Mortality Salience, Fears of Death, and Their Treatment in Anxiety-Related Disorders

Abstract

The present studies explore the role of death anxiety across various mental health disorders. At the onset, death anxiety had been shown to have a causal role in only one subtype of OCD. Study 1 examined common developmental pathways to OCD, finding that death anxiety significantly predicted the course of this disorder. Study 2 found that death anxiety significantly correlated with all six subtypes of OCD. Study 3 extended the research focus beyond OCD, to explore whether death anxiety predicts psychopathology across a range of different diagnostic categories. Using a clinical sample, the results demonstrated significant correlations between death anxiety and number of lifetime diagnoses, medication use, number of hospitalisations, distress, and the severity of 12 different disorders. In Study 4, a mortality salience paradigm was used to examine whether death anxiety drives behaviours relevant to panic disorder, illness anxiety and somatic symptom disorder. Results indicated that reminders of death significantly increased body scanning duration, identification with images indicating poorer health, and intention to visit a medical specialist, suggesting the causal role of the construct. In Study 5, a meta-analysis found that psychological interventions can ameliorate fears of death, with cognitive behaviour therapy (CBT) being particularly efficacious. These studies suggest that death anxiety (1) is associated with numerous mental health conditions, (2) plays a causal role in some anxiety-related disorders, and (3) can be improved with CBT. These findings suggest that death anxiety is a central transdiagnostic construct and may need to be addressed directly in treatment. Thus, in the next chapter, the development of a novel online CBT program for death anxiety is outlined. Currently, research is examining the efficacy of this treatment to determine whether targeting death anxiety specifically improves broader mental health.