Reactance, Mortality Salience, and Skin-Cancer Prevention Among Young Adults

In an experiment (N = 206) using skin cancer prevention messages and a 2 (mortality: salient, control) × 2 (freedom-limiting language: freedom-limiting, autonomy-supportive) independent-group design, we tested the terror management health model and integrated its predictions with the theory of psychological reactance. We used a sample of young adults because they are most at risk for excessive tanning. Consistent with the study predictions about proximal defenses, mortality salience significantly increased intentions to wear sunscreen all year around, relative to the control condition. A significant interaction between freedom-limiting language and mortality salience on behavioral intention to purchase high-SPF lotion revealed that, when a freedom-limiting message was paired with mortality salience, intentions to purchase high-SPF lotion were significantly greater as compared to autonomy-supportive language, indicating that mortality salience mitigated the maladaptive effects of reactance. These results add to a growing body of research identifying boundary conditions for reactance effects and, further, point to the utility of directive (albeit freedom-limiting language) in health-prevention messages attempting to communicate deadly health risks.

When Fears Come True: An Experimental Approximation of Patient Comprehension During Initial Cancer Diagnoses

An experiment (N = 624 U.S. adults) was designed to approximate how well patients attend to information during a cancer-related doctor visit. To make this assessment, we manipulated mortality salience (present, absent) and language complexity (simple words, complex words) to understand whether these factors impact newly diagnosed patients' ability to attend to relevant treatment information. Message attention was measured through a comprehension quiz and a signal detection task. We found that a state of heightened mortality salience slightly improved message comprehension. We also found that language simplicity in an article about skin cancer treatment improved comprehension and attention, particularly under conditions of high mortality salience. These findings suggest that practitioners should use simple language when discussing health care options with their patients.

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.

Death-is-life-enhancing: Adaptation and validation of the Norwegian Death Mindsets Measure (NDMM)

While existing psychological frameworks and their accompanying measures focus on death as anxiety-inducing and debilitating, we highlight an overlooked perspective of death-that death can be a basis for living with more meaning and presence. The present research adapts and validates the Death Mindsets Measure (DMM), which assesses the mindset that "death-is-life-enhancing," for a Norwegian context. Firstly, we translated the DMM and consulted with Norwegian bereavement experts and bereaved Norwegians on items' clarity and relevance to cultural perspectives of death. Secondly, we validated the Norwegian DMM (NDMM) on a predominantly bereaved community sample of Norwegians (N = 241). Using structural equation modeling, we confirmed the hierarchical two-factor structure of our measure. The NDMM also demonstrated high internal consistency and discriminant validity with existing death anxiety and death attitudinal measures. Finally, our measure explained additional variance in psychological well-being beyond existing death anxiety and attitudinal measures.

Have the effects of Covid-19 been overcome? Levels of Covid-19 fear, Covid-19 anxiety and hopelessness in young adolescents: A structural equation modeling

OBJECTIVE

This research aimed to determine the level of fear, anxiety, and hopelessness of Covid-19 in young adolescents' post Covid-19 period.

DESIGN AND SAMPLES

Young adolescents in the 17-24 age group were included in this study, which was conducted in a descriptive-cross-sectional design.

MEASUREMENTS

Sociodemographic characteristics questionnaire form and Coronavirus (Covid-19) Fear Scale, Coronavirus Anxiety Scale, and Beck Hopelessness Scale were used to collect data.

RESULTS

90.8% of the participants had been vaccinated, 26.9% had previously caught in Covid-19, and 10.3% of those who had been caught in the disease had a severe course. 10.7% of young adolescents had to take medicines, 56.4% had a family history of Covid-19, and 18.7% had lost a relative as a result of Covid-19, was found. The level of fear, anxiety and hopelessness was higher among women, first-grade students, those who did not receive the Covid-19 vaccine, those who have caught in Covid-19 before, and those who have lost a family due to Covid-19.

CONCLUSION

It is thought that the increase in the awareness level of young adolescents about Covid-19 improves preventive health behaviors and enables the development of positive behaviors related to the disease.

The effects of death awareness and reactance on texting-and-driving prevention

Using a 2 (mortality: salient, control) × 2 (freedom-limiting language: freedom-limiting, autonomy-supportive) independent-group design, this study examined the relationship between mortality salience and psychological reactance in the context of texting-and-driving prevention messages. The terror management health model and the theory of psychological reactance guided study predictions. Results showed mortality salience produced adaptive effects on attitudes toward texting-and-driving prevention and behavioral intentions to reduce unsafe driving practices. Additionally, some evidence for the effectiveness of directive, albeit freedom-limiting communication, emerged. These and other results are discussed along with the implications, limitations, and future research directions.

"Life's too short to be small": An experimental exploration of the relationship between death anxiety and muscle dysmorphia symptoms

Growing research demonstrates that death anxiety is strongly associated with numerous mental health conditions. It is possible that death anxiety may similarly contribute to behaviours associated with muscle dysmorphia (MD). The current pre-registered study examined this possibility in 322 young men with an interest in health and fitness. The mortality salience paradigm was used to experimentally examine whether reminders of death increased behaviours relevant to MD. Measures of MD symptoms and death anxiety were also completed by participants. Contrary to expectations, reminders of death did not significantly increase willingness to trial workout supplements, or dissatisfaction with current muscularity. Participants reminded of death reported lower intention to exercise in the near future, compared to the control condition. Moreover, death reminders did not lead to significantly larger portion sizes being chosen. However, in post-hoc analyses, men with high, but not low, MD symptoms did choose larger portions after being primed with death. Lastly, positive correlations were found between self-report measures of MD symptoms and two measures of death anxiety. Cumulatively, these results suggest that while fears of death may be associated with self-reported MD symptoms, they may not drive excessive exercise, nor body dissatisfaction in men.

Breaking bad news in the era of artificial intelligence and algorithmic medicine: an exploration of disclosure and its ethical justification using the hedonic calculus

An appropriate ethical framework around the use of Artificial Intelligence (AI) in healthcare has become a key desirable with the increasingly widespread deployment of this technology. Advances in AI hold the promise of improving the precision of outcome prediction at the level of the individual. However, the addition of these technologies to patient-clinician interactions, as with any complex human interaction, has potential pitfalls. While physicians have always had to carefully consider the ethical background and implications of their actions, detailed deliberations around fast-moving technological progress may not have kept up. We use a common but key challenge in healthcare interactions, the disclosure of bad news (likely imminent death), to illustrate how the philosophical framework of the 'Felicific Calculus' developed in the eighteenth century by Jeremy Bentham, may have a timely quasi-quantitative application in the age of AI. We show how this ethical algorithm can be used to assess, across seven mutually exclusive and exhaustive domains, whether an AI-supported action can be morally justified.

Keeping Employees Safe During Health Crises: The Effects of Media Exposure, HR Practices, and Age

Occupational health and safety are critical in promoting the wellness of organizations and employees. The COVID-19 pandemic is one of the most life-threatening viruses encountered in recent history, providing a unique opportunity for research to examine factors that drive employee safety behavior. Drawing from terror management theory, we propose and test a moderated mediation model using data collected from employees working during a peak of the pandemic. We identify two sources of influence - one external (i.e., media exposure), and one internal (i.e., HR practices) to the organization - that shape employees' mortality salience and safety behaviors. We find that COVID-19 HR practices significantly moderate the relationship between daily COVID-19 media exposure and mortality salience, with media exposure positively associated with mortality salience at lower levels of HR practices but its effects substituted by higher levels of HR practices. Moreover, our results also show that mortality salience spurs safety behaviors, with age moderating this relationship such that younger - but not older - employees are more likely to engage in safety behaviors due to mortality salience. Taken together, we offer theoretical implications for the safety behavior literature and practical implications for organizations faced with health crises or having employees who commonly work in hazardous conditions.

Investigating the Role of Normative Support in Atheists' Perceptions of Meaning Following Reminders of Death

According to terror management theory, humans rely on meaningful and permanence-promising cultural worldviews, like religion, to manage mortality concerns. Prior research indicates that, compared to religious individuals, atheists experience lower levels of meaning in life following reminders of death. The present study investigated whether reminders of death would change atheists' meaning in life after exposure to normative support for atheism. Atheists (N = 222) were either reminded of death or a control topic (dental pain) and exposed to information portraying atheism as either common or rare, and then asked to rate their perceived meaning in life. Results showed that reminders of death reduced meaning in life among atheists who were told that atheism is common. Results were consistent with the view that atheism reflects the rejection of religious faith rather than a meaningful secular terror managing worldview. Discussion considers implications for maintaining healthy existential wellbeing, identifies limitations, and highlights future research directions.

The proximal and distal effects of mortality salience on COVID-19-related health perceptions and intentions

Health preventative measures are important in reducing transmission of COVID-19, yet death-related thoughts might hinder preventative action. Using two online samples (N = 948), we examined how mortality salience (MS) may produce health-related proximal and distal defenses relevant to COVID-19, examining health optimism and appearance self-worth as moderators. MS decreased perceived vulnerability as a proximal defense for those with high health optimism (Study 1), while those with low health optimism decreased perceived response efficacy of face masks and intention to wear a protective face mask (Study 2). Additionally, those with high appearance self-worth displayed increased intention to wear an aesthetically appealing face mask as a distal defense to MS (Study 2). Our findings demonstrate the importance of considering how mortality concerns may channel health-defeating and health-promoting behaviors in respect to COVID-19 and provide insight into how to produce sustained engagement in health preventative action to combat the pandemic.

The Role of Existential Concerns in the Individual's Decisions regarding COVID-19 Vaccine Uptake: A Survey among Non-Vaccinated Italian Adults during the Third Wave of the Pandemic

Recent studies have suggested that health constructs embraced by the Terror Management Theory (TMT) and the Basic Psychological Needs Theory (BPNT) may drive individuals' COVID-19 health-related decisions. This study examines the relationships between existential concerns (ECs; within the TMT), basic psychological needs (BPNs; within the BPNT) and COVID-19 vaccine hesitancy (VH), as well as the mediating role of negative attitudes toward COVID-19 vaccines. A cross-sectional survey was carried out from April to May 2021 on a sample of two hundred and eighty-seven adults (Mage = 36.04 ± 12.07; 59.9% females). Participants provided information regarding existential concerns, basic psychological needs, attitudes toward COVID-19 vaccines and vaccine hesitancy for Pfizer-BioNTech and AstraZeneca vaccines separately. Higher vaccine hesitancy (32.1%) and vaccine resistance (32.8%) rates were found for AstraZeneca than for Pfizer-BioNTech COVID-19 vaccine (22.3% and 10.1%, respectively). Structural equation modeling showed that existential concerns were related to Pfizer-BioNTech and AstraZeneca vaccine hesitancy both directly and indirectly through negative attitudes toward potential side effects of COVID-19 vaccines. The findings of the study confirm that the TMT is efficient in explaining COVID-19 vaccine hesitancy. Targeted efforts are needed to increase the acceptance of COVID-19 vaccines.

The Effect of Fear of COVID-19 on Green Purchase Behavior in Pakistan: A Multi-Group Analysis Between Infected and Non-infected

The coronavirus disease 2019 (COVID-19) pandemic and its effects on an individual's life have altered the consumer behavior. In the context of purchase and consumption, a shift from conventional to green purchase has been noticed. Although the factors underlying this shift were relatively unexplored, the study aimed to identify the factors that influenced a significant role in the green purchases during the outbreak and the relationship of these factors with green purchase behavior (GPB). Subsequently, this study investigates and interprets the role of fear of COVID-19 (FCV), psychological distress (PD), and mortality salience (MS) in predicting consumer's GPB. This research adopted a quantitative methodology using data collected from 432 respondents in various cities across Pakistan. Smart-PLS 3 was used to evaluate the measurement model, structural model, and multi-group analysis (MGA). Despite having the negative psychological and physical impact of the pandemic, a significant proportion of customers have switched to healthier and sustainable products. This research revealed that the FCV, PD, and MS plays a substantial role in adopting GPB. All the direct relationships were positive and significant. In addition, MS and PD partially mediate the effect of FCV on GPB. Furthermore, the MGA revealed that the infected respondents were interested in purchasing green products than uninfected respondents due to their FCV; conversely, the PD and MS were higher in uninfected individuals than infected ones. However, there is a vast literature on GPB, but little has investigated the cumulative impact of FCV, PD, and MS on GPB.

Understanding user responses to the COVID-19 pandemic on Twitter from a terror management theory perspective: Cultural differences among the US, UK and India

This study uses a new approach to understand people's varied responses to the COVID-19 pandemic. Heightened media coverage and surging death tolls undoubtedly increase individuals' death-related thoughts. Thus, this study draws on terror management theory to analyze the general public's reactions during which mortality is salient. Twitter data were collected from three countries-the US, the UK, and India. Topic modeling analysis using Latent Dirichlet Allocation identified a total of seven themes reflecting two types of defenses: proximal defenses and distal defenses. Proximal defenses included calls for behavioral changes in response to COVID-19. Distal defenses included searching for meaning, political polarization and government incompetence, racial division, and sharing up-to-date information. During a prolonged crisis, anxiety-buffering systems can be undermined and lead to either maladaptive defenses (i.e., psychological distress) or new forms of defenses (i.e., adjusting to the new normal). The analysis highlights cultural differences in defenses across the three countries. Theoretical and practical implications for public health practitioners and social media platform managers are then discussed.

Responding to Worldview Threats in the Classroom: An Exploratory Study of Preservice Teachers

This study used two training sessions and two focus groups with 17 preservice teachers (aged 20-36) completing their first teaching practicum placement during their Bachelor of Education program at an urban research university in western Canada. The aim was to implement ideas from terror management theory (TMT) during their teaching practicum. Participants explored how to facilitate contentious issues so as to prevent defensive reactions when worldviews clash in the classroom. A dramaturgical analysis identified participant objectives, conflicts, tactics, attitudes, emotions, and subtexts as they explored how to anticipate and avoid worldview and self-esteem threat, navigate tense pedagogical spaces, build capacity for expressing uncomfortable emotions, and diffuse threat with humor. Because difficult emotions are central to teaching potentially polarizing content, participating preservice teachers explored when compensatory reactions might emerge and, as a result, developed their own emotional awareness-TMT became both an experience and a teachable theory.

Predictors of Intention to Vaccinate Against COVID-19 in a Peruvian Sample

BACKGROUND

Vaccination against COVID-19 is considered one of the most effective strategies to control this global public health crisis. However, vaccine hesitancy is one of the main threats to mitigating the pandemic. The present study aimed to identify predictors of intention to vaccinate against COVID-19 in 3 geographical regions of Peru.

METHODS

An online analytical cross-sectional study was conducted. Participants were selected by non-probability convenience sampling and size was estimated using the online statistical calculator proposed by Soper. A total of 529 Peruvian nationals completed the questionnaires. Student's t-test and Fisher's F test (ANOVA) were used. A significance level of .05 was considered.

RESULTS

Face-to-face work (β = 2.037, P < .001), fear of COVID-19 (β = .461, P < .001), vaccine confidence (β = 2.881, P < .001) and trust in health care institutions (β = .432, P < .01) predict a higher intention to receive the vaccine. However, the variables perception of a worldwide conspiracy (β = -1.900, P < .001), and practice Protestant religion (β = -2.274, P < .001) predict negatively their acceptance.

CONCLUSION

Several positive predictors of intention to vaccinate against COVID-19 have been identified. However, having a perception of a global conspiracy and practice Protestant religion are shown to be risk variables for vaccine acceptance. Therefore, there is a need to develop strategies to ensure high uptake and success of COVID-19 vaccination campaigns.

Together we can slow the spread of COVID-19: The interactive effects of priming collectivism and mortality salience on virus-related health behaviour intentions

Behaviours recommended for reducing transmission of COVID-19 - social distancing, wearing masks, and now, vaccination - are aimed at not only reducing one's own risk, but risk to others. We posited that a collectivist mindset, versus individualistic, would facilitate intentions to engage in behaviours aimed at curtailing the spread of the virus when the awareness of mortality is activated. This hypothesis was informed by the terror management health model and tested in two studies. In each study, collective 'we' (vs. the individual 'I') was primed, in conjunction with mortality salience compared to a control condition. The results were generally consistent, with Study 1 showing that when collectivism, but not individualism, was primed, individuals responded to a COVID-19-based mortality reminder with a significant increase in health intentions, including social distancing and mask wearing. In Study 2, when mortality was salient, priming individualism led to reduced vaccination intention compared to collectivism. We discuss limitations to the research and conclude with the recommendation that COVID-19-based communications highlight the dangers of the virus in conjunction with a focus on the collective 'we' to best encourage optimal virus mitigation behaviour.

The relationship between fear of COVID-19 and intention to get vaccinated. The serial mediation roles of existential anxiety and conspiracy beliefs

Today, we witness the progress toward global COVID-19 vaccinations organized by countries worldwide. Experts say a mass vaccination plan is the only effective antidote against the spread of SARS-COV-2. However, a part of the world population refuses vaccination. The present study aimed to understand the impact of some individual variables on the intention to get vaccinated. Through a serial mediation model, we tested the influence of fear of COVID-19 on the intention to get vaccinated and the serial mediating effect of existential anxiety and conspiracy beliefs. Via a cross-sectional design this research was conducted with the participation of 223 French adults (Female: 69.5%; Male: 30.5%; M age = 30.26, SD = 13.24; range: 18-75 years) who responded to an online survey. The results showed a positive relationship between fear of COVID-19 and intention to get vaccinated; however, when this fear was associated with high levels of existential anxiety through conspiracy beliefs, the intention to get vaccinated decreased. Our findings were in line with Terror Management Health Model, which states that, in facing health threats, humans may strive to reduce their own perceived vulnerability not only by engaging in healthy behaviors but also denying or avoiding death anxiety, as anti-vaxxers do.

Adaptive self-objectification in the context of breast cancer: A theoretical integration of the terror management health model and research on objectification

Integrating theorizing from the terror management health model with research on the objectification of women's bodies, we present a novel framework for understanding reactions to breasts in the context of breast cancer: adaptive self-objectification. We suggest that, despite evidence that objectifying the body has harmful consequences for women, viewing the breasts as objects has the potential to lead to positive outcomes in the context of breast health and cancer. We find evidence for this in the context of mass communication about breast cancer screening, in women's willingness and comfort with engagement in breast cancer screening, and in the decisions women make with respect to cancer treatment (e.g. mastectomy). We conclude with a call to action for research to examine the impact of objectification of the breasts on screening behavior and treatment decisions, and consider how adaptive self-objectification can be encouraged, with the aim of saving lives.

Trait self-control and disinhibited eating in COVID-19: The mediating role of perceived mortality threat and negative affect

As the coronavirus disease 2019 (COVID-19) spreads globally, people are at risk of developing disinhibited eating behaviors. This study aimed to examine whether perceived mortality threat and negative affect mediate the relationship between trait self-control and disinhibited eating during the pandemic. A longitudinal survey was administered to a sample of college students (N = 634) before the outbreak (September 2019, T1), during the mid-term (February 2020, T2), and in the later stage of the pandemic (April 2020, T3). Self-report measures of trait self-control (T1), perceived mortality threat (T2, T3), negative affect (T2, T3), and disinhibited eating (T2, T3) were successively completed. Trait self-control was found to be negatively associated with negative affect, perceived mortality threat, and disinhibited eating during the mid-term and later stage of the pandemic. Disinhibited eating was positively associated with negative affect and perceived mortality threat. The longitudinal mediation results demonstrated that trait self-control (T1) could negatively predict disinhibited eating (T3) through negative affect (T2) rather than through perceived mortality threat. These findings suggest that trait self-control is of great importance in regulating psychological discomfort and disinhibited eating during stressful periods and that negative affect might be the main psychological mechanism underlying the relationship between self-control ability and disinhibited eating.

The role of perceived level of threat, reactance proneness, political orientation, and coronavirus salience on health behavior intentions

OBJECTIVE

This pre-registered study was designed to test whether reminders of death and coronavirus would have similar or different effects on health behavior intentions concerning COVID-19 (e.g., mask wearing, social distancing) and whether the type of framing of these behaviors would moderate these effects.

DESIGN

The study utilized a 3 (threat: mortality salience vs. coronavirus reminder vs. control topic) x 3 (framing: autonomy-supportive vs. controlled vs. neutral) design. Measures of perceived threat of COVID-19, reactance proneness, and political orientation were included as individual differences.

RESULTS

Although the interaction between threat and framing conditions was not significant, the data revealed that (1) lower perceived threat of COVID-19 was associated with lower health behavior intentions to reduce the spread of the virus; (2) after an induction to express their thoughts and feelings about COVID-19, participants with low perceived threat of COVID-19 significantly increased their health intentions; (3) perceived threat of COVID-19 moderated the relationship between reactance proneness and health intentions, such that those high in reactance proneness reported lower intentions unless they had high perceptions of threat; and (4) politically conservative participants reported lower intentions to engage in healthy behaviors, and this relationship was mediated by their lower perceived threat of COVID-19.

Memories of a Death Threat: Negative Consequences of Unconscious Thoughts About a Terrorist Attack on Attitudes Towards Alcohol

Based on the terror management health model (TMHM), we examined the impact of terrorist attacks as reminders of death on implicit alcohol-related attitudes, including the moderating role of conscious death-related thoughts and alcohol-based self-esteem (ABS). With an online experiment (N = 487), we analyzed how thoughts and memories about a recent terrorist attack unconsciously (with a delay task) and consciously (without a delay task) affected implicit alcohol-related attitudes. We found that such thoughts increased the death-thought accessibility. While no main effect of the salience of the terrorist attack on alcohol-related attitudes existed, respondents with low ABS had more positive attitudes, when unconsciously thinking about the attack as compared to the control group. Respondents with high ABS in the delay task had lower alcohol-IAT scores. Overall, this study provides evidence that thoughts about terrorism that can be provoked through media affect alcohol-related attitudes. Such attitudes may cause negative health consequences through health-related decisions.

The contagion of mortality: A terror management health model for pandemics

The novel coronavirus, COVID-19, proliferates as a contagious psychological threat just like the physical disease itself. Due to the growing death toll and constant coverage this pandemic gets, it is likely to activate mortality awareness, to greater or lesser extents, depending on a variety of situational factors. Using terror management theory and the terror management health model, we outline reactions to the pandemic that consist of proximal defences aimed at reducing perceived vulnerability to (as well as denial of) the threat, and distal defences bound by ideological frameworks from which symbolic meaning can be derived. We provide predictions and recommendations for shifting reactions to this pandemic towards behaviours that decrease, rather than increase, the spread of the virus. We conclude by considering the benefits of shifting towards collective mindsets to more effectively combat COVID-19 and to better prepare for the next inevitable pandemic.

When You Become a Superman: Subliminal Exposure to Death-Related Stimuli Enhances Men's Physical Force

Research based on terror management theory (TMT) has consistently found that reminders to individuals about their mortality engender responses aimed at shoring up faith in their cultural belief system. Previous studies have focused on the critical role that the accessibility of death-related thought plays in these effects. Moreover, it has been shown that these effects occur even when death-related stimuli are presented without awareness, suggesting the unconscious effects of mortality salience. Because one pervasive cultural ideal for men is to be strong, we hypothesized that priming death-related stimuli would lead to increasing physical force for men, but not for women. Building on self-escape mechanisms from TMT, we propose that the mechanism that turns priming of death-related stimuli into physical exertion relies on the co-activation of the self with death-related concepts. To test this hypothesis, we subjected 123 participants to a priming task that enabled us to combine the subliminal priming of death-related words with briefly presented self-related words. Accordingly, three different conditions were created: a (control) condition in which only self-related stimuli were presented, a (priming) condition in which death-related words were subliminally primed but not directly paired with self-related stimuli, and a (priming-plus-self) condition in which death-related words were subliminally primed and immediately linked to self-related stimuli. We recorded handgrip force before and after the manipulations. Results showed that male participants in the priming-plus-self condition had a higher peak force output than the priming and control conditions, while this effect was absent among female participants. These results support the hypothesis that unconscious mortality salience, which is accompanied with self-related stimuli, increases physical force for men but not for women. The gender difference may reflect the cultural belief system, in which individuals are taught that men should be strong. Thus, the unconscious mortality salience produced by exposure to the death-related stimuli motivates need to conform to this internalized cultural standard.

Encounters with offspring help terminally ill adult patients cope with death anxiety

This overview of recent work drawing on the theories of terror management and symbolic immortality suggests practical ways of helping the terminally ill to cope with death anxiety and its potential effects. The literature review shows that parenthood can act as an anxiety buffer mechanism against the fear of death but that individual differences, including attachment avoidance, moderate this association. Encounters with adult patients' offspring may help minimize fear of death, improve coping, and increase quality of life and emotional well-being. Practical suggestions for psychologists, social workers and physicians are presented.

Effects of a Brief Mindfulness Induction on Death-Related Anxiety

This study examined effects of a mindfulness induction on proximal and distal defense responses to mortality salience and negative affect. Three experimental conditions were included: mindfulness, mind-wandering, and worrying. Participants in the mindfulness condition underwent a mindfulness induction at the experiment's outset, while participants in the other two conditions underwent a mind-wandering or worry induction. Inductions involved following guided audio instructions presented via headphones. All conditions (N = 77) underwent a mortality salience induction after experimental manipulation, involving a written exercise pertaining to one's death. Results indicated fewer proximal responses in the mindfulness and mind-wandering groups, compared with the worrying group, but no differences in distal responses. Negative affect was lower in the mindfulness group than in the worrying group following mortality salience. Results suggest that mindfulness exercises effectively buffer against negative affect and some responses to mortality salience, although these effects are not different from those of mind-wandering.

The Effect of Mortality Salience and Type of Life on Personality Evaluation

Mortality salience, or awareness of the inevitability of one’s own death, generates a state of anxiety that triggers a defense mechanism for the control of thinking that affects different human activities and psychological processes. This study aims to analyze the effect of mortality salience on the formation of impressions. The sample comprised 135 women who made inferences about a woman’s personality from information about her life (type of life, LT: positive, negative), provided through five words, all positive or negative, that appeared surrounding a photograph, together with a sixth word that indicated whether she was “dead” or “alive” at the time (mortality manipulation, MM: dead, alive). The results pointed to a more negative assessment of life (Dead M - Alive M = -1.16, SE = .236, p < .001), emotional stability (Dead M - Alive M = -1.13, SE = .431, p = .010), and responsibility (Dead M - Alive M = -1.14, SE = .423, p = .008) only when the participants had access to negative information about the person assessed, and she was known to be dead. We discuss the results within the framework of Terror Management Theory, and analyze the different effects that the manipulation of mortality has on the formation of impressions depending on the type of information available.

Tolerating dissimilar other when primed with death: neural evidence of self-control engaged by interdependent people in Japan

Mortality salience (MS) has been shown to lead to derogation of others with dissimilar worldviews, yet recent research has shown that Asian-Americans who presumably adopt an interdependent self-construal (SC) tend to reveal greater tolerance after MS induction. In the present study, we demonstrated that Japanese individuals who are high on interdependent SC indeed show greater tolerance toward worldview-threatening other in the MS (vs control) condition, thus replicating the prior research. Extending this research, we also found that interdependent people's tolerance toward worldview-threatening other was mediated by increased activity in the right ventrolateral prefrontal cortex in the MS condition. These data suggested that when exposed to death-related stimuli, highly interdependent individuals may spontaneously activate their neural self-control system which may serve to increase tolerance toward others.

Where Health and Death Intersect: Insights from a Terror Management Health Model

This paper offers an integrative understanding of the intersection between "health" and "death" from the perspective of the terror management health model. After highlighting the potential for health-related situations to elicit concerns about mortality, we turn to the question, how do thoughts of death influence health decision-making? Across varied health domains, the answer depends on whether these cognitions are in conscious awareness or not. When mortality concerns are conscious, people engage in healthy intentions and behavior if efficacy and coping resources are present. In contrast, when contending with accessible but non-conscious thoughts of death, health relevant decisions are guided more by esteem implications of the behavior. Lastly, we present research suggesting how these processes can be leveraged to facilitate health promotion and reduce health risk.

Smoking Is So Ew!: College Smokers' Reactions to Health- Versus Social-Focused Antismoking Threat Messages

This study utilizes Terror Management Theory (TMT) to examine differences between eliciting social death and physical death anxiety related to smoking, smoking attitudes, and quitting intent among college students. Moreover, an important TMT variable-self-esteem-was used as a moderator. A 2 × 3 between-subjects factorial design crossed smoking-based self-esteem (low, high) with mortality salience manipulation (health-focused, social-focused, control). Results suggest while both making health-focused salient and making social-focused mortality salient were effective at getting smokers to quit, there was less effect for health-focused mortality salience on those whose self-esteem is strongly tied to smoking. Effect of social-focused mortality salience was more pronounced among participants who highly linked self-esteem with smoking. For smokers with low smoking-based self-esteem, both health-focused and social-focused mortality salience were effective at motivating attitude change toward smoking and quitting intentions. Implications for smoking cessation ad design and TMT are discussed.

Play It Safe or Go for the Gold? A Terror Management Perspective on Self-Enhancement and Self-Protective Motives in Risky Decision Making

Terror management theory (TMT) posits that bolstering self-esteem buffers mortality concerns; accordingly, in past research, heightening mortality salience (MS) increases self-enhancement. However, risky self-esteem-relevant decisions often present a choice between enhancing self-esteem by striving for excellence and protecting self-esteem by avoiding potential failure. Which strategy is preferred under MS? Combining TMT with insights from Steele, Spencer, and Lynch's (1993) resource model, the authors hypothesized and found that MS leads high, but not low, self-esteem participants faced with a risky decision to pursue opportunities for excellence despite substantial risk of failure (Studies 1 and 2); in Study 3, using a more impactful decision, this effect was replicated and it was furthermore found that mortality-salient low-self-esteem participants become more risk-averse. Furthermore, in Study 2, a self-affirmation prime, previously shown to reduce MS-induced defenses, eliminated the self-enhancement effect among high-self-esteem participants. Implications for understanding self-esteem, TMT, and risky decision making are briefly discussed.

Mother Teresa Versus Ebenezer Scrooge: Mortality Salience Leads Proselfs to Endorse Self-Transcendent Values (Unless Proselfs Are Reassured)

Recently, Jonas, Schimel, Greenberg, and Pyszczynski demonstrated that mortality salience (MS) increased contributions to (an ingroup) charity (i.e., the Scrooge effect). The authors examined whether individual differences in social value orientations would moderate the Scrooge effect. In line with an Ebenezer shift hypothesis, proselfs were less likely than prosocials to endorse self-transcendent values in a dental pain control condition but were indistinguishable from prosocials in an MS condition as proselfs increased endorsement of self-transcendent values under MS (Experiments 1 and 2a). However, when participants gave their impressions of an unfavorable prosocial or a favorable proself prior to the MS manipulation, proselfs were again less likely than prosocials to endorse self-transcendent values (Experiments 2a and 2b), suggesting that proselfs are unlikely to transform into prosocials under conditions of MS when given reasons to disidentify with prosocial values or identify with proself values.

Dying To Be Thin: The Effects of Mortality Salience and Body Mass Index on Restricted Eating Among Women

Following terror management theory, the authors suggest women’s striving to attain a thin physique is fueled in part by existential concerns. In three studies, women restricted consumption of a nutritious but fattening food in response to reminders of mortality (mortality salience; MS). When conducted in private (Study 1), this effect was found among women but not men; when replicated in a group setting in which social comparison was likely (Studies 2 and 3), only women who were relatively less successful attaining the thin ideal (i.e., high body mass index; BMI) restricted eating after MS. In Study 3, MS caused high BMI women to perceive themselves as more discrepant from their ideal thinness; this perceived failure mediated the effects of MS and BMI on eating behavior. Findings are discussed from a self-regulatory framework, which considered in the context of pressures for women to be thin, can shed light on health risk behavior.

In Defense of the Body: The Effect of Mortality Salience on Female Body Objectification

Previous research has illustrated the negative psychological consequences of female body objectification. The present study explores how female body objectification may serve as a defense against unconscious existential fears. Drawing from terror management theory, an experiment was designed to test the potential functionality of female body objectification. Men and women were primed to think about either their own mortality or an aversive control topic, and levels of body objectification were then assessed for both self- and other (women)-objectification. Findings supported the hypothesis that priming mortality would increase both self- and other-objectification among women, and self-objectification among those who derive self-esteem from their body. Implications for this research are discussed.

A natural experiment of social network formation and dynamics

Social networks affect many aspects of life, including the spread of diseases, the diffusion of information, the workers' productivity, and consumers' behavior. Little is known, however, about how these networks form and change. Estimating causal effects and mechanisms that drive social network formation and dynamics is challenging because of the complexity of engineering social relations in a controlled environment, endogeneity between network structure and individual characteristics, and the lack of time-resolved data about individuals' behavior. We leverage data from a sample of 1.5 million college students on Facebook, who wrote more than 630 million messages and 590 million posts over 4 years, to design a long-term natural experiment of friendship formation and social dynamics in the aftermath of a natural disaster. The analysis shows that affected individuals are more likely to strengthen interactions, while maintaining the same number of friends as unaffected individuals. Our findings suggest that the formation of social relationships may serve as a coping mechanism to deal with high-stress situations and build resilience in communities.

A cross-sectional survey investigating the desensitisation of graphic health warning labels and their impact on smokers, non-smokers and patients with COPD in a London cohort

OBJECTIVES

There is a lack of evidence regarding the effectiveness of graphic health warning labels (GHWL) in different individuals, including patients with chronic obstructive pulmonary disease (COPD). Investigating knowledge and attitudes may allow better implementation of future public health policies. We hypothesised that differences in the impact of GHWL exist between non-smokers, smokers and patients with COPD, with decreased efficacy in those groups who are longer and more frequently exposed to them.

PARTICIPANTS AND SETTING

163 participants (54% male, aged 21-80) including 60 non-smokers, 53 smokers and 50 patients with COPD (Gold stage II-IV), attending London respiratory outpatient clinics, participated in case-controlled surveys (50 items).

OUTCOME MEASURES

Ten different GHWL were shown and demographics, smoking history, plans to quit, smoking-risk awareness, emotional response, processing and impact of GHWL on behaviour were recorded. Patients were further asked to prioritise the hypothetical treatment or prevention of five specific smoking-related diseases.

RESULTS

Smokers, in particular those with COPD, were less susceptible to GHWL than non-smokers; 53.4% of all participants expressed fear when looking at GHWL, non-smokers (71.9%) more so than smokers (39.8%, p<0.001). COPD participants were less aware of the consequences than non-COPD participants (p<0.001), including an awareness of lung cancer (p=0.001). Lung cancer (95%), oral cancer (90.2%), heart disease (84.7%) and stroke (71.2%) were correctly associated with smoking, whereas blindness was least associated (23.9%). However, blindness was prioritised over oral cancer, stroke and in patients with COPD also over heart disease when participants were asked about hypothetical treatment or prevention.

CONCLUSIONS

GHWL are most effective in non-smokers and a desensitisation effect was observed in smokers and patients with COPD. As a consequence, a tailored and concerted public health approach to use such messages is required and 'blindness' deserves to be mentioned in this context because of an unexpectedly high-deterring impact.

Changes in alcohol use after traumatic experiences: the impact of combat on Army National Guardsmen

OBJECTIVE

This research documents the impact of combat experiences on alcohol use and misuse among National Guard soldiers. Whereas much research regarding combat personnel is based on post-experience data, this study's design uses both pre- and post-deployment data to identify the association between different types of combat experiences and changes in substance use and misuse.

METHOD

A National Guard Infantry Brigade Combat Team was surveyed before and after its deployment to Iraq in 2005-2006. Members of the unit completed anonymous surveys regarding behavioral health and alcohol use and, in the post-survey, the combat experiences they had during deployment. The unit was surveyed 3 months prior to its deployment and 3 months after its deployment.

RESULTS

Prevalence rates of alcohol use increased from 70.8% pre-deployment to 80.5% post-deployment. Prevalence rates of alcohol misuse more than doubled, increasing from 8.51% before deployment to 19.15% after deployment. However, among the combat experiences examined in this study, changes in alcohol misuse post-deployment appear to be solely affected by the combat experience of killing. Alcohol misuse decreased amongst those who experienced killing during combat.

CONCLUSIONS

This study highlights the role of combat experiences on substance use.

Investigating the impact of gender and existential anxiety on the willingness to participate in point-of-care testing for cardiovascular disease

Two studies (N = 136) investigated whether or not gender or mortality reminders would impact middle-aged and older adults' appraisal of a novel point-of-care testing device for cardiovascular disease risk. Middle-aged females were significantly more likely to positively appraise and commit to using the device compared to middle-aged males, but there were no such gender differences among older adults. Both studies also failed to support hypotheses that existential concerns would lead to avoidance of the device. When taken together, the findings suggest that similar devices may beneficially affect screening behaviours and underscore a need to target middle-aged males for cardiovascular screening interventions.

The effects of age and death awareness on intentions for healthy behaviours

Terror management theory (TMT) suggests that people are motivated to distance themselves from death. One way of doing this is to report greater intentions to engage in health-promoting behaviours following increased awareness of mortality, also referred to as a proximal defense. Older adults' comparatively fewer remaining years and greater likelihood of having significant health problems may result in greater intentions to promote health following mortality reminders, but little is known about their proximal defenses and existing results are inconsistent. The current study examined how older (60-89 years) and younger (18-30 years) adults' intentions for future healthy behaviours were influenced by a death reminder (immediately and after a delay) compared to a control condition. Older adults (60-89 years) indicated greater overall intention to engage in healthy behaviours than younger adults (18-30 years). A two-way interaction revealed that regardless of age, participants engaged in proximal defenses immediately following a death reminder by distancing themselves from death via greater healthy intentions. After a period of delay, participants exhibited a reversal of this pattern, indicating lower intention to engage in healthy behaviours in the mortality condition compared to control. Results are discussed from the perspectives of TMT and terror management health model.