A systematic review of the psychometric properties of death anxiety self-report measures.

Recent research suggests that the transdiagnostic construct of death anxiety may be a basic fear underlying a range of anxiety disorders. Although the investigation of death anxiety in clinical populations is relatively recent, the death anxiety literature as a whole has a longer history evidenced by the number of instruments developed to measure this construct. This systematic review aimed to evaluate the evidence supporting the psychometric properties of self-report death anxiety measures. Relevant studies were identified via a systematic search of four electronic databases in addition to reference list searches. Two independent reviewers evaluated relevant studies using the established Terwee et al. quality appraisal tool. Of the 1831 studies identified, 89 met inclusion criteria. These studies investigated the psychometric properties of 21 self-report scales of death anxiety as well as six subscales. No measure was found to possess evidence of adequacy on all evaluated quality criteria. The Templer Death Anxiety Scale, Concerns about Dying Instrument and Death Concern Scale were found to possess the most evidence supporting their validity and reliability. Overall findings suggest that additional research is needed to establish the psychometric adequacy of death anxiety instruments, especially given increased utilization of these measures in both clinical and research settings.

Are anxiety disorders a pathway to obsessive-compulsive disorder? Different trajectories of OCD and the role of death anxiety.

OBJECTIVES: A body of research has demonstrated high rates of comorbidity among individuals with obsessive-compulsive disorder (OCD). Further, recent empirical evidence has demonstrated the relevance of death anxiety in OCD. Given that the trajectory towards OCD remains unclear, the current study aimed to examine which disorders individuals typically experience prior to the onset of this disorder. Further, the study aimed to explore the role of death anxiety in the developmental pathways to the disorder. METHODS: The present study involved administering a measure of death anxiety and conducting structured diagnostic interviews among a treatment-seeking sample of 98 individuals with OCD. RESULTS: First, the findings revealed a number of anxiety-related disorders commonly experienced prior to the development of OCD, the most frequent of which were separation anxiety disorder, specific phobias, and generalised anxiety disorder. Second, consistent with hypotheses, individuals with higher death anxiety experienced more disorders prior to the onset of OCD. Conversely, those with lower fears of death were significantly more likely to develop OCD as their first disorder. CONCLUSIONS: These findings support the argument that death anxiety may influence the trajectory towards OCD, and the comorbidity among anxiety-related disorders. However, further research is needed to clarify whether death anxiety plays a causal role in this trajectory.

The effects of psychosocial interventions on death anxiety: A meta-analysis and systematic review of randomised controlled trials.

Death anxiety has been proposed as a transdiagnostic construct, underlying numerous mental disorders. Although it has been argued that treatments, which reduce death anxiety, are needed, research investigating the impact of interventions on death fears has produced mixed results. As such, the current meta-analysis aimed to examine the effect of psychosocial interventions on death anxiety. Overall, results from 15 randomised controlled trials suggested that psychosocial treatments produced significant reductions in death anxiety, with a small to medium effect size (g = .45). Intervention type (death education vs. therapy) did not significantly moderate the effect of intervention on death anxiety (g = -.47). However, therapy type was a significant moderator of treatment efficacy (g = -1.39). Cognitive Behaviour Therapy was found to be particularly efficacious, producing significant reductions in death anxiety relative to control (g = 1.7), whereas other therapies did not (g = .20). The number of treatment sessions and baseline death anxiety significantly moderated intervention efficacy, whereas the duration of the intervention, training of the interventionist, and clinical nature of the sample did not. Given the small number and generally low quality of the included studies, future research using more rigorous methodology, as well as clinical samples, is needed.