The implications of death for health: a terror management health model for behavioral health promotion

This article introduces a terror management health model (TMHM). The model integrates disparate health and social psychology literatures to elucidate how the conscious and nonconscious awareness of death can influence the motivational orientation that is most operative in the context of health decisions. Three formal propositions are presented. Proposition 1 suggests that conscious thoughts about death can instigate health-oriented responses aimed at removing death-related thoughts from current focal attention. Proposition 2 suggests that the unconscious resonance of death-related cognition promotes self-oriented defenses directed toward maintaining, not one's health, but a sense of meaning and self-esteem. The last proposition suggests that confrontations with the physical body may undermine symbolic defenses and thus present a previously unrecognized barrier to health promotion activities. In the context of each proposition, moderators are proposed, research is reviewed, and implications for health promotion are discussed.     

Self-affirmation and mortality salience: affirming values reduces worldview defense and death-thought accessibility

To the extent that cultural worldviews provide meaning in the face of existential concerns, specifically the inevitability of death, affirming a valued aspect of one's worldview should render reminders of death less threatening. The authors report two studies in support of this view. In Study 1, mortality salience led to derogation of a worldview violator unless participants had first affirmed an important value. In Study 2, self-affirmation before a reminder of death was associated with reduced accessibility of death-related thoughts a short while thereafter. The authors propose that actively affirming one's worldview alters reactions to reminders of mortality by reducing the accessibility of death-related thoughts, not by boosting self-esteem. These studies attest to the flexible nature of psychological self-defense and to the central role of cultural worldviews in managing death-related concerns.     

Self-regulatory processes defend against the threat of death: Effects of self-control depletion and trait self-control on thoughts and fears of dying

Nine studies (N = 979) demonstrated that managing the threat of death requires self-regulation. Both trait and state self-control ability moderated the degree to which people experienced death-related thought and anxiety. Participants high (vs. low) in self-control generated fewer death-related thoughts after being primed with death, reported less death anxiety, were less likely to perceive death-related themes in ambiguous scenes, and reacted with less worldview defense when mortality was made salient. Further, coping with thoughts of death led to self-regulatory fatigue. After writing about death versus a control topic, participants performed worse on several measures of self-regulation that were irrelevant to death. These results suggest that self-regulation is a key intrapsychic mechanism for alleviating troublesome thoughts and feelings about mortality.     

Death, sex, love, and neuroticism: why is sex such a problem?

Terror management theory posits that sex is a ubiquitous human problem because the creaturely aspects of sex make apparent our animal nature, which reminds us of our vulnerability and mortality. People minimize this threat by investing in the symbolic meaning offered by the cultural worldview. Because people high in neuroticism have difficulty finding or sustaining meaning, sex is a particular problem for them. In Study 1, mortality salience caused high-neuroticism participants to find the physical aspects of sex less appealing. Study 2 revealed that for such individuals thoughts of physical sex increase the accessibility of death-related thoughts. This finding was replicated in Study 3, which also showed that providing meaning by associating sex with love reduces the accessibility of death-related thoughts in response to thoughts of physical sex. These findings provide insight into why people high in neuroticism have conflicting thoughts about sexuality and why sexuality is so often regulated and romanticized.     

Reports of My Death Anxiety Have Been Greatly Exaggerated: A Critique of Terror Management Theory from an Evolutionary Perspective

Although terror management theory's proponents claim that it is an evolutionary theory of human behavior, its major tenets are implausible when examined carefully from a modern evolutionary perspective. We explain why it is unlikely that natural selection would have designed a “survival instinct” or innate “fear of death,” nor an anxiety-reduction system in general, or worldview-defense system in particular, to ameliorate such fears. We argue that results of mortality-salience experiments are better explained as by-products of a psychological system of coalitional computation that evolved for a variety of functions, including defense against other humans, that is activated by certain kinds of death-related thoughts.     

Cancer and the threat of death: the cognitive dynamics of death-thought suppression and its impact on behavioral health intentions

Five studies examined the cognitive association between thoughts of cancer and thoughts of death and their implication for screening intentions. Study 1 found that explicit contemplation of cancer did not increase death-thought accessibility. In support of the hypothesis that this reflects suppression of death-related thoughts, Study 2 found that individuals who thought about cancer exhibited elevated death-thought accessibility under high cognitive load, and Study 3 demonstrated that subliminal primes of the word cancer led to increased death-thought accessibility. Study 4 revealed lower levels of death-thought accessibility when perceived vulnerability to cancer was high, once again suggesting suppression of death-related thoughts in response to conscious threats associated with cancer. Study 5 extended the analysis by finding that after cancer salience, high cognitive load, which presumably disrupts suppression of the association between cancer and death, decreased cancer-related self-exam intentions. Theoretical and practical implications for understanding terror management, priming and suppression, and responses to cancer are discussed.     

The role of control motivation in mortality salience effects on ingroup support and defense

Terror management research has shown that mortality salience (MS) leads to increased support and defense of cultural ingroups and their norms (i.e., worldview defense, WD). The authors investigated whether these effects can be understood as efforts to restore a generalized sense of control by strengthening one's social ingroup. In Studies 1-3, the authors found that WD was only increased following pure death salience, compared with both dental pain salience and salience of self-determined death. As both the pure death and the self-determined death conditions increased accessibility of death-related thoughts (Study 4), these results do not emerge because only the pure death induction makes death salient. At the same time, Study 5 showed that implicitly measured control motivation was increased in the pure death salience condition but not under salience of both self-determined death and dental pain. Finally, in Study 6, the authors manipulated MS and control salience (CS) independently and found a main effect for CS but not for MS on WD. The results are discussed with regard to a group-based control restoration account of terror management findings.     

Does the thought of death contribute to the memory benefit of encoding with a survival scenario?

Four studies tested whether the thought of death contributes to the survival processing advantage found in memory tests (i.e., the survival effect). In the first study, we replicated the “Dying To Remember” (DTR) effect identified by Burns and colleagues whereby activation of death thoughts led to better retention than an aversive control situation. In Study 2, we compared an ancestral survival scenario, a modern survival scenario and a “life-after-death” scenario. The modern survival scenario and the dying scenario led to higher levels of recall than the ancestral scenario. In Study 3, we used a more salient death-thought scenario in which people imagine themselves on death row. Results showed that the “death-row” scenario yielded a level of recall similar to that of the ancestral survival condition. We also collected ratings of death-related thoughts (Studies 3 and 4) and of survival-related and planning thoughts (Study 4). The ratings indicated that death-related thoughts were induced more by the dying scenarios than by the survival scenarios, whereas the reverse was observed for both survival-related and planning thoughts. The findings are discussed in the light of two contrasting views of the influence of mortality salience in the survival effect.     

The association between vivid thoughts of death and authenticity

Many theoretical perspectives link death-related thoughts to authenticity; however, there is little empirical research directly examining this association. The current studies examined how recalling a vivid experience associated with mortality relates to outcomes indicative of authentic engagement. In Study 1, participants described an experience that made them think about their mortality, indicated how vivid their recollection was, and completed measures of authenticity and goal-pursuit. Results indicated that how vividly a mortality experience was recalled predicted greater authenticity and more important goal-pursuits. Study 2 replicated many of the findings and found a similar pattern when individuals vividly recalled a mortality experience of a close other. Study 3 again replicated these results after controlling for a host of death-related variables. Exploratory analyses further revealed that ruminating about death was often negatively associated with authenticity. Implications for the role of death-related thoughts in authentic and alienated becoming are discussed.     

Exploring the effects of self-esteem and mortality salience on proximal and distally measured death anxiety: a further test of the dual process model of terror management

The dual process model of terror management theory posits that proximal and distal defenses prevent death-related cognition from leading to death-anxiety. Further, the theory identifies self-esteem as a trait level resource that helps people avoid the awareness of death-anxiety. However, to date, no studies have examined the proximal and distal effects of death-related cognition and self-esteem on death-anxiety. In the present study, we assessed trait self-esteem, manipulated the awareness of death (mortality salience), and measured death-anxiety either immediately (proximally) or after a delay/distraction task (distally). Mortality salience did not lead to increased death-anxiety immediately after the mortality salience, but did so after a delay. Furthermore, this distal increase in death anxiety was only observed at low levels of self-esteem.     

Death thoughts mediate ostracism mood reduction: The moderating role of marital status

Ostracism is known to cause psychological distress; however, it remains unclear why ostracism evokes this response. Two experiments tested empirically whether fear of death mediates ostracism distress (mood) and whether marital status moderates this role. A total of 345 participants played Cyberball with two other ostensible players. After the game, accessibility of death-related thoughts was assessed by a word completion task, and a mood questionnaire was used to measure their distress. Death thoughts fully mediated ostracism distress. Marital status moderated this mediation effect in that no moderation was observed in married participants, suggesting that marriage may buffer death anxiety. The discussion centers on the ways in which these findings contribute to the ostracism and terror management literature by providing empirical evidence that death thoughts mediate ostracism distress, and the moderating effects of marriage on this mediation effect.     

Existential function of babies: Babies as a buffer of death-related anxiety

The present study examined babies as death anxiety buffers with Chinese participants in three experiments. In Experiment 1, death-related thoughts increased college-aged participants' interest in human babies. In Experiment 2, images of newborn animals reduced the number of death-related thoughts recorded by college-aged participants. In Experiment 3, female factory workers who read news articles describing deaths of babies had pessimistic estimations of their own life expectancies. An explanation of these results is provided within a terror management theory framework, with a primary focus on how babies reinforce cultural worldviews and enhance self-esteem via the notion of symbolic immortality. Thus, the anxiety-buffering function of baby is subsumed under cultural worldviews validation and self-esteem enhancement.     

The Postself and Terror Management Theory: Reflecting on After Death Identity Buffers Existential Threat

In contemporary secular societies, ideas of an afterlife have become quite diverse, ranging from secular to religious and spiritual conceptions. In this article, an experimental study is reported in which the postself, a person's imagination of an after-death reputation, is tested as a protective buffer against mortality salience effects within a largely secular sample of participants. Before inducing mortality salience, the postself was affirmed or not affirmed. Results show that this reflection on personal continuity after death eliminates the effects of mortality salience on the accessibility of death-related thoughts. The discussion focuses on how the postself (the self will succeed death) relates to the more general concept of symbolic immortality (the self is part of a cultural worldview that will succeed death). Moreover, the relation between the postself and religiosity is discussed, and suggestions for future research are provided.     

Why do people need self-esteem? A theoretical and empirical review

Terror management theory (TMT; J. Greenberg, T. Pyszczynski, & S. Solomon, 1986) posits that people are motivated to pursue positive self-evaluations because self-esteem provides a buffer against the omnipresent potential for anxiety engendered by the uniquely human awareness of mortality. Empirical evidence relevant to the theory is reviewed showing that high levels of self-esteem reduce anxiety and anxiety-related defensive behavior, reminders of one's mortality increase self-esteem striving and defense of self-esteem against threats in a variety of domains, high levels of self-esteem eliminate the effect of reminders of mortality on both self-esteem striving and the accessibility of death-related thoughts, and convincing people of the existence of an afterlife eliminates the effect of mortality salience on self-esteem striving. TMT is compared with other explanations for why people need self-esteem, and a critique of the most prominent of these, sociometer theory, is provided.     

Structured Terror: Further Exploring the Effects of Mortality Salience and Personal Need for Structure on Worldview Defense

ABSTRACT Previous research indicates that people respond to heightened death‐related cognition with increased defense of predominant cultural beliefs (cultural worldview defense). However, recent research indicates that individual differences in personal need for structure (PNS) impact responses to threatening thoughts of death such that those high, but not low, in PNS respond to death thoughts by seeking a highly structured, clear, and coherent view of the world. Research has yet to fully consider the extent to which PNS affects the cultural worldview defenses typically exhibited after death is rendered salient. The current 3 studies examine the potential for PNS to determine the extent to which people respond to mortality salience with increased worldview defense. In all three studies PNS was measured and mortality salience induced. Subsequently, university‐related (Study 1) or religious (Studies 2 and 3) worldview defense was assessed. Only individuals high in PNS responded to mortality salience with increased worldview defense.     

A time to tan: proximal and distal effects of mortality salience on sun exposure intentions

According to the dual defense model of terror management, proximal defenses are engaged to reduce the conscious impact of mortality salience, whereas thoughts of death outside of conscious awareness motivate distal defenses aimed at maintaining self-esteem. Two experiments examined these ideas by assessing women's intentions to engage in tanning-related behavior. In Study 1, when concerns about death (relative to dental pain) were in focal attention, participants increased intentions to protect themselves from dangerous sun exposure. In contrast, when thoughts about death were outside of focal attention, participants decreased interest in sun protection. In Study 2, participants primed to associate tanned skin with an attractive appearance responded to mortality concerns outside of focal attention with increased interest in tanning products and services. These findings are discussed in relation to the dual-defense model of terror management, societal determinants of self-esteem, and implications for health risk and promotion.     

Death as a counseling concern

Both the professional and the popular attention now given to the topic of death and issues reflecting a death theme indicate that these areas can be of great concern to many of the individuals served by counselors. If counselors are going to respond to these concerns, they must prepare by investigating the available information on death and related topics, exploring their own feelings and beliefs about these same areas, and developing an initial foundation for providing service to clients who are manifesting a problem that is death-related.     

Culturally divergent responses to mortality salience

Two experiments compared the effects of death thoughts, or mortality salience, on European and Asian Americans. Research on terror management theory has demonstrated that in Western cultural groups, individuals typically employ self-protective strategies in the face of death-related thoughts. Given fundamental East-West differences in self-construal (i.e., the independent vs. interdependent self), we predicted that members of Eastern cultural groups would affirm other people, rather than defend and affirm the self, after encountering conditions of mortality salience. We primed European Americans and Asian Americans with either a death or a control prime and examined the effect of this manipulation on attitudes about a person who violates cultural norms (Study 1) and on attributions about the plight of an innocent victim (Study 2). Mortality salience promoted culturally divergent responses, leading European Americans to defend the self and Asian Americans to defend other people.     

Thomson and the current state of the abortion controversy

ABSTRACT Many philosophers who wish to defend abortion, but who have become frustrated by the resistance of the personhood question to yield to any nonarbitrary solution welcomed Judith Thomson's 'A defense of abortion.'Thomson argues that abortion is sometimes justifiable even if the foetus is a person. In this paper I argue that Thomson's argument is a defense of abortion, rather than merely extraction without death, only because of the current state of medical technology. Once the technology is in place to extract foetuses while preserving their lives and to allow them to develop to full term outside the uterus, Thomson cannot defend the killing of the foetus. If she is right, however, a woman will still have the right to have a foetus extracted from her body. Finally, it is pointed out that the source of the problem with Thomson's argument is the major premise in most arguments for the permissibility of abortion: a woman's right to control her own body. If the defence of abortion is to entail a defence of the termination of the foetus, then this premise, understood as the right to remove an unwanted entity from one's body or the right to alter one's body as one wishes, simply will not do the trick.     

Mortality salience and the desire for offspring

Research on terror management theory (TMT) illustrates that following mortality salience (MS) people defend their cultural worldviews and bolster self-esteem to transcend death. Recently, research additionally showed that MS increased self-reports of the number of children desired in Dutch men but not in Dutch women. We conducted three studies to further investigate the role of desire for offspring in terror management. In Study 1, we conceptually replicated previous findings for Germany and found increased desire for offspring following MS in both men and women. Extending prior research Study 2 revealed that following MS not only was the accessibility of death-related thoughts increased, but also the accessibility of thoughts related to offspring. Finally, Study 3 suggested that the MS effect on ingroup bias was eliminated under conditions of offspring salience. Relating these findings to TMT, anticipated or actual offspring is discussed as a buffer against existential anxiety.