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Death Anxiety Scale

Chapter · January 2017

DOI: 10.1007/978-3-319-28099-8_21-1

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D

Death Anxiety Scale anticipation of future misfortune or danger. There

are many types of situations that induce anxiety,
ranging from participation in social gatherings,
Ahmed M. Abdel-Khalek1 and school examinations, or sexual encounters to exis-
Robert A. Neimeyer2 tential concerns related to mortality. The Death
1
University of Alexandria, Alexandria, Egypt Anxiety Scale (DAS), developed by Templer
2
University of Memphis, Memphis, TN, USA (1970) nearly 50 years ago, represents one classic
attempt to study the latter area. Still today, despite
sustained contributions to research and instrumen-
Synonyms tation in this field, it remains the most popular
measure of death attitudes in the literature.
DAS Kastenbaum stated: “the DAS has the distinctive
status as the first self-report questionnaire to have
gone through the mill of psychometric evaluation
Definition and correspondingly the instrument with the
broadest database.”
Death anxiety is a relatively stable personality The DAS consists of 15 statements, such as “I
trait referring to a negative attitude toward and am very much afraid to die,” “I fear dying a
negative affect and cognitions concerning death painful death,” and “The sight of a dead body is
and dying, whether of self or significant others, or horrifying to me.” The true/false format is the
the idea of death in general. It is most commonly original response option. However, a few
assessed using a simple 15-item self-report researchers have used the DAS with a modified
questionnaire using a Likert response format, answer format, most often a five-point Likert-type
although many revisions and extensions of the format with the anchors 1 (strongly disagree) to
measure have permitted a broader and more ade- 5 (strongly agree). In the scoring of the DAS, six
quate assessment of distress concerning human items are reverse scored to mitigate response bias,
mortality. with higher scores reflecting higher death anxiety.
Although the vast majority of research using
the DAS has been conducted in predominantly
Introduction English-speaking countries, the scale has been
translated into several different languages,
Anxiety is a universal human emotion, character- including Afrikaans, Arabic, Chinese, Dutch,
ized by feelings of worry, insecurity, tension, and Farsi, French, German, Hindi, Hmong, Italian,
# Springer International Publishing AG 2017
V. Zeigler-Hill, T.K. Shackelford (eds.), Encyclopedia of Personality and Individual Differences,
DOI 10.1007/978-3-319-28099-8_21-1
2 Death Anxiety Scale

Japanese, Korean, Portuguese, Russian, Spanish, items derived from Boyar’s (1964) scale. The
and Swedish (Templer et al. 2006). Its popularity current version of the RDAS consists of 25 items
derives in part from its brevity, straightforward answered on a five-point Likert scale. More
scoring (a simple tally of “anxious” responses), recently, Templer et al. (2006) constructed the
and clear name recognition, contributing to its use DAS-Extended. It consists of 51 items: the
in hundreds of studies (Neimeyer et al. 2003). 15 original DAS items plus 36 new items that
A host of studies have sought to investigate the were generated on a rational basis. It too has
scale’s associations with demographic variables good psychometric properties. However, the
such as age, sex, religion, personality, adjustment, large number of the items of the DAS-Extended
psychopathology (mainly anxiety and depres- may hamper its use.
sion), locus of control, ego strength, dogmatism,
self-concept, physical health, bodily concern,
somatization, occupation, death of significant Cross-Cultural Comparison on the DAS
others, and attitudes about euthanasia, among
other factors. To investigate the cross-cultural differences in
DAS scores, Lester et al. (2006–2007) identified
samples from 24 the United States (USA) and
Psychometric Properties 16 international studies. All participants were uni-
versity undergraduates. Strong sex differences
The DAS has good psychometric properties. It has were found, with women reporting greater death
a high 3-week test-retest reliability and acceptable anxiety. Further, the fear of death of the American
internal consistency. It has been found to be inde- female students increased from 1970 to 2003.
pendent of social desirability. There were two The majority of samples from the third world
initial validation procedures. In one, the names including the Arab samples obtained significantly
of state hospital patients who had voluntarily ver- higher mean DAS scores than did their Western
balized death anxiety concerns to chaplains or counterparts including Americans. In a similar
nurses were obtained. These patients were vein, the mean scores on the Death Obsession
matched with control patients on the basis of Scale for the Arabic participants from Egypt,
diagnosis, sex, and approximate age. They had a Kuwait, Lebanon, and Syria were higher than
significantly higher DAS score than did the con- those of their Western counterparts from Britain,
trol group. For the second procedure, the DAS Spain, and the USA. Although this difference
correlated significantly and positively with three could reflect cultural or religious factors that dis-
MMPI special anxiety scales but with lower cor- tinguish the two groups, it is also possible that the
relations than that with Boyar’s Fear of Death greater threat of military aggression or terrorism
Scale, thereby demonstrating its discriminant in the former countries could help account for the
validity (Templer et al. 2006). Studying Arabic greater anxiety and rumination about death in the
male and female undergraduates from Egypt, Arabic population.
Kuwait, and Lebanon, the Cronbach alpha
reliability coefficients of the DAS ranged between
acceptable and high: 70–0.85 (Abdel-Khalek The Effect of War on the DAS Scores
2002a).
In keeping with the above rationale, Abdel-
Khalek (2004) compared the DAS level among
Further Developments of the DAS different samples of Kuwait undergraduates at
seven-time points, the first in 1988 carried out
Thorson and Powell (1994) developed the before the Iraqi aggression and six further assess-
Revised Death Anxiety Scale (RDAS). They ments carried out after the liberation from that
combined the 15 items of the original DAS with aggression, i.e., between the years 1993 and
Death Anxiety Scale 3

2002. The aggression had taken place in 1990 and own death, the death of others, or death in general,
lasted for 7 months of armed occupation charac- Templer et al. (1990) developed the Death
terized by brutal treatment of Kuwaiti citizens, Depression Scale (DDS). In a similar vein, the
such as detention, torture, intimidation, assassina- Death Obsession Scale (DOS; Abdel-Khalek
tion, and kidnapping. There was a significant 1998) was developed to assess the amount of
increase in the DAS mean score directly after the preoccupation one has with death. The Reasons
aggression in comparison with that before it for for Death Fear Scale (RDFS; Abdel-Khalek
both sexes. For men, after the aggression, the 2002b) was specifically designed to answer the
mean DAS scores in 1993, 1995, and 1996 were question: “Why do we fear death?” Taken
significantly higher than that before the aggres- together, these and other measures permit a more
sion. With women, there were a number of comprehensive reading of death attitudes than
fluctuations. does the DAS taken alone.

Age and DAS Scores Suggested Studies

Many studies were carried out to investigate the The vast majority of death anxiety studies have
relation between death anxiety and age. It gener- been carried out in Western industrialized socie-
ally has been found that death anxiety decreases ties and with largely Christian or secular
from midlife to old age. However, death anxiety is populations. However, as Neimeyer et al. (2004)
higher for older adults who (a) have more physical observed, the emerging research on non-Western
health problems, (b) report a history of psycho- religions suggests that they may be characterized
logical distress, (c) have weaker religious beliefs, by distinctive forms of death anxiety, such as the
and (d) have lower ego integrity, life satisfaction, intense apprehension reported by many Muslims
or resilience (Fortner and Neimeyer 1999). regarding “the torture of the grave” (a special and
horrific set of punishments that can be exacted on
the sensate bodies of the dead according to
Related Constructs detailed passages in the Qur’an). Such findings
argue for much more culturally attuned research in
Although the DAS launched the study of death the future.
attitudes, several more recent measures have been
proposed and used by scholars to study reactions
to death that go beyond the global death anxieties Applications
that are the focus of Templer’s measure. On the
basis of George Kelly’s personal construct theory, Although the majority of studies on death atti-
the Threat Index (TI) was developed to measure tudes have been motivated by theoretical con-
the degree of challenge death poses to one’s con- cerns, there is ample evidence that such research
struing of self, complementing the focus on emo- has clear practical relevance. For example,
tional reactions that characterizes most other Neimeyer et al. (2004) reviewed a broad literature
death attitude instruments (Neimeyer et al. documenting the association of fear of death with
2003). Furthermore, based on a multidimensional numerous medical conditions and the discomfort
rational distinction, the Collett-Lester Fear of of many professional caregivers with situations
Death Scale (CLFD; Collett and Lester 1969) and patients triggering their personal anxieties
has been constructed to incorporate four sub- about death and dying, leading to their potential
scales: fear of death of self, fear of death of others, avoidance of those in their care. Perhaps most
fear of dying of self, and fear of dying of others. urgently, the death concerns reported by many
On the basis of the frequent mention of depres- patients at the end of life suggest the relevance
sion, sorrow, or sadness in connection with one’s of closely evaluating and discussing sources of
4 Death Anxiety Scale

anxiety, whether these reflect fear of a painful Abdel-Khalek, A. M. (2002a). Death, anxiety, and depres-
death, anxieties about the loss of attachments, or sion: A comparison between Egyptian, Kuwaiti, and
Lebanese undergraduates. Omega: Journal of Death
spiritual concerns. Recently, a resurgence of inter- and Dying, 45, 277–287.
est in the relation between death anxiety and psy- Abdel-Khalek, A. M. (2002b). Why do we fear death?: The
chopathology is yielding evidence that it may construction and validation of the Reasons for Death
even serve as a “trans diagnostic” factor deserving Fear Scale. Death Studies, 26, 669–680.
Abdel-Khalek, A. M. (2004). Does war affect death anxi-
attention in a great variety of mental and behav- ety level? Seven readings of measurements
ioral disorders, ranging from hypochondriasis and (1988–2002) before and after the Iraqi invasion of
obsessive-compulsive behavior to panic attacks Kuwait. Omega: Journal of Death and Dying, 49,
and depression (Iverach et al. 2014). If so, novel 287–297.
Collett, L. J., & Lester, D. (1969). The fear of death and the
interventions to reduce fear of death could prove fear of dying. Journal of Psychology, 72, 179–181.
beneficial to those who suffer from a wide range Fortner, B. V., & Neimeyer, R. A. (1999). Death anxiety in
of psychological problems. Though the DAS and older adults: A quantitative review. Death Studies, 23,
other measures of distress over mortality are 387–411.
Iverach, L., Menzies, R. G., & Menzies, R. E. (2014).
rarely used in hospitals and other relevant settings Death anxiety and its role in psychopathology:
(such as elder care facilities), their use alongside Reviewing the status of a transdiagnostic construct.
more commonly used measures of depression and Clinical Psychology Review, 34, 580–593.
anxiety could help focus clinical attention on this Lester, D., Templer, D. I., & Abdel-Khalek, A. M.
(2006–2007). A cross-cultural comparison of death
neglected dimension of patient concerns at the end anxiety. Omega: Journal of Death and Dying, 54,
of life. 255–260.
Neimeyer, R. A., Moser, R. P., & Wittkowski, J. (2003).
Assessing attitudes toward dying and death: Psycho-
metric considerations. Omega: Journal of Death and
Conclusion Dying, 47, 45–76.
Neimeyer, R. A., Wittkowski, J., & Moser, R. P. (2004).
The unique capacity of human beings to contem- Psychological research on death attitudes: An overview
plate their own mortality engenders not only a and evaluation. Death Studies, 28, 309–340.
Templer, D. I. (1970). The construction and validation of a
potential appreciation for the gift of life but also death anxiety scale. Journal of General Psychology, 82,
a potential sense of angst or dread regarding the 165–177.
specter of death. In more than 40 years of research Templer, D. I., Lavoie, M., Chalgujian, H., & Thomas-
on the Death Anxiety Scale and related measures Dobson, S. (1990). The measurement of death depres-
sion. Journal of Clinical Psychology, 46, 834–838.
demonstrating good validity and reliability, psy- Templer, D. I., Awadalla, A., Al-Fayez, G., Frazee, J.,
chologists have made a substantial and still grow- Bassman, L., Connelly, H. J., Arikawa, H., & Abdel-
ing contribution to the study of death attitudes, Khalek, A. M. (2006). Construction of a death anxiety
one that has moved from theoretical fascination scale – extended. Omega: Journal of Death and Dying,
53, 209–226.
toward practical relevance. Thorson, J. A., & Powell, F. C. (1994). A revised Death
Anxiety Scale. In R. A. Neimeyer (Ed.), Death anxiety
handbook (pp. 31–43). Washington, DC: Taylor &
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