Cited by 124Death Anxiety and Social ExclusionCOVID-19 and Mental HealthSocial and Intergroup Psychology

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

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Courtney, Emily P., Goldenberg, Jamie L., Boyd, Patrick·2020·British Journal of Social Psychology

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Abstract

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

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Method
The Association of Restrained Eating and Overeating during COVID-19: A Cross-Lagged Model
Cui, Y.-C., Liu, X.-Y., Xiang, G., Li, Q.-Q., Xiao, M.-Y., & Chen, H. (2021) · Nutrients · doi:10.3390/nu13124535 · Cited by 7
“From the perspective of the terror management health model, individuals would reduce the perceived vulnerability to health threat by displaying a health-oriented response [23].”
Background
The influence of fear of isolation on contact experience disclosure: Evidence from safety management of the COVID ‐19 pandemic
Lu, H., Duan, J., Wu, T., Zhou, B., & Xu, C. (2022) · Asian Journal Of Social Psychology · doi:10.1111/ajsp.12527 · Cited by 7
“They are more likely to show avoidance behaviours, such as denying the possibility of being infected (Courtney et al., 2020) or exhibiting selfinterested behaviours (Ahmed et al., 2021) to reduce their self-anxiety.”
Background
The macropsychology of COVID-19: Psychological governance as pandemic response.
McVeigh, J., & MacLachlan, M. (2021) · American Psychologist · doi:10.1037/amp0000909 · Cited by 6
An existential perspective on interpersonal closeness and social distancing during the COVID-19 pandemic
Fairlamb, S., & Courtney, E. P. (2022) · Psychology and Health · doi:10.1080/08870446.2022.2129052 · Cited by 7
“The social distancing findings support the idea that proximal health-related responses to death can become distal defenses if they become embedded within cultural worldviews (Courtney et al., 2020).”
BackgroundInfluentialSelf-citation
Looking for your cross‐group friends after the breakout? Children's intergroup contact behaviours before and after the onset of COVID ‐19
Bağci, S. Ç., Yalcin, F. T., Türnüklü, A., Vezzali, L., Tercan, M., & Yilmaz, A. D. (2022) · British Journal of Social Psychology · doi:10.1111/bjso.12616 · Cited by 6
“…more strongly with their ingroup and embracing strict group-based ideologies, which are in turn associated with increased prejudice and xenophobia directed towards vulnerable minority groups (see also Terror Management Theory, Courtney et al., 2020; Fritsche et al., 2013; Pyszczynski et al., 2021).”
BackgroundInfluential
Ma(r)king The Unthinkable: Cultural and Existential Engagements of Extreme Historical Violence
Varga, B. A., & van Kessel, C. (2021) · Journal of Curriculum Theorizing · doi:10.63997/jct.v36i2.985 · Cited by 6
Facing a real threat of death: dynamic changes in death-thought accessibility
Zhou, J., Chen, Y., Xu, Y., Liao, B., & Fu, W. (2022) · Psychology Research and Behavior Management · doi:10.2147/prbm.s361432 · Cited by 5
College Students’ Experiences of Freedom, Isolation, Meaninglessness, and Death: A Qualitative Examination
Brown, M. E., Alliegro, M. C., & Prince, M. A. (2023) · Journal of Humanistic Psychology · doi:10.1177/00221678231210153 · Cited by 5
“Courtney et al. (2020) labeled the COVID-19 virus as a global contagion of mortality that affected every human being.”
The relationship between the COVID-19 pandemic and environmental attitudes and what this means for environmental justice
Marais-Potgieter, A., & Thatcher, A. (2022) · Psychology in society · doi:10.57157/pins2022vol64iss1a5457 · Cited by 5
“The COVID-19 pandemic has personally affected every human being (Courtney et al, 2020) with the potential to change the existential path of individuals (Tomaszek & Muchacka-Cymerman, 2020), perception of risk (Cori et al, 2020), and degrees of concern about environmental issues (Schiller et al,…”
Background
Beyond Wishful Thinking during the COVID-19 Pandemic: How Hope Reduces the Effects of Death Arousal on Hostility toward Outgroups among Conservative and Liberal Media Users for COVID-19 Information
Lee, J., Kim, Y., & Kelsey, J. P. (2021) · Health Communication · doi:10.1080/10410236.2021.1921906 · Cited by 5
“Daily COVID-19 death toll reports from news and health organizations have emphasized the growing risks of the virus and heightened death awareness among people around the world (Courtney et al., 2020; Greenberg & Solomon, 2020).”
Background
Proactive personality, social support and post-traumatic growth caused by COVID-19: mediating effect meaning in life in China
Yao, Y., Wang, P., Zhao, K., Li, Q., & Li, Y. (2024) · BMC Psychology · doi:10.1186/s40359-024-02156-z · Cited by 7
The Role of Existential Concerns in the Individual’s Decisions regarding COVID-19 Vaccine Uptake: A Survey among Non-Vaccinated Italian Adults during the Third Wave of the Pandemic
Franchina, V., Bonfanti, R. C., Coco, G. L., & Salerno, L. (2022) · Vaccines · doi:10.3390/vaccines10071079 · Cited by 8
“Moreover, previous studies showed that the pandemic is linked with increased ECs [33], which may afterwards affect health-related decisions about COVID-19, such as being vaccinated [32].”
Background
Terror Management: The Effects of Mortality Salience on Desire for Money Among Singaporeans
Chew, P. K. H., Danni, B., Koh, S. Y., & Tay, G. M. S. (2023) · Journal of Humanistic Psychology · doi:10.1177/00221678231203513 · Cited by 4
“Given the severity of the pandemic, researchers have argued that it could act as a form of persistent and prolonged mortality salience (Courtney et al., 2020; Pyszczynski et al., 2021).”
Have the effects of Covid‐19 been overcome? Levels of Covid‐19 fear, Covid‐19 anxiety and hopelessness in young adolescents: A structural equation modeling
Sarman, A., & Tuncay, S. (2024) · Journal of Child and Adolescent Psychiatric Nursing · doi:10.1111/jcap.12458 · Cited by 4
Do Pandemics Trigger Death Thoughts?
Leung, H.-T., Chew, P. K. H., & Caltabiano, N. J. (2024) · Journal of Humanistic Psychology · doi:10.1177/00221678241273422 · Cited by 3
Changes in Chinese early adolescents’ group orientation and mental health from before to during the COVID-19 pandemic
Han, X., Xia, Y., Yang, P., Li, D., Ding, X., Zhang, R., & Zhang, M. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1093128 · Cited by 3
“, 2013), which could decrease the value of the universalism aspect (concern for welfare of all) of selftranscendence (Courtney et al., 2020).”
Background
A Study of Children’s Culture across 35 Societies
Messner, W. (2023) · Journal of International Consumer Marketing · doi:10.1080/08961530.2023.2268274 · Cited by 5
“In contrast, individualistic children are “first and foremost concerned about protecting their own systems of meaning” (Courtney, Goldenberg, and Boyd 2020, p. 611); they are on their own, lacking good friends, do not feel safe in their environment, and do not receive sufficient and caring support.”
Background
Wanderlust to wonderland? : Exploring key issues in expatriate careers: Individual, organizational, and societal insights
Abdul Hadi, A., Andresen, M., Barzantny, C., Bassetto, J., Biswas, T., Bozhinoska Lazarova, M., Dickmann, M. H., Enser, D., Escobar Borruel, I., Freitas Monteiro, T., et al. (2022) · Personalmanagement und Arbeits- und Organisationspsychologie · doi:10.20378/irb-55344 · Cited by 4
Exploring the Existential Implications of COVID-19 in Health Communication
Harvell-Bowman, L. A. (2023) · American Behavioral Scientist · doi:10.1177/00027642231164052 · Cited by 3
“Courtney et al. (2020) offer a revised model of the TMHM for pandemics.”
Evidence-inclusive communication: steering crisis leadership outcomes in Portugal, Brazil, New Zealand, and the US
Donadelli, F., Luczak–Roesch, M., Fischer, R. D., & Li, N. (2023) · International Review of Public Administration · doi:10.1080/12294659.2023.2246738 · Cited by 3
The effects of COVID-19 pandemic and auditor-client geographic proximity on auditors' going concern opinions
Wang, Y., Chiu, T., & Kogan, A. (2024) · International Journal of Disclosure and Governance · doi:10.1057/s41310-024-00254-3 · Cited by 3
“Although several studies have argued that focusing solely on mortality could neglect the impact of morbidity (Zylke and Bauchner 2020), people’s behaviors in response to the pandemic are determined primarily by their awareness and fear of death (Courtney et al. 2020).”
Differences in proximal and intimacy-related defense mechanisms among patients with cancer in different psychological stages of dying
Zhou, J., Li, M., Dong, J., Shi, H., & Shi, M. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1329043 · Cited by 2
“Winters (2022) also suggested that psychological changes lead to a disruption of one’s physical and mental balance and predisposition to autoimmune diseases, which can have adverse effects on cancer treatment, recovery, and social stability (Grossman et al., 2018; Courtney et al., 2020).”
Background
Positive Affect Predicted Death Anxiety in Health Workers during the Covid-19 Pandemic
Ruini, C. (2023) · Psychology & Psychological Research International Journal · doi:10.23880/pprij-16000364 · Cited by 4
Motiver la population à se protéger : le cas du premier confinement en France
Laporte, M.-È., & Berger‐Remy, F. (2024) · Revue internationale de Psychosociologie · doi:10.3917/rips1.080.0035 · Cited by 1
Fear of monkeypox and intention to vaccinate against monkeypox: a network analysis
Caycho‐Rodríguez, T., Ventura‐León, J., Carbajal‐León, C., Vilca, L. W., Gallegos, M., Delgado-Campusano, M., Noé-Grijalva, M., Toia, Á. M. D. C., Barria‐Asenjo, N. A., Torales, J. C., et al. (2024) · Medicina Clínica y Social · doi:10.52379/mcs.v8i2.403 · Cited by 2
“This finding can be explained by the Terror Management Health Model (54), where people who experience fearful states, which generate sleep problems, can cope with proximal, direct, and rational defenses that eliminate the dangerous stimulus, in this case the Monkeypox vaccination.”
Background
Pandemics and Resiliency: Psychometrics and Mental Models
Tallapragada, M. (2021) · Risk, systems and decisions · doi:10.1007/978-3-030-77344-1_5 · Cited by 2
Knowledge Versus Terror: Knowledge Transfer to Address the Terrorist Threat to the Smart City
Dayan, R. (2024) · Advanced sciences and technologies for security applications · doi:10.1007/978-3-031-68542-2_4 · Cited by 3
Potential Implications and Applications of Terror Management Theory for Library and Information Science
Hollister, J. M., Lee, J., Elkins, A. J., & Latham, D. (2020) · Journal of the Korean Society for Library and Information Science · doi:10.4275/kslis.2020.54.4.317 · Cited by 2
Introduction to the special issue: forms and effects of 'distancing' on consumer behaviors and business practices: towards coping strategies and new consumption trends in a pandemic context
Batat, W. (2021) · Journal of Marketing Management · doi:10.1080/0267257x.2022.2046135 · Cited by 2
“…research contributes to prior works on coping strategies (e.g. Jonas & Fischer, 2006; Landau et al., 2006) by empirically categorizing the coping mechanisms adopted by consumers while social distancing, and thus explaining the role of death anxiety in response strategies (Courtney et al., 2020).”
Background
Using narrative 360° video as a tool to promote breast self-examination
Farmer, H., Skoulikari, E. A., Bevan, C., Gray, S. I., Cater, K. F., & Fraser, D. S. (2024) · Virtual Reality · doi:10.1007/s10055-023-00918-5 · Cited by 5
“Indeed, Fairlamb (2021) demonstrates a strong link between the daily number of COVID cases and deaths and DTA within a UK population, while other researchers have highlighted the relevance of terror management theory in the COVID pandemic (Courtney et al. 2020; Pyszczynski et al. 2021).”
Resilience in the Face of Crisis: A Literary Exploration of Pandemic Novels (Remnants of Resiliency and Survival: A Thematic Analysis on Pandemic Novels)
Quezon Avenue, I. C., Eslit, E. R., & Villanueva, P. A. (2024) · International Journal of Social Science and Human Research · doi:10.47191/ijsshr/v7-i02-32 · Cited by 1
Virus-Encoded MicroRNAs Reveal How Ranavirus Interacts with Amphibian Immune Defense
Yang, A. (2024) · Journal of Biomedical Science and Engineering · doi:10.4236/jbise.2024.1710014 · Cited by 1
Constructing a Conformer–Explorer Identity in Pandemic Narratives: A Qualitative Study of Chinese Emerging Adults
Liu, Y., Zhu, W., & Fa-wen, H. (2024) · Qualitative Health Research · doi:10.1177/10497323241280394 · Cited by 1
Human dimensions in water crisis management: Gender bias in water manager appraisals and implications for water decision-making
Smith, L. K. M., Bergsieker, H. B., & Wolfe, S. E. (2025) · PLOS Water · doi:10.1371/journal.pwat.0000460 · Cited by 1
“First, MS may have been influenced by study recruitment timing (2021–2022), amid an ongoing pandemic, recognized as a society-wide mortality reminder [134,135].”
Fear in Public Policy Compliance: Citizens' Response to Crisis‐Induced Policies
Ladi, S., Gardiner, K., Angelou, A., & Panagiotatou, D. (2026) · European Policy Analysis · doi:10.1002/epa2.70039 · Cited by 1
Applying Terror Management Theory to Explain International Faculty Responses to COVID-19 Control Measures
Kuzhabekova, A. (2023) · Journal of Studies in International Education · doi:10.1177/10283153221150112 · Cited by 1
“These defenses are not directly addressing death, but they increase the sense of meaning of one ’ s life and enhance the feeling of literal or symbolic immortality (Courtney et al., 2020).”
BackgroundMethod
Anxiety and Brand Topic Searches During COVID-19: The Mediating Role of Vaccination Behavior
Wang, T. H. (2023) · Social Behavior and Personality An International Journal · doi:10.2224/sbp.12417 · Cited by 1
Being a good citizen in pandemics – compliance to social distancing and prosociality following death reminders
Leung, H.-T., Chew, P. K. H., & Caltabiano, N. J. (2023) · Current Psychology · doi:10.1007/s12144-023-05474-4 · Cited by 1
“These health-related behaviours could also be appreciated as TMT defence mechanisms aimed at regulating anxiety arising from an innate need for self-preservation in the face of death threats (i.e., pandemics) (Courtney et al., 2020; Pyszczynski et al., 2021).”
Influential
Beyond the watery grave: death and water reminders as (un)expected ways to increase environmental identity / Más allá de la tumba acuática: recordatorios de muerte y agua como formas (in)esperadas para fomentar la identidad ambiental
Smith, L. K. M., & Wolfe, S. E. (2025) · PsyEcology Bilingual Journal of Environmental Psychology · doi:10.1177/21711976241309249 · Cited by 1
“UU. y Canadá alrededor de marzo de 2020 (Courtney et al., 2020; Pyszczynski et al., 2021).”
The Mediating Role of Existential Anxiety and Conspiracy Beliefs in the Relationship between Fear of Covid-19 and the Intention to Get Vaccinated in the Iranian PopulationPreprint
Mahmoodi, H., & Payghambari, S. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3967279 · Cited by 2

Authors: Courtney, E. P., Goldenberg, J. L., & Boyd, P.
Affiliations: University of South Florida (US)
National Institutes of Health (US)
Corresponding author: Courtney, Emily P.
ORCID: Courtney, Emily P.
Goldenberg, Jamie L.
Boyd, Patrick
Venue: British Journal of Social Psychology
Publisher: Wiley
Published: 2020-06-17
Volume: 59
Issue: 3
Pages: 607-617
ISSN: 0144-6665 (ISSN-L)
2044-8309
DOI: 10.1111/bjso.12392
PMC: PMC7323320
OpenAlex: W3035864377
Cited by: 124
References: 29
Citations by year: 2026: 6 · 2025: 7 · 2024: 15 · 2023: 20 · 2022: 29 · 2021: 39 · 2020: 8
FWCI: 26.22
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: British Journal of Social Psychology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Health and Human Services
National Institutes of Health
National Cancer Institute
Topics: Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
Keywords: terror management theory, COVID-19 pandemic, death awareness, psychological threat, ideological frameworks, symbolic meaning, collective mindset, pandemic preparedness, public health behavior
MeSH terms: Betacoronavirus, COVID-19, SARS-CoV-2, Defense Mechanisms, Denial, Psychological, Fear, Health Promotion, Humans, Pneumonia, Viral, Self Concept, Coronavirus Infections, Risk Reduction Behavior, Health Communication, Pandemics

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

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