Death anxiety and mental health: Requiem for a dreamer

Psychosocial Correlates of Death Anxiety in Advanced Cancer: A Scoping Review

OBJECTIVES

Individuals living with advanced cancer commonly experience death anxiety, which refers to the distressing thoughts or feelings associated with awareness of one's mortality. Deriving an overview of existing literature on the psychological and social factors linked to death anxiety may inform conceptual models, clinical screening, and intervention strategies in oncology and palliative care. Therefore, the present scoping review was conducted to summarize the current literature on the psychosocial correlates of death anxiety among individuals with advanced cancer.

METHODS

A comprehensive scoping review methodology was used following the Arksey and O'Malley framework. A literature search was conducted using four electronic databases: CINAHL, Embase, PsycInfo, and MEDLINE. Abstracts and full-text articles were screened, and relevant data were extracted and summarized.

RESULTS

Sixteen studies met the inclusion criteria. Seventeen psychosocial correlates of death anxiety were identified, with depression, spiritual well-being, and attachment security representing the most frequently investigated. Four previously tested death anxiety models were also identified, two of which were designed longitudinally.

CONCLUSIONS

This review provides a current summary of psychosocial factors and established models related to death anxiety in advanced cancer. Multiple psychosocial correlates should be targeted concurrently in research and clinical practice to address death anxiety. Longitudinal studies designed to test new models are especially needed to identify unique pathways contributing to death anxiety across the disease trajectory of advanced cancer.

Flourishing, Cinematic Self, and Sense of Self as Predictors of Death Anxiety: A Gender-Invariant Model

This research delved into the intricate landscape of death anxiety, a profound psychological phenomenon that deeply influences individuals' perceptions and responses to mortality. Through a meticulous examination of key psychological factors - flourishing, cinematic self, and sense of self - we aimed to unravel the complexities surrounding this existential concern. With a diverse sample of 327 Portuguese participants, our study sheds light on the significant role these constructs play in shaping individuals' experiences of death anxiety. Notably, we highlight the profound impact of a robust sense of self in mitigating anxiety levels. Additionally, our exploration of gender dynamics revealed consistent patterns across diverse groups, underscoring the universal nature of these psychological processes. By providing a nuanced understanding of death anxiety and its determinants, our study offers valuable insights for the development of tailored interventions aimed at alleviating psychological distress and promoting well-being in individuals facing existential concerns.

Death Anxiety in Patients With Advanced Cancer and Their Family Caregivers

CONTEXT

Death anxiety is associated with fears of suffering and uncertainty at the end of life. It is also relevant to patients' family caregivers, who can experience fears about the patients' death and dying.

OBJECTIVES

This study investigates the prevalence of death anxiety in advanced cancer patients and their family caregivers and its association with sociodemographic and medical characteristics.

METHODS

We recruited patients with UICC stage IV solid tumors from in- and outpatient oncology and palliative care settings. We administered the Death and Dying Distress Scale to assess clinically significant death anxiety. We analyzed its association with sociodemographic and medical characteristics using simultaneous multiple linear regression analyses.

RESULTS

Death anxiety was prevalent in 37% of patients (N = 481) and 75% of family caregivers (N = 140). Most frequent death anxiety concerns were "feeling distressed about the impact of one's own death on loved ones" (52% of patients) and "feeling distressed about running out of time with their loved one" (69% of family caregivers). Patients who experienced high death anxiety were more likely to be younger (standardized β = -0.1; P=0.005) and have known about their diagnosis for less time (standardized β = -0.1; P=0.046). Being female predicted higher death anxiety in patients (β = 0.12; P=0.041) and family caregivers (β = 0.32; P=0.002).

CONCLUSION

The results indicate that death anxiety is a common, clinically significant problem in patients with advanced cancer and their family caregivers, emphasizing the need for targeted psychological support.

Fear of Death and Sleep Quality in the Aftermath of an Earthquake

PURPOSE

To examine fear of death and disruption in sleep patterns in individuals who have experienced an earthquake.

METHOD

A descriptive and relationship-oriented study was performed with 322 individuals who experienced the February 6, 2023, earthquake in Turkey. Data were collected between February 20 and May 15, 2023. A personal information form, the Pittsburgh Sleep Quality Index (PSQI), and Death Anxiety Scale (DAS) were used for data collection.

RESULTS

Participants' mean DAS score was 7.96 (SD = 1.05), and mean PSQI score was 8.74 (SD = 4.06). Statistically significant relationships were found between sex, marital status, and mean DAS score, and these variables accounted for 11.7% of the total variance. Similarly, statistically significant relationships were found among economic status, relationship to person trapped under the rubble, financial loss from the earthquake, and mean PSQI score, accounting for 11.3% of the total variance. Women and married people had greater fear of death, and those with good economic status, whose family members were buried under rubble, and who experienced financial loss as a result of the earthquake had lower sleep quality.

CONCLUSION

The earthquake led to moderate fear of death and poor sleep quality among participants. Findings highlight the need for targeted support for vulnerable groups following disasters. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Investigating the relationship between changes in metaphysical beliefs and death anxiety following a significant psychedelic experience

Research examining the potential of the psychedelic experience to alter attitudes toward death is steadily emerging. However, the specific mechanisms leading to this change are not well understood. The present study investigated the potential relationship between changes in metaphysical beliefs and changes in death anxiety following a single significant psychedelic experience. A total of 155 participants completed a retrospective questionnaire that included questions about their acute experience and changes in death anxiety and metaphysical beliefs following a significant psychedelic experience. Although some participants reported an increase in death anxiety, there was an overall significant reduction in death anxiety from before to after the experience. Improvements in death anxiety were positively correlated with changes in belief in panpsychism, but no other measured metaphysical beliefs. The findings from this exploratory study provide direction for future research looking at the relationship between changes in metaphysical beliefs and death anxiety in the context of psychedelic experiences.

Effects of different psychosocial interventions on death anxiety in patients: a network meta-analysis of randomized controlled trials

Objective

This research intended to assess and compare influence of psychosocial interventions in death anxiety in patients, providing evidence-based guidance for both patients and healthcare providers.

Design

The present study exclusively gathered randomized controlled trials by comprehensively searching across multiple databases, comprising of PubMed, Embase, Cochrane Library, Web of Science, and Scopus. The methodological quality of the enrolled studies involved in the analysis was assessed using the Cochrane bias risk assessment tool, and data analysis was performed utilizing appropriate software.

Results

This research, encompassing 15 randomized controlled trials with a cumulative sample size of 926 patients, spanned from the earliest possible date to December 2023. The findings of network meta-analysis unveiled that the Rational-Emotive Hospice Care Therapy significantly reduced death anxiety among patients (Sequentially Updated Cumulative Ranking Analysis: 100%).

Conclusion

The ranking plot of the network suggested that the rational-emotive hospice care therapy exhibited superior efficacy as a psychological treatment for reducing the death anxiety of patients.Systematic review registration: [https://clinicaltrials.gov/], identifier: [CRD42023484767].

The Effect of Death Anxiety on Work Passion: Moderating Roles of Work Centrality and Work Connection

Fear of death is an emotional manifestation of the instinct for self-preservation. Any threat to our existence induces an anxiety response. Death anxiety can trigger obsessive-compulsive behaviours, such as an obsessive passion for work. Using a sample of 314 participants (68.2% female), with a mean age of 38.97 years (SD = 10.36), this study sought to observe the predictive effect of death anxiety on work passion, as well as the moderating effect of work-family centrality and connection on the relationship between anxiety and passion. The results revealed that death anxiety negatively affects harmonious passion, and positively affects obsessive passion. Work centrality did not moderate the influence of death anxiety on harmonious and obsessive passion. Nonetheless, work connection moderated the influence of death anxiety on harmonious passion. The negative influence of death anxiety on harmonious passion was greater in a group with high work connection than a group with low connection.

Relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases: mediating effects of death anxiety

BACKGROUND

Many studies have explored the relationship between self-esteem and quality of life. However, few studies have elucidated the mechanisms underlying the relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases. The present study aimed to explore the mediating role of death anxiety in this relationship.

METHODS

Middle-old-aged patients with chronic diseases were selected as the respondents by using a multi-stage sampling method, random number table method from October 2021 to February 2022 in the Second Affiliated Hospital of Zhejiang University School of Medicine. The Cumulative Disease Rating Scale, the Self-Esteem Scale (SES), the Chinese version of the Death Anxiety Scale (CT-DAS), and the Simplified version of the Quality of Life Scale (SF-12) were used as the researching tools to conduct the survey. SPSS26.0 was used to analysis data. AMOS 23.0 software was used to construct structural equation modeling.

RESULTS

294 valid questionnaires were collected. There were significant differences in quality of life among middle-aged and elderly patients with chronic diseases who have different physical activities, socialization, and chronic pain (P < 0.01); Self-esteem was positively associated with quality of life (r = 0.330, P < 0.01), self-esteem was negatively associated with death anxiety (r = -0.222, P < 0.01), and death anxiety was negatively associated with quality of life (r = -0.263, P < 0.01); Death anxiety partially mediated the relationship between self-esteem and quality of life, with the mediating effect accounting for 18.40% of the total effect.

CONCLUSION

Death anxiety partially mediates the relationship between self-esteem and quality of life. Interventions to improve self-esteem and reduce death anxiety should be used to improve the quality of life of middle-aged and senior patients with chronic diseases.

Examining terror management theory in Ukraine: impact of air-raid alarms and explosions on mental health, somatic symptoms, and well-being

Objective

This study sought to evaluate Terror Management Theory (TMT) assumptions about death awareness and its psychological impact in the context of a real-world war situation with high external validity. We examined if factors such as habituation to war circumstances and psychological resilience could buffer the effects on civilians' anxiety, physical and mental health, and affect.

Method

We implemented a pre-registered smartphone-based experience sampling method study over four weeks, with 307 participants (k = 7,824) living in war-affected areas in Ukraine whereby participants were regularly exposed to war situations, including air-raid alarms, explosions, and infrastructural problems.

Results

The data indicated that war situations significantly increased anxiety, negatively impacting mental health, and raising somatic symptom severity. While habituation showed a mild buffering effect on these impacts, resilience did not.

Conclusion

This real-world investigation supports TMT's fundamental assumptions about death awareness and its psychological implications. However, even amidst the presence of real, life-threatening situations, the buffering effects of habituation were surprisingly minimal. This suggests that further exploration of TMT's buffering factors in real-world scenarios is warranted.