Death Anxiety and Spirituality Across The Lifespan:
Factors and Relationships Amidst COVID-19
Researcher: Regan Thompson
Supervisor: Dr. Lesley Jessiman

INTRODUCTION
• Death is inevitable, and although dying is a natural part of life, being
aware and accepting of death can be very difficult.
• Death anxiety: one’s fear of death or the process of dying, which can
lead to a preoccupation with death (Greene, 2019).
• Death anxiety can lead to negative psychological and physical effects
such as general anxiety, depression, insomnia, low self-confidence,
loneliness, physical discomfort, and pain (Rasmussen & Johnson, 1994;
Taghipour et al., 2017 ).
• Spirituality: an individual practice involving belief in an afterlife and
living a meaningful life without following or belonging to a specific
religion (Rasmussen & Johnson, 1994) .
• Research has suggested that there is a negative relationship between
death anxiety and spirituality (Rasmussen & Johnson, 1994), a negative
relationship between death anxiety and age (Russac et al., 2007), and a
positive relationship between spirituality and age (Wink & Dillon, 2002).
• There is, however, a gap in the literature as to how these constructs
change across the lifespan.
• The aim of this study was therefore to examine the relationships between
death anxiety, spirituality, and age amidst the COVID-19 pandemic.

METHODOLOGY
Participants
• The sample consisted of 308 participants recruited from the UFV SONA
system, social media, and local community groups.
• The sample consisted of 124 young adults (aged 19-40), 59 middle-aged
adults (aged 41-59), and 76 older adults (aged 60+).
Materials & Procedure
The Collett-Lester Fear of Death Scale 3.0 (CLFD; Lester & Abdel-Khalek,
2003) is a measure of death anxiety.
• The CLFD provides an overall death anxiety score and four subscale
scores (Fear of Death of Self, Fear of Death of Others, Fear of Dying of
Self, and Fear of Dying of Others).
The Spiritual Well-Being Scale (SWBS; Paloutzian & Ellison, 1982) is a
measure of spirituality.
• The SWBS provides an overall spirituality score and two subscale
scores (Religious Well-Being and Existential Well-Being).
The Geriatric Depression Scale (GDS; Sheikh & Yesavage, 1986) is a
measure of depression in older adults. Some items were revised for the
younger adult participants. Considering the COVID-19 pandemic some items
were also revised.
The UCLA Loneliness Scale Version 3 (UCLA-3; Russell, 1996) is a
measure of loneliness. Considering the COVID-19 pandemic some items
were also revised.
Open-ended questions were created for the current study, and asked
participants about their spiritual upbringing, if their careers involved death, if
they have experienced a recent loss, and the impacts of COVID-19 on their
death anxiety and spirituality.

Qualitative: Thematic Analysis
Three themes emerged as to how COVID-19 impacted
participants’ death anxiety and spirituality.

RESULTS
Correlations

Significant Person’s correlations were found between death
anxiety, spirituality, age, depression, and loneliness.
Death anxiety was found to decrease with increasing age, in
addition to one’s fear of their own death and own dying, as well
as one’s fear of the death and dying of others. It was also found
that depression and loneliness, decreased with age. Existential
well-being also increased with age while religious well-being
did not.

Figure 1: Interitem Pearson’s correlations for Death Anxiety,
Spirituality, Depression, and Loneliness.

Death anxiety, depression, and loneliness were also found to
decrease with increasing spirituality. Spirituality decreased one’s
fear of their own death and own dying, and one’s fear of the
death and dying of others. Death anxiety and its subscales were
also found to decrease with increasing existential well-being,
although not religious well-being.

One-way ANOVAs were performed to examine the effects of age and religious
affiliation on death anxiety, spirituality, depression, and loneliness.

•
•
•

Mean total death anxiety was greater in young adults compared to middle-aged and older
adults, and was greater in middle-aged adults compared to older adults.
Young adults were more fearful of their own death, others’ death, and others’ dying compared
to both middle-aged adults and older adults, and middle-aged adults were more fearful of their Figure 2: Mean total death anxiety scores for young
adults, middle-aged adults, and older adults.
own death, their own dying, others’ death, and others’ dying than older adults. Young adults
were also more fearful of their own dying compared to older adults.
Mean existential well-being was higher in older adults than young adults.
Mean depression was higher in young adults compared to the middle-aged adults and older
adults. Middle-aged adults had higher mean depression scores than older adults.
Mean loneliness was higher in young adults in comparison to older adults.

Mean fear of others’ death scores for religions that celebrate death (Buddhist, Jewish,
Hindu, Sikh, Indigenous Spirituality) or fear death (Catholic, Christian, Muslim,
Atheist, No Religion) are shown in Figure 3. Analyses revealed main effects on the
fear of others’ death and existential well-being subscales (p<.05). Tukey HSD tests
found (p<.05):
•
•

Religions that celebrate death had significantly higher fear of others’ death scores
Religions that fear death has significantly higher existential well-being scores

Mean total death anxiety scores for No Religion/Atheists, Sikhs/Hindus, Catholics,
and Christians are shown in Figure 4. Analyses revealed main effects on each
dependent variable (p<.05). Tukey HSD tests found the following significant
differences (p<.05):
•
•
•
•
•
•
•
•
•

Mean total death anxiety was greater in Sikhs/Hindus compared to No Religion/Atheists and
Christians. Catholics also had higher total death anxiety scores compared to Christians.
Sikhs/Hindus and Catholics were more fearful of their own death in comparison to No
Religion/Atheists and Christians.
Catholics were more fearful of their own dying compared to Christians.
Sikhs/Hindus were more fearful of others’ death compared to No Religion/Atheists and
Christians.
Catholics and Sikhs/Hindus more fearful of others’ dying in comparison to Christians.
Mean spirituality was higher in Sikhs/Hindus, Catholics, and Christians compared to No
Religion/Atheists. Mean spirituality was higher in Christians in comparison to Sikhs/Hindus.
Mean religious well-being was higher in Sikhs/Hindus, Catholics, and Christians in
comparison to No Religion/Atheists.
Mean existential well-being was higher in No Religion/Atheists and Christians compared to
Sikhs/Hindus.
Mean depression was higher in Sikhs/Hindus in comparison to Christians.

Coping
mechanism

SPIRITUALITY
BUFFERED
DEATH
ANXIETY

Trust in
‘God’s
Plan’

RELIGIOSITY
BUFFERED
DEATH
ANXIETY

Coping
mechanism

Sense of
community

“[The] pandemic has strengthened my faith and although death is very
much a real thing, it does not scare me. If I die from COVID, then
that's what God planned, and if not, then let it be so.”

Mean total death anxiety scores for each age group are shown in Figure 2. Analyses
revealed a main effect of age on total death anxiety, each death anxiety subscale,
existential well being, depression, and loneliness (p<.01). Tukey HSD tests were
performed and found the following significant differences (p<.01):
•

Death is
natural and
inevitable

Belief in a
spiritual
afterlife

Analyses of Variance (ANOVA)

•

“I believe [in] a
“I have thought about
Fear of
spiritual afterlife.
death as much in the
Fear of
spreading
[I’m] comfort[ed]
past year as I have in
the virus to
their own
death
family
that my [deceased]
my whole life.”
members
loved ones are
Fear of
watching over
Increased
COVID-19
themselves
myself and
mortality
or loved
INCREASED
salience
my family and
ones dying
DEATH
alone
will hopefully be
ANXIETY
there to greet
me once I pass.”

Figure 3: Mean scores on the fear of others’ death
subscale for religions that celebrate and fear death.

DISCUSSION & IMPLICATIONS
• Death anxiety decreased with increasing spirituality and
age, and spirituality and religiosity helped to buffer
heightened death anxiety during the COVID-19 pandemic.
• Death anxiety, spirituality, and religiosity was higher in
Sikhs/Hindus and Catholics in comparison to Christians
and No Religion/Atheists. Existential well-being was
higher in Christians and No Religion/Atheists, however,
suggesting that spirituality is a more effective buffer for
death anxiety compared to religiosity.
• The results of this study indicate that spirituality may help
buffer death anxiety and its effects. Thus, healthcare
workers and the bereaved may benefit from workshops and
courses designed to increase one’s spirituality.
• The findings of the current study can contribute to research
on COVID-19 by showing how the pandemic has affected
participants’ death anxiety and spirituality.

REFERENCES

Figure 4: Mean total death anxiety scores for
Religion/Atheists, Sikhs/Hindus, Catholics, and Christians.
Note: Although Catholicism is recognized as a branch of Christianity, the
two groups were analyzed as separate categories due to their significant
differences in scores on death anxiety and existential well-being.

Greene, J. M. (2019). Death anxiety (thanatophobia). In Salem Press Encyclopedia of Health.
https://search-ebscohost-com.proxy.ufv.ca:2443/login.aspx?direct=true&db=ers&AN=119214246&site=eds-live
Lester, D. & Abdel-Khalek, A. (2003). The Collett-Lester fear of death scale: A correction. Death Studies, 27(1), 81-85.
https://doi.org/10.1080/07481180302873
Paloutzian, R. F., & Ellison, C. W. (1982). Loneliness, Spiritual Well-Being and the Quality of Life. In L. A. Peplau, & D. Perlman
(Eds.), Loneliness: A Sourcebook of Current Theory, Research and Therapy (pp. 224-236). John Wiley & Sons.
Rasmussen, C. H., & Johnson, M. E. (1994). Spirituality and religiosity: Relative relationships to death anxiety. Omega— Journal
of Death and Dying, 29(4), 313-318. https://doi.org/10.2190/D1M9-3W6J-FY33-G3HQ
Russac, R. J., Gatliff, C., Reece, M., & Spottswood, D. (2007). Death anxiety across the adult years: An examination of age and
gender effects. Death Studies, 31, 549-561. https://doi.org/10.1080/07481180701356936
Russell, D. (1996). UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. Journal of Personality
Assessment, 66, 20-40. https://doi.org/10.1207/s15327752jpa6601_2
Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter
version. Clinical Gerontologist: The Journal of Aging and Mental Health, 5(1-2), 165–173.
https://doi.org/10.1300/J018v05n01_09
Taghipour, B., Mehravar, F., Nia, H. S., Shahidifar, S., Hasani, S. A., & Alahyari, Z. (2017). Association between death anxiety and
spiritual intelligence with the spiritual health and quality of life in hemodialysis patients. Journal of Nursing and Midwifery
Sciences, 4(2), 26- 32. https://doi.org/10.4103/2345-5756.231742
Wink, P., & Dillon, M. (2002). Spiritual development across the adult life course: Findings from a longitudinal study. Journal of
Adult Development, 9(1), 79-94. https://doi.org/10.1023/A:1013833419122