Which risk factors are associated with spiritual fitness?

The correct choice highlights that feelings of hopelessness, despair, and isolation are significant risk factors associated with spiritual fitness. Spiritual fitness encompasses an individual's sense of purpose, connection to others, and their overall well-being. When a person experiences hopelessness, it can hinder their ability to find meaning in life, negatively impacting their spiritual health. Similarly, feelings of despair and isolation can lead to a disconnection from one's own beliefs or the community, which is crucial for fostering spiritual resilience and growth.

In contrast, while emotional distress and instability, physical health issues, and social relationship problems can certainly affect overall well-being, they do not specifically target the core components of spiritual fitness as clearly as hopelessness and despair do. The essence of spiritual fitness relates to one's inner state and the capacity to cope with life's challenges through a lens of meaning and connection, making the correct answer particularly relevant to understanding the nuances of spiritual health.