Journal of Behavioral Medicine, Vol. 29, No. 6, December 2006 ( C  2006) DOI: 10.1007/s10865-006-9074-3 Positive and Negative Religious Coping in German Breast Cancer Patients Christian Zwingmann, 1,4 Markus Wirtz, 2 Claudia M ¨ uller, 1 J¨ urgen K ¨ orber, 3 and Sebastian Murken 1 Accepted for publication: July 27, 2006 Published online: September 2, 2006 A growing interest has been focusing on the relationship between religious coping and psychosocial adjustment among cancer patients. However, previous research mostly has not differentiated between positive and negative components of religious coping. The current cross-sectional study investigated the role of both positive religious coping, i.e., a confident and constructive turning to religion, and negative religious coping, i.e., religious struggle and doubt, in a sample of 156 German breast cancer patients. Participants were assessed upon ad- mission to an inpatient rehabilitation program. In addition to religious coping, two basic non- religious coping styles (depressive coping and active problem-focused coping) and psychoso- cial adjustment (anxiety and depression) were measured. Major research questions concern- ing the mediating role of nonreligious coping and the relative predictive power of positive and negative religious coping were primarily addressed using structural equation modeling. Re- sults indicated that the relationship between religious coping and psychosocial outcomes was completely mediated by nonreligious coping, whereby only depressive coping and not active problem-focused coping proved to be a mediating variable. Positive and negative religious coping were somewhat positively related to each other; their (indirect) predictive power on psychosocial adjustment was identical though in an opposite direction. All in all, the results correspond to previous Anglo-American research. There are, however, some discrepancies which may be due to the specific religious-cultural background in Germany. KEY WORDS: positive and negative religious coping; breast cancer; Germany; structural equation modeling. INTRODUCTION Within the last few years the connection be- tween religiousness and psychosocial adjustment has become a subject of increasing interest within the field of health care (Koenig et al., 2001; Plante and Sherman, 2001). Religious or—somewhat more 1 Psychology of Religion Research Group, University of Trier, Bad Kreuznach, Germany. 2 Department of Rehabilitation Psychology, University of Freiburg, Freiburg, Germany. 3 Rehabilitation Center Nahetal, Bad Kreuznach, Germany. 4 To whom correspondence should be addressed at Psychology of Religion Research Group, University of Trier, Franziska- Puricelli-Str. 3, D-55543 Bad Kreuznach, Germany; e-mail: christian.zwingmann@web.de. broadly defined—spiritual issues seem to play an im- portant role in the coping process for many patients, particularly those facing severe and potentially life- threatening illness such as cancer (Gall et al., 2005; MacLean et al., 2003). Across studies of participants with diverse types of cancer the majority reported, often spontaneously, religious faith to be a major source of support in dealing with their illness (Fe- her and Maly, 1999; Flannelly et al., 2002). It was assumed that religious involvement may help can- cer patients in order to relieve stress, retain a sense of control, maintain hope and self-esteem as well as a sense of meaning and purpose in life, and to fa- cilitate social support from a religious community (e.g., Coward, 1995; Levin, 1996; Moadel et al., 1999; Taylor, 1995). 533 0160-7715/06/1200-0533/0 C  2006 Springer Science+Business Media, Inc.