More than 40 million American adults suffer from anxiety, but only a third receive care despite evidence of effective treatment. This is attributed to lack of access to adequate services, cultural-based myths, and prohibitive symptoms associated with anxiety, especially for marginalized populations such as racial minorities. Since spirituality is often used as a coping mechanism especially for racial groups, psychotherapy has slowly begun incorporating it into treatment. While this has the potential to reduce some barriers to care, the increasing number of Americans who are disaffiliating with traditional faiths or belong to minority spiritualities may not use the same coping mechanisms. The current study sought to contribute to the literature by obtaining a better understanding of whether the use of traditional spiritual activities and perceptions of God are different for spiritual majorities and minorities especially in managing anxiety. Using a nationally representative sample of U.S. adults (n=1525) from the Baylor Religion Study, structural equation models were tested to examine the relationships between anxiety and religious beliefs related to attachment to God as well as between anxiety and spiritual activities that encompass both social, organizational and private, subjective religiosity. Minority stress and attachment theories guided hypotheses that higher levels of anxiety would be associated with status as a spiritual minority but would be positively mediated by participation in spiritual activities such as worship services, prayer and scripture reading as well as mediated by more secure attachment to God. Results indicated that unlike spiritual majorities, spiritual minorities show lower anxiety levels compared with spiritual majorities unless using traditional forms of spiritual activities. Rather than positive or negative perceptions of the relationship with God, inconsistent perceptions were associated with higher levels of anxiety for all participants. Spiritual minorities had lower levels of both positive and negative perceptions of God's persona as well as lower levels of positive perceptions of the relationship with God, none of which correlated to anxiety. The results may indicate that spiritual minorities use other activities to successfully cope with anxiety and that they have greater anxiety when trying to conform to the dominant culture. This has important implications for practice given that many therapists lack training on how to incorporate spirituality into treatment. Distinctions between perceptions of the relationship with God and of God's persona indicate the need for further study of how more nuanced spiritual beliefs influence anxiety outcomes for a diverse range of spiritual practice and of the process by which individuals intentionally use spiritual tools to cope with anxiety. / Ph. D. / More than 40 million American adults suffer from the debilitating impact of anxiety through persistent worrying, obsessive thoughts, fear of social situations, compulsions, and paranoia. Only a third receive care despite effective treatment options because of such disruptive symptoms in addition to a lack of insurance, racial disparities, cultural myths, and concerns that their beliefs will not be valued. This limits access to care especially for those who need it the most, including racial minority groups. Since many Americans use spirituality as a coping mechanism to combat anxiety, psychotherapy has begun incorporating aspects of it. While this could reduce some barriers to care, it is not known whether the increasing number of Americans who are disaffiliating with traditional faiths or belong to minority spiritualities use these same aspects to cope. This study sought to understand whether the use of traditional spiritual activities and perceptions of God are different for spiritual majorities and minorities especially in managing anxiety. Using a nationally representative sample of 1,525 U.S. adults from the Baylor Religion Study, the study examined the relationship between anxiety and spiritual activities such as frequency of attendance at worship services and private prayer and scripture reading. The study also examined how attachment to God through perceptions of the relationship with God and of God’s persona might be associated with spiritual minorities and their anxiety levels. Results show that unlike spiritual majorities, spiritual minorities have less anxiety unless using traditional forms of spiritual activities. This could indicate that they use other activities to successfully cope with anxiety and that they have greater anxiety when trying to conform to the dominant culture. Rather than positive or negative perceptions of the relationship with God, inconsistent perceptions were related to higher levels of anxiety for all participants. Spiritual minorities were more moderate in their attachment to God, with less positive and negative perceptions of God’s persona and less positive perceptions of their relationship with God. However, none of spiritual minorities’ perceptions did not have a significant relationship with their anxiety levels. The study’s results show a need to explore further how a more diverse range of spiritual beliefs influence anxiety and the process by which people intentionally use spiritual tools to cope with their anxiety. Guidance for how therapists can increase their spiritual competence is discussed.