Ebola salience, death-thought accessibility, and worldview defense: A terror management theory perspective

An existential perspective on interpersonal closeness and social distancing during the COVID-19 pandemic

OBJECTIVE

The terror management health model proposes that COVID-19's association with death should increase a desire for closeness, which could undermine social distancing intentions. Alternatively, social distancing intentions may increase if it has become culturally valued. The present research assessed these claims.

DESIGN

We conducted three pre-registered online experiments (N = 409) where we manipulated COVID-19 thoughts, and examined either proximal (i.e. immediate) or distal (i.e. delayed) reactions.

MAIN OUTCOME MEASURES

Death-thought accessibility, desire for closeness, social distancing intentions, and measures concerning the perceived cultural value of social distancing.

RESULTS

COVID-19 thoughts increased death-thought accessibility (Study 1). COVID-19-induced death thoughts increased a distal desire for closeness, particularly in securely attached individuals, but also increased the perceived value of, and intentions to engage in, social distancing (Studies 2 and 3).

CONCLUSION

Our findings demonstrate how proximal strategies may progress to distal strategies when they become embedded within cultural worldviews. These findings can aid in sustained efforts to encourage social distancing behavior.

Systematic review on attitudes towards death and dying in adults 50 years and older living in countries with community transmission of COVID-19

BACKGROUND

The COVID-19 pandemic has underscored older adults' vulnerability to severe illness or death. Increased public awareness of mortality, with daily reminders of preventive measures, spurred interest in understanding the impact on death-related thoughts. This systematic review analyses existing literature on death attitudes among individuals aged 50 and older during the COVID-19 pandemic and focuses on associated factors.

METHODS

A systematic literature search was conducted using the WHO COVID database without any language limit, up until April 2023. The review protocol was registered in PROSPERO and PRISMA guidelines were followed. Included studies were systematically analysed and summarized using a predefined data extraction sheet.

RESULTS

Of the 2297 studies identified, 9 met inclusion criteria. The review showed moderate to high levels of death anxiety during the pandemic, linked to direct health risks from COVID-19 rather than mitigation measures. The impact of health and personal factors on older people's death anxiety was complex, with a range of health and personal factors such as chronic conditions, loss of capacity, loneliness, occupation, and resilience associated with it, suggesting potential intervention avenues.

CONCLUSION

The systematic review shows a significant link between COVID-19 and heightened death anxiety among individuals aged 50 and above. Negative attitudes to death can harm physical and mental health, diminish life satisfaction, increase avoidance behaviour, impair coping mechanism and undermine end-of-life decision making. Findings underscore the need for further research into risk and protective factors (personal, health, and environmental) and the importance of standardized data collection to guide interventions and public health strategies aimed at mitigating death anxiety.

Dressing up social psychology: Empirically investigating the psychological functions of clothing using the example of symbolic protection

Clothing behaviour remains an understudied research area within social psychology. Through the present research, we aim to anchor attire as an empirical research subject by investigating the psychological properties of one of its functionalities, namely, to provide protection. We argue that attire's undisputed role in shielding humans from environmental hazards may extend to the psychological level and protect them from the incorporeal consequences of existential threats symbolically. In this Registered Report, a mixed-methods approach links an ecologically valid field study of self-presentation in social media posts during Russia's war on Ukraine (Study 1; N = 248) with supraliminal priming of mortality salience in an online experiment (Study 2; N = 248). Across both studies, we expect that mortality concerns let people accentuate the physically protective attributes of clothing (e.g. more layers of clothing) and resort to more in-group prototypical dress styles (i.e. more gender-stereotypical). Findings show that people adjust their clothing preferences in response to existential threats, favouring in-group prototypical clothing (more gender-typical for both women and men in Study 1) and physically protective attire (higher in women and lower in men in Study 2) during high (vs. low) levels of existential threat. By positioning clothing as a research area within social psychology, our goal is to stimulate a wave of research on its profound role for humankind. Furthermore, we provide a dynamic and robust methodological approach to researching terror management theory.

Death anxiety and satisfaction with life among the adults in the social isolation process of Covid-19 pandemic: the mediating role of perceived stress

BACKGROUND

The present study examined the mediating role of perceived stress during the social isolation process of the Covid-19 pandemic on the association between death anxiety and satisfaction with life. The participants of the study included 410 individuals (212 females and 198 males) from Turkey. Data were collected using the Death Anxiety Scale, the Perceived Stress Scale and the Satisfaction with Life Scale.

AIMS

The aim of this study was to reveal the relationships between death anxiety, perceived stress and satisfaction with life and to test the mediating role of perceived stress on the effect of death anxiety and satisfaction with life in the Covid-19 pandemic process.

METHODS AND RESULTS

The structural equation modelling results indicated that stress mediated the impact of death anxiety on satisfaction with life. Moreover, the bootstrapping procedure revealed significant links from death anxiety to satisfaction with life through perceived stress in the social isolation process of Covid-19.

CONCLUSIONS

The findings of the study contributed to the structuring of psychological health services to be offered within the scope of public health during the Covid-19 pandemic and the understanding of the complex nature of the relationship between psychological factors and satisfaction with life. Possible explanations and limitations were discussed.

Facing a Real Threat of Death: Dynamic Changes in Death-Thought Accessibility

Purpose

This study explored the relationship between emotion and death-thought accessibility (DTA) in individuals experiencing true mortality salience (MS), specifically, patients with cancer.

Patients and Methods

The study included 255 participants; among them, 132 patients had cancer and represented the MS group, and 123 had dental pain and served as a control group. Participants completed the Projective Diseases Attitude Assessment Questionnaire to induce priming, completed an affect scale, completed one of four calculation tasks as manipulation of cognitive load (all four were done over several sessions), and performed a Pinyin-Chinese characters exercise to measure DTA.

Results

MS was associated with strong negative emotional arousal. When these negative emotions are generated, they enter an individual’s consciousness and activate proximal defense mechanisms. At this point, DTA can be measured. Patients with cancer had significantly higher levels of DTA in the high-frequency cognitive load condition than in the other three conditions (no task, simple delay task, and single cognitive load task). Patients with dental pain had significantly higher levels of DTA in the no task and simple delay conditions than in the single cognitive load or high-frequency cognitive load conditions. This study also found that negative experiences without MS (specifically, dental pain) are associated with higher levels of DTA.

Conclusion

These findings suggest that in addition to death-related events, both negative and stress-inducing events can produce DTA.

Evaluation of Psychopathological Symptoms, Death Anxiety, Coronavirus Anxiety, Suicide Risk, and Associated Risk Factors Among Hemodialysis Patients in the COVID-19 Pandemic

BACKGROUND

Hemodialysis (HD) patients have significant mental health problems related to the COVID-19 pandemic. Thus, this study aimed to evaluate the psychopathological symptoms, death anxiety, coronavirus anxiety, suicide risk, and associated risk factors in HD patients during COVID-19.

METHODS

This cross-sectional study was conducted from July 15 to October 15, 2021, with 114 HD patients who were undergoing treatment in two central Dialysis Units.

RESULTS

It was determined that HD patients had high levels of psychopathological symptoms. Approximately one-third of HD patients (%31.6) had high to very high-level death anxiety. Additionally, of the participants 30.7% had coronavirus anxiety, and also the rate of severe suicide risk was 10.5%.

CONCLUSIONS

HD patients have experienced various mental health problems during the COVID-19 pandemic. Psychosocial support and interventions need to be planned by the healthcare system and healthcare providers to help HD patients in managing their disease and related mental health problems.

An Infectious Silver Lining: Is There a Positive Relationship Between Recovering From a COVID Infection and Psychological Richness of Life?

This paper draws from the recent literature on psychological richness of life (PRL), conceptualized as a third dimension of a good life which would be particularly desirable when happiness or meaning in life cannot be satisfactory attained, to investigate whether recovering from a COVID infection could be associated with PRL. We hypothesize that people who have recovered from being infected by the virus rate their PRL higher than those who have not been infected. Two cross-sectional studies (n = 937, and n = 1,012) support the hypothesis, and also found that people who recovered from a COVID infection were less prone to want to delete the pandemic time period from their life line and reported lower levels of death anxiety. The findings have implications for coping both on a societal and individual level, by changing perspectives and valuing the richness of positive as well as negative experiences, as well as counteracting repetitiveness and tedium and stimulating new experiences and reflection. The findings also have implications for future research on well-being, which could be informed by expanding the perspective from living well to a life well-lived, and future research on PRL and coping in terms of investigating causalities and interaction effects.

Mortality Salience Effects of Critical Incidents - A Systematic Literature Review and Research Agenda

Critical incidents (CI) trigger acute stress reactions and psychological trauma because of direct or vicarious exposure. These events include natural disasters, wars, terrorist attacks and pandemics, and usually result in deaths and serious physical injuries. Their life-threatening nature makes them reasonable candidates to induce mortality salience (MS). The current review aims to consolidate Terror Management Theory (TMT) research using CIs as MS. A systematic literature review was conducted. Overall, 74 articles with 113 studies were included. Through this review, strong support for MS effects of CI has been found. Consistent with TMT, CIs tend to trigger worldview defence, self-esteem enhancement and relationship seeking. CIs have also been found to impact negatively on individual well-being and organisational health. Recommendations specific to crisis interventions and well-being will be discussed. The review concludes with potential future research directions to strengthen and expand empirical knowledge in CI salience.

Testing alternative models and predictive utility of the Death Anxiety Inventory-Revised: A COVID-19 related longitudinal population based study

The beginning of the COVID-19 pandemic had a profound effect on all aspects of daily life and triggered a swell of anxiety across the world. Some suggest this emotional response to the pandemic can be explained through death anxiety (DA), a transdiagnostic dimension associated with numerous psychological disorders. However, it remains unclear as to whether DA is a unidimensional or multidimensional construct. The primary aim of this study was to examine the underlying structure of the Death Anxiety Inventory-Revised (DAI-R; Tomás-Sábado et al., 2005) and assess its associations with mental health and demographic variables during the COVID-19 pandemic. To achieve these aims, we utilized data from Waves 1 (N = 2205: collected between March 23 and March 28, 2020) and 2 (N = 1406: collected between April 22 and May 1, 2020) of the COVID-19 Psychological Research Consortium (C19PRC), a multi-wave nationally representative study. Results showed that a 4-factor model provided the best fit to the data compared to a unidimensional and 4-factor second-order model. Further analyses showed that DA at Wave 1 was positively associated with somatic symptoms, paranoia, depression, anxiety, and traumatic stress symptoms at Wave 2, supporting previous research that suggests that the fear of death is predictive of psychopathology. Significantly, the factor labelled ‘Thoughts about Death’ at Wave 1 was the strongest predictor of the five main psychological variables at Wave 2, after statistically controlling for the other latent variables. These findings highlight the transdiagnostic nature of DA and support this important diagnostic construct becoming a measure of mental health more generally within the population. It is hoped that this research will shine a light on those suffering from DA and become a catalyst for increased therapeutic intervention, funding, and research in this area.

Morbid Polarization: Exposure to COVID-19 and Partisan Disagreement about Pandemic Response

The COVID-19 pandemic has affected the lives of all Americans, but the severity of the pandemic has been experienced unevenly across space and time. Some states saw sharp rises in COVID-19 cases in early March, whereas case counts rose much later in the rest of the country. In this article, we examine the relationship between exposure to COVID-19 and citizens' views on what type of measures are required to deal with the crises and how experience with and exposure to COVID-19 is associated with greater partisan polarization. We find consistent evidence of partisan divergence in pandemic-response policy preferences across the first six months of the COVID-19 pandemic: Republicans support national control measures whereas Democrats support welfare policies, and interparty differences grow over time. We find only limited evidence that exposure or experience moderates these partisan differences. Our findings are consistent with the view that Americans interpret the COVID-19 pandemic in fundamentally partisan manner, and that objective pandemic conditions play at most a minor role in shaping mass preferences.

Vaccination anxiety when vaccinations are available: The role of existential concerns

This study examined how existential fears are related to COVID-19 vaccination anxiety and followed the Terror Management Theory (TMT) by examining the contribution of two existential concerns, subjective nearness-to-death (SNtD) and death anxiety, to COVID-19 vaccination anxiety during the first month of COVID-19 vaccinations. Data were collected during January 2021, when Israel was in lockdown, from a convenience sample of 381 Jewish Israelis (M = 55.39, SD = 17.17). Participants completed questionnaires examining demographics, SNtD, death anxiety and COVID-19 vaccination anxiety. A hierarchical regression analysis examined the connections between these variables and COVID-19 vaccination anxiety while controlling for demographics and for receiving COVID-19 vaccinations. In line with the hypotheses, SNtD and death anxiety were each positively associated with COVID-19 vaccination anxiety, and death anxiety levels moderated the positive connection between SNtD and COVID-19 vaccination anxiety, as this association was not significant for individuals with low death anxiety. The findings of this study provide preliminary evidence concerning the role of death anxiety in moderating the effect that SNtD has on COVID-19 vaccination anxiety. These findings are in line with the TMT and justify further investigation and may be utilized in future research in order to address COVID-19 vaccination anxiety more effectively.

Knowledge, Perceived Risk, and Preventive Behaviors amidst Covid-19 Pandemic among Dental Students in Malaysia

PURPOSE

Coronavirus disease 19 (COVID-19) has affected dental education in Malaysia. However, studies on dental students' knowledge, perception, and behaviors with regards to COVID-19 are very limited. Thus, this study aims to determine the knowledge status, perceived risk, and preventive behaviors of dental students in Malaysia regarding COVID-19.

METHODS

A cross-sectional study was conducted among students from 13 dental schools across Malaysia using online questionnaires.

RESULTS

From 355 respondents, 93.5% obtained a high score of knowledge of COVID-19. Female respondents scored higher than males in perceived risks and preventive behaviors. Chinese respondents scored highest in knowledge, while Malay respondents had the highest perceived risk score. The mean preventive behavior score did not vary across ethnicity. On-campus students scored higher in knowledge and perceived risk whereas off-campus students practiced more preventive behaviors. Clinical students' knowledge score was higher than preclinical students. Final year students scored higher in knowledge and perceived risk compared to their juniors.

CONCLUSION

The majority of dental students have good knowledge and a high perceived risk of COVID-19, and they practiced most of the preventive behaviors. However, the latest information on this disease should be incorporated into dental schools' curriculums and updated periodically.

How healthcare workers respond to COVID-19: The role of vulnerability and social support in a close relationships defense mechanism

Healthcare workers play a vital role in the fight against COVID-19. Based on Terror Management Theory (TMT), the present research examined whether a close relationships defense mechanism reduces anxiety among healthcare workers (N = 729) in China. Our results suggest that this defense mechanism, as indexed by relationship satisfaction, serves as an effective terror management source after exposure to reminders of death (MS; mortality salience). These findings extend TMT by identifying two moderating variables: vulnerability and social support. In a low objective vulnerability group, healthcare workers who subjectively believed themselves as less vulnerable to COVID-19 showed a stronger defense mechanism after a MS manipulation as compared to those who felt more vulnerable. Further, healthcare workers with higher levels of social support reported more relationship satisfaction. These findings have practical implications for guiding healthcare workers on how to buffer death-related anxiety and maintain their mental health in the fight against COVID-19.

Death Concerns, Benefit-Finding, and Well-Being During the COVID-19 Pandemic

Because of the coronavirus (COVID-19) pandemic, reminders of death are particularly salient. Although much terror management theory research demonstrates that people engage in defensive tactics to manage mortality awareness, other work shows that existential concerns can motivate growth-oriented actions to improve health. The present study explored the associative link between coronavirus anxieties, fear of death, and participants' well-being. Results, using structural equation modeling, found that increased mortality concerns stemming from COVID-19 were associated with heightened benefit finding (e.g., relationship investment, gratefulness, patience) from the pandemic. Increased benefit finding, in turn, was related to higher life satisfaction, meaning in life, self-esteem, resilience, and vitality while also correlating negatively with depression and stress scores. There was no evidence for reverse mediation in that fear of mortality did not predict well-being through coronavirus worries. Overall, although many persons have experienced mental health concerns (e.g., fear, stress) as a function of the COVID-19 pandemic, our findings demonstrate positive benefits that paradoxically follow in terms of an increased appreciation of life, improved relationships, and better health.

'It's like being in a war with an invisible enemy': A document analysis of bereavement due to COVID-19 in UK newspapers

The COVID-19 pandemic has been followed intensely by the global news media, with deaths and bereavement a major focus. The media reflect and reinforce cultural conventions and sense-making, offering a lens which shapes personal experiences and attitudes. How COVID-19 bereavement is reported therefore has important societal implications. We aimed to explore the reportage and portrayal of COVID-19 related bereavement in the top seven most-read British online newspapers during two week-long periods in March and April 2020. We conducted a qualitative document analysis of all articles that described grief or bereavement after a death from COVID-19. Analysis of 55 articles was informed by critical discourse analysis and Terror Management Theory, which describes a psychological conflict arising between the realisation that death is inevitable and largely unpredictable and the human need for self-preservation. We identified three main narratives: (1) fear of an uncontrollable, unknown new virus and its uncertain consequences-associated with sensationalist language and a sense of helplessness and confusion; (2) managing uncertainty and fear via prediction of the future and calls for behaviour change, associated with use of war metaphors; and (3) mourning and loss narratives that paid respect to the deceased and gave voice to grief, associated with euphemistic or glorifying language ('passed away', 'heroes'). Accounts of death and grief were largely homogenous, with bereavement due to COVID-19 presented as a series of tragedies, and there was limited practical advice about what to do if a loved one became seriously ill or died. Reporting reflected the tension between focusing on existential threat and the need to retreat from or attempt to control that threat. While the impact of this reporting on the public is unknown, a more nuanced approach is recommended to better support those bereaved by COVID-19.

Can a pandemic make people more socially conservative? Political ideology, gender roles, and the case of COVID-19

The first months of 2020 rapidly threw people into a period of societal turmoil and pathogen threat with the COVID-19 pandemic. By promoting epistemic and existential motivational processes and activating people's behavioral immune systems, this pandemic may have changed social and political attitudes. The current research specifically asked the following question: As COVID-19 became pronounced in the United States during the pandemic's emergence, did people living there become more socially conservative? We present a repeated-measures study (N = 695) that assessed political ideology, gender role conformity, and gender stereotypes among U.S. adults before (January 25-26, 2020) versus during (March 19-April 2, 2020) the pandemic. During the pandemic, participants reported conforming more strongly to traditional gender roles and believing more strongly in traditional gender stereotypes than they did before the pandemic. Political ideology remained constant over time. These findings suggest that a pandemic may promote the preference for traditional gender roles.

Benevolent Creativity Buffers Anxiety Aroused by Mortality Salience: Terror Management in COVID-19 Pandemic

With the outbreak of the COVID-19 crisis, the public keeps getting epidemic-related information on the media. News reports on the increasing number of fatalities have exposed individuals to death, which causes negative emotional experiences such as tension, anxiety, and fear. This study aimed to investigate whether creativity could serve as an anxiety-buffer when mortality is salient. Based on previous findings, the present study utilized type of creative task and personal search for meaning as moderators. In Study 1, a 2 (mortality salience: absent, present) × 2 (type of creative task: benevolent, malevolent) between-subject design was utilized, and 168 subjects were randomly assigned to four experimental conditions. In Study 2, 221 subjects were recruited. The experimental procedure was similar to Study 1, except that the priming paradigm of mortality was changed and search for meaning was included as an additional moderating variable. State anxiety was measured as the dependent variable in both studies. Results of Study 1 showed that, while the benevolent creative task could buffer anxiety in the mortality salience condition, the malevolent creative task did not have the same effect. Furthermore, there was a significant interaction between mortality salience, type of creative task, and search for meaning in life on anxiety. In Study 2, the buffering function of benevolent creativity was more intense for participants with a higher level of search for meaning. Together, these findings reveal the influence of different types of creative tasks on individual anxiety levels under death priming conditions and the moderating effect of search for meaning in this relationship. Further, they suggest the need to focus on the role of creativity in terror management.

Death anxiety in the time of COVID-19: theoretical explanations and clinical implications

The recent COVID-19 pandemic has triggered a surge in anxiety across the globe. Much of the public's behavioural and emotional response to the virus can be understood through the framework of terror management theory, which proposes that fear of death drives much of human behaviour. In the context of the current pandemic, death anxiety, a recently proposed transdiagnostic construct, appears especially relevant. Fear of death has recently been shown to predict not only anxiety related to COVID-19, but also to play a causal role in various mental health conditions. Given this, it is argued that treatment programmes in mental health may need to broaden their focus to directly target the dread of death. Notably, cognitive behavioural therapy (CBT) has been shown to produce significant reductions in death anxiety. As such, it is possible that complementing current treatments with specific CBT techniques addressing fears of death may ensure enhanced long-term symptom reduction. Further research is essential in order to examine whether treating death anxiety will indeed improve long-term outcomes, and prevent the emergence of future disorders in vulnerable populations.

Key learning aims

(1)To understand terror management theory and its theoretical explanation of death anxiety in the context of COVID-19.(2)To understand the transdiagnostic role of death anxiety in mental health disorders.(3)To understand current treatment approaches for directly targeting death anxiety, and the importance of doing so to improve long-term treatment outcomes.

[Coronavirus: Predictive brain and terror management]

Emerging infectious diseases like Covid-19 cause a major threat to global health. When confronted with new pathogens, individuals generate several beliefs about the epidemic phenomenon. Many studies have shown that individual protective behaviors largely depend on these beliefs. Due to the absence of treatment and vaccine against these emerging pathogens, the relation between these beliefs and these behaviors represents a crucial issue for public health policies. In the premises of the Covid-19 pandemic, several preliminary studies have highlighted a delay in the perception of risk by individuals, which potentially holds back the implementing of the necessary precautionary measures: people underestimated the risks associated with the virus, and therefore also the importance of complying with sanitary guidelines. During the peak of the pandemic, the salience of the threat and of the risk of mortality could then have transformed the way people generate their beliefs. This potentially leads to upheavals in the way they understand the world. Here, we propose to explore the evolution of beliefs and behaviors during the Covid-19 crisis, using the theory of predictive coding and the theory of terror management, two influential frameworks in cognitive science and in social psychology.