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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Mental Health and Spirituality among Undergraduates in Yucatán: An Exploratory Data Analysis Approach</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Nora L. Cuevas-Cuevas</string-name>
          <email>nora.cc@merida.tecnm.mx</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Esperanza C. Orozco-del-Castillo</string-name>
          <email>esperanza.orozco@cinvestav.mx</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Mauricio G. Orozco-del-Castillo</string-name>
          <email>mauricio.od@merida.tecnm.mx</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Pedro A. G. Ortiz-Sánchez</string-name>
          <email>pedro.os@merida.tecnm.mx</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Carlos Bermejo-Sabbagh</string-name>
          <email>carlos.bs@merida.tecnm.mx</email>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jesús Sandoval-Gio</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Cinvestav-IPN, Departamento de Matemática Educativa</institution>
          ,
          <addr-line>Ciudad de México</addr-line>
          ,
          <country country="MX">México</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Tecnológico Nacional de México / IT de Mérida</institution>
          ,
          <addr-line>Mérida, Yucatán</addr-line>
          ,
          <country country="MX">México</country>
        </aff>
      </contrib-group>
      <fpage>143</fpage>
      <lpage>156</lpage>
      <abstract>
        <p>This study examines the complex relationship between religiosity, spirituality, and mental health, recognizing their crucial but frequently disregarded impact on psychological well-being. Despite a growing body of evidence highlighting this connection, there is still a gap in understanding how diferent aspects of personal beliefs-religiosity and spirituality-afect levels of depression and anxiety. Our research, carried out among undergraduate students, employed a cross-sectional design to investigate these links, uncovering, in a general manner, an inverse relationship where increased levels of religiosity and spirituality are associated with reduced symptoms of depression and anxiety. Our results suggest distinct possible protective efects of religiosity and spirituality, each ofering unique forms of support. This study suggest the possibility to integrate personal belief systems into mental health research and intervention strategies, calling for a comprehensive approach that acknowledges the diverse elements of human well-being.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;data science</kwd>
        <kwd>exploratory data analysis</kwd>
        <kwd>mental health</kwd>
        <kwd>religion</kwd>
        <kwd>spirituality</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        The transition from adolescence to adulthood usually implies numerous challenges, notably for
university students who confront both the academic demands of higher education and significant
developmental transitions. This period is marked by heightened susceptibility to mental health issues, particularly
depression and anxiety, which are prevalent within this demographic and recognized as significant
barriers to personal well-being and academic success [
        <xref ref-type="bibr" rid="ref1 ref2 ref3">1, 2, 3</xref>
        ]. The unique pressures of the academic
environment compound these challenges, emphasizing the necessity for a detailed examination of their
prevalence, impact, and causative factors among students [
        <xref ref-type="bibr" rid="ref4 ref5">4, 5</xref>
        ]. Accordingly, the mental well-being
of university students emerges as a pivotal area of concern, warranting comprehensive research to
understand the extent, consequences, and determinants of these mental health issues within this specific
population.
      </p>
      <p>
        The intersection of mental health with spiritual and religious beliefs in university students presents
a significant gap in current research. While the influence of these beliefs on well-being has been
acknowledged, there remains a substantial need for in-depth studies to unravel how these dimensions
interact with mental health, particularly among students transitioning into university life [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ]. This gap
becomes even more pronounced in regions like Yucatán, Mexico, where the cultural context, deeply
embedded with Mayan heritage, likely plays a pivotal role in shaping these beliefs and, by extension,
mental health outcomes. The urgency for such research in Yucatán is further highlighted by its alarming
suicide rates, the highest per violent death across Mexican states, signaling a critical public health issue
that demands a closer examination of its unique socio-cultural and spiritual landscape [
        <xref ref-type="bibr" rid="ref7 ref8">7, 8</xref>
        ]. Despite
the global acknowledgment of mental health challenges faced by university students, the specific needs
and experiences of those in culturally distinct settings like Yucatán remain underexplored, with most
studies concentrating on Western contexts [
        <xref ref-type="bibr" rid="ref10 ref11 ref9">9, 10, 11</xref>
        ]. Addressing these research gaps is crucial for
developing targeted interventions that are culturally and contextually sensitive, ultimately contributing
to the broader field of mental health research with insights from a unique cultural setting [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ].
      </p>
      <p>
        The aim of this study is to explore the relationships between depression, anxiety, and
spiritual/religious beliefs within a select group of undergraduate students in Yucatán, Mexico. Recognizing the
limitations imposed by our sample size, our study is positioned as a preliminary inquiry into these
dynamics, ofering insights that can inform future, more expansive research [
        <xref ref-type="bibr" rid="ref13 ref14">13, 14</xref>
        ]. Accordingly, our
research questions are framed as follows: (1) In what ways do spiritual and religious beliefs intersect with
the levels of depression and anxiety observed in our participants? (2) Can we identify patterns within
our data that suggest a relationship between students’ mental health and their spiritual or religious
orientations? Addressing these questions, our study contributes to the growing body of research in this
area, laying groundwork for future studies that might expand on our findings and ofering preliminary
data that could guide the development of culturally sensitive mental health interventions for students
and young adults in this region [
        <xref ref-type="bibr" rid="ref15 ref16">15, 16</xref>
        ].
      </p>
      <p>
        This article is structured as follows. Section 2 delves into the existing body of literature, highlighting
previous findings and identifying gaps that our study aims to address. Section 3 provides a detailed
account of our research design, sample selection, data collection instruments, and analytical techniques,
ensuring transparency and reproducibility of our methods [
        <xref ref-type="bibr" rid="ref17">17</xref>
        ]. In Section 4 we present our findings,
including statistical analyses, patterns observed, and initial interpretations of the data. Section 5 ofers
an in-depth analysis of our results in the context of existing research, exploring the implications of our
ifndings for mental health interventions and future research [
        <xref ref-type="bibr" rid="ref18">18</xref>
        ]. Finally, Section 6 summarizes the key
insights from our study and proposes directions for subsequent research endeavors.
      </p>
    </sec>
    <sec id="sec-2">
      <title>2. Background</title>
      <p>
        The mental well-being of university students has emerged as a significant public health concern,
supported by an increasing body of literature documenting the prevalence of mental health issues
within this demographic. A comprehensive study spanning 26 campuses across the United States
found notable rates of depression (17.3%), generalized anxiety (7.0%), and suicidal ideation (6.3%)
among college students, highlighting the widespread nature of these challenges [
        <xref ref-type="bibr" rid="ref19">19</xref>
        ]. Similarly, an
examination of depression, anxiety, and suicidality among students at a large public university revealed
that approximately 15.6% of undergraduates and 13.0% of graduate students were grappling with at
least one form of mental health disorder, further accentuating the pressing need for addressing student
mental health [
        <xref ref-type="bibr" rid="ref20">20</xref>
        ]. These mental health issues not only have a profound impact on students’ academic
performance but also afect their social integration and quality of life. The persisting and escalating
prevalence of mental health problems among university students necessitates a deeper exploration into
the contributing factors and potential mitigating strategies [
        <xref ref-type="bibr" rid="ref21">21</xref>
        ].
      </p>
      <p>
        The relation between spiritual/religious beliefs and mental health has garnered significant attention
in recent years [
        <xref ref-type="bibr" rid="ref22">22</xref>
        ], with numerous studies aiming to expose the complex nature of this relationship,
including among university students. Research has highlighted that spiritual and religious engagement
can serve as a coping mechanism, ofering solace and resilience in the face of psychological distress [
        <xref ref-type="bibr" rid="ref23">23</xref>
        ].
For instance, a study found that university students who placed a high importance on spiritual and
religious beliefs were more likely to rely on these values for problem-solving and coping with health
and psychological challenges, suggesting a protective efect against mental health issues [
        <xref ref-type="bibr" rid="ref24">24</xref>
        ]. Similarly,
another investigation revealed a positive correlation between religious beliefs and mental health status
among students, indicating that stronger religious convictions might be associated with better mental
well-being [
        <xref ref-type="bibr" rid="ref25">25</xref>
        ]. Moreover, the positive association between spiritual well-being and mental health in
students further substantiates the potential of spiritual and religious beliefs to enhance psychological
resilience and reduce the prevalence of mental health disorders such as depression and anxiety [
        <xref ref-type="bibr" rid="ref26">26</xref>
        ].
However, it is important to note that the impact of spirituality and religion on mental health can vary
widely among individuals, influenced by factors such as personal beliefs, the extent of religious practice,
and the nature of the religious community [
        <xref ref-type="bibr" rid="ref27 ref7">7, 27</xref>
        ].
      </p>
      <p>
        Cultural and regional factors play a pivotal role in shaping the mental health landscape of university
students, influencing their perceptions, experiences, and coping strategies in the face of psychological
challenges [
        <xref ref-type="bibr" rid="ref28">28</xref>
        ]. The diversity in cultural backgrounds among students contributes to a wide spectrum
of attitudes towards mental health, stigma, and help-seeking behaviors. For instance, studies have
shown that cultural stressors and values can significantly impact the mental health of college students,
suggesting the need for culturally responsive mental health interventions [
        <xref ref-type="bibr" rid="ref29">29</xref>
        ]. Similarly, the
sociocultural environment, including family and academic pressures, can exacerbate mental health issues
among university students, emphasizing the importance of considering these factors in mental health
support programs [
        <xref ref-type="bibr" rid="ref30">30</xref>
        ]. The unique socio-cultural dynamics of regions like Yucatán, with its rich cultural
heritage and diverse student population, necessitate a profound understanding of how cultural identity,
values, and regional characteristics influence student mental health.
      </p>
      <p>
        Despite the growing body of research on mental health among university students, significant gaps
remain, particularly in understanding the cultural subtleties and regional specificities that influence
mental health outcomes. This is especially true for regions like Yucatán, Mexico, where unique cultural,
social, and historical contexts may impact the prevalence and manifestation of mental health issues
among students. While studies have begun to explore the mental health challenges faced by students
in various global contexts, there is a notable scarcity of research focusing on indigenous populations
[
        <xref ref-type="bibr" rid="ref31 ref9">9, 31</xref>
        ]. Additionally, the complexity of mental health, compounded by cultural identity and spiritual
beliefs, requires a deeper investigation within specific regional settings to suit interventions efectively
[
        <xref ref-type="bibr" rid="ref6">6</xref>
        ]. The need for such region-specific studies is highlighted by research suggesting that insights gained
in one region cannot be universally applied without considering local contexts [
        <xref ref-type="bibr" rid="ref32">32</xref>
        ]. Our study aims to
support the filling of these gaps by exploring the interconnections between mental health, spirituality,
and religious beliefs among university students in Yucatán.
      </p>
    </sec>
    <sec id="sec-3">
      <title>3. Methodology</title>
      <p>Our research was conceived as a cross-sectional study aimed at unraveling the interrelations between
depression, anxiety, and spiritual/religious beliefs among undergraduate students. The study was set in
the academic environment of Yucatán, Mexico. Conducted over a three-month period from September to
November 2021, this investigation sought to capture a snapshot of mental health and spiritual/religious
dynamics of Yucatán. The participants were 160 engineering students from Mérida, Yucatán. Inclusion
criteria were defined to select currently enrolled undergraduate students, while excluding non-student
or postgraduate participants to maintain focus on the undergraduate experience. Prior to participation,
individuals were fully briefed on the study’s objectives, the voluntary nature of their involvement,
and the confidential handling of their responses, ensuring informed consent. Ethical oversight was
provided by the corresponding ethics committee, which reviewed and approved the study protocol.
Data collection and analysis were conducted with strict adherence to ethical guidelines, including the
anonymization of participant data to protect privacy and confidentiality.</p>
      <p>
        Data collection hinged on the deployment of two validated instruments: the Patient Health
Questionnaire-9 (PHQ-9) [
        <xref ref-type="bibr" rid="ref33">33</xref>
        ] and the Generalized Anxiety Disorder Scale (GAD-7) [
        <xref ref-type="bibr" rid="ref34">34</xref>
        ], renowned
for their eficacy in gauging depression and anxiety levels respectively. The PHQ-9, with its nine-item
framework, ofers insights into depression severity by scoring responses on a 4-point Likert scale.
The PHQ-9 scores range from 0 to 27, with higher scores indicating more severe levels of depression,
classified into five categories from none to severe depression [
        <xref ref-type="bibr" rid="ref35 ref36">35, 36</xref>
        ]. The GAD-7, on the other hand, is
a seven-item construct which measures anxiety on a scale from 0 to 21, with four levels from minimal
to severe anxiety [
        <xref ref-type="bibr" rid="ref35 ref37">35, 37</xref>
        ]. To capture the spiritual and religious dimensions of participants’ lives,
participants were ofered five self-identification options: Religious, Spiritual Non-religious, Agnostic,
Atheist, and Other. The data collection process unfolded online, leveraging a secure web platform
[
        <xref ref-type="bibr" rid="ref38 ref39">38, 39</xref>
        ] that facilitated anonymous participation. Comprehensive instructions accompanied each survey,
guiding participants through the process and ensuring clarity and ease of response, thereby optimizing
the integrity and reliability of the data collected.
      </p>
      <p>
        Data analysis focused on Exploratory Data Analysis (EDA) to identify patterns and correlations
[
        <xref ref-type="bibr" rid="ref40 ref41">40, 41</xref>
        ]. Initial steps included assessing sociodemographic characteristics and the distribution of
spirituality/religious factors among participants [
        <xref ref-type="bibr" rid="ref42">42</xref>
        ]. Subsequent analyses involved descriptive statistics
and univariate analysis through boxplot visualizations to explore the behavior of PHQ-9 and
GAD7 scores in relation to spiritual/religious self-identification, paying attention to outliers that might
signify data entry errors or provide significant insights. Furthermore, we employed a quartile approach
to achieve a balanced data distribution and facilitate the examination of the relationships between
depression and anxiety levels with spiritual and religious classifications [
        <xref ref-type="bibr" rid="ref42 ref43">43, 42</xref>
        ].
      </p>
      <p>Building on the foundational insights garnered from the EDA and the qualitative assessment of
Sankey diagrams, our subsequent quantitative analysis delved into the distribution percentages of
depression and anxiety levels, and the varying degrees of religiosity and spirituality. To quantitatively
represent the relationships observed qualitatively in the Sankey diagrams, we calculated diferential
percentages that represent the distribution shifts across the quartiles of depression and anxiety for each
spiritual and religious classification. This method allowed us to quantitatively confirm and expand
upon the patterns and correlations initially identified through qualitative means, providing a robust
statistical foundation to our exploratory findings. The calculated diferentials served as a critical tool in
translating the qualitative observations from the Sankey diagrams into quantifiable metrics, enabling a
deeper understanding of how religious and spiritual identities correlate with mental health indicators
among the study participants.</p>
    </sec>
    <sec id="sec-4">
      <title>4. Results</title>
      <p>The demographic makeup of our sample was predominantly male, constituting approximately 77.5%,
with female participants making up the remaining 22.5%. The vast majority were single (96.9%),
with a singular participant reporting being married. The age range of participants spanned from
eighteen to twenty-five years, reflecting a typical undergraduate age distribution. Employment status
varied, with 15% of the students working part-time while pursuing their studies. The spiritual and
religious self-identifications revealed a predominance of religious afiliation (44.4%), followed by varied
representations of other spiritual beliefs.</p>
      <p>The analysis of mental health among the participating students revealed insightful trends in the
prevalence of depression and anxiety as measured by the PHQ-9 and GAD-7 scales, respectively. The
PHQ-9 results indicated a broad range of depression levels within the student population, with a mean
score of 4.3, suggesting a predominance of minimal to mild depression among the majority. Notably,
the distribution across depression severity levels highlighted that a significant portion of the sample
fell within the ’none’ to ’mild’ categories, yet there were instances of moderately severe to severe
depression. Similarly, the GAD-7 scores, with a mean of 3.9, mirrored this pattern for anxiety, primarily
clustering around the minimal to mild anxiety levels. These observations on the distribution of mental
health symptoms are visually depicted in the histograms presented in Figure 1.</p>
      <p>With respect to the spiritual and religious convictions of the participants, a substantial number
identified as “Religious”, accounting for 44.4% of the participants, which aligns with the historically
deep-rooted religious traditions in the region. “Spiritual Non-religious” and “Agnostic” categories were
closely represented, with 15% and 13.8% respectively, suggesting a significant portion of the student
body leans towards spiritual exploration outside conventional religious frameworks. “Atheists”, though
the smallest group, constituted 11.3% of the sample. The “Other” category, potentially encompassing a
variety of less traditional or more personal spiritual beliefs, was selected by 15.6% of the students. A
breakdown of these spiritual and religious orientations among the participants is shown in descending
(a) PHQ-9 scores
(b) GAD-7 scores
order in Table 1.</p>
      <p>
        The EDA aimed to uncover relationships between mental health indicators and the spiritual/religious
beliefs of the participants. Notably, the PHQ-9 and GAD-7 scores, representing depression and anxiety
levels respectively, were subjected to correlation analysis with the categorized spiritual and religious
beliefs. Preliminary findings indicated that certain spiritual/religious orientations appeared to correlate
with specific mental health outcomes. For instance, individuals identifying as “Spiritual Non-religious”
exhibited a slight but discernible trend towards higher anxiety levels as compared to their “Religious”
counterparts. This suggests that the nature of one’s spiritual beliefs might indeed play a role in
their mental well-being. Conversely, those with “Agnostic” beliefs did not initially show a significant
diference in depression scores when compared to the “Religious” group, indicating that the absence
of conventional religious beliefs does not necessarily correlate with higher depression levels. These
behaviors are represented in the boxplots for PHQ-9 and GAD-7 scores in Figure 2. The correlation plot
(Figure 3) further illustrates these associations, highlighting a slight trend of linear correlation between
the values of PHQ-9 and GAD-7, consistent with reported comorbidity of depression and anxiety [
        <xref ref-type="bibr" rid="ref44">44</xref>
        ],
across diferent spiritual and religious classifications.
      </p>
      <p>In our EDA, particular attention was given to outliers and data dispersion, especially as represented
in the boxplot graphics for PHQ-9 and GAD-7 scores (Figure 2). These outliers, while few, were not
merely statistical anomalies but potentially indicative of individuals with exceptionally high levels
of depression or anxiety, significantly deviating from the median scores. For example, the PHQ-9
boxplot revealed five outlier data points, suggesting a small subset of students experiencing severe
depression. Similarly, the GAD-7 analysis identified three outliers, pointing towards notable cases of
elevated anxiety levels. Such dispersion in the data highlights the presence of significant mental health
challenges within segments of the student population.</p>
      <p>We introduced a quartile-based categorization system to our EDA to refine our understanding of the
data distribution for anxiety and depression levels. This approach was instrumental in balancing the
dataset, which enhanced the reliability of our subsequent analyses. Specifically, we divided the range of
scores into four quartiles: the first quartile ( 1) included scores from zero to one, indicating minimal
symptoms; the second quartile (2) contained scores from two to three, suggesting mild symptoms;
the third quartile (3) ranged from four to six, corresponding to moderate symptoms; and the fourth
quartile (4) encompassed scores of seven and above, indicative of more severe symptomatology.</p>
      <p>We categorized the students’ spiritual and religious beliefs into three distinct levels, respectively,
to examine possible correlations with their mental health. The first level consisted of students who
considered themselves “Atheists”, indicating they do not hold religious or spiritual beliefs (1 and 1
for religious and spiritual beliefs, respectively). The second level, for 2 we considered participants who
identified themselves as either “Agnostic”, “Other”, or “Spiritual Non-religious”. For  we considered
individuals who identified themselves as either “Agnostic” or “Other”. Finally, the third level consisted,
for 3 students who identified as “Religious”, and for 3 students who identified as either “Religious” or
“Spiritual Non-religious”. This approach helped us investigate the relationship between varying degrees
of spirituality and religiousness with the students’ levels of depression and anxiety.</p>
      <p>The Sankey diagrams in Figure 4 provide a visual representation of these relationships, revealing
how mental health status flows and intersects with personal beliefs. For GAD-7, the most substantial
frequency observed was between the lowest quartile of anxiety (1) and the highest level of spirituality
(3), as well as with the highest religious factor (3), suggesting a prominent connection between lower
anxiety and stronger spiritual or religious self-identification. Similarly, for PHQ-9, the greatest frequency
was seen bridging the lowest depression quartile (1) with the highest spirituality and religiosity levels
(3 and 3), implying a correlation where individuals with minimal depression symptoms often align
with more definitive spiritual or religious stances.</p>
      <p>Building upon the visually intuitive insights provided by the Sankey diagrams in Figure 4, we further
quantified the interrelationships between mental health and personal beliefs. To this end, we introduced
a statistical measure that illustrates the shift in depression prevalence across diferent levels of religiosity.
As we transition from the narrative conveyed by the diagrams to a more analytical interpretation, we
employ a mathematical approach to capture the essence of our data into a coherent statistical narrative.
In this regard, we have formalized the representation of religious groups with , spiritual groups
with  and quartiles of depression/anxiety with  , which allowed for a precise computation of the
proportion of individuals within each intersection of these categories.</p>
      <p>For example, in the highly-religious group 3, the proportion of individuals in the lowest quartile
of depression 1 was calculated, and similarly, this proportion was computed for the non-religious
group 1. By comparing these proportions, we obtained a diferential 3,1 (1), which numerically
encapsulates the increase in lower severity depression scores as one moves from atheistic to religious
self-identification.</p>
      <p>Let  denote the ℎ religious classification group, where  can take values from the set {1, 2, 3}.
Similarly, let  represent the ℎ depression quartile, where  is from the set {1, 2, 3, 4}, indicating
increasing severity of depression from minimal to severe. For a given religious group , the proportion
of participants in a depression quartile  is denoted by  ( ) and is calculated as the number of
participants in both  and  , denoted by ( ), divided by the total number of participants in ,
denoted by  ():
 ( ) =
( )
 ()
.</p>
      <p>Applying this to our specific case, for the most religious group 3, the proportion of participants in the
lowest quartile of depression 1 is given by:
 (31) =
(31)
 (3)
=</p>
      <p>25
25 + 16 + 18 + 12
= 35.21%
.</p>
      <p>Similarly, for the least religious group 1, we calculate:
(a) Anxiety levels and spirituality (S1-S3).
(b) Anxiety levels and religious factors (1-3).
(c) Depression levels and spirituality (S1-S3).
(d) Depression levels and religious factors (1-3).
.
.</p>
      <p>(11) =
(11)
 (1)
=
The diferential measure 3,1 (1) between 3 and 1 for the lowest quartile 1 is then:
3,1 (1) =  (31) −  (11) = 35.21 − 22.22 = 12.99%</p>
      <p>This diferential, 3,1 (1), signifies the increase in the relative frequency of participants in the
lowest depression quartile 1 as we move from the least religious group 1 to the most religious group
3. Such a comparison shows the positive association between higher levels of religious identification
and the prevalence of lower severity depression scores within our sample population, in other words,
an inverse relation between religiousness and depression.</p>
      <p>To ofer a comprehensive perspective on the complex relationships identified in our analysis, Table 2
presents the range of calculated diferentials and their interpretations. This table combines the insights
into both depression and anxiety, revealing the nature of their relationships with varying levels of
spirituality and religiousness. A further analysis is discussed in the following section.</p>
    </sec>
    <sec id="sec-5">
      <title>5. Discussion</title>
      <p>In our investigation, we delved into the complex relationships between personal beliefs, specifically
religiosity and spirituality, and mental health outcomes among undergraduate students. A key discovery
of our study is the inverse relationship between levels of depression and anxiety and the degree of
religious and spiritual identification. This finding indicates that students who identify more strongly
with religious or spiritual beliefs tend to exhibit lower levels of depression and anxiety. This pattern was
consistently observed across various degrees of religiosity and spirituality, highlighting a significant
association between personal belief systems and mental well-being in this demographic.</p>
      <p>Table 2 enhances our comprehension of the dynamics between mental health and personal belief
systems by quantitatively showing the diferentials and their implications on depression and anxiety.
An overarching inverse relationship is observed in most instances, signifying that heightened religiosity
or spirituality commonly correlates with diminished levels of depression and anxiety. This trend is
consistently evident in comparisons between high religiosity (3) and low religiosity (1), as well
as between high spirituality (3) and low spirituality (1), particularly within the first quartile ( 1),
which denotes minimal symptomatology. An intriguing departure is noted in the analysis of the fourth
quartile (4), where a direct relationship is observed between elevated spirituality (3) and anxiety
levels, suggesting that, in certain contexts, greater spirituality may be associated with increased anxiety.
This counterintuitive finding warrants further exploration to ascertain the specific facets of spirituality
contributing to this pattern. We also considered the notion of a “neutral” relationship for diferentials
under 2%, such as 4,1 (1), 4,1 (1), and 4,1 (3) in the anxiety context, implying a lack
of significant correlation between these variables. This refinement ofers a deeper understanding of
scenarios where the link between mental health and personal beliefs may not be as marked.</p>
      <p>
        The overall inverse relationship observed between religiosity/spirituality and depression/anxiety
suggests that personal beliefs may serve as a protective factor in mental health, consistent with previous
research [
        <xref ref-type="bibr" rid="ref24 ref45 ref46">24, 45, 46</xref>
        ]. This connection could be attributed to several factors inherent in religious and
spiritual practices. For instance, these practices often involve community support, regular social
interactions, and a framework for understanding life’s challenges, all of which can contribute to better
mental health outcomes. Furthermore, the sense of purpose and meaning that individuals often derive
from their religious or spiritual beliefs could play a critical role in mitigating feelings of despair or
anxiety. Such interpretations align with existing psychological theories that emphasize the importance
of social support and a coherent worldview in promoting mental resilience [
        <xref ref-type="bibr" rid="ref47 ref48">47, 48</xref>
        ]. Therefore, our
ifndings contribute to a growing body of evidence suggesting that the benefits of religious and spiritual
involvement may extend beyond personal fulfillment to include tangible efects on mental health.
      </p>
      <p>The insights gleaned from our study hold substantial practical implications, particularly for mental
health professionals and intervention programs. Recognizing the inverse relationship between
religiosity/spirituality and depression/anxiety, therapists and counselors might consider integrating discussions
around personal beliefs and values into their therapeutic approaches. Such incorporation could enhance
the relevance and eficacy of mental health interventions by aligning them more closely with the
individual’s belief system, providing an additional layer of support and resilience. Furthermore, educational
and community programs aimed at promoting mental well-being could benefit from acknowledging
the role of spiritual and religious practices. By fostering environments that respect and encourage
these aspects of personal identity, such initiatives could contribute to more supportive community
networks, potentially reducing the prevalence of mental health issues. This approach underscores the
importance of a multi-dimensional strategy in mental health care, where psychological, social, and
spiritual components are interwoven to support overall well-being.</p>
      <p>In our investigation, EDA was a pivotal tool that allowed us to unveil patterns and correlations within
our dataset, providing an initial, broad view of the relationships between mental health indicators
and spiritual/religious beliefs among undergraduate students in Yucatán. This approach facilitated a
more profound understanding of the data, enabling us to identify and visualize trends, outliers, and
distribution characteristics that might not be immediately apparent with more traditional statistical
methods. Through the application of EDA techniques, such as descriptive statistics, Sankey diagrams
and boxplot visualizations, we could explore the intricate behaviors of depression and anxiety scores
in relation to the participants’ spiritual or religious self-identification. This methodological choice
evidences the importance of adopting flexible, data-driven approaches in psychological research.</p>
      <p>Our study, while presenting important correlations, is subject to certain limitations that warrant
mention. Primarily, the cross-sectional nature of our research design precludes the establishment of
causality between the variables studied. Furthermore, our reliance on self-reported measures introduces
the potential for response bias, which might afect the accuracy of the data collected. The sample,
comprised solely of undergraduate students, limits the generalizability of our findings to broader
populations. These limitations open avenues for future research, such as longitudinal studies that could
explore the dynamic nature of these relationships over time and delve into causality. Additionally,
employing a more diverse sample and integrating objective measures alongside self-reports could
enhance the robustness and applicability of the findings. Future studies might also consider the
multifaceted nature of religiosity and spirituality, exploring how diferent aspects of these constructs
interact with various mental health outcomes.</p>
    </sec>
    <sec id="sec-6">
      <title>6. Conclusions</title>
      <p>Our investigation revealed a significant inverse relationship between religiosity/spirituality and
depression and anxiety levels among undergraduate students, pinpointing the protective influence of
personal belief systems on mental health. This discovery suggests that individuals with a strong sense
of religious or spiritual identity may tend to show fewer symptoms of depression and anxiety. Delving
deeper, our study began to distinguish between the efects of religiosity and spirituality on mental
well-being. Religiosity, with its communal rituals and structured beliefs, may provide individuals
with social support and a collective identity, potentially bufering against mental health challenges.
Spirituality, characterized by personal reflection and a search for meaning, might ofer a unique form
of emotional sustenance, enabling individuals to navigate life’s stresses with a sense of inner peace.
This diferentiation between the impacts of religiosity and spirituality highlights the complex role of
personal beliefs in mental health and the necessity of considering these varied dimensions in mental
health research and practice.</p>
      <p>The findings from our study should encourage mental health practitioners to explore more holistic
approaches which recognize and integrate the spiritual and religious dimensions of individuals’ lives
into therapeutic practices. This integration could not only enrich the therapeutic process by aligning
with clients’ personal belief systems but also leverage these beliefs as resources for resilience, coping,
and recovery. The practical implications extend beyond clinical settings, suggesting that educational
curricula and community health initiatives could benefit from incorporating elements that foster
spiritual well-being, thus contributing to a more comprehensive strategy for mental health promotion.</p>
      <p>Future research directions should leverage advanced data science and computational techniques to
extend our findings, focusing on evidencing causal relationships between religiosity/spirituality and
mental health through sophisticated longitudinal data analysis. The employment of machine learning
models and artificial intelligence algorithms could ofer new insights into these complex dynamics
across varied cultural and demographic landscapes, thereby enhancing the robustness and applicability
of the results. Further exploration into the granular aspects of religious and spiritual practices, utilizing
computational text analysis and natural language processing, could unearth the specific elements
that exert the most substantial influence on mental well-being. Integrating quantitative models with
multidisciplinary knowledge from psychology, sociology, and theology, facilitated by big data analytics,
could furnish a holistic and nuanced understanding of the intricate nexus between personal beliefs and
mental health.</p>
    </sec>
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