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Religiousness, Religious Doubt, and Death Anxiety

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Terror Management Theory (TMT) (Greenberg, Pyszczynski, & Solomon, 1986) suggests that culturally-provided worldviews (e.g., religion) may protect individuals from experiencing death anxiety, and several studies have supported this position. However, if one's worldview can offer protection, doubts concerning one's worldview could undermine this protection. The current study investigated whether age, gender, religiousness, and religious doubt were associated with death anxiety. Using data from 635 younger, middle-aged, and older adults, a structural equation model with age, gender, religiousness, and religious doubt predicting death anxiety was tested. The model had a good fit (chi2 (76) = 193.467, p < .001; GFI = .961, CFI = .976, TLI = .967, RMSEA = .049) and accounted for 12.3% of the variance in death anxiety. Results were consistent with TMT, as religiousness was inversely associated with death anxiety, while religious doubt was positively associated with death anxiety.
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RELIGIOUSNESS, RELIGIOUS DOUBT, AND
DEATH ANXIETY
JAMES HENRIE, PH.D.
West Virginia University and
State University of New York at Buffalo
JULIE HICKS PATRICK, PH.D.
West Virginia University
ABSTRACT
Terror Management Theory (TMT) (Greenberg, Pyszczynski, & Solomon,
1986) suggests that culturally-provided worldviews (e.g., religion) may
protect individuals from experiencing death anxiety, and several studies
have supported this position. However, if one’s worldview can offer
protection, doubts concerning one’s worldview could undermine this
protection. The current study investigated whether age, gender, religious-
ness, and religious doubt were associated with death anxiety. Using data
from 635 younger, middle-aged, and older adults, a structural equation
model with age, gender, religiousness, and religious doubt predicting
death anxiety was tested. The model had a good fit (c2(76) = 193.467,
p< .001; GFI = .961, CFI = .976, TLI = .967, RMSEA = .049) and
accounted for 12.3% of the variance in death anxiety. Results were
consistent with TMT, as religiousness was inversely associated with
death anxiety, while religious doubt was positively associated with
death anxiety.
203
Ó2014, Baywood Publishing Co., Inc.
doi: http://dx.doi.org/10.2190/AG.78.3.a
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INT’L. J. AGING AND HUMAN DEVELOPMENT, Vol. 78(3) 203-227, 2014
Terror Management Theory (TMT; Greenberg, Pyszczynski, & Solomon,
1986) argues that the human ability to ponder our own mortality results in
emotional turmoil, specifically described as death anxiety. Given that death
anxiety, the degree to which individuals experience apprehension in refer-
ence to death and death-associated objects, places, or practices (Fortner &
Neimeyer, 1999), has been found to be associated with a number of indices of
psychological well-being (e.g., subjective well-being and perceived purpose
in life; Rappaport, Fossler, Bross, & Gilden, 1993), researchers have investi-
gated various influences on death anxiety. These influences have included
demographic variables, such as age and gender (e.g., Rasmussen & Brems,
1996), and sociocultural variables, such as religiousness (e.g., Thorson, 1991).
The sociocultural variables are of particular importance, given that TMT
argues that culturally-provided worldviews can offer protection from existen-
tial distress (Greenberg et al., 1986), and religious beliefs may be one of those
worldviews (Vail, Rothschild, Weise, Solomon, Pyszczynski, & Greenberg,
2010). This follows logically: if the worldview to which you adhere argues
that you or your essence will continue even after corporeal death, as many
religions do, there would be no need for anxiety about the cessation of your
existence. However, if one’s worldview offers protection from death anxiety,
doubts concerning one’s worldview could result in the loss of this benefit.
Surprisingly, this has received little empirical attention. Thus, it is necessary to
examine the death anxiety’s associations with demographic variables (age and
gender), different approaches to religiousness, and, preliminarily, religious
doubt to assess the unique contribution of each variable to death anxiety.
AGE, GENDER, AND DEATH ANXIETY
Relatively consistent age and gender differences have been found in the
numerous studies of death anxiety. Concerning age, younger adults tend to
express higher levels of death anxiety than do older adults (e.g., Rasmussen
& Brems, 1996; Stevens, Cooper, & Thomas, 1980; Thorson, 1991). Even
when investigating death anxiety solely among older adults, the oldest old
report having the lowest death anxiety (Bengtson, Cuellar, & Ragan, 1977;
Wu, Tang, & Kwok, 2002). Some have argued that this age difference in
death anxiety may be due to psychosocial maturity (Rasmussen & Brems,
1996), while others (e.g., Argue, Johnson, & White, 1999; Thorson, 1991)
have contended that this decline may be due to increasing levels of religious-
ness with age.
Concerning gender, across diverse samples, females tend to report greater
death anxiety. Specifically, this difference has been found among adolescents
(e.g., Cotter, 2002; Ens & Bond, 2007; Young & Daniels, 1981) and college
204 / HENRIE AND PATRICK
students (e.g., Berman & Hays, 1973; McDonald, 1976; Pierce, Cohen,
Chambers, & Meade, 2007), as well as age-diverse samples (e.g., Harding,
Flannelly, Weaver, & Costa, 2005; Rasmussen & Johnson, 1994) and samples
of adults from Pakistan (Suhail & Akram, 2002), Iran (Roshdieh, Templer,
Cannon, & Canfield, 1998), and Kuwait (Thorson, Powell, Abdel-Khalek,
& Beshai, 1997). Thus, these demographic influences are relatively well
established.
Spirituality, Religion, and Death Anxiety
The relations between religiousness and death anxiety have been investi-
gated quite frequently, with studies focusing on several different aspects of
religiousness. In comparisons between belief systems, research has found
that Mormons and non-Mormons had similar levels of death anxiety
(McDonald, 1976) and self-identified born-again Christian high school
students in the rural south had lower death anxiety than those who did not
identify themselves as born-again Christians (Young & Daniels, 1980, 1981).
A number of studies have used Allport and Ross’s (1967) distinction between
intrinsic (internal religious motivations, such as desiring to be closer to a
higher power) and extrinsic religiosity (external motivations, such as desiring
to be a part of a community). Although intrinsic religiosity is often asso-
ciated with lower death anxiety (e.g., Roff, Butkeviciene, & Klemmack,
2002) and extrinsic religiosity is often associated with higher death anxiety
(Ens & Bond, 2007), Kirkpatrick and Wood (1990) have argued that the
intrinsic-extrinsic religiosity distinction does not truly capture the psychology
of religious belief, as extrinsic religiosity and intrinsic religiosity seem to
touch on a number of different aspects of religiousness, meaning findings
are too ambiguous to be fully disentangled. More nuanced studies of reli-
giousness and death anxiety have included studies of spirituality, specific
religious beliefs, importance of beliefs, and organizational religiousness,
with mixed results.
Religious Beliefs
The associations between specific beliefs and death anxiety have been
frequent topics of research. Several researchers have found that greater belief
in an afterlife is associated with less death anxiety (Harding et al., 2005;
Lundh & Radon, 1998; Ochsmann, 1984; Rasmussen & Johnson, 1994;
Roshdieh et al., 1998; Templer & Ruff, 1975; Thorson, 1991), although a few
have failed to find this relation (Alvarado, Templer, Bresler, & Thomas-
Dobson, 1995; Berman & Hays, 1973; Templer & Dotson, 1970). Additionally,
Harding et al. (2005) and Naidu and Sinha (1992) found that belief in the
RELIGIOUS DOUBT AND DEATH ANXIETY / 205
existence of a higher power was associated with lower death anxiety. Although
the findings are somewhat mixed, a trend predominates, as it appears that
death anxiety may be inversely associated with specific religious beliefs,
such as the existence of an afterlife.
Organizational Religiousness
Several studies have investigated associations between organizational reli-
giousness and death anxiety, often focusing on religious service attendance.
Although some have failed to find an association (e.g., Alvarado et al., 1995;
Templer & Dotson, 1970), others have found that those who attend religious
services more frequently also report less death anxiety (e.g., Aday, 1984;
Long & Elghameni, 1987; Templer & Ruff, 1975). In contrast, Thorson
(1991) found that frequency of religious service attendance was positively
correlated with death anxiety (r= .16) for females, though a similar trend was
nonsignificant for males.
Religious Meaning
A number of studies have examined the relation between religious meaning
(the relative importance that individuals find in their religion) and death
anxiety. However, results are equivocal, as some have found no relation
(Templer & Dotson, 1970), some a negative relation (Alvarado et al., 1995;
Long & Elghanemi, 1987; Lundh & Radon, 1998; Roshdieh et al., 1998; Suhail
& Akram, 2002; Templer & Ruff, 1975), some a positive relation (Thorson,
1991), and still others a curvilinear relation (Leming, 1980; Wink & Scott,
2005). Clearly, further study is required.
Spirituality
Few studies have considered the relations between non-religion-specific
spirituality and death anxiety. Non-religion-specific spirituality refers to
feelings of connectedness with a higher cause or power and may involve a
search for answers in which answers may not always be concrete or reinforced.
Importantly, while religions may offer a belief in an afterlife, spiritual beliefs
or practices may not make the same promises. Results from studies investi-
gating associations between spirituality and death anxiety have been mixed,
as Rasmussen and Johnson (1994) found a negative relation between death
anxiety and spirituality among 18- to 61-year-olds, but Wink (2006) did not
find a significant relation between spirituality and death anxiety.
206 / HENRIE AND PATRICK
Religious Doubt
The association between religious doubt and death anxiety has not been
explicitly studied. However, if, as many studies suggest, religiousness is
inversely associated with death anxiety, it follows that doubts may be posi-
tively associated with death anxiety. Although one might view doubt as
solely being lower religiousness, Hecht (2003) suggests that there has been
doubt in religion as long as there has been religion, and that those who are
highly religious can certainly experience doubts. In fact, Allport (1950)
suggested that doubt may indeed be normative, and could contribute to the
development of one’s faith. Thus, it is of little surprise that experiencing
religious doubts is actually quite common (Hunsberger, McKenzie, Pratt,
& Pancer, 1993).
Many potential causes of religious doubt have been proposed. Krause,
Ingersoll-Dayton, Ellison, and Wulff (1999) suggested that doubt may
arise when comparing two seemingly valid but incompatible perspectives.
Ingersoll-Dayton, Krause, and Morgan (2002) found that stressful life events,
such as divorce, death of a loved one, or dissolution with one’s religious
community or with individuals within one’s community, were associated with
religious doubt. Krause and Ellison (2009) also found that more negative
social interaction within one’s religious community was associated with
increased doubting. Additionally, religious doubts may involve issues with
the foundations of the religion and issues concerning whether changes are
needed within the religious community (Hunsberger, Alisat, Pancer, & Pratt,
1996), and have also been linked to individuals not having their expecta-
tions met by their religion (Nipkow & Schweitzer, 1991).
Similar to death anxiety, religious doubt research has emphasized the inves-
tigation of negative outcomes with which it is associated. Higher levels of
religious doubt have been associated with a number of psychological issues,
including greater general psychological distress and diminished feelings of
well-being (Krause et al., 1999), as well as being less satisfied with personal
health and experiencing more depression (Krause & Wulff, 2004). Experi-
encing religious doubt due to seeing suffering and evil in the world appears
to have deleterious effects on mental health, including higher levels of
depression, anxiety, paranoia, hostility, and obsessive-compulsive symptoms,
although the effects of religious doubt may diminish with age (Galek, Krause,
Ellison, Kudler, & Flannelly, 2007). Also, having higher levels of doubt
over time was associated with declines in self-esteem, optimism, and, in those
with less education, life satisfaction (Krause, 2006). Given that religious
doubt and death anxiety are associated with similar psychological and
physical issues, and given that religious doubt is essentially the questioning
RELIGIOUS DOUBT AND DEATH ANXIETY / 207
of a worldview that may protect against those effects, religious doubt is an
intriguing potential predictor of death anxiety within a larger model.
Conceptual Model and Hypotheses for
the Current Investigation
While several studies have separately investigated age, gender, and
religiousness in relation to death anxiety, the results have frequently been
mixed, and religious doubt has not been studied in this area. Additionally,
given that religiousness has been shown to vary by age, with older adults
typically reporting higher levels of religiousness (e.g., Pew Research Forum,
2010), and by gender, with females typically reporting higher levels of reli-
giousness (e.g., Levin & Taylor, 1993), it is also possible that religiousness
may mediate the relations of age and gender with death anxiety. Thus, a model
(Figure 1) was tested investigating the relative influence of age, gender,
religiousness, and religious doubt on death anxiety. Within the model, based
on prior research (e.g., Ens & Bond, 2007; Harding et al., 2005; Pew Research
Forum, 2010; Rasmussen & Brems, 1996) and theory (TMT) (Greenberg
et al., 1986), it was expected that age would be positively associated with
208 / HENRIE AND PATRICK
Figure 1. Investigation of the relative influence of age, gender,
religiousness, and religious doubt on death anxiety.
Doubt
Death
Anxiety
Relig
Gender
Age
religiousness, and inversely associated with both religious doubt and death
anxiety; that gender (coded as female = 0 and male = 1) would be positively
associated with religious doubt, and inversely associated with religiousness
and death anxiety; that religiousness would be inversely associated with
death anxiety; and that religious doubt would be positively associated
with death anxiety.
METHOD
Participants and Procedure
Data from 634 participants (Table 1) were used in the current study.
Although primarily consisting of younger adults, middle-aged and older adults
were included in the sample. The sample was religiously diverse: 36.0% were
Protestant, 24.5% were Catholic, 1.4% reported being Jewish, 1.1% were
Muslim, 13.3% reported having no religious affiliation, and 23.9% chose
“other” and did not provide further detail on their religious affiliation.
Among the non-Catholic Christian participants, 34.1% were Methodist,
27.2% were Baptist, 7.8% were Lutheran, 7.3% were Pentecostal, 5.6% were
Presbyterian, 3.4% were Episcopalian, and 10.8% reported being non-
denominational. In terms of education, all but two participants had at least a
high school diploma, and 40 participants (6.3%) had earned a master’s or
doctoral degree. Participants were recruited through university psychology
courses at a Mid-Atlantic university, referrals of other individuals by prior
participants, and press releases to the regional and local newspapers. Data were
collected using an online data collection system (a university-administered
program through SONA Systems). Individuals who wished to participate
contacted the researchers and were provided with log-in information for
SONA. Once participants logged on, informed consent was attained and the
participants were presented with the questionnaires.
RELIGIOUS DOUBT AND DEATH ANXIETY / 209
Table 1. Participants’ Ages
Range NMean SD
All participants
Young adults
Middle-aged adults
Older adults
18-89
18-35
36-39
60-89
634
498
85
51
27.81
20.17
49.66
65.36
15.34
2.32
6.27
5.54
Materials and Measures
Death anxiety was indexed using two measures. As with many constructs,
researchers have operationalized death anxiety in multiple ways, including
singular and multidimensional approaches. Using both approaches, in the
present study death anxiety was measured using both a single factor measure
(the Death Anxiety Scale-Extended (DAS-E) (Templer, Awadalla, Al-Fayez,
Frazee, Bassman, Connelly, et al., 2006) and a multidimensional measure
(the Death Anxiety Inventory (DAI) (Tomás-Sábado & Gómez-Benito, 2005).
The DAS-E asks participants to indicate whether 51 statements about death
and dying are true (1) or false (0) for them. Included in the questionnaire are
statements about general fear of death (e.g., “I am very much afraid to die”)
and specific scenarios involving personal death (e.g., “I fear drowning”), as
well as statements about pain and suffering (e.g., “I very much fear being
tortured to death”). Higher scores represent higher death anxiety. In the present
study, the DAS-E had strong internal consistency (KR-20 = .93), but was
positively skewed; thus, a square root transformation was used.
Similarly, the DAI (Tomás-Sábado & Gómez-Benito, 2005) is a 20-item
questionnaire that can be used in a true-false format (used in the present study)
or 6-point Likert-style format ranging from totally agree to totally disagree.
Through factor analyses, the authors found a five-factor structure, which was
used in the current study:
1. externally generated death anxiety (e.g., “The sight of a corpse deeply
shocks me”; KR-20 = .70);
2. meaning and acceptance of death (e.g., “The idea of death bothers
me”; KR-20 = .71);
3. thoughts about death (e.g., “I frequently think of my own death”;
KR-20 = .70);
4. life after death (e.g., “The idea that there is nothing after death frightens
me”; KR-20 = .69); and
5. brevity of life (e.g., “The certainty of death makes life meaningless”;
KR-20 = .45).
All subscales of the DAI were strongly positively skewed, and logarithmic
transformations were used. Means, standard deviations, and ranges for the
DAS-E, DAI, and all other measures can be seen in Table 2. Means and
standard deviations for all measures used with this sample were comparable
to other published samples (within 1, if adjusted for scaling; for example,
using 1 and 2 vs. 0 and 1 for dichotomous items). Within the model (see
Figure 2), death anxiety was conceptualized as a latent variable consisting
of the DAS-E and the five DAI subscales, allowing for prediction of the
210 / HENRIE AND PATRICK
underlying construct both measures are estimating. Of note, due to the low
internal consistency of the Brevity of Life subscale of the DAI, analyses were
conducted both including and excluding that subscale, finding little difference
between the measurement models or the predictive models. Thus, the predictive
model including the Brevity of Life subscale is reported.
Religiousness
Several measures were used to assess religiousness. In the model, each
measure of religiousness was used as an indicator for a latent religiousness
construct.
Religious beliefs were measured using the five-item Beliefs Scale of
the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS)
(Fetzer Institute, 1999). Participants indicated whether they held general and
RELIGIOUS DOUBT AND DEATH ANXIETY / 211
Table 2. Means, Standard Deviations, and Ranges
for All Measures
Variable Min. Max. Mean SD
Death Anxiety Scale-Extended
Death Anxiety Inventory
Externally Generated Death Anxiety
Meaning and Acceptance of Death
Thoughts about Death
Life after Death
Brevity of Life
Religious Beliefs
Religious Meaning
Spirituality
Organizational Religiousness
Religious Doubt
Experiences
Pressure
Emphasis
0
0
0
0
0
0
0
5
20
16
5
14
8
4
2
48
20
5
5
4
3
3
25
100
96
20
70
40
20
10
15.44
5.94
1.52
1.62
0.97
1.07
0.74
20.42
65.66
58.13
9.41
34.00
19.54
8.67
5.72
9.93
4.78
1.48
1.39
1.23
1.13
0.84
5.15
21.43
18.29
4.20
12.68
8.39
4.29
2.39
212 / HENRIE AND PATRICK
Figure 2. Structural equation model: Associations between age, gender, religiousness, religious doubt, and death anxiety.
(c2(50) = 95.179, p< .001; GFI = .978, CFI = .990, TLI = .984, RMSEA = .038). All parameters p< .001.
Gender: coded as female = 0, male = 1. R2: Religiousness = .089, Religious Doubt = .072, Death Anxiety = .123.
specific beliefs, such as a belief in an afterlife, believing that everything
happens for a reason, and believing that a higher power loves them. In the
current investigation, the Beliefs Scale had a Cronbach’s alpha of .90, but
scores were strongly negatively skewed. Scores were inverted, a logarithmic
transformation was used, and the scores were re-inverted so that higher scores
reflected reporting stronger beliefs.
Religious meaning, the importance that individuals place on religion, was
measured using the 20-item Religious Meaning Scale of the BMMRS (Fetzer
Institute, 1999). Participants indicated to what extent they agreed with
statements about feeling a purpose in life due to a relationship with a higher
power and their religious beliefs. The Cronbach’s alpha for the Religious
Meaning Scale was .98 in the current study. Scores were strongly negatively
skewed; thus, scores were inverted, a logarithmic transformation was used,
and the scores were re-inverted so that higher scores reflected finding more
meaning in religion.
Spirituality was measured using the 16-item Daily Spiritual Experiences
Scale (DSES) of the BMMRS (Fetzer Institute, 1999). Participants indicated
how frequently they have certain spiritual experiences, such as feeling the
presence of a higher power, finding strength in religion/spirituality, being
thankful, and finding beauty in the world. The DSES had a Cronbach’s alpha
of .95, and scores were normally distributed.
Organizational religiousness was measured using a five-item scale derived
from Kenney, Cromwell, and Vaughan (1977). Participants indicated their
frequency of involvement in particular activities associated with their religious
community, including attendance, financial support, and membership. The
Cronbach’s alpha was .89. Scores were strongly positively skewed, and a
logarithmic transformation was used.
Religious doubt was indexed using a scale developed for the current study
(see the Appendix A). The scale was derived from measures and items used
in prior research and the available religious doubt literature. A scale was
developed, rather than using a pre-existing scale, because views of religious
doubt varied. The focus ranged from explicit questions of doubt (Hunsberger
et al., 1996) to the impact of experiences with evil or suffering (Galek et al.,
2007; Krause et al., 1999) to difficulties with a religious community (Ingersoll-
Dayton et al., 2002; Nipkow & Schweitzer, 1991). Thus, a measure was
developed to cover each of these areas of doubt. Participants indicated how
true 14 statements about experiences or feelings that may cause doubt were for
them, with possible answers ranging from “very untrue” (1) to “very true” (5).
The scale had a Cronbach’s alpha of .92. An exploratory factor analysis
(Table 3) with a varimax rotation (the scales were expected to be highly
correlated) was conducted to determine whether the scale was best used as a
RELIGIOUS DOUBT AND DEATH ANXIETY / 213
single scale or as multiple subscales. The factor analysis revealed a three-factor
solution accounting for 68.9% of the variance with zero crossloading items.
Items in Factor 1 focused heavily on the impact of experiences on religious
doubt (labeled Experiences from here forward; Cronbach’s alpha = .91),
items in Factor 2 emphasized feeling pressured by one’s religion or religious
community (labeled Pressure from here forward; Cronbach’s alpha = .89), and
items in Factor 3 focused on the degree to which one emphasizes religion
over other perspectives (labeled Emphasis from here forward; Cronbach’s
alpha = .74). The Experiences and Pressure subscales were positively skewed,
and square root transformations were used. Correlations between each of
the measures in the current study can be found in Table 4.
214 / HENRIE AND PATRICK
Table 3. Exploratory Factor Analysis
of the Religious Doubt Measure
Factor
Item 1 2 3
2
5
1
6
7
8
3
11
10
12
9
14
13
4
.783
.773
.766
.718
.713
.696
.689
.661
.873
.859
.836
.708
.858
.842
Note: Item numbers correspond to the
item numbers in Appendix A.
RESULTS
The aim of the current investigation was to test a model predicting death
anxiety, with known predictors (age, gender, and religiousness) being accom-
panied by a theoretically valid predictor (religious doubt). Thus, structural
equation modeling was used.
Preliminary Analyses
Initially, correlations between each of the variables in the study were investi-
gated (Table 4). Interestingly, while religious doubt was significantly posi-
tively correlated with all measures of death anxiety, few significant correla-
tions were found between the other religiousness measures and death anxiety
measures. This result was relatively unexpected; although the literature has
shown mixed results, it was not expected that there would be so few significant
correlations. The possibility of non-linear associations between the constructs
(which could have explained the nonsignificant linear associations) were also
examined using scatterplots, nonparametric correlations, and curve estimation;
however, these did not reveal any non-linear associations. Additional analyses
were conducted searching for mulitcollinearity issues and multivariate outliers,
finding none.
Given the importance of the broader construct of religiousness in the general
research question, prior research suggesting associations between religious-
ness and death anxiety (e.g., Alvarado et al., 1995; Harding et al., 2005; Lundh
& Radon, 1998), and the importance of religiousness in Terror Management
Theory (Greenberg et al., 1986; Vail et al., 2010), the four religiousness
variables were kept in the model as a latent construct.
Model Testing
Overall, the model (Figure 2; c2(76) = 193.467, p< .001) had an excellent
fit (GFI = .961, CFI = .976, TLI = .967, RMSEA = .049) and accounted for
8.9% of the variance in religiousness, 7.2% of the variance in religious doubt,
and 12.3% of the variance in death anxiety. Examining the parameter estimates
(Table 5) revealed a number of interesting associations. First, the expected age
and gender associations with religiousness, religious doubt, and death anxiety
were found, all in the expected directions. Additionally, while religiousness
was inversely associated with death anxiety (b= –.408, p< .001), religious
doubt was positively associated with death anxiety (b= .383, p< .001). Overall,
the associations found in the model were consistent with prior research and
expectations based on theory.
RELIGIOUS DOUBT AND DEATH ANXIETY / 215
Table 4. Correlations
Variable 1 2 345678910111213
1 Experiences (Doubt)
2 Pressure (Doubt)
3 Emphasis (Doubt)
4 Religious Meaning
5 Organizational Rel.
6 Religious Belief
7 Spirituality
8 Death Anxiety Scale-
Extended
9 Externally Generated
Death Anxiety (DAI)
10 Meaning and
Acceptance (DAI)
11 Thoughts about
Death (DAI)
12 Life after Death (DAI)
13 Brevity of Life (DAI)
— .612**
.458**
.223**
–.532**
–.333**
–.720**
–.476**
–.265**
–.604**
.714**
–.557**
–.327**
–.695**
.769**
.615**
–.550**
–.360**
–.691**
.834**
.706**
.773**
.225**
.213**
–.031
–.061
–.045
–.006
–.051
.113*
.145**
–.063
–.033
–.039
–.022
–.030
.593**
.144**
.112*
–.058
–.044
–.024
–.029
–.029
.652**
.522**
.189**
.214**
–.024
–.047
–.010
–.011
–.069
.660**
.447**
.476**
.120**
.053
–.065
–.010
–.031
–.055
–.005
.540**
.413**
.517**
.403**
.221**
.170**
.052
–.113*
–.109*
–.084*
–.114*
.565**
.442**
.536**
.498**
.466**
*p< .05. **p< .01.
216 / HENRIE AND PATRICK
Mediation of the associations of age and gender with death anxiety was
also tested using bootstrapping (Table 6). This did not reveal evidence of
mediation; although there were indirect effects from age and gender to death
anxiety, they were not statistically significant.
DISCUSSION
Findings from the current investigation are discussed in terms of theories that
may guide interpretation and implications of significant results. Additionally,
methodological issues in the study of religiousness and death anxiety are
addressed. Consistent with prior research, the model showed that age, gender,
and religiousness were significant predictors of death anxiety. In addition, it
is particularly interesting that the latent religiousness construct was inversely
associated with the latent death anxiety construct in the model, while the
religiousness/spirituality measures were mostly not significantly correlated
with the death anxiety measures in the preliminary analyses. This suggests
perhaps that underlying construct of religiousness, common to all of the
measures, may be associated with death anxiety, whereas the unique aspects
of each of the measures may not be associated.
The inverse association between the latent religiousness construct and the
latent death anxiety construct is consistent with Terror Management Theory
(TMT) (Greenberg et al., 1986). Religious belief may provide feelings of
RELIGIOUS DOUBT AND DEATH ANXIETY / 217
Table 5. Regression Weights from the Structural Equation Model
Predicting Death Anxiety
Variable Predictor bC.R. p
Religiousness
Religiousness
Religious Doubt
Religious Doubt
Death Anxiety
Death Anxiety
Death Anxiety
Death Anxiety
¬Age
¬Gender
¬Age
¬Gender
¬Age
¬Gender
¬Religiousness
¬Religious Doubt
.239
–.216
–.178
.160
–.300
–.186
–.408
.383
6.030
–4.448
–4.497
3.332
–6.236
–4.139
–7.669
7.214
< .001
< .001
< .001
< .001
< .001
< .001
< .001
< .001
Note: Gender: coded as female = 0, male = 1. R2: Religiousness = .089, Religious
Doubt = .072, Death Anxiety = .123.
greater purpose and immortality. In fact, religious texts and leaders often
discuss those topics in great detail, providing guidance to religious followers.
Thus, it is of little surprise that individuals who believe that the cessation
of their bodily life is not the end of their existence may report significantly
less worry about the cessation of their bodily life, as was found in the
current investigation and others (e.g., Harding et al., 2005; Ochsmann, 1984;
Templer & Ruff, 1975). It is also important to note that religiousness did
not mediate the associations of age and gender with death anxiety, as had been
speculated. Instead, age, gender, and religiousness all appear to be unique
predictors of death anxiety.
Of greatest interest in the current study was that religious doubt was a
significant predictor of death anxiety, such that those who reported experi-
encing more religious doubt also tended to report experiencing more death
anxiety. This result is also consistent with TMT (Greenberg et al., 1986). If
religious belief may provide a worldview through which individuals may
be buffered from the uneasiness associated with our mortality (Vail et al.,
2010), experiencing doubts about that worldview may threaten the support
and buffering received from that worldview. Questioning core beliefs and
cultural practices, especially those concerned with morality and mortality,
like religion, may involve an existential crisis, which could cause anxiety.
Conversely, awareness of mortality, a possible existential crisis in its own
right, might provoke individuals to question core beliefs, such as religion.
218 / HENRIE AND PATRICK
Table 6. Standardized Direct, Indirect, and Total Effects
in the Model
Variable Predictor Direct Indirect Total
Religiousness
Religiousness
Religious Doubt
Religious Doubt
Death Anxiety
Death Anxiety
Death Anxiety
Death Anxiety
¬Age
¬Gender
¬Age
¬Gender
¬Age
¬Gender
¬Religiousness
¬Religious Doubt
.239***
–.178***
–.216***
.160***
–.300***
–.186***
–.408***
.383***
.000
.000
.000
.000
–.015
.011
.000
.000
.239***
–.178***
–.216***
.160***
–.315***
–.175***
–.408***
.383***
Note: Gender: coded as female = 0, male = 1.
***p< 0.001.
The methods used in the current investigation cannot determine causation
or directionality.
As with any study, there are limitations. The first limitation concerns the
sample. The sample was primarily comprised of undergraduates. The middle
and older adults were recruited primarily through referrals; however, less
than 8% (133 out of approximately 1700) of those who received invitations
to participate actually participated. Thus, it is highly unlikely that this sample
is representative of the general population.
Second, the mode of participation (online survey) may have skewed the
sample and the findings. While most young adults and middle adults are
internet savvy, only about 53% of older adults use the internet, though that
number is rising (Pew Internet & American Life Project, 2012). The use of an
online survey immediately excluded all individuals who were not internet
users. It is possible that, especially among older adults, internet users and
non-users might significantly differ on the variables of interest.
Third, the study was cross-sectional. Thus, age differences may be due to
developmental changes, cohort differences, or other extraneous variables,
meaning causal inferences regarding age’s associations with other variables
generally cannot be made. In fact, it is unlikely that age is cause of change in
another variable, such as religiousness or death anxiety; rather the cause of
change is more likely to be another age-associated process or experience.
Thus, longitudinal data could potentially allow for a better understanding
of age associations and developmental trends.
Fourth, this study is the first to investigate religious doubt in association
with death anxiety. Results from this study may be unique to this sample or
methodological, and thus should be treated as preliminary. Thus, further
study is needed in varying samples and with differing methods to substantiate
or challenge the results. Additionally, the religious doubt measure was
developed for the current investigation, meaning the psychometric properties
of the measure are not fully understood.
Finally, the analyses were correlational in nature, making determination
of causal relations and directionality difficult. Once again, longitudinal
research may help, as it could assist in determining the directionality of the
causal link, if there is one, as a third variable could obviously be responsible.
Experimental research may also be helpful. However, results from studies
using “naturally-occurring” death anxiety and results using experimentally-
induced death anxiety have contradictory results. For example, when pre-
existing death anxiety is assessed, it is inversely associated with risk-taking
(e.g., Cotter, 2002, where those with lower levels of death anxiety reported
participating in more high-risk activities), while experimentally-induced
death anxiety is positively related (e.g., Ford, Ewing, Ford, Ferguson, &
RELIGIOUS DOUBT AND DEATH ANXIETY / 219
Sherman, 2004, where those who completed a death anxiety measure first
reported greater willingness to participate in high-risk sexual behaviors).
Thus, it seems as though the methodology influences the results, meaning
the results need to be interpreted carefully.
Future research should attempt to address these concerns, especially the
use of longitudinal designs. Additionally, the construct of religious doubt,
and its relation with death anxiety, needs to be further examined. Specifically,
religious doubt has many possible causes, from internal debate (Krause et al.,
1999), to stressful life events (Ingersoll-Dayton et al., 2002), to negative
interaction with one’s religious community (Krause & Ellison, 2009). It is
possible that doubts from these various causes could have differential effects
on many outcomes, including death anxiety.
220 / HENRIE AND PATRICK
(Appendix follows)
APPENDIX A: RELIGIOUS DOUBT SCALE
Below are some statements about thoughts you may or may not have had concerning religion and the world.
Please indicate how true these statements are for you. Choose only one response for each question.
*Items starting with (R) are reverse coded.
Very
Untrue
Somewhat
Untrue Neutral
Somewhat
True
Very
True
1
2
3
4
5
6
Seeing suffering and evil in the world makes me question the
existence of a god or question God’s power.
Feeling personal pain and suffering has made me question
the existence of a god or feel that God has abandoned me.
My prayers are being ignored, or they do not make a difference.
(R) Solutions for my problems can be found in religious
literature (e.g., the Bible) or through the help of religious
leadership (e.g., the clergy).
When natural disasters occur, and innocent people are harmed
or killed, I question the existence of a god or question God’s
love and morality.
Disagreeing with a stance taken by my religion or my religious
community makes me question whether I want to be a part of
this religion or community.
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
RELIGIOUS DOUBT AND DEATH ANXIETY / 221
APPENDIX A (Cont’d.)
Very
Untrue
Somewhat
Untrue Neutral
Somewhat
True
Very
True
7
8
9
10
11
12
Dissatisfaction with the clergy or leadership of my religion or
religious community makes me question if I wish to continue
to be involved in my religion or community.
Sometimes I perceive that the teachings or literature of my
religion are contradictory, and this perception makes me
question if I wish to continue to be involved in my religion.
I have felt pressured by my religion, my religious community,
or the leadership of my religion/community to forgive someone
for a transgression that I did not want to forgive.
I have felt pressured by my religion, my religious community,
or the leadership of my religion/community to be generous to
someone that I did not believe deserved my generosity.
I have experienced doubts concerning the existence of God
and/or the truth about the religion I practice.
I have felt pressured by my religion, my religious community, or
the leadership of my religion/community to be compassionate
toward someone for whom I felt no sympathy.
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
4
4
4
4
4
4
5
5
5
5
5
5
222 / HENRIE AND PATRICK
13
14
15
(R) When the views of my religion contrast with the views of
scientific research or theory, I side with my religion.
I have felt pressured by my religion, my religious community,
or the leadership of my religion/community to change the
way that I live against my will.
For some people, certain events have caused them to
experience doubt in the truth of religious teachings or the
existence of a higher power. Have you ever had an experience
like that? If yes, please describe that experience and how/why
it provoked doubt in the space below. (open ended)
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
RELIGIOUS DOUBT AND DEATH ANXIETY / 223
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RELIGIOUS DOUBT AND DEATH ANXIETY / 227
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An astonishing cultural phenomenon is where, far away from or close to a city center, people in different societies localize cemeteries that function as both sites of memory of lost ones and symbols of mortality. Yet a psychological account of such differences in behavioral responses to symbols of mortality is lacking. Across five studies ( N = 1,590), we tested a psychological model that religious afterlife beliefs decrease behavioral avoidance of symbols of mortality (BASM) by developing and validating a word-position task for quantifying BASM. We showed evidence that religious believers, including Christians, Muslims, Hindus, and Buddhists, exhibited decreased BASM relative to nonbelievers. We also provide evidence for a causal relationship between religious afterlife beliefs and reduced BASM. Our findings provide new insight into the functional role of religious afterlife beliefs in modulating human avoidance behavior in response to symbols of mortality.
... Multiple studies have evaluated the association between religiousness and anxiety with different results in varying communities and cultures (77)(78)(79). It is shown that religiousness may be negatively correlated with the level of preoperative anxiety (36,80). ...
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During the pre-operation period, surgical candidates experience situations that stimulate psychological anxiety leading to stress during and after surgery which is known as preoperative anxiety. This condition can cause psychological and physiological adverse effects on both children and adults. Due to the high prevalence and adverse effects of preoperative anxiety, different treatments have been evaluated including pharmacological and non-pharmacological approaches. As pharmacological treatments may cause adverse effects such as breathing problems, drowsiness, interfering with anesthetic drugs, and prolonged recovery, non-pharmacological interventions are becoming more popular. These methods include cognitive-behavioral therapy, music therapy, pre-op preparation video, aromatherapy, hypnosis, guided imagery relaxation therapy, and massage. In this study, the most popular non-pharmacological approaches to preoperative anxiety are reviewed focusing on more recent evidence provided by clinical studies. The reviewed clinical evidence on the mentioned methods shows the efficacy of non-pharmacological interventions for the treatment of preoperative anxiety, so they can be used in patients of different ages and types of disease and surgery.
... High levels of Stoicism were found to significantly predict lower levels of death anxiety. Stoicism also predicted more variance in death anxiety than did age, a well-established predictor of fears of death [44,45], and spirituality. The authors concluded that cultivating cognitions associated with Stoicism may be a valuable target for intervention. ...
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Growing empirical evidence has revealed the central role of death anxiety in numerous mental health conditions. Given this, there is a significant need for treatments which specifically address fears of death. Whilst such treatments have only recently been developed within clinical psychology, the discipline of philosophy has a long history of offering valuable perspectives on death which may ameliorate this fear. In particular, we propose that the philosophy of Stoicism, which originated in ancient Greece and influenced the early development of cognitive and behaviour therapy (CBT), is of particular benefit to clinicians seeking to address death anxiety. We present a summary of Stoic philosophy and its arguments concerning death. Through integrating the ideas of Stoicism, we argue that current treatments for death anxiety would benefit from directly integrating Stoic perspectives on death. Lastly, we review evidence which suggests that cultivating attitudes to death which are consistent with Stoic philosophy may be associated with reduced death anxiety. We conclude that an awareness of Stoic philosophy has the potential to guide and improve CBT treatments for fears of death. Further research is needed in order to confirm whether treatments centering on Stoic perspectives on death lead to significant reductions in death anxiety.
... The human features the physicians share with the grievously ill reinforces their common fallibility, foreshadowing not only an end, but a potential trajectory that sees them wasting away. Death anxiety has high correlations to burnout, depersonalisation and absenteeism [66][67][68][69] and may lead to wavering of religious faith previously serving as a coping mechanism [70,71]. ...
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... The same study conducted in Turkey among a sample that primarily endorsed being religious did not find relationships between religiosity and death anxiety (Gonen et al., 2012). It is thus important to note that religiosity is a complex concept with beliefs, emotions, and behaviors all contributing to its strength (Henrie & Patrick, 2014). ...
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... It has been thought that the dramatically increasing COVID-19 death rates in Turkey (Genel Koronavirüs, 2021) when compared with many countries in the world caused death anxiety to be high. In addition, it was suggested in a study that in stressful events such as the death of a loved person, individuals experienced religious doubt, and this had a negative effect on their religious coping (Henrie & Patrick, 2014). In positive religious coping, individuals approach God, worshiping, religious individuals and groups, they endure the troubles they experience and interpret these positively (Abanoz, 2020). ...
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This study examines adolescent perceptions of death with a sample of 220 high school students. Variables examined were personifications of death, death anxiety, locus of control, self-esteem, and level of risk. Chi-square, regression analysis, and analysis of variance were used to analyze the data. High risk behaviors were negatively correlated with death anxiety. Males had higher risk scores and lower death anxiety scores than females. Females revealed higher death anxiety scores than males and lower self-esteem scores. High self-esteem correlated with an internal locus of control. Most students selected a male, cold, remote death personification image; females were more likely to select a female death personification image than males. These results suggest that adolescents have formulated a perception of death. When asked to personify death most students chose a negative, cold, remote image, with females more likely to select a gentle, comforting death image than males. The grim, terrifying, and robot-like images were more likely to be selected by males but were chosen much less frequently than the cold, remote, and gentle well-meaning images.
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This paper examines the social basis of various forms of religious behavior among low income ethnic minority groups. The data suggest that traditional measures of religious behavior are not appropriate to such groups. Three distinct patterns are described and analyzed in terms of their relationship to traditional measures of religiosity.
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This study examines adolescent perceptions of death with a sample of 220 high school students. Variables examined were personifications of death, death anxiety, locus of control, self-esteem, and level of risk. Chi-square, regression analysis, and analysis of variance were used to analyze the data. High risk behaviors were negatively correlated with death anxiety. Males had higher risk scores and lower death anxiety scores than females. Females revealed higher death anxiety scores than males and lower self-esteem scores. High self-esteem correlated with an internal locus of control. Most students selected a male, cold, remote death personification image; females were more likely to select a female death personification image than males. These results suggest that adolescents have formulated a perception of death. When asked to personify death most students chose a negative, cold, remote image, with females more likely to select a gentle, comforting death image than males. The grim, terrifying, and robot-like images were more likely to be selected by males but were chosen much less frequently than the cold, remote, and gentle well-meaning images.
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Women report both a higher death anxiety and extrinsic religiosity than men, but it is unknown why. Research has not previously linked these findings. We provide two alternative theoretical models of causal links: (a) women's higher death anxiety promotes extrinsic religiosity or (b) women's higher extrinsic religiosity promotes greater death anxiety. High school and college students in the United States (118 young men and 257 young women) completed Templer's (1970) Death Anxiety Scale and the intrinsic and extrinsic religiosity subscales of Allport and Ross’ (1967) Religious Orientation Scale. Women reported significantly higher levels of death anxiety and extrinsic religiosity. Gender differences in extrinsic religiosity were partially explainable by gender differences in death anxiety. Also, gender differences in death anxiety could partially be explained by gender differences in extrinsic religiosity. This provides future research with some direction in the link between gender, religious orientation, and death anxiety. It also underscores recent arguments that religious motivations vary between cultures and groups.