Death anxiety (psychology)

Death anxiety is anxiety caused by thoughts of death. One source defines death anxiety as a "feeling of dread, apprehension or solicitude (anxiety) when one thinks of the process of dying, or ceasing to 'be'".[1] Also referred to as thanatophobia (fear of death), death anxiety is distinguished from necrophobia, which is a specific fear of dead or dying people and/or things; the latter is the fear of others who are dead or dying, whereas the former concerns one's own death or dying.[2]

"Fear of dying" redirects here. For the Jack Off Jill song, see Clear Hearts Grey Flowers.

Additionally, there is anxiety caused by death-recent thought-content,[3] which might be classified within a clinical setting by a psychiatrist as morbid and/or abnormal, which for classification pre-necessitates a degree of anxiety which is persistent and interferes with everyday functioning.[4][5] Lower ego integrity, more physical problems and more psychological problems are predictive of higher levels of death anxiety in elderly people perceiving themselves close to death.

Death anxiety can cause extreme timidness with a person's attitude towards discussing anything to do with death.[6]

Types

Robert Langs distinguishes three types of death anxiety:[7]

Predatory death anxiety

Predatory death anxiety arises from the fear of being harmed.[8] It is the most basic and oldest[9]:615 form of death anxiety, with its origins in the first unicellular organisms' set of adaptive resources. Unicellular organisms have receptors that have evolved to react to external dangers, along with self-protective, responsive mechanisms made to increase the likelihood of survival in the face of chemical and physical forms of attack or danger.[9]:616 In humans, predatory death anxiety is evoked by a variety of danger situations that put one at risk or threaten one's survival.[9]:617 Predatory death anxiety mobilizes an individual's adaptive resources and leads to a fight-or-flight response: active efforts to combat the danger or attempts to escape the threatening situation.[9]:617

Predation or predator

Predation or predator death anxiety is a form that arises when an individual harms another, physically and/or mentally. This form of death anxiety is often accompanied by unconscious guilt.[10] This guilt, in turn, motivates and encourages a variety of self-made decisions and actions by the perpetrator of harm to others.[11]

Existential

Existential death anxiety stems from the basic knowledge that human life must end. Existential death anxiety is known to be the most powerful form.[12] It is said that language has created the basis for existential death anxiety through communicative and behavioral changes.[10] Other factors include an awareness of the distinction between self and others, a full sense of personal identity, and the ability to anticipate the future.[12]

Awareness of human mortality arose some 150,000 years ago.[13] In that extremely short span of evolutionary time, humans have fashioned a single basic mechanism through which they deal with the existential death anxieties this awareness has evoked—denial.[13] Denial is effected through a wide range of mental mechanisms and physical actions, many of which go unrecognized.[12] While denial can be adaptive in limited use, excessive use is more common and is emotionally costly.[12] Denial is the root of such diverse actions as breaking rules, violating frames and boundaries, manic celebrations, directing violence against others, attempting to gain extraordinary wealth and power—and more.[13] These pursuits are often activated by a death-related trauma, and while they may lead to constructive actions, more often than not, they lead to actions that are damaging to self and others.[13]

Theories

Thanatophobia

Sigmund Freud hypothesized that people express a fear of death, called thanatophobia. He said he saw this as a disguise for a deeper source of concern. It was not actually death that people feared, because in Freud's view nobody believes in their own death. The unconscious does not deal with the passage of time or with negations, which does not calculate amount of time left in one's life. Furthermore, that which one does fear cannot be death itself, because one has never died. People who express death-related fears, actually are trying to deal with unresolved childhood conflicts that they cannot come to terms with or express emotion towards.[7][14][15] The name Thanatophobia is made from the Greek figure of death known as Thanatos.

Wisdom: ego integrity vs. despair

Developmental psychologist Erik Erikson formulated the psychosocial theory that explained that people progress through a series of crises as they grow older. The theory also envelops the concept that once an individual reaches the latest stages of life, they reach the level he titled as "ego integrity". Ego Integrity is when one comes to terms with their life and accepts it. It was also suggested that when a person reaches the stage of late adulthood they become involved in a thorough overview of their life to date. When one can find meaning or purpose in their life, they have reached the integrity stage. In opposition, when an individual views their life as a series of failed and missed opportunities, then they do not reach the ego integrity stage. Elders that have attained this stage of ego integrity are believed to exhibit less of an influence from death anxiety.[7][14][15]

Terror management theory
Main article: Terror management theory

Ernest Becker based this theory on existential views which turned death anxiety theories towards a new dimension. It said that death anxiety is not only real, but also it is people's most profound source of concern. He explained the anxiety as so intense that it can generate fears and phobias of everyday life—Fears of being alone or in a confined space. Based on the theory, many of people's daily behavior consist of attempts to deny death and to keep their anxiety under strict regulation.[7][14][15][16]

As an individual develops mortality salience, i.e. becomes more aware of the inevitability of death, they will instinctively try to suppress it out of fear. The method of suppression usually leads to mainstreaming towards cultural beliefs, leaning for external support rather than treading alone. This behavior may range from simply thinking about death to severe phobias and desperate actions.[9]:603

Being, time and Dasein

Martin Heidegger, the German philosopher, on the one hand showed death as something conclusively determined, in the sense that it is inevitable for every human being, while on the other hand, it unmasks its indeterminate nature via the truth that one never knows when or how death is going to come. Heidegger does not engage in speculation about whether being after death is possible. He argues that all human existence is embedded in time: past, present, future, and when considering the future, we encounter the notion of death. This then creates angst. Angst can create a clear understanding in one that death is a possible mode of existence, which Heidegger described as "clearing". Thus, angst can lead to a freedom about existence, but only if we can stop denying our mortality (as expressed in Heidegger's terminology as "stop denying being-for-death").[17]

Meaning management theory

Paul T. P. Wong's work on the meaning management theory[18] indicates that human reactions to death are complex, multifaceted and dynamic.[17] His "Death Attitude Profile" identifies three types of death acceptances as Neutral, Approach, and Escape acceptances.[19][20] Apart from acceptances, his work also represents different aspects of the meaning of death fear that are rooted in the bases of death anxiety. The ten meanings he proposes are finality, uncertainty, annihilation, ultimate loss, life flow disruption, leaving the loved ones, pain and loneliness, prematurity and violence of death, failure of life work completion, judgment and retribution centered.

Other theories

Other theories on death anxiety were introduced in the late part of the twentieth century.[21] The existential approach, with theorists such as Rollo May and Viktor Frankl, views an individual's personality as being governed by the continuous choices and decisions in relation to the realities of life and death.[22] Another approach is the regret theory which was introduced by Adrian Tomer and Grafton Eliason.[23] The main focus of the theory is to target the way people evaluate the quality and/or worth of their lives.[23] The possibility of death usually makes people more anxious if they feel that they have not and cannot accomplish any positive task in the life that they are living.[23] Research has tried to unveil the factors that might influence the amount of anxiety people experience in life.[23]

Personal meanings of death
See also: Meaning-making

Humans develop meanings and associate them with objects and events in their environment, provoking certain emotions within an individual. People tend to develop personal meanings of death which could accordingly be negative or positive for the individual. If they are positive, then the consequences of those meanings can be comforting (for example, ideas of a rippling effect[24] left on those still alive). If negative they can cause emotional turmoil. Depending on the certain meaning one has associated with death, the consequences will vary accordingly whether they are negative or positive meanings.[25]

Religiosity

The thought of death may cause different degrees of anxiety for different individuals, depending on many factors.

A 2012 study involving Christian and Muslim college-students from the US, Turkey, and Malaysia found that their religiosity correlated positively with an increased fear of death.[26]

Other studies have found that a strong sense of religion in a person's life can relate to a lower sense of anxiety towards death.[27] Although there has been no association discovered between religiosity and death anxiety,[27] it has also been shown that death anxiety tends to be lower in individuals who regularly attend religious meetings or gatherings.[27]

A 2010 study asked one hundred and sixty-five church participants to fill out the "Intrinsic Religious Motivation Scale, the Revised Death Anxiety Scale" and the results were analyzed using factor analyses, Pearson correlation, and linear and quadratic regression. All found an inverse relationship between intrinsic religious motivation and death anxiety. This suggested that the more religious a person is, the less anxious they may be about death, possibly associating it with an expected afterlife.[27] The study also found that gender did not have an effect on religiosity and total death anxiety.[28]

A 2017 review of the literature found that in the US, both the very religious and the not-at-all religious enjoy a lower level of death anxiety and that a reduction is common with old age.[29]

Children

The earliest documentation of the fear of death has been found in children as young as age 5.[30] Psychological measures and reaction times were used to measure fear of death in young children. Recent studies that assess fear of death in children use questionnaire rating scales.[30] There are many tests to study this including The Death Anxiety Scale for Children (DASC) developed by Schell and Seefeldt.[31] However the most common version of this test is the revised Fear Survey Schedule for Children (FSSC-R).[30] The FSSC-R describes specific fearful stimuli and children are asked to rate the degree to which the scenario/item makes them anxious or fearful.[30] The most recent version of the FSSC-R presents the scenarios in a pictorial form to children as young as 4. It is called the Koala Fear Questionnaire (KFQ).[30] The fear studies show that children's fears can be grouped into five categories. One of these categories is death and danger.[30] This response was found amongst children age 4 to 6 on the KFQ, and from age 7 to 10.[30] Death is the most commonly feared item and remains the most commonly feared item throughout adolescence.[30]

A study of 90 children, aged 4–8, done by Virginia Slaughter and Maya Griffiths showed that a more mature understanding of the biological concept of death was correlated to a decreased fear of death. This may suggest that it is helpful to teach children about death (in a biological sense), in order to alleviate the fear.[32]

Relationship to adult attachment

There has been much literature that supports the existence of a correlation between one's state of coping skills, mental health, emotions and cognitive reactions to stressful events, and one's ability to regulate affect concerning one's death anxiety. A series of tests determined that significantly high levels of death anxiety tend to occur in close relationships with an intimate partner (more so amongst females than males).[33]

Sexes

The connection between death anxiety and one's sex appears to be strong. Studies show that females tend to have more death anxiety than males. Thorson and Powell (1984) did a study to investigate this connection, and they sampled men and women from 16 years of age to over 60. The Death Anxiety Scale showed higher mean scores for women than for men. Moreover, researchers believe that age and culture could be major influences in why women score higher on death anxiety scales than men.[34]

Through the evolutionary period, a basic method was created to deal with death anxiety and also as a means of dealing with loss.[35] Denial is used when memories or feelings are too painful to accept and are often rejected.[36] By maintaining that the event never happened, rather than accepting it, allows an individual more time to work through the inevitable pain.[36] When a loved one dies in a family, denial is often implemented as a means to come to grips with the reality that the person is gone.[36] Closer families often deal with death better than when coping individually.[36] As society and families drift apart so does the time spent bereaving those who have died, which in turn leads to negative emotion and negativity towards death.[36] Women, who are the child bearers and are often the ones who look after children hold greater concerns about death due to their caring role within the family.[37] It is this common role of women that leads to greater death anxiety as it emphasize the 'importance to live' for her offspring.[37] Although it is common knowledge that all living creatures die, many people do not accept their own mortality, preferring not to accept that death is inevitable, and that they will one day die.[37]

Age

It is during the years of young adulthood (20 to 40 years of age) that death anxiety most often begins to become prevalent. However, during the next phase of life, the middle age adult years (40–64 years of age), death anxiety peaks at its highest levels when in comparison to all other age ranges throughout the lifespan. Surprisingly, levels of death anxiety then slump off in the old age years of adulthood (65 years of age and older). This is in contrast with most people's expectations, especially regarding all of the negative connotations younger adults have about the elderly and the aging process (Kurlychek & Trenner, 1982).[38]

Measuring

There are many ways to measure death anxiety and fear.[39] Katenbaum and Aeinsberg (1972) devised three propositions for this measurement.[39] From this start, the ideologies about death anxiety have been able to be recorded and their attributes listed.[39] Methods such as imagery tasks to simple questionnaires and apperception tests such as the Stroop test enable psychologists to adequately determine if a person is under stress due to death anxiety or suffering from post-traumatic stress disorder.[39] The Lester attitude death scale was developed in 1966 but not published until 1991 until its validity was established.[39] By measuring the general attitude towards death and also the inconsistencies with death attitudes, participants are scaled to their favorable value towards death.[39]

See also

References
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Bibliography
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