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Existential Anxiety in Adolescents: Prevalence, Structure, Association with Psychological Symptoms and Identity Development

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Abstract

Existential anxiety is hypothesized to be a core human issue in a great deal of theoretical and philosophical writing. However, little is known about the emergence of these concerns and their relation to emotional functioning in youth. The purpose of this study was to examine the phenomenon of existential anxiety in a sample of adolescents. Data on existential concerns, identity development and psychological symptoms were collected on a sample of 139 youth in grades 9–12. Results indicated that existential anxiety concerns have a theoretically consistent factor structure, are common among adolescents, and are associated with psychological symptoms, as well as identity issues. Results are discussed with regard to the importance of existential concerns in the lives of youth and the need for additional research.
jyjy jy p
Journal of Youth and Adolescence ( C
2006)
DOI: 10.1007/s10964-006-9032-y
Existential Anxiety in Adolescents: Prevalence, Structure,
Association with Psychological Symptoms
and Identity Development
Steven L. Berman,1Carl F. Weems,2and Timothy R. Stickle3
Existential anxiety is hypothesized to be a core human issue in a great deal of theoretical and
philosophical writing. However, little is known about the emergence of these concerns and their
relation to emotional functioning in youth. The purpose of this study was to examine the phenomenon
of existential anxiety in a sample of adolescents. Data on existential concerns, identity development
and psychological symptoms were collected on a sample of 139 youth in grades 9–12. Results
indicated that existential anxiety concerns have a theoretically consistent factor structure, are common
among adolescents, and are associated with psychological symptoms, as well as identity issues.
Results are discussed with regard to the importance of existential concerns in the lives of youth and
the need for additional research.
KEY WORDS: existential anxiety; identity; adjustment.
INTRODUCTION
Much has been written about existential anxiety,
which involves apprehension about the meaning of life
and death, and research is emerging pointing to the im-
portance of such concerns in the psychological well being
of individuals, yet little is known about the phenomenon
in adolescence. This is unfortunate since adolescence
is likely a time for the emergence of such concerns.
For example, Westenberg et al. (2001) and Warren and
Sroufe (2004) have presented models that suggest that by
1Assistant Professor of Psychology, University of Central Florida. Re-
ceived PhD from Florida International University. Interests are identity
development including associated anxiety and distress, cross-national
comparisons, and the development of identity interventions. To whom
correspondence should be addressed at Psychology Department, Uni-
versity of Central Florida, 1200 W. International Speedway Blvd.,
Daytona Beach, Florida 32174; e-mail: sberman@ucf.edu.
2Assistant Professor of Psychology, University of New Orleans. Re-
ceived PhD from Florida International University. Interests focus on
the developmental psychopathology of anxiety and depression.
3Assistant Professor of Psychology, University of Vermont. Received
PhD from the University of Arizona. Interests include a range of topics
in developmental psychopathology, prevention, program evaluation,
and research methodology.
adolescence, youth have the cognitive capacity for insight
into mortality and broader world concerns that may give
rise to existential concerns. The purpose of this study was
to provide an initial examination of existential anxiety in
adolescents. In the following, the conceptual background
for understanding existential anxiety in adolescents is pre-
sented and relevant research is reviewed.
Existential Anxiety
Existential anxiety is hypothesized to be a core hu-
man issue in a great deal of theoretical and philosophi-
cal writing (e.g., Kierkegaard, 1843/1954a,1849/1954b;
Sartre, 1957; Tillich, 1952a,b; Yalom, 1975). Our concep-
tualization of existential anxiety draws primarily from the
work of Tillich (1952a) who provided an integrative view
of existential concerns. Tillich wrote extensively on these
topics; however, his view of existential anxiety is most
definitively articulated in his 1952a work The Courage to
Be. This text is thus used as the primary source for this pa-
per (also see Tillich, 1952b,1961). Tillich (1952a) defines
existential anxiety around 3 related domains of apprehen-
sion. The first domain is fate and death. Anxiety about fate
0047-2891/06 C
2006 Springer Science +Business Media, Inc.
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Berman, Weems, and Stickle
and death concerns the absolute threat to one’s being in
death and the relative threat to the self in our personal fate.
The second domain is emptiness and meaninglessness.
Anxiety about emptiness and meaninglessness concerns
the fear that there is no “ultimate concern,” and hence no
ultimate importance in life that gives meaning to one’s
existence. The third domain is guilt and condemnation.
Anxiety about guilt and condemnation involves perceived
threats to one’s moral and ethical identity. Although lit-
tle research has examined Tillich’s theorizing directly, a
number of studies speak to the various domains outlined
in his theorizing.
The first of Tillich’s (1952a) 3 domains concerns
anxiety about fate and death. Anxiety about fate and
death has received considerable empirical attention by
researchers particularly in surveys of children’s specific
fears and phobias, in adult surveys of death anxiety and
also in the context of terror management theory (see
Fortner and Neimeyer, 1999 for a review of death anx-
iety and Pyszczynski et al.,1999 for a review of terror
management theory). Most germane to the study of ado-
lescents, the literature using surveys of youth’s specific
fears and phobias suggests that when assessed via fear sur-
veys and clinical interviews, the fear of death is one of the
most commonly reported fears in youths (Ollendick et al.,
1985). This finding has been replicated in several studies
employing American samples (Ollendick, 1983; Ollen-
dick et al.,1985,2001), as well as, in studies of British
(Ollendick et al.,1991), Australian (Ollendick et al.,1989;
Ollendick and King, 1994), Chinese (Dong et al.,1994,
Ollendick et al.,1995), and Nigerian/Kenyan (Ollendick
et al.,1996; Ingman et al.,1999) samples of youth.
Emptiness and meaninglessness is the second of
Tillich’s domains and is typically what has been at the
core of the definition of existential anxiety in past writing
in the existentialist tradition as well as previous research
(e.g., Crumbaugh and Maholick, 1969; Good and Good,
1974; Sartre, 1957). For Tillich (1952a) the anxiety of
emptiness is relative and is apprehension that specific be-
liefs no longer have the meaning that they were once
believed to have by the individual. In other words, that
a belief has been threatened by non-being. Meaningless-
ness is an absolute concern and is about the loss of the
significance of life, the future, the world, and everything.
Emptiness and meaninglessness have been the primary
focus of existential anxiety scales. However, this is the
least studied aspect of existential anxiety in youth.
Anxiety about guilt and condemnation, Tillich’s third
domain, is anxiety resulting from threat to our moral and
ethical self-affirmations (Tillich, 1952a) and has received
some research attention in youth. For Tillich, guilt is the
relative anxiety that your behavior has not lived up to your
standards. Condemnation is the ultimate concern that you
or your life has not met certain universal standards. The
development of guilt has been explored and the associa-
tion between guilt and psychological symptoms has been
investigated. This research suggests that guilt is associated
with fear in young children, that it is present in children
as young as 22 months of age, and is associated with a
fearful temperament (Kochanska et al.,2002).
Although studies have examined aspects of existen-
tial anxiety few studies have examined existential anxiety
as conceptualized by Tillich (1952a). Weems et al. (2004)
reported data from 2 initial empirical studies of Tillich’s
model of existential anxiety and its relation to symptoms
of anxiety and depression. A self-report measure of ex-
istential anxiety, the Existential Anxiety Questionnaire
(EAQ) based on Tillich’s conceptualization, was devel-
oped and data were collected from 2 socioeconomic and
ethnically diverse samples of adults (Study 1, N=225;
Study 2, N=331). Results indicated that the EAQ had
good test–retest and internal consistency reliability and a
factor structure consistent with theory (i.e., a 3-factor hi-
erarchical model corresponding to the 3 domains outlined
in Tillich’s theorizing). The EAQ also demonstrated good
convergent and incremental validity estimates. The data
suggest that existential anxiety concerns are common in
young adults and that they are associated with symptoms
of anxiety and depression as well as psychological distress
related to identity problems.
The Potential Importance of Existential
Concerns in Adolescence
Adolescence is an important time to study the devel-
opment of existential concerns. Models of social and cog-
nitive development suggest that by the high-school years
youth are able to comprehend the meaning of life and
death and that broader life issues become salient (Warren
and Sroufe, 2004; Westenberg et al.,2001). For example,
research suggests that even by around 13 years of age
fears of death and dying are a prominent concern (Weems
and Costa, in press). In addition, psychosocial develop-
mental theory (e.g., Erikson, 1963,1968) suggests that
adolescence is a critical period in the development of life
goals and values as well as in the establishment of a sense
of direction and purpose in life. While a person develops
their sense of identity (who they are, what they believe
in, and where they are going), existential concerns should
become prominent.
Marcia (1966), whose work has been among the
most influential in the identity literature has operational-
ized Erikson’s concept of identity formation in terms of 4
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Existential Anxiety
statuses derived from 2 developmental continuums. The
statuses are defined relative to the degree that the indi-
vidual has made progress toward achieving a satisfactory
identity. The formation of an identity is conceptualized
as involving two basic dimensions, exploration and com-
mitment. Exploration is the process by which the indi-
vidual actively searches for a resolution to the issues of
choosing the goals, roles, and beliefs about the world
that provide the individual’s life with direction and pur-
pose. Youth actively engaged in identity exploration may
experience greater existential concerns. Commitment rep-
resents a positive outcome of the process of exploration.
If commitments are made with respect to issues such as
the selection of an occupation, gender role, friendship,
group membership, moral issues, religion, etc., an as-
sured sense of identity is achieved. Those with firm iden-
tity commitment may be less likely to have existential
concerns.
Marcia’s 4 identity statuses are defined with respect
to the 2 dimensions of exploration and commitment. The
4 identity statuses are: diffusion (low in exploration and
commitment), foreclosure (low in exploration, but high
in commitment), moratorium (high in exploration, low in
commitment), and achievement (high in exploration and
commitment). The moratorium status is thought to pre-
cede identity achievement. Individuals in this status ex-
perience a “crisis” due to their active exploration or con-
sideration of the different options but have not yet chosen
from the available alternatives or committed themselves.
These individuals may also display high levels of identity
distress (Berman et al.,2004). Individuals in the morato-
rium status are likely to be grappling with core issues and
thus should be likely to have elevated existential anxiety
concerns.
This Study
The literature reviewed suggests that understanding
the prevalence of existential anxiety and its association
with clinical symptoms and identity development may
provide important insight into the development and
clinical significance of existential anxiety. Cognitive
models of emotional disorders further highlight the
potential importance of examining existential anxiety.
For example, cognitive models of emotional disorders
suggest that emotional disturbances such as anxiety and
depression stem from negative ways of thinking (Beck,
1976). Existential apprehension may be associated with
depressive and anxiety disorder symptoms by similarities
in maladaptive thinking about the self, future, and
the world. In other words, existential apprehension
may be linked to depression and anxiety symptoms
by similar apprehension and concern about the self
(guilt/condemnation), future (death/fate) and the world
(meaninglessness/emptiness).
In this study, descriptive data (e.g., test–retest,
internal consistency reliability estimates, factor struc-
ture, and prevalence of existential concerns) from the
Existential Anxiety Questionnaire (EAQ), a measure of
existential anxiety based on Tillich’s conceptualization,
in a sample of adolescents is presented. We examined
factor structure with confirmatory factor analysis and hy-
pothesized that the data from the EAQ would be hierar-
chical (i.e., 1 higher order factor of existential anxiety)
with 3 lower order factors corresponding to the 3 domains
in Tillich’s (1952a) conceptualization of existential anxi-
ety (i.e., fate and death, emptiness and meaninglessness,
and guilt and condemnation). We believed that it would
be hierarchical based on our previous work with young
adults and theoretically because although composed of
three domains, existential anxiety is a holistic concept
in Tillich’s theorizing. We also tested if similar associa-
tions found with young adult samples would be evident in
adolescents. We examined the hypothesis that existential
anxiety is associated with clinical symptoms, in particu-
lar, depression and anxiety. We examined the specificity of
associations between EAQ scores, depression and anxiety
by examining unique associations among EAQ scores,
depression, and anxiety. We predicted that EAQ scores
would be related to symptoms of depression even when
controlling for symptoms of anxiety and also would be
related to symptoms of anxiety even when controlling
for symptoms of depression. Finally, the association of
EAQ scores with identity was also examined. We pre-
dicted that youth classified as being in the moratorium
status would have elevated existential concerns and that
EAQ scores would be positively correlated with iden-
tity exploration and negatively correlated with identity
commitment.
METHOD
Participants
Data were collected from a sample of 140 adoles-
cents, aged 15–18 years (mean age =16.7 years, SD =
0.9 years) in grades 9–12 (grade 12, 45%, grade 11, 39%,
grade 10, 13%, and grade 9, 3%). Participants were mainly
Euro-American (78%), 5% were African-American, 4%
were Hispanic, 1% Asian, 3% mixed or other ethnic back-
grounds, and 9% did not endorse a racial/ethnic identifier.
Seventy percent of the samplexs was female.
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Berman, Weems, and Stickle
Measures and Procedures
Participants were recruited from a high school in
East-Central Florida. All students enrolled in the school’s
psychology classes were asked to participate. Students
were provided with an informed consent sheet approxi-
mately 1 week before the assessment. Students with con-
sent forms signed by a parent or a legal guardian and
returned by the assessment date participated in the study.
Participation rate was over 90%. Participants completed
the EAQ, a demographic questionnaire, the Ego Identity
Process Questionnaire and the Brief Symptom Inventory
in a group setting and were assisted as necessary by the
authors or trained research assistants. The demographic
questionnaire assessed age, gender, and ethnicity. Six par-
ticipants had missing or incomplete data and pair or analy-
sis (when more than 2 variables) wise deletion of missing
cases was used to handle missing data in the analyses
(Tabachnick and Fidell, 2001).
The Existential Anxiety Questionnaire (EAQ; Weems
et al.,2004) is a true–false rating scale designed to assess
the critical domains and sub-concepts outlined in Tillich’s
(1952a) work. Initial scale development resulted in a 13-
item scale with 2 questions for each of the 6 concepts
(3 items for “fate”), half positively worded and half neg-
atively worded (for “fate” 1 is positively scored, 2 are
negatively scored). Example items are “I know that life
has meaning,” “I never think about emptiness,” “I often
think about death and this causes me anxiety.” Results of
reliability analyses in samples of young adults have in-
dicated that the EAQ had adequate internal consistency
(coefficient α=0.71) and a 2-week test–retest reliability
(r=0.72, p<0.001) and a factor structure consistent
with theory (Weems et al.,2004).
The Brief Symptom Inventory-18 (BSI-18. Derogotis,
2000) is a self-report measure that consists of 18-
items assessing psychological symptoms and is a briefer
version of the Symptom Checklist-90-R (SCL-90-R;
Derogotis, 1994). Items are rated on a 5-point scale rang-
ing from 0 (not at all)to4(extremely) to reflect the
level of distress an individual has experienced by each
of the symptoms during the previous month. Designed
to be brief and easy to administer, the test measures 3
primary symptom dimensions (depression, anxiety, and
somatization) as well as global severity and is designed
to provide an overview of a patient’s symptoms and their
intensity at a specific point in time. The scale has good
reliability and validity. Dimension and global scores form
the BSI-18 test correlate highly (i.e., >0.90) with anal-
ogous scores from the SCL-90-R test based in a large
community population (N=1,122; 605 males and 517
females).
The Ego Identity Process Questionnaire (EIPQ;
Balistreri et al.,1995) was used to identify participants’
identity status. The EIPQ has 2 subscales, identity ex-
ploration and identity commitment. Cronbach’s αfor the
exploration subscale has been reported to be 0.86 with
test–retest reliability of 0.76. Cronbach’s αfor the com-
mitment subscale has been reported to be 0.80 with test–
retest reliability of 0.90 (Balistreri et al.,1995). Median
splits provided by Balistreri et al. (1995) were used to
assign participants into 1 of 4 identity statuses as defined
by Marcia (1966). Low scores on exploration and com-
mitment are “diffused,” low in exploration but high in
commitment is “foreclosed,” high in exploration but low
in commitment is “moratorium,” and high in both explo-
ration and commitment is “achieved.”
RESULTS
Preliminary Descriptive Analyses
Mean score on the EAQ was 4.56 (SD =2.8) and
scores had a fairly normal distribution with a slightly pos-
itive skew (skew =0.56). Results of reliability analyses
indicated that the EAQ had adequate internal consistency
(coefficient α=0.71). No statistically significant asso-
ciations were found between EAQ scores and age, grade
level, gender, or ethnicity. The prevalence of existential
anxiety concerns was examined by calculating the per-
centage of individuals positively endorsing apprehension
about each of the 6 facets of existential anxiety in Tillich’s
conceptualization. The percentages were as follows: death
48%, fate 64%, meaninglessness 30%, emptiness 70%,
condemnation 53% and guilt 59%. Ninety-six percent of
the sample had at least 1 affirmatively endorsed existential
anxiety concern.
Factor Structure
Confirmatory factor analysis (CFA) for binary vari-
ables using robust weighted least squares estimation was
conducted with Mplus (Muth´
en and Muth´
en, 1998–2004)
to test whether a single or a hierarchical 3-factor model
best represents the data from the EAQ. This approach
to CFA was employed because of the item rating scale
(yes, no) and uses a tetrachoric correlation matrix to give
unbiased estimates of the relationships among the vari-
ables and factors. The models were tested based on a
priori hypotheses comparing a single factor model versus
a 3-correlated-factors model (i.e., anxiety about fate and
death items 1, 2, 10, 11, and 12, anxiety about emptiness
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Existential Anxiety
and meaninglessness items 3, 7, 8, and 13, and anxiety
related to guilt and condemnation items 4, 5, 6, and 9)
consistent with a hierarchical model of existential anx-
iety. Fit for a 3-correlated-factor model is theoretically
identical to a hierarchical 3-factor model (Bollen, 1989).
This is because the restrictions placed upon the model
for 3-correlated factors and a higher order model with 3
lower order factors are identical and have identical im-
plied covariance matrices. The Root-Mean-Square-Error
of Approximation (RMSEA), the Comparative Fit Index
(CFI), and the Tucker–Lewis Index (TLI) were used to
evaluate fit of the models. The CFI and TLI range from
0 to 1, with 0 indicating variation with no relation to the
proposed factors and 1 indicating a perfect fit. In general,
CFI and TLI between 0.80 and 0.90 are considered mod-
erate fit, 0.90–0.95 are considered good fit. The RMSEA
denotes a perfect fit with 0, with values less than 0.05
considered an exact fit, and those between 0.05 and 0.08
considered to be close fit, and those above 0.10 considered
poor fit.
The results of the CFA indicated that the 3-
factor model (CFI =0.88, TLI =0.89, RMSEA =
0.07) provides a better fit to the data than a 1-factor
model (CFI =0.76, TLI =0.77, RMSEA =0.10). A
hierarchical model with 3 lower order factors and 1 higher
order factor was also conducted and the fit indices were
identical (CFI =0.88, TLI =0.89, RMSEA =0.07)
to the 3-correlated-factor model as expected (Bollen,
1989). The 3-correlated-factor model was also a better fit
than a 3-uncorrelated-factor model (CFI =0.52, TLI =
0.49, RMSEA =0.15). Table Ipresents the standardized
loadings on each of the items for the 3 lower-order factors
(Fate and Death, Emptiness and Meaninglessness, and
Guilt and Condemnation). As can be seen in Table I,
none of the items had a standardized loading below 0.40
and the 3 factors were fairly highly correlated. Fate and
Death correlated 0.50 with Emptiness and Meaning-
lessness and 0.62 with Guilt and Condemnation. Guilt
and Condemnation correlated 0.59 with Emptiness and
Meaninglessness.
Associations with Anxiety, Depression, and Identity
Next, the association between EAQ scores and symp-
toms on the BSI were examined. Results are summarized
in Table II. Hypothesized associations between the EAQ,
symptoms of depression and anxiety as assessed by the
BSI were found. The specificity of the association between
EAQ scores and anxiety and depression was also exam-
ined using a partial correlation strategy. Results are also
summarized in Table II. Overall, anxiety and depression
Tab le I . Items and Factor Loadings for the Existential Anxiety
Questionnaire
Items Factor 1 Factor 2 Factor 3
1. I often think about death and this
causes me anxiety, (D)
0.77
2. I am not anxious about fate because I
am resigned to it, R (F)
0.55
3. I often feel anxious because I am
worried that life might have no
meaning, (M)
0.99
4. I am not worried about nor think
about being guilty, R (G)
0.49
5. I often feel anxious because of
feelings of guilt, (G)
0.65
6. I often feel anxious because I feel
condemned, (C)
0.95
7. I never think about emptiness, R (E) 0.56
8. I often think that the things that were
once important in life are empty, (E)
0.63
9. I never feel anxious about being
condemned, R (C)
0.40
10. I am not anxious about death
because I am prepared for whatever it
may bring, R (D)
0.75
11. I often think about fate and it causes
me to feel anxious, (F)
0.55
12. I am not anxious about fate because
I am sure things will work out, R (F)
0.70
13. I know that life has meaning, R (M) 0.58
Note. R: Reverse scored item. Factor 1: Fate (F) and Death (D); Factor
2: Emptiness (E) and Meaninglessness (M); Factor 3: Guilt (G) and
Condemnation (C).
were significantly correlated with the EAQ when control-
ling for either anxiety or depression suggesting that the
EAQ possesses incremental validity to predict depression
beyond an existing measure of anxiety and to predict anx-
iety beyond an existing measure of depression.
The subscales prediction of anxiety and depression
was examined using hierarchical regression. Two separate
analyses were conducted, 1 with the BSI anxiety scale
and the other with the depression scale as the dependent
variable. In both analyses subscale scores on the Fate
and Death, Emptiness and Meaninglessness, and Guilt
and Condemnation scales were entered simultaneously as
predictors. Results indicated that the overall model was
significant [F(3, 138) =28.92, p<0.001, model R2=
0.37 for anxiety and F(3, 138) =20.71, p<0.001, model
R2=0.32 for depression]. Standardized βs for the model
predicting depression were 0.14 for fate and death, 0.29
for emptiness and meaninglessness, and 0.31 for guilt and
condemnation all pvalues were less than 0.01 except for
fate and death (p=0.067). Standardized βs for the model
predicting anxiety were 0.07 for fate and death, 0.51 for
emptiness and meaninglessness, and 0.16 for guilt and
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Berman, Weems, and Stickle
Tab le I I. Summary of Correlations Among Study Variables and Partial Correlations Among EAQ Scores and BSI Anxiety and Depression Scales
Variables 1 2 3 4567 Mean(SD)
Zero order
1. Existential anxiety 4.56 (2.8)
2. Fate & death 0.77∗∗ 1.63 (1.4)
3. Emptiness & meaning 0.71∗∗ 0.29∗∗ 1.44 (1.2)
4. Guilt & condemnation 0.73∗∗ 0.34∗∗ 0.32∗∗ 1.50 (1.2)
5. BSI anxiety 0.53∗∗ 0.27∗∗ 0.58∗∗ 0.35∗∗ 1.09 (0.9)
6. BSI depression 0.54∗∗ 0.33∗∗ 0.44∗∗ 0.45∗∗ 0.68∗∗ 0.92 (0.8)
7. EIPQ exploration 0.26∗∗ 0.180.180.220.24∗∗ 0.32∗∗ 54.21 (9.5)
8. EIPQ commitment 0.25∗∗ 0.24∗∗ 0.29∗∗ 0.02 0.26∗∗ 0.23∗∗ 0.31∗∗ 54.58 (9.3)
Partial correlation analyses
Controlling
for
BSI Anxiety
and EAQ
BSI Depression
and EAQ
1. BSI Anxiety na 0.29∗∗
2. BSI Depression 0.27∗∗ na
Note. EAQ: Existential Anxiety Questionnaire, BSI: Brief Symptom Inventory, EIPQ: Ego Identity Process Questionnaire.
p<.05; ∗∗p<.01.
condemnation all pvalues were less than 0.05 except for
fate and death (p=0.341).
Correlations among the EAQ and identity explo-
ration and commitment as measured by the EIPQ are
presented in Table II and indicated that exploration and
commitment were related to existential anxiety in the hy-
pothesized manner. To examine the association between
the identity statuses and existential anxiety participants
were first classified into identity statuses based on their
EIPQ scores. Mean scores on the EAQ were [M(SD) =
4.56(2.6), 3.93(2.2), 5.93(3.6), 4.05(2.7) respectively for
the diffused (n=47), foreclosed (n=46), moratorium
(n=27), and achieved (n=19) groups] and were sig-
nificantly different across the groups [F(3, 138) =3.36,
p<0.05]. Tukey’s contrasts indicated that the par-
ticipants classified as being in the moratorium status
had significantly higher EAQ scores than those in the
foreclosed status.
DISCUSSION
Results support the viability of empirically exam-
ining Tillich’s theory of existential anxiety in youth and
suggest the importance of further exploring the relation
between existential anxiety concerns and the symptoms of
depression and anxiety. Existential anxiety concerns were
highly prevalent in this sample of adolescents and thus
it may be reasonable to consider them a normative phe-
nomenon. Such findings add empirical support to the no-
tions of philosophers and writers in the existentialist tradi-
tion such as Dostoyevsky, Kierkegaard, Sartre and Camus
who have noted that existential concerns, as defined in this
study, are core human issues. Similar to our findings with
young adults samples (Weems et al.,2004) the “relative”
existential anxiety concerns were more prevalent than the
“absolute” concerns. This may be because relative con-
cerns are more salient in the every day lives of people than
the “ultimate” aspects of existential apprehension.
Results indicated that the EAQ has adequate relia-
bility and validity estimates in youth. In particular, levels
of existential anxiety were fairly evenly distributed across
the sample and the EAQ had adequate internal consis-
tency. In terms of convergent and incremental validity,
the EAQ was correlated with symptoms of depression
and anxiety in the theoretically predicted manner. Results
thus provide initial support for the assessment of existen-
tial anxiety as conceptualized in Tillich’s model and its
relevance to the phenomenology of depression and anx-
iety and results were broadly consistent with previous
research (e.g., Abdel-Khalek, 2000–2001).
Results were consistent with our hypothesis that the
data from the EAQ would be hierarchical with 3 lower
order factors corresponding to the 3 domains in Tillich’s
(1952a) conceptualization of existential anxiety. We
believed that it would be hierarchical because although
composed of 3 domains existential anxiety is a holistic
concept according to Tillich’s theorizing and preliminary
findings in samples of young adults supported this
hypothesis. Although the hierarchical 3-factor model
provided the better fit to the data than a 1-factor model,
the fit can only be considered moderate. The moderate
fit indices may have resulted from the small item pool for
the factors or from the dichotomous “yes” or “no” rating
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Existential Anxiety
system. The dichotomous “yes” or “no” rating system
was used for ease of scoring and administration; however,
future research may benefit from using likert-type ratings.
Fit estimates and item loadings were very similar to
those reported in Weems et al. (2004) but were slightly
higher and this may have been the result of using the
tetrachoric correlations in the analysis of factor structure
in this study (see relevant discussion in Mislevy, 1986;
Muth´
en, 1978). Finally, future researchers may wish to
expand the item pool. This may be particularly important
for research aimed at examining further the components
of Tillich’s conceptualization of existential anxiety.
Examining the associations demonstrated in this
study between the EAQ and depression and anxiety
closely, reveals some interesting differences between our
previous findings in young adults and this sample. Exam-
ination of the standardized β’s in the subscale regression
analyses indicates that the meaninglessness and empti-
ness subscale had the largest βin the regression predict-
ing anxiety but the guilt and condemnation subscale had
the largest βin the regression predicting depression. The
fate and death subscale was not significant in either re-
gression. This contrasts to our previous findings in young
adults (Weems et al.,2004) in that the meaninglessness
and emptiness subscale had the largest βin the regression
predicting depression for adults and the fate and death
subscale had the largest βin the regression predicting
anxiety. Such findings may represent developmental dif-
ferences in the relative importance of various existential
concerns.
Although the prevalence of existential anxiety con-
cerns suggests that such apprehension may be normative,
results also suggest that highly elevated existential anxiety
may be associated with problematic levels of depression.
Research to examine possible developmental associations
between existential anxiety and symptoms of clinical de-
pression and anxiety may thus be warranted. Theoreti-
cally, existential apprehension may influence the devel-
opment of depressive and anxiety disorders by fostering
maladaptive thinking about the self, future, and the world.
In other words, existential apprehension may foster a neg-
ative view of the self, the worldor the future. However, no
causal or directional conclusions should be drawn from
the results of this study. Prospective longitudinal designs
are needed to better address these types questions.
Results were consistent with our hypothesis that in-
dividuals in the moratorium status would have elevated
existential anxiety. Such individuals are likely to be grap-
pling with core issues and thus should be likely to have
elevated existential concerns because individuals in this
status are exploring different options for their core beliefs
but have not yet chosen from the available alternatives or
committed themselves. However, post hoc tests indicated
that they only significantly differed from the foreclosed
group. Although no directional conclusions can be made
from the design of this study, taken together with the cor-
relational analyses the results are consistent with the idea
that worry about finding appropriate life roles, goals, and
values may lead to deeper concerns about the meaning
of life and death but that commitment to identity may be
protective. However, research is needed to explore if con-
cern about one’s ability to successfully manage identity
issues (i.e., identity distress) is relevant to understand-
ing the linkages between identity and existential anxiety.
In other words, the exploration of identity options may
not directly foster existential anxiety. Distress or confu-
sion about identity related issues might be more important
in fostering negative existential concerns (Berman et al.,
2004).
Although the study contributes to an understanding
of the phenomenon of existential anxiety there are
several limitations. First, this study is limited by the
cross-sectional nature of the investigation and thus lon-
gitudinal research is needed to clarify the developmental
phenomenology of existential anxiety and its associations
with emotional functioning. Second, because multiple
self-report measures were employed there is the potential
issue of source variance. Future research may benefit
from employing interview schedules of depression and
anxiety. Finally, the symptoms of anxiety and depression
that were correlated with existential anxiety were not
DSM-IV diagnoses of anxiety or depression. Future
research could benefit from studying Tillich’s model of
existential anxiety in participants who meet the clinical
criteria for anxiety and depressive disorders. In particular,
the relationship between existential anxiety and panic
disorder, in which the fear of death is a part of the
diagnostic criteria, and post-traumatic stress disorder,
in which the threat of death to one’s self is a part of
the diagnostic criteria, could be examined in an effort to
better understand the role of existential apprehension in
these disorders (Fortner and Neimeyer, 1999).
In summary, philosophers in the existentialist tradi-
tion have long commented on the role of existential ap-
prehension in human emotional functioning. Intervention
theorists such as Yalom (1975) have pointed out the im-
portance of existential factors in the clinical domain and
researchers (Debats et al.,1995) have called for increased
scientific and clinical consideration of facets of existen-
tial anxiety. The literature reviewed and the results of this
study point out that existential concerns are common and
measurable phenomenon. Results also support the viabil-
ity and utility of empirically examining Tillich’s (1952a)
theory of existential anxiety and highlight the importance
jyjy jy p
Berman, Weems, and Stickle
of further exploring the relation between existential con-
cerns and clinical symptoms such as depression and anxi-
ety in youth. Tillich’s theory may also be a useful platform
for additional theoretical work on the role of existential
anxiety in youth emotional functioning.
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Background Existential philosophy and psychotherapy focuses on the “givens” of human experience, including feelings of meaninglessness, isolation, death anxiety, and concerns surrounding identity and freedom. Although borderline personality disorder (BPD) is arguably characterized by issues in a number of these domains, it has not been systematically examined through the lens of existential therapy. Method The current systematic review included 37 articles which examined existential concerns in relation to BPD. Results These articles highlighted the predominance of chronic identity and isolation-related concerns in BPD, as well as the potential role of meaning in buffering against the distress of BPD, such as suicidality and comorbid depressive features. Implications The implications of existential phenomenological findings in the conceptualization of BPD, treatment and future existential research are discussed.
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1443 ‫ه.‬ 2021 ‫م.‬ ‫مستخلص‬ ‫البحث‬ ‫عن‬ ‫الكشف‬ ‫الحالي‬ ‫البحث‬ ‫يهدف‬ ‫صالح‬ ‫صحة‬ ‫موظفي‬ ‫عند‬ ‫ة‬ ‫المنجز‬ ‫بالهوية‬ ‫وعالقتها‬ ‫المبادئة‬ ‫(المجابهة‬ ‫الدين)‬. (‫ية‬ ‫نظر‬ ‫على‬ ‫باإلعتماد‬ ‫المبادئة‬ ‫المجابهة‬ ‫مقياس‬ ‫ببناء‬ ‫الباحثان‬ ‫قام‬ ‫البحث‬ ‫أهداف‬ ‫ولتحقيق‬ Lazarus,1991) ‫الصدق‬ ‫اج‬ ‫إستخر‬ ‫تم‬ ‫إذ‬ ‫للمقياس‬ ‫ية‬ ‫السايكومتر‬ ‫الخصائص‬ ‫من‬ ‫الباحثان‬ ‫تحقق‬ ‫وقد‬ ‫المبادئة‬ ‫للمجابهة‬ ‫يفه‬ ‫وتعر‬ ‫البناء‬ ‫وصدق‬ ‫الظاهري،‬ ‫الصدق‬ ‫وهما:‬ ‫يقتين‬ ‫بطر‬ ، ‫الث‬ ‫تخرج‬ ُ ‫إس‬ ‫كما‬ ‫الثبات‬ ‫معامل‬ ‫فبلغ‬ ‫اإلختبار‬ ‫إعادة‬ ‫يقة‬ ‫بطر‬ ‫بات‬ (0,870 (‫من‬ ‫النهائية‬ ‫ته‬ ‫بصور‬ ‫المقياس‬ ‫وتكون‬) 20 ‫لقياس‬ ‫صالحة‬ ‫ة‬ ‫فقر‬) ‫المبادئة‬ ‫المجابهة‬. ‫ألهداف‬ ً ‫استكماال‬ ‫و‬ ‫ـ(التميمي‬ ‫ل‬ ‫ة‬ ‫المنجز‬ ‫الهوية‬ ‫مقياس‬ ‫بتبني‬ ‫الباحثان‬ ‫قام‬ ‫البحث‬ 2020 (‫ية‬ ‫نظر‬ ‫على‬ ‫باإلعتماد‬) Marcia,1966) ‫من‬ ‫يتكون‬ ‫الذي‬ ‫و‬ (30 ‫ة‬ ‫فقر‬) ‫إعادة‬ ‫يقة‬ ‫بطر‬ ‫الثبات‬ ‫تخرج‬ ُ ‫إس‬ ‫كما‬ ‫الظاهري.‬ ‫الصدق‬ ‫يقة‬ ‫بطر‬ ‫الصدق‬ ‫اج‬ ‫إستخر‬ ‫وقد‬ (‫الثبات‬ ‫معامل‬ ‫فبلغ‬ ‫اإلختبار‬ 0,92). ‫المق‬ ‫تطبيق‬ ‫تم‬ ‫وبعدها‬ ‫يا‬ ‫س‬ ‫ين‬ (‫البالغة‬ ‫األساسية‬ ‫البحث‬ ‫عينة‬ ‫على‬ 150) ‫وموظفة‬ ‫موظف‬ ‫من‬ ‫صحة‬ ‫ة‬ ‫دائر‬ ‫للعام‬ ‫الدين‬ ‫صالح‬ 2020 ‫باستخدام‬ ‫إحصائيا‬ ‫البيانات‬ ‫معالجة‬ ‫وبعد‬ ، ‫ائية‬ ‫العشو‬ ‫يقة‬ ‫بالطر‬ ‫إختيارهم‬ ‫تم‬ ‫الذين‬ ‫م‬ ‫االحصائي‬ ‫نامج‬ ‫البر‬ spss ‫نتائج‬ ‫إلى‬ ‫التوصل‬ ‫تم‬ ‫البحث‬ ‫العالقة‬ ‫و‬ ‫ة‬ ‫منجر‬ ‫وهوية‬ ‫مبادئة‬ ‫مجابهة‬ ‫تمتلك‬ ‫العينة‬ ‫ان‬ ‫بينهما‬ ‫موجبة‬ ‫طردية.‬ : ً ‫ال‬ ‫او‬ ‫البحث‬ ‫مشكلة‬ : ‫لل‬ ‫مجابهة‬ ‫عند‬ ‫كبير‬ ‫دور‬ ‫اد‬ ‫األفر‬ ‫ال‬ ‫في‬. ‫منها‬ ‫المفرحة‬ ‫وحتى‬ ‫المؤلمة‬ ‫و‬ ‫المزعجة‬ ‫اقف‬ ‫مو‬ ‫ثقافية‬ ‫وقناعات‬ ‫مهنية‬ ‫هوية‬ ‫على‬ ‫ار‬ ‫اإلستقر‬ ‫عدم‬ ‫إلى‬ ‫تؤدي‬ ‫المختلفة‬ ‫الحياة‬ ‫تحديات‬ ‫مجابهة‬ ‫في‬ ‫فالضعف‬ ‫ي‬ ‫وبالتالي‬ ‫اضحة‬ ‫و‬ ‫سياسية‬ ‫أيدولوجيات‬ ‫و‬ ‫ت‬ ‫ق‬ ‫مز‬ ‫المجمتع‬ ‫اد‬ ‫افر‬ ‫في‬ ‫وضعف‬ ‫العجز‬ ‫و‬ ‫اب‬ ‫اإلضطر‬ ‫و‬ ‫بالقلق‬ ‫ويصيبهم‬ ‫افق‬ ‫التو‬ ، ‫تما‬ ‫على‬ ‫بهم‬ ‫ويدفع‬ ‫الذاتي‬ ‫سكهم‬ ، ‫و‬ ‫أحد‬ ‫عتبر‬ ُ ‫ي‬ ‫وهذا‬ ‫ين‬ ‫اآلخر‬ ‫نظر‬ ‫وجهات‬ ‫بفلسفات‬ ‫التأثر‬ ‫سرعة‬ ‫إلى‬ ‫الهوية.‬ ‫إلنجاز‬ ‫الكامل‬ ‫الفقدان‬ ‫إلى‬ ‫يقود‬ ‫الذي‬ ‫و‬ ‫المرحلة‬ ‫هذه‬ ‫أخطار‬ ‫في‬ ‫عمله‬ ‫خالل‬ ‫من‬ ‫الباحثان‬ ‫احد‬ ‫الحظ‬ ‫وقد‬ ‫الصحة‬ ‫مؤسسات‬ ‫في‬ ‫الممرضين‬ ‫و‬ ‫األطباء‬ ‫مع‬ ‫اصله‬ ‫وتو‬ ‫الصحي‬ ‫الجانب‬ ، ‫م‬ ‫من‬ ‫البعض‬ ‫ان‬ ‫الى‬ ‫ا‬ ‫أشارو‬ ‫وظفي
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Climate change is the biggest threat of our century, one that will impact every aspect of children's lives: their physical, emotional, moral, financial, and social health and well-being. The relationship between the climate crisis and mental health in young people is therefore by definition multi-disciplinary and multi-cultural, requiring multiple perspectives on how to understand and guide younger generations. This book provides a unique synthesis of those perspectives - the science, psychology, and social forces that can be brought to bear on supporting young people's psychological well-being. No matter the setting in which an adult may interact with younger people, this book provides the intellectual rigor and tools to ensure those interactions are as helpful and supportive as they can be.
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Anxiety disorders are among the most prevalent mental health problems in childhood. In this timely book, an international team of psychiatrists and psychologists review the most recent theoretical and empirical developments in the field and indicate how these may inform research and clinical practice. Following a historical introduction, chapters review conceptual and management issues, including cognitive, neurobiological, learning and developmental processes, and the influence of the peer group and family. Phenomenology, classification and assessment are covered, as are clinical course, intervention and outcome, with attention to both pharmacological and psychosocial treatment approaches. For clinicians and researchers this is an authoritative guide to the understanding and assessment of anxiety disorders in the young, and will appeal to all mental health professionals involved with this age group.
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This chapter aims to explicate a developmental approach to anxiety disorders and provide potential insights that may benefit clinicians. It outlines the sequence and timing for the onset of fears and anxiety during typical development, how this relates to the onset of anxiety disorders in children and adolescents, and explores if any developmental pathways for anxiety disorders can be defined (considering temperament and the attachment relationship), and the potential for integration into a developmental model.
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