirituality on the relationship between irrational beliefs and self-esteem. Journal of the Korea Contents Association. 2015;15(12):640–9.
34. Elhai JD, Levine JC, O’Brien KD, Armour C. Distress tolerance and mindfulness mediate relations between depression and anxiety sensitivity with problematic smartphone use. Computers in human behavior. 2018;84:477–84.
35. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior research methods. 2008;40(3):879–91.
36. Macavei B, Miclea M. An empirical investigation of the relationship between religious beliefs, irrational beliefs, and negative emotions. Journal of Evidence-Based Psychotherapies. 2008;8(1):1–16.
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