Spiritual Struggle Related to Plasma Interleukin-6 Prior to Cardiac Surgery

Amy L. Ai, E. Mitchell Seymour, Terrence N. Tice, Ziad Kronfol, Steven F. Bolling

Research output: Contribution to journalArticle

35 Citations (Scopus)


Spiritual struggle appeared consistently to predict poor health outcomes, including mortality. Despite surging interest in the health benefits of religion and spirituality, the health hassle of existential conflicts and proinflammatory cytokines as a potential physiological mechanism has been overlooked. Based on psychological and theological assumptions, we argue for the universal nature of spiritual struggle, a crisis-related existential conflict, and for investigating its physiological influence as essential to understanding human nature. Increased levels of inflammatory cytokines such as interleukin-6 (IL-6) have been linked with adverse health outcomes and negative emotions. This study thus examined spiritual struggle related to plasma IL-6 in 235 adult patients undergoing cardiac surgery, along with positive religious coping, general coping, and optimism, controlling for standardized clinical medical indicators. Multiple regression analysis, following a preplanned sequence, showed that spiritual struggle (p = .011), behavioral coping (p = .013) were positively associated with excess plasma IL-6, controlling for medical correlates (e.g., left ventricular ejection fraction). We conclude that spiritual struggle, indicating the crisis in an existential relation, and behavioral coping strategies are associated with elevated pre-operative plasma IL-6. The interdisciplinary implications are discussed.

Original languageEnglish
Pages (from-to)112-128
Number of pages17
JournalPsychology of Religion and Spirituality
Issue number2
Publication statusPublished - May 2009
Externally publishedYes



  • cardiac diseases and cardiac surgery
  • coping with stress
  • immune-inflammatory marker interleukin-6
  • religion
  • spiritual struggle

ASJC Scopus subject areas

  • Social Psychology
  • Religious studies
  • Applied Psychology

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