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Coping as a pathway linking religiosity and spirituality to mental health and early cardio-cerebrovascular risk among university students in Malaysia


Citation

Hein, Zaw Myo and Spaska, Anastasiya and Jasim, Abdullah Duraid Nasif and Abdul Hamid, Hafizah and Jaffer, Usman and Che Mohd Nassir, Che Mohd Nasril (2026) Coping as a pathway linking religiosity and spirituality to mental health and early cardio-cerebrovascular risk among university students in Malaysia. International Journal of Environmental Research and Public Health, 23 (6). art. no. 738. pp. 1-26. ISSN 1661-7827; eISSN: 1660-4601

Abstract

Background: Mental health disorders such as depression, anxiety, and stress are increasingly prevalent among university students and contribute to long-term cardio-cerebrovascular disease (CCVD) risk. However, limited research has examined the interplay between mental health, CCVD risk factors, and religiosity/spirituality within Southeast Asia’s multicultural context. Methods: This cross-sectional study investigated these relationships among 484 undergraduate students enrolled in medical and health sciences programs across Peninsular Malaysia. Mental health status was assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Self-reported clinical indicators associated with early CCVD vulnerability were also assessed. Religiosity and spirituality were measured using the Duke University Religion Index (DUREL), Brief Religious Coping (RCOPE), Spirituality Scale (SS), and Spiritual Coping Questionnaire (SCQ). Results: High prevalence rates of severe anxiety (50.4%), depression (29.3%), and stress (21.1%) were observed, with significant associations across ethnicity, religion, and academic programs. Higher religiosity and spirituality were generally associated with better mental health outcomes. However, coping style emerged as a key modifier of the relationship between religiosity/spirituality and mental health outcomes, with negative religious coping associated with greater psychological distress, whereas positive coping demonstrated mixed associations and partial mediating effects. Students with poorer mental health also exhibited higher CCVD risk burden. Conclusions: These findings highlight the importance of culturally and spiritually sensitive strategies in promoting student well-being.


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Additional Metadata

Item Type: Article
Subject: Pollution
Subject: Public Health, Environmental and Occupational Health
Subject: Health, Toxicology and Mutagenesis
Divisions: Faculty of Medicine and Health Science
DOI Number: https://doi.org/10.3390/ijerph23060738
Publisher: Multidisciplinary Digital Publishing Institute (MDPI)
Keywords: cardio-cerebrovascular risk; mental health; religiosity; spirituality; university student
Sustainable Development Goals (SDGs): SDG 3: Good Health and Well-being, SDG 4: Quality Education, SDG 10: Reduced Inequalities
Depositing User: Ms. Siti Radziah Mohamed@mahmod
Date Deposited: 27 Jul 2026 08:29
Last Modified: 27 Jul 2026 08:29
Altmetrics: http://www.altmetric.com/details.php?domain=psasir.upm.edu.my&doi=10.3390/ijerph23060738
URI: http://psasir.upm.edu.my/id/eprint/127393
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