Death Anxiety: A Cognitive-Behavioral Approach

Psychopathology is considered to be a maladaptive way of coping with fears of death.

“Regardless of whether fear of death is conscious or unconscious, psychopathology is considered to be a maladaptive way of coping with these fears”

The Death Anxiety Scale and the Collett-Lester Fear of Death Scale are the most widely used inventories in death anxiety research.

“The Death Anxiety Scale and the Collett-Lester Fear of Death Scale appear to be the most widely used inventories in death anxiety research”

Comorbid disorders commonly occur with death anxiety.

“comorbid disorders commonly occur with death anxiety (Furer & Walker, 2008).”

Death anxiety is considered to be a basic fear underlying the development, maintenance and course of numerous psychological conditions.

“Consequently, death anxiety is considered to be a basic fear underlying the development, maintenance and course of numerous psychological conditions”

Both theoretical knowledge and clinical observation suggest that the sense of bodily threat experienced in somatic symptom disorders, such as hypochondriasis and health anxiety, is related to a pathological fear of death.

“Both theoretical knowledge and clinical observation suggest that the sense of bodily threat experienced in somatic symptom disorders, such as hypochondriasis and health anxiety, is related to a pathological fear of death (Furer & Walker, 2008;Furer, Walker, & Stein, 2007;Starcevic, 2005).”

A large body of research has been dedicated to the study of death anxiety in non-clinical populations, and a number of consistent findings have emerged.

“A large body of research has been dedicated to the study of death anxiety in non-clinical populations, and a number of consistent findings have emerged”

Death anxiety is considered to be an integral construct in the assessment and treatment of hypochondriasis.

“Death anxiety is also considered to be an integral construct in the assessment and treatment of hypochondriasis (Furer & Walker, 2008;Hiebert et al., 2005;Noyes et al., 2002;Starcevic, 2005Starcevic, , 2007)).”

Individuals who met criteria for both panic disorder and hypochondriasis also reported higher levels of death anxiety than individuals who only met criteria for one disorder.

“and individuals who met criteria for both panic disorder and hypochondriasis also reported higher levels of death anxiety than individuals who only met criteria for one disorder (Furer & Walker, 2008;Furer et al., 1997).”

Death anxiety and existential concerns are considered to play an important role in panic disorder.

“Death anxiety and existential concerns are considered to play an important role in panic disorder (Furer & Walker, 2008;Randall, 2001;Starcevic, 2007;Torres & Crepaldi, 2002)”

Death anxiety appears to be a basic fear underlying a range of mental disorders, including hypochondriasis, panic disorder, separation anxiety, depression, and eating disorders.

“In support of Yalom's (1980) existential perspective, death anxiety appears to be a basic fear underlying a range of mental disorders, including hypochondriasis, panic disorder, separation anxiety, depression, and eating disorders (Becker, 1973;Furer & Walker, 2008;Greenberg, 2012;Starcevic, 1989;Strachan et al., 2007).”

CBT holds promise as a transdiagnostic treatment for death anxiety.

“This evidence confirms that CBT holds promise as a transdiagnostic treatment for death anxiety, and suggests the need for controlled studies to determine the efficacy of various CBT treatment strategies to reduce death anxiety (Furer & Walker, 2008).”

CBT for death anxiety in health anxiety and hypochondriasis appears to increase proximal and distal death defenses by improving life goals, enjoyment, and satisfaction and by developing a healthy lifestyle.

“Similarly, CBT for death anxiety in health anxiety and hypochondriasis also appears to increase proximal and distal death defenses by improving life goals/enjoyment/satisfaction and developing a healthy lifestyle, respectively (Furer & Walker, 2008;Hiebert et al., 2005).”

If certain unpleasant sensations are signals of fear of death, interoceptive exposure is used.

“If certain unpleasant sensations are signals of fear of death, interoceptive exposure is used [24].”

Since avoidance is a common way of dealing with the fear of death, CBT focuses a lot on exposure (in vivo or imaginal) allowing clients to face their fears.

“Since avoidance is a common way of dealing with the fear of death, CBT focuses a lot on exposure (in vivo or imaginal) allowing clients to face their fears.”

In vivo exposure includes reading obituaries, preparing a will, visiting cemeteries, hospices, funeral homes, etc., i.e., visiting places and engaging in activities directly related to death.

“In vivo exposure includes reading obituaries, preparing a will, visiting cemeteries, hospices, funeral homes, etc., i.e., visiting places and engaging in activities directly related to death.”

Imaginal exposure involves writing a story about different aspects of the client's own death or deaths of loved ones, about fears concerning death, pain, and suffering.

“Imaginal exposure involves writing a story about different aspects of client's own death or deaths of their loved ones, about fears concerning death, pain, suffering.”

There are few empirical studies on the psychological coping strategies of patients with advanced cancer whose death anxiety causes them psychological turmoil.

“However, there are few empirical studies on their psychological coping strategies.10”

Current treatment approaches for death anxiety include imaginal exposure for the death of a loved one or for one's own death, such as writing a detailed 'illness story'.

“Current treatment approaches for death anxiety include imaginal exposure for the death of a loved one, or for one's own death, such as in the form of a writing a detailed 'illness story' (e.g., Furer and Walker [41]).”

Furer and Walker (2008) explored the assessment and treatment of death anxiety from a broader cognitive-behavioral framework, indicating the theoretical importance of considering death anxiety in the context of cognitive-behavioral treatment.

“Furer and Walker (2008) explored the assessment and treatment of death anxiety from a broader cognitive-behavioral framework, indicating the theoretical importance of considering death anxiety in the context of cognitive-behavioral treatment.”