Fear and Compassion: A Terror Management Analysis of Emotional Reactions to Physical Disability.

Objective: To examine whether death anxiety underlies emotional reactions toward people with disabilities (PWDs). Study Design: In Study 1, participants were primed with thoughts of death, read a vignette describing a PWD, and completed a compassion scale. Study 2 replicated the design of Study 1 and also examined the impact of target ethnicity. Studies 3 and 4 assessed the impact of physical disability on death-related cognitions and on fear of personal death. Results: Men reacted to death primes by emotionally withdrawing from a PWD and reporting less compassion, whereas women exhibited more compassionate responses. These differences in compassion were reflected in the death-related cognitions and fears sparked by physical disability. Conclusions: The human need to manage the terror of death shapes emotional reactions toward PWDs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Oral sedation

"I fear a trip to the dentist more than I fear death" is the response one person gave in a national survey recently cited in USA Today. While clearly representing an extreme, the results of many surveys suggest that fear of dentistry is still prevalent and is a measure of the failure of current therapeutic approaches to reduce pain and anxiety sufficiently to enable people, especially those with special needs, to visit the dentist. Patients who are fearful would likely seek oral health care more regularly if anesthesia and sedation were more readily available. Taking into consideration that the safety of anxiolytic drugs is highly dependent on the drug, dose, and route of administration used, oral premedication should be the sedative technique used by most dentists because it is efficacious, requires little monitoring when appropriate doses are used, and is unlikely to result in serious morbidity.     

Arthrodesis of the shoulder for synovial osteochondromatosis

OBJECTIVES: To identify the reasons for non-compliance with fecal occultblood test in the screening programme for colorectal cancer. DESIGN AND SETTING: The people who had never participated in the screening programme for colorectal cancer served as the subjects of this study. A structured questionnaire which included the reasons for rejection was sent to each of non-compliers. They were requested to choose two major reasons which were described in a best way that why they did not participate in the programme. The frequency of the stated reasons were analysed from the viewpoint of both sex and age effects. MAIN RESULTS:A total of 439 people was identified as non-compliers, and 356 (81.1%) people completed the questionnaire. No significant difference was noted in response to the questionnaire between male and female as well as aged 40-59 and those 60-79. The most commonest reason was felt well (47.8%) in male, fear or shyness of further examination (40.2%) in female, and also felt well (48.5%) in aged 40-59, fear or shyness of further examination (40.1%) in aged 60-79. Significant differences were observed in the frequencies of felt well (p<0.01), fear or shyness of further examination (p<0. 01), busy for work (p<0.01) and fear of cancer (p<0.01) between male and female, and also felt well (p<0.01), fear or shyness of further examination (p<0.01), busy for work (p<0.01) and coexistent disease (p<0.01) between aged 40-59 and those 60-79. CONCLUSIONS: These results suggest that public education about the concept of asymptomatic illness, the benefits of early detection, the safety and painless colonoscopy, and the effective treatment should be emphasised to increase compliance with screening for fecal occult blood.     

Death of One's Partner: The Anticipation and the Reality.

The loss of a chosen partner is, for many people, one of the most tragic events that can occur. The severity of the sense of loss and grief is contingent on length of marriage/relationship, age of partner and of their children, whether the partner's death was sudden or followed a long illness, socioeconomic status, existence of a support network, and whether the relationship was predominantly happy or discordant. This article explores the fear about and reactions to death of a partner. It is based on over 35 years of clinical practice and draws on myriad observations about how family, friends, and patients perceive and cope with this life-altering event. Case illustrations are used, and interventions are highlighted to provide a possible template for clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward understanding why fairness matters: The influence of mortality salience on reactions to procedural fairness.

This article focuses on the question of why fairness matters to people. On the basis of fairness heuristic theory, the authors argue that people especially need fairness when they are uncertain about things that are important to them. Following terror management theory, the authors focus on a basic kind of human uncertainty: fear of death. Integrating these two theoretical frameworks, it is proposed that thinking about their mortality should make fairness a more important issue to people. The findings of three experiments support the authors' line of reasoning: Asking participants to think about their mortality led to stronger fair process effects (positive effects of perceived procedural fairness on subsequent reactions) than not asking them to think about mortality. It is argued that these findings suggest that fairness especially matters to people when they are uncertain about fundamental aspects of human life such as human mortality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spiritual values and death anxiety: Implications for counseling with terminal cancer patients.

Investigated death fear as a function of discomfort level, previous experience with death, and religiosity among indigent cancer patients in a county general hospital. The patients were those participants in a cancer rehabilitation program who were judged closest to death. The Allport Religious Orientation Scale, Discomfort Indices, and the Death Anxiety Scale (DAS) were administered to each patient. Patients also participated in a structured interview which examined death fear at the conscious and imagery (unconscious) levels, religious values, and support systems. The DAS was also administered to a standardization sample of outpatients in the eye clinic of the same hospital. Results indicate that these patients depend strongly on perceived strength of religious beliefs and integral religious values in their coping with imminent death. Also highly associated with minimal or low fear of death was previous experience with a dying person with whom one had a close relationship. The mean DAS score for the cancer patients was significantly lower than that obtained for the standardization population. These findings reveal sources of support that are very important to this population and that are suggestive of untapped resources available as appropriate intervention avenues. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multidimensional treatment of fear of death.

Conducted research to provide a multidimensional conceptualization of fear of death and to develop a factor analytic scale for its measurement. Questionnaire data were collected from 375 undergraduates. Based on previous work and the results of factor analysis, 8 fear of death dimensions are proposed: fear of the dying process, fear of the dead, fear of being destroyed, fear for significant others, fear of the unknown, fear of conscious death, fear for body after death, and fear of premature death. The mean reliability coefficient for the proposed subscales was .75. Some initial evidence for construct validity was presented by a test of one aspect of the theoretically expected relation between fear of death and religiosity. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three processes of dying and their behavioral effects.

Differing processes underlying dying may serve to clarify the behavior of those facing death. From the study of groups who were dying differently, three major processes are delineated, each with its own behavioral effect. Marked differences in interpersonal transactions occurred depending upon which process of dying was operative, that is, (a) the existence of death, (b) the presence of death, or (c) the presentment of death. The presentment of death gives rise to patient-nursing-staff-family behavior that is characterized by acts of aggression, negativism, and withdrawal. Such a process enables a "blind" to be established between patient and those concerned that is increasingly disruptive and maladaptive. Suggestions are made concerning an approach to more meaningful communication with those dying. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Retributive and utilitarian motives and other correlates of Canadian attitudes toward the death penalty.

An in-depth survey of 144 English Canadian adults examined the motives behind, and other social psychological correlates of, attitudes toward capital punishment. The results suggested that for a substantial percentage of people the motive of retribution may be more important than deterence as a reason for favoring the death penalty. Other findings indicated that the more strongly people favored the death penalty, the more likely they were to score high on measures of authoritarianism, punitiveness, dogmatism, and prejudice. They were also more likely to be older and less educated. The hypothesis that people who felt threatened by crime would be more likely to favor capital punishment received equivocal support. Both theoretical and practical applications of the data are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is death really the worm at the core? Converging evidence that worldview threat increases death-thought accessibility.

According to terror management theory, if the cultural worldview protects people from thoughts about death, then weakening this structure should increase death-thought accessibility (DTA). Five studies tested this DTA hypothesis. Study 1 showed that threatening Canadian participants' cultural values (vs. those of another culture) increased DTA on a word-fragment completion task. Study 2 showed that when participants could dismiss the threat, DTA remained low. Study 3 replicated the results of Study 1, but DTA was measured using a lexical decision task. Response latencies to death, negative, and neutral content were measured. Worldview threat increased DTA relative to accessibility for negative and neutral content. Study 4 showed that the DTA effect emerged independently of the arousal of anger or anxiety. Finally, Study 5 demonstrated that participants with a pro-creation (vs. pro-evolution) worldview had higher DTA after reading an anti-creation article. Discussion focused on theoretical implications and directions for further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fear, anger, and risk.

Drawing on an appraisal-tendency framework (J. S. Lerner & D. Kelmer, 2000), the authors predicted and found that fear and anger have opposite effects on risk perception. Whereas fearful people expressed pessimistic risk estimates and risk-averse choices, angry people expressed optimistic risk estimates and risk-seeking choices. These opposing patterns emerged for naturally occurring and experimentally induced fear and anger. Moreover, estimates of angry people more closely resembled those of happy people than those of fearful people. Consistent with predictions, appraisal tendencies accounted for these effects: Appraisals of certainty and control moderated and (in the case of control) mediated the emotion effects. As a complement to studies that link affective valence to judgment outcomes, the present studies highlight multiple benefits of studying specific emotions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age and gender differences in cardiac reactivity and subjective emotion responses to emotional autobiographical memories.

This research reports age and gender differences in cardiac reactivity and subjective responses to the induction of autobiographical memories related to anger, fear, sadness, and happiness. Heart rate (HR) and subjective state were assessed at baseline and after the induction of each emotion in 113 individuals (61 men, 52 women; 66% European American, 34% African American) ranging in age from 15 to 88 years (M = 50.0; SD = 20.2). Cardiac reactivity was lower in older individuals; however, for anger and fear, these age effects were significantly more pronounced for the women than the men. There were no gender differences in subjective responses, however, suggesting that the lower cardiac reactivity found among older people is dependent on gender and the specific emotion assessed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathological fear of cot death

Cot death (sudden infant death syndrome) is one of the most common causes of death in the first year of life. Four cases with a pathological fear of cot death are presented. All the patients were depressed and in 2 cases the fear of cot death had an obsessional quality. In all cases there were complications during pregnancy (miscarriage, threatened abortion, recurrent vomiting in last trimester). In 1 case, the patient knew 3 mothers who had suffered cot deaths; in another, the infant was gravely ill in the neonatal period. Pathological fear of cot death can be recognised by the presence of two central features - overvigilance and excessive nocturnal checking of the baby's breathing. Therapeutic interventions are discussed.     

Is stress linked to heart disease? The evidence grows stronger

Acute stress caused by strong emotions such as fear can sometimes cause sudden death in people with underlying coronary artery disease (CAD). Chronic mental stress may also promote the long-term development of coronary disease, although the distinction between Type A and Type B personalities appears overly simplistic. Stress-management interventions measurably improve CAD patients' performance on cardiac function tests, and should be incorporated more often in standard cardiac rehabilitation programs.     

AIDS in one city: An interview with Mervyn Silverman, Director of Health, San Francisco.

Summarizes the acquired immune deficiency syndrome (AIDS) programs and efforts in San Francisco and indicates that they are providing a continuum of care from information and education programs to counseling for those who already have AIDS. The mental health concerns include not only fear of death, but also ostracism, numerous reactions from peers (other gays), and the reaction of the general community. Understanding psychologists who comprehend the political and social ramifications and who understand the disease are needed. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ursula Delworth (1934-2000).

Announces the death of Ursula Delworth, a former editor (1989-1994) of Professional Psychology: Research and Practice, who died on May 24, 2000, of cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Television viewing and fear of victimization: Is the relationship causal?

Previous findings have suggested that people who watch a lot of TV are more likely to fear their environment than are those who report being less frequent viewers. From this simple correlation, previous authors (e.g., G. Gebner and L. Gross, 1974 and 1976) have suggested that TV causes people to overestimate the amount of danger that exists in their own neighborhoods. The present study attempted to replicate this finding and to determine if the apparent effect was due to a previously uncontrolled factor: the actual incidence of crime in the neighborhood. Respondents to a door-to-door survey indicated their media usage and estimated the likelihood of their being a victim of violence. Neighborhoods were chosen to include a high- and a low-crime area in downtown Toronto and a high- and a low-crime area in Toronto's suburbs. Pooling across the 4 areas sampled, the previous findings were replicated. However, the average within-area correlation was insignificant, suggesting that when actual incidence of crime is controlled for, there is no overall relationship between TV viewing and fear of being a victim of crime. A multiple regression analysis and a canonical correlation analysis confirmed these findings. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental disorders and access to medical care in the United States

OBJECTIVE: The authors examined the barriers to receipt of medical services among people reporting mental disorders in a representative sample of U.S. adults. METHOD: The sample was drawn from adults who responded to the 1994 National Health Interview Survey (N=77,183). The authors studied the association between report of a mental disorder and 1) access to health insurance and a primary provider, and 2) actual receipt of medical care. Multivariate techniques were used to model problems with access as a function of mental disorders, controlling for demographic, insurance, and health variables. RESULTS: While people who reported mental disorders showed no difference from those without mental disorders in likelihood of being uninsured or of having a primary care provider, they were twice as likely to report having been denied insurance because of a preexisting condition or having stayed in their job for fear of losing their health benefits. Among respondents with insurance, those who reported mental illness were no less likely to have a primary care provider but were about two times more likely to report having delayed seeking needed medical care because of cost or having been unable to obtain needed medical care. CONCLUSIONS: People who reported mental disorders experienced significant barriers to receipt of medical care. Efforts to measure and improve access to health care for this population may need to go beyond simply providing insurance benefits or access to general medical providers.     

Terror management and religion: Evidence that intrinsic religiousness mitigates worldview defense following mortality salience.

Terror management theory suggests that people cope with awareness of death by investing in some kind of literal or symbolic immortality. Given the centrality of death transcendence beliefs in most religions, the authors hypothesized that religious beliefs play a protective role in managing terror of death. The authors report three studies suggesting that affirming intrinsic religiousness reduces both death-thought accessibility following mortality salience and the use of terror management defenses with regard to a secular belief system. Study 1 showed that after a naturally occurring reminder of mortality, people who scored high on intrinsic religiousness did not react with worldview defense, whereas people low on intrinsic religiousness did. Study 2 specified that intrinsic religious belief mitigated worldview defense only if participants had the opportunity to affirm their religious beliefs. Study 3 illustrated that affirmation of religious belief decreased death-thought accessibility following mortality salience only for those participants who scored high on the intrinsic religiousness scale. Taken as a whole, these results suggest that only those people who are intrinsically vested in their religion derive terror management benefits from religious beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived self-efficacy domains as predictors of fear of the unknown and fear of dying among older adults.

Using a sample of 167 women and 121 men, aged 65-87, this study tested the hypothesis that self-efficacy beliefs of older persons are significantly stronger predictors of death fears than are demographics, social support, and physical health variables used in earlier predictor models. Standard self-report measures were used to assess all predictor variables, including perceived self-efficacy in 8 different domains. Findings from a series of hierarchical regression analyses that were conducted separately for men and women supported the hypothesis concerning the superiority of self-efficacy variables as predictors of fear of the unknown after death and fear of dying, with spiritual health efficacy and instrumental efficacy being the most potent predictors of death fears for women and men. respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)