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PSYC3018 - A > 6 Transdiagnostic Issues: Death Anxiety > Flashcards

6 Transdiagnostic Issues: Death Anxiety Flashcards

1
Q

What is a transdiagnostic construct or process?

A
  • Feature across several disorders (Self-esteem)

- Represent a causal mechanism across several disorders

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2
Q

Why is there increasing interest in transdiagnostic constructs?

A

Due to the high comorbidity also allows for transdiagnostic treatments (instead of revolving door effect)

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3
Q

What is terror management theory?

A

A theory about how people respond to the knowledge of their own mortality. Two buffers:

1) cultural worldviews
- gaining immortality by buying into beliefs

2) self-esteem
- gaining meaning by fulfilling expectations of a cultural worldview (being rich, gaining tertiary qual)

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4
Q

What did Greenburg et al., (1986) find in the study about death anxiety?

A

200 + ‘Mortality Sailence’ (MS) Studies
Death reminders impact a whole range of human behaviours
- Reminders of death also increase spending behaviour, and may also give harsher punishments than the norm

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5
Q

What did Iverach, Menzies, & Menzies (2014) find out about death anxiety?

A

It might be a transdiagnostic construct and underpin a number of disorders
- Anxiety disorders, OCD, eating disorders, PTSD, depression etc

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6
Q

What is the role of death anxiety in panic disorder?

A

Significantly higher fear of death than social phobia patients and controls (Furer & Walker, 2008; Randall, 2001)

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7
Q

What is the role of death anxiety in agoraphobia according to Foa et al., (1994)?

A

Many symptoms are associated with death fears

  • Fear of harm when leaving home
  • Increased focus on internal sensations
  • Hypochoncrical concerns
  • Frequent catastrophic death-related fears
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8
Q

What is the role of death anxiety in specific phobias?

A
  • Freud argued that fears of death underlie phobias
  • When death anxiety focuses on more specific, manageable threats
  • MS increased in these people
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9
Q

What is the role of death anxiety in PTSD according to Chatard et al., (2012)?

A

Death anxiety argued to play a role in development & Maintenance

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10
Q

What is the role of death anxiety in PTSD according to Martz, (2004) and Safren et al., (2003)?

A

Death anxiety is significantly correlated with overall PTSD symptom severity and re-experiencing, avoidance and hyper-arousal

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11
Q

What is the role of death anxiety in depressive disorders?

A

Depressive disorders may be exacerbated by existential despair and lack of meaning (e.g. Ghaemi, 2007; Simon et al., 1998)

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12
Q

What is the evidence of death anxiety in depressive disorders according to Simon et al., (1996)?

A

Some evidence that depression may be assocaited with weaker buffers against death anxiety

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13
Q

What is the role of death anxiety in Eating Disorders according to Giles (1995)?

A

Women diagnosed with anorexia nervosa show significantly higher death anxiety than controls

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14
Q

What is the role of death anxiety in Eating Disorders according to Le Marne & Harris (2016)?

A

Death anxiety positively correlated with disordered eating, perfectionism, and self-reports of a current mental disorder
- Perfectionism was only a significant predictor when death anxiety and self-esteem were excluded

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15
Q

What is the role of death anxiety in PTSD from the perspective of TMT?

A

PTSD may involve disrupted anxiety buffers where their normal buffers of world views may not be working as normal as they usually are.

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16
Q

What does the severity depend on according to Maxfield et al., (2014)

A

The severity of PTSD depends on both the severity of trauma and prior strength of buffers

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17
Q

What did Kesebir et al., (2011) conclude on TMT and PTSD?

A

Individuals with PTSD don’t show increased worldview defence after MS, unlike control particiapnts

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18
Q

What did Chatard et al., (2012) study on using MS with individuals following a civil war include?

A

Low PTSD symptoms -> suppression of death doughts

High PTSD symptoms -> immediate increase in death-related thoughts

Suggests anxiety-buffering defences are disrupted in PTSD

19
Q

What are some limitations of previous studies?

A
  • Rarely a treatment-seeking clinical sample
  • Rarely looking outside of the one disorder of interest (not the whole picture)
  • No studies investigating fear of deaths relationship to complex mental health severity in a clinical population
20
Q

What did Menxies, Sharpe & Dar-Nimrod (2019) find in fear of death predicting mental health severity?

A

Death anxiety predicted (N=200)

  • Clinical’s judgement of distress (r=.75)
  • Number of medications (r=.64)
  • Number of hospitalizations
  • Depression, stress and anxiety
  • Number of lifetime diagnoses
21
Q

What is the correlation between death anxiety vs other transdiagnostic constructs?

A

Death anxiety correlations are very strong whereas the other constructs (perfectionism, rumination and self-esteem) are getting a lot more attention

22
Q

What are (more) limitations of previous studies?

A

Almost always correlational

How can we test whether death anxiety is causing the disorder? if death anxiety is at the root, reminders of death should lead to more behaviours associated with that disorder AND there should be specificity

23
Q

Which disorder did Goldenburg, Arndt, Hart & Brown (2005) experimental study focus on and what were the results?

A

Eating Disorders

  • Reminders of death led women (but not men) to: Perceive themselves as further from their ideal thinness and eat 40% less in a taste-testing task than controls
  • Death may be driving women to strive for thinness promoted by their cultural worldviews
24
Q

What was the experimental study Strrachen et al. (2007) focus and what were the results?

A

Social Anxiety Disorder

They used MS with students in high vs low in social anxiety
- Death priming produced significantly more social avoidance among socially anxious participants

25
Q

For the specific phobia of spiders, what did Strachan et al. (2007) test and conclude?

A

They tested whether mortality salience could increase phobic behaviours and found that for those with spider phobia, reminders of death (MS)

  • Increased avoidance of spider-related stimuli
  • Increased perceived threat
26
Q

What were the experimental studies for OCD?

A

Verbal reports among common subtypes suggest the role of death fears

  • contamination
  • checking
  • aggressive obsessions
  • Tapping, counting
27
Q

What did Menzies, Dar-nimrod (2017) experimental study for OCD find?

A

First attempt at a MS study in OCD

  • No difference between washers and non-washers in the absence of MS (no reminder of death they behave identically)
  • MS is leading washers to wash, and not affecting the non-washers
  • Clinical significance of this effect
  • Thoughts of death can worsen OCD Symptoms (i.e. hand washing) among washers
28
Q

What did Furer & Walker, (2008) study find for panic disorder, illness anxiety & somatic symptom disorder?

A

Fears of death argued to play a central role

29
Q

What was the conclusion of the experimental study in regards to panic disorder, illness anxiety & somatic symptom disorder?

A

In terms of behaviours these appear to have:
- High levels of bodily vigilance, threat perception and scanning behaviours
If death anxiety is underlying, reminders of death should increase these behaviours

30
Q

What did Menzies, Sharpe, & Dar-Nimrod, (2019) study find for panic disorder, illness anxiety & somatic symptom disorder?

A

Large correlations between death anxiety & all 3 disorders (R’s >.62)

31
Q

What were the hypothesis for Menzies, Sharpe, & Dar-Nimrod, (2019) experimental study?

A

Do reminders of death

  1. Increase time spent scanning one’s body
  2. Increase perception of one’s own body as being less healthy
  3. Increase the intention to visit the GP in the future
32
Q

Do reminders of death: make people spend longer checking their body (Menzies, Sharpe, & Dar-Nimrod, (2019)?

A

Yes, MS produced longer scanning time, on average… but only for those with a scanning disorder

33
Q

Do reminders of death: change how people see their body (Menzies, Sharpe, & Dar-Nimrod, (2019)?

A

Yes, significant effect of prime on threat perception. But… only for those with a scanning disorder, MS produced no difference in threat perception for those with depression

34
Q

Do reminders of death: make people seek more reassurance from their Gp (Menzies, Sharpe, & Dar-Nimrod, (2019)?

A

Yes, overall, MS led participants to report greater intention to visit their GP in the next 2 months

35
Q

What were the preliminary conclusions for Menzies, Sharpe, & Dar-Nimrod, (2019) experimental study?

A

Among panic disorder, illness anxiety, and somatic symptom disorder, thoughts of can worsen symptoms

  • Body checking
  • Threat perception
  • Reassurance seeking from GP

It was first experimental evidence that death anxiety drives these 3 disorders

36
Q

What are the implications of the role of death anxiety in experimental studies?

A
  • Results of recent research suggest we may need to rethink the treatment of these conditions
  • All of these treatments produce great pre-post measures
  • Increased functionality, but are these contributing to the ‘revolving door’ of mental health?
37
Q

What do treatments for death anxiety look like?

A

Most just take away proximal causes of death

38
Q

What are the implications of the role of death anxiety in behavioural experiments and exposure?

A

For panic disorders and exposure in specific phobias, they take away the proximal threat, but what about fear of death?

39
Q

What is often assumed from single measures?

A

We often assume success from a single measure of a single disorder

  • Bacteria on the doorknob won’t hurt them -> they touch more doorknobs
  • Stand on higher runs of a ladder -> they’re able to stand on higher rungs of a ladder
40
Q

What question does this raise in the problem of the treatment?

A

That treatment studies are measuring the thing we’re targeting in the treatment, not necessarily the core problem

41
Q

What are the implications of TMT?

A
  • TMT and recent search may suggest a completely different approach to treatment
  • Treatments that take away a proximal threat may be part of the problem
  • We may need innovative treatments to address the underlying dread of death
42
Q

What is the best treatment for death anxiety?

A

CBT produced the largest improvements in death anxiety -> exposure therapy

43
Q

What is involved in CBT: exposure therapy?

A
  • Getting people to write their own tombstones
  • Visit places associated with death
  • Literature on death
  • A lot of films associated with death
  • WeCroak
  • Normalize death and accept it

PSYC3018 - A (6 decks)

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