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This is to certify that the

dissertation entitled

EXISTENTIAL THEORY, EGO DEVELOPMENT,
PURPOSE IN LIFE, AND DEATH ANXIETY
AMONG OLDER ADULTS

presented by

CHARLES E. GUTIERREZ

has been accepted towards fulfillment
of the requirements for

Ph.D. Psychology

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Existential Theory, Ego Development,
Purpose in Life, and Death Anxiety
Among Older Adults

By

Charles E. Gutierrez

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Psychology
1992

ABSTRACT

EXISTENTIAL THEORY, EGO DEVELOPMENT,
PURPOSE IN LIFE, AND DEATH ANXIETY
AMONG OLDER ADULTS

By

Charles E. Gutierrez

Existential theory and prior research findings led to the hypothe—
sis that level of ego development would correlate positively with the
extent to which one reported their life to be meaningful and negatively
with one’s death-related anxieties. It was also hypothesized these
latter constructs would relate inversely. Measures representing each
construct were administered to 87 women and 13 men community volunteers
averaging 73 years of age and about one year of college. Ego develop-
ment was assessed by Loevinger’s (1970) Sentence Completion Test (SCT),
purpose in life was measured using Crumbaugh and Maholick’s (1968)
Purpose in Life (PIL) inventory, and death anxiety was addressed by
Templar’s (1970) Death Anxiety Scale. A brief questionnaire assessed
recent experiences with death of close associates, specific death educa-
tion experiences from parents, health status, recreational experiences,
and religiosity.

Despite small numbers of men, the two subsamples differed signifi-
cantly (p < .05) only on the PIL, with men scoring higher than women. A
multiple analysis of variance indicated SCT ratings associated signifi-
cantly (p < .05) only with DAS scores. This positive relationship be-
tween ego development and death anxiety is incongruent with the hypothe-
sized inverse association. Contrary to hypotheses, PIL measure did not

correlate significantly with either ego development or death anxiety.

All correlations were examined among the three principal measures
and the seven questionnaire variables separately for the subsamples of
men and women. Among older women, level of ego development correlated
significantly and positively with general education (I - .30) and with a
simple report about death education received from parents (I - .32).
Also significant was women’s .25 correlation of death education with PIL
responses which contrasted with men’s parallel correlation of -.36.
Health emerged as a salient variable for these older men, correlating
significantly and positively with their ego development (r - .67) and
education (1 = .66), but inversely with age (r = -.64). These
correlations differed significantly (p < .05) from women’s parallel
correlations (respective [’5 = -.l6, -.21, and .16) when tested using
Fisher’s r to z transformation. Such results suggest health concerns
are more prominent in the minds of the men than among the women.

The results did not support the Existential position about
relationships between the constructs of ego development, death anxiety,
and purpose in living. Future studies of these constructs seem well-
advised to attend more closely to the variables of age, gender, and
health. Also notable is the Purpose in Life inventory’s irrelevance to
the present measures of ego development and death anxiety. Limitations
of the study’s design and execution were discussed. Overall, the

findings raise questions about prior research reports in this sector.

ACKNOWLEDGMENTS

My heartfelt thanks to John Hurley, as chairman of my dissertation
committee, for his guidance, support, and caring. I would also like to thank
Bert Karon, Hi Fitzgerald, and Al Aniskiewicz for their wonderful support.

Finally, I wish to express my gratitude to my wife Irma and my parents,
whose love and support helped sustain me through this long and difficult

process.

TABLE OF CONTENTS

Page
INTRODUCTION ................................................... 1
Psychoanalytic Theory ...................................... 2
Existential Theory ......................................... 15
Existential Analysis ....................................... 16
Empirical Literature ....................................... l7
Hypothesis 1 ............................................... 45
Hypothesis 2 ............................................... 45
Hypothesis 3 ............................................... 45
METHOD ......................................................... 46
Subjects ................................................... 46
Procedure .................................................. 46
Instruments ................................................ 48
Death Anxiety Scale ................................... 48
Sentence Completion Test .............................. 49
Purpose in Life Test .................................. 49
RESULTS ........................................................ 51
DISCUSSION ..................................................... 62
SUMMARY AND CONCLUSIONS ........................................ 68
REFERENCES ..................................................... 70
APPENDIX A ..................................................... 74
APPENDIX B ..................................................... 75
APPENDIX C ..................................................... 76
APPENDIX D ..................................................... 77
APPENDIX E ..................................................... 79
APPENDIX F ..................................................... 85

APPENDIX 6 ..................................................... 87

INTRODUCTION

The issue of death is a crucial aspect of existence; however, its
significance has not yet been fully realized in psychology. The import of
death was initially examined in psychoanalysis (Freud, 1900), which based
mental phenomena on the emergence of instinctual needs from the uncon-
scious, and from previously experienced situations. However, Freud
concluded at that time that death was not an appropriate area for investi-
gation. According to Freud (1900) "the unconscious seems to contain
nothing that could give any content to our concept of the annihilation of
life...nothing resembling death can ever have been experienced; or if it
has, as in fainting, it has left no observable traces behind."
Consequently, death was not a major factor in the etiology of anxiety or
fear in classical psychoanalytic theory. It was not until 1920, when
Freud postulated the existence of Thanatos, that death was elevated to
primary significance. Freud posited that life is ultimately directed
toward death, and the principle of thanatos is to lead what is living back
into an inorganic state. Thus, death was integrated into psychoanalysis
through Freud’s assertion that it is an instinct; however, with few
exceptions (e.g., Klein, 1948) the concept of thanatos has not had a
significant impact on psychoanalytic theory. The diminution of the
significance of death is further evidenced by the neglect of death in the
literature. Indeed, the present state of events is not unlike that of
twenty years ago, when Maurer (1966) likened death to the previously

hidden state of sexuality, and described death as ”the new pornography to

be discussed privately in hushed tones, never mentioned to children and
certainly out of bounds for psychologists." This review will trace the
evolution of death in theory, initially examining its emergence in psycho-
analysis, where it has traditionally been regarded as a derivative of
primary unconscious issues. Death has been construed as being a deriva-
tive of the fear of separation or object loss, as symbolic of castration,
or as representative of the fear of abandonment and/or persecution by the
superego. Death will also be explored with regard to the concept of
thanatos, ego development, and the philosophies of Kierkegaard and
Heidegger, whose work has contributed significantly to the understanding
of death. Finally, the implications of theory and philosophy will be
examined relative to the research literature, and a study will be
conducted to provide integration.
W

In order to more fully comprehend the issue of death in psycho—
analysis, it may be fruitful to provide an overview of Freud’s work on
anxiety, as the latter forms a common thread to the precursors of death in
classical psychoanalytic theory. Freud (1895) initially approached the
problem of anxiety in his investigation of the "actual neuroses."
According to Freud, (1895), neurosis occurs as a result of the transforma-
tion of repressed sexual excitation, or libido. The theory of the libido
remained in force for almost three decades, and was abandoned after Freud
formulated a new theory based on the structural model of the psyche. In
this theory, the importance of libidinal strivings was modified, in as
much as its role in anxiety was replaced by the function of the ego which

seeks the avoidance of unpleasure. Another central aspect of the

structural model is "primary anxiety" which Freud presented as the ego’s
first developmental task with regard to coping with traumatic situations.
According to Freud (1926), primary anxiety is prototypic of the anxiety
and helplessness that occurs within the ego following an accumulation of
excitation, with which it cannot cope. The source of this excitation may
be either internal or external, which is differentiated as the ego
develops, and which is initially perceived as traumatic (Freud, 1926).
Freud posited that the ego learns to cope with traumas by recreating the
anxiety arousing situation so as to lessen its impact, as in an inocula-
tion. This process results in "signal anxiety" which forewarns the ego of
a potential danger. Perhaps the concept that is most salient to this
study is the helplessness that was theorized to be felt by the ego when
confronted by overwhelming trauma.

In early childhood, the first traces of consciousness are thought to
not differentiate between ego and nonego, but rather, between greater and
lesser tension, which with satiation, returns to a state of nondifferentia-
tion (Fenichel, 1945). It is through the differentiation of self and
other that the recognition that others are necessary for satisfaction
occurs, which is a process that parallels the development of the ego.
Indeed, Freud (1926) regarded separation as the critical issue in the
development of anxiety, which he posited to be the antecedent of castra-
tion anxiety and fear of loss of love, which highlights the importance of
objects. Freud also posited that separation occurs as a developmental
sequence with regard to the roots of anxiety, which parallels the matura-
tion of the ego, with the fear of death being the final transformation.

In summary, a review of classical psychoanalytic theory demonstrates that

anxiety was initially associated with libidinal excitation, but was later
centered on the functions of the ego and its relationships with others.
However, death was not specifically addressed until 1920, when Freud
initially posited the existence of Thanatos, or the death instinct.
According to Freud, thanatos is an instinct of death and destruction, that
works in opposition to the instinct of Eros, which serves to preserve the
species. Freud later integrated aggression with thanatos, as he posited
that aggression is its derivative and primary representation (Freud,
1923). Finally, Freud (1933) argued that thanatos is an inate tendency
that exists within people that seeks a return to our inorganic origins.
For Freud, the duality that ensues between the instincts of eros and
thanatos colors life.

Freud's thesis of the death instinct initially met with much scepti-
cism. However, his theory of thanatos was not entirely abandoned, and his
elevation of death into theory was paralleled by the work of Rank. Rank
was an analyst who contributed significantly to psychoanalytic theory with
respect to the issue of birth trauma and death. As previously noted,
Rank’s theories on the trauma of birth were seminal in Freud’s development
of both primary anxiety and signal anxiety in classical theory.
Nevertheless, Rank’s (1929) formulations were quite distinct from Freud’s
and may be characterized as existential, as his focus was on the human
situation of man rather than on the operations of the ego. Rank held that
fear rather than anxiety was the quintessential issue, which he posited
emerges in the experience of birth. Rank also differed from Freud in his
conceptualization of what the issue of death involves. For Rank, a

polarity exists between union and separation, with fear of death being the

fear of having to live in isolation. Rank (1929) also posited the exis—
tence of a positive life instinct; however, he maintained that a ”primary
ambivalence” must be assumed, which arises from the presence of the fear
of life and fear of death. Another important difference between Rank and
Freud concerns the etiology of neurosis, which Rank grounded on the fear
of death. According to Rank (1929) death is the essential punishment that
the neurotic seeks to avoid. More specifically, the neurotic attempts to
subject death to his own will by limiting his life, thereby punishing him-
self so that he will not have to face the final punishment of death. In
summary, Rank regarded death as a critical variable in human development,
which if it is handled creatively, may further actualize development, or
may lead to neurosis, if it is avoided. In this regard, Rank stressed the
interpersonal aspects of life, rather than the intrapsychic, and high-
lighted the difficulties involved in being an individual. In summary,
Rank’s theories foreshadowed later developments in psychology and the
contributions of the existential philosophers.

Klein is another analyst who was strongly influenced by Freud’s
theories. She emphasized the object relationships that occur in deveTOp-
ment, and formulated a theory linking object relationships and thanatos.
Klein (1948) posited that the experience of the ego during the initial
stages of development is one of persecution. Persecution arises from the
activity of the death instinct that is perceived within, but which is
experienced as coming from without. Klein promulgated a theory of develop-
ment that outlines the processes by which the ego transacts its relation-
ship with the object of its libido, as colored by the innate destructive
impulses that are directed against it. According to Klein (1948) the

interaction and ultimately the fusion between aggression and libido are
the causes of anxiety and guilt; or more generally, anxiety arises from
the activity of the death instinct which is kept at bay by the life
instinct. Finally, Klein posited the existence of persecutory anxiety and
depressive anxiety, which are structurally related to two distinct
"positions'I or stages of ego development, and which form the foundation
ofher provocative theory.

Stern provided another perspective on the importance of death for a
complete understanding of early ego development. Stern’s (I966) thesis
was principally based on clinical observations and reinterpretation of
classical cases. Stern maintained that "mortal terror" is the quintes-
sential affective state of birth, and the foundation of the fear of
death. He also reinterpreted Freud’s (1923) concept, that the fear of
death should be regarded as analogous to the fear of castration.
Essentially, he argued that Freud was misinterpreted; that he did not
refer to fear of future death, but rather to mortal terror - ”the response
in a traumatic situation, that is, to a situation of acute extreme danger
to life.” Like Rank, Stern suggested that adaptation to death is a neces-
sary part of maturation and that deficiency in this adaptation is an inte-
gral factor in neurosis. Stern’s work allows for a further integration of
the relationship between trauma, anxiety and depression, which he outlined
in his theory of biotrauma.

Perhaps the most critical issue that is raised by the theories of
Rank, Klein, and Stern is that of the experience of the ego, and its level
of awareness of its environment. As previously indicated, Klein posited

that the ego’s experience of the death instinct is one of annihilation

anxiety, while Rank theorized that fear is the salient issue, and Stern
posited that the ego's initial experience of trauma is one of mortal
terror. Klein's thesis presumes an awareness in the ego beyond that of
itself; as a knowing beyond that of primary narcissism. To be afraid of
annihilation presupposes that awareness of oneself exists, as well as the
awareness of the possibility of no longer being. Consequently, a review of
Mahler’s work may prove useful in addressing the issue of the ego’s aware-
ness of itself and others, as her investigations have been particularly
valuable to increasing our understanding of this area. Mahler (I967)
posited that the infant is in a state of "normal autism” during its first
weeks of life, in which the infant is incapable of differentiating between
self and other. Increased awareness begins in the second month, which
marks the phase of normal symbiosis. This phase is marked by the infant’s
perception that he and his mother are part of an omnipotent system.

As differentiation progresses, the infant is posited to become more
aware of himself physically, with this representation becoming the founda-
tion of his body image. In summary, Mahler suggested that differentiation
between self and other is not immediately present at birth, but that it
occurs as a result of later development. Thus, the ego’s early experience
of excessive tension, which may occur in situations of extreme hunger may
be more parsimoniously viewed as one of an affective state of anxiety, as
Freud has suggested, rather than that of annihilation anxiety or terror as
Klein and Stern have posited. However, in order to fully address the area
of annihilation anxiety, the work of Hurvich (1988) will also be examined,
as his contributions in this area have been extremely valuable. Hurvich’s

work provides an integration of disparate elements of classical psycho-

analytic theory. First of all, he attempted to bridge the conceptual
controversy of the primacy of the affects of fear and anxiety by using
them interchangeably in his monograph. Like Stern, he traced the develop-
ment of Freud’s formulations with regard to the origins of anxiety.
However, his focus has been primarily in the area of the ego’s helpless-
ness following a traumatic situation. As previously outlined, Freud
theorized that angst initially occurs as a result of the ego being in a
state of helplessness following an accumulation of excitation, with which
it cannot cope. Hurvich proposed that one’s reaction to being overwhelmed
or annihilated, which he termed mortal danger, may be seen as an elabora-
tion of the traumatic moment. Citing Freud's theories, Hurvich noted that
this trauma may have occurred at a time when the ego was immature and over-
whelmed, and may persist with current anxiety reactions, serving as the
basis for later anticipatory anxiety. Hurvich also posited that the fear
of being overwhelmed underlies the sequenceof fear of the loss of the
object, loss of the penis, and loss of love, and that annihilation anxiety
is a significant element in severe psychopathology. In summary, Hurvich’s
work represents an important elaboration of the area of annihilation
anxiety, and his conclusions with regard to the first elements of con-
sciousness support the formulations of Freud, Rank, and Stern.

In completing my analysis of the origin of anxiety, the work of May
(1977) is also salient, as he has demonstrated that a child's fears, and
ultimately fear in general, is an "objectivated form of underlying
anxiety.” In summary, anxiety is likely to be the fundamental affective
state of the ego. Perhaps as important are the relationships that are

formed, and how one copes with the certainty that relationships end. An

unavoidable reality in the understanding of psychic processes is that we
will never know the "truth” of certain issues. In this regard, theory and
research provide our best approximations to such truths. Thus, a review
of the literature with regard to how children learn about death may prove
profitable in elucidating the effect of this awareness.

One of the earliest studies that was conducted in this area is that of
Anthony (1940). Essentially, Anthony used parents’ written accounts of
their children’s spontaneous verbalizations about death, a story comple-
tion test, and the revised Stanford-Binet Intelligence Scale to study the
etiology of the concept of death in children between the ages of 3 and 13
years. Anthony found five distinct stages of children's thoughts about
death, which ranged from ignorance to a clear definition of death in bio-
logical or logically essential terms. In addition, these stages of
understanding were found to be more closely related to the child’s intel-
lectual performance than to his age or personal experience of death. In
summary, the child of 5 or 6 years attached meaning to death, but not in
biological or logical terms. However, by 8 or 9 years, causal or logical
explanations were used to some degree, which resembled that of adults.

The work of Nagy (1948) has also contributed greatly to our
understanding of how children learn about death. Nagy explored this issue
by asking the following: “Hhat does the child think death to be, what
theory does he construct of the nature of death." Her study included
children from the ages of 3 to 10, and involved the use of written composi-
tions, drawings and discussions. Nagy conducted an interview after the
compositions, with the questions based on the content of the children’s

compositions. The range of questions were as follows: "(a) Hhat is

10

death?; (b) Why do people die?; (c) How can one recognize death?; (d) 00
you usually dream? Tell me a dream about death!" The aforementioned
questions were asked only when such issues did not arise in the inter-
view. In brief, Nagy found a pattern of response that suggested the
presence of stages of development with regard to the child’s understanding
of death. More specifically, the child of less than five years was found
to not recognize death as an irreversible fact, but conceived of death as
temporary and reversible. Life and consciousness were attributed to the
dead, who were thought of as merely being asleep. Between the ages of
five and nine, death was often personified and associated with aggressive
intent on the part of others. Some of the children believed in a ”death-
man" who lurks in the night, is difficult to see, and who carries people
away. At this stage, death was not perceived as being inevitable, as the
children could conceive of others dying but not of their own death. Only
after the age of nine was it recognized that death is a universal process
that is related to natural laws. Nagy recognized the importance of the
child’s level of cognitive development in his understanding of death, and
posited that the stages of awareness parallel the developmental periods of
Piaget. Finally, Nagy examined the children’s feelings about death, and
found that the most painful aspect of this was the separation, which she
substantiated in a control study.

Thus, the findings of both Anthony and Nagy suggest that the child’s
level of cognitive development is a critical variable in his understanding
of death. The latter appears to parallel Piaget’s periods of cognitive

development, as illustrated by the work of Hulf (1973). Indeed, Piaget

11

(1955) credited a knowledge of the fact of death with opening the door to
logical thinking.

The work of Maurer (1966) is also important, as she has attempted to
put the literature of the child’s understanding of death into perspec—
tive. Maurer argued that just as the child develops a sense of being, he
is also aware of a sense of nonbeing, which occurs in the transition from
sleep to wakefulness. She presented a biological explanation for the lat-
ter, and attempted to sidestep the issue of cognition, as she suggested
that a child innately knows that the loss of his parents means his loss of
life. Thus, she hypothesized that fear of death underlies separation
anxiety. Maurer’s formulations about the importance of loss are supported
by Nagy (1948), who found that the most painful aspect of death for her
subjects was separation. However, Maurer suggested that the experience is
not so much one of anxiety or loss, but one that approaches terror. In
this regard, her formulations approach those of Stern (1966); however,
unlike Stern, she did not address the issue of mourning. Indeed, it is
likely that elements of mourning are what Nagy’s children spoke of being
most difficult, rather than the issue of terror, which may occur first,
but which is likely to be repressed.

At this time, a brief overview of the issue of mourning in psychoanaly-
sis, will be presented. Mourning, a natural concomitant of death, is an
issue that appears to be more salient for older children. To reiterate,
the issue of the ego's experience of separation has been primarily
interpreted as one of anxiety or terror, which speaks to the helpless
state that the ego is theorized to experience. Indeed, to this point the

focus has been primarily in this area; however, the relationship that

12

exists between mourning and death is also significant, which has important
implications for ego development as well. Freud’s (1913) initial writings
about mourning stressed the importance of the survivor separating his
memories from those of the dead, and in coming to grips with the loss.
Freud (1917) also addressed the complications that sometimes arise in
mourning, in which a turning away from reality sometimes occurs.

In describing the conflict that ensues, Freud highlighted the pain
involved in caping with the loss, and the difficulty in letting go. He
suggested that acceptance was made easier by the ego's awareness of its
own existence, in that the ego’s erotic narcissism facilitates the sever—
ing of the attachment to the deceased. In addition, he noted that the
libido that had been cathected onto the object may be withdrawn into the
ego, thereby retaining a part of the lost object. Freud noted that identi-
fication occurs when libido from the ruptured attachment is withdrawn into
the ego, and that identification and emulation two important mechanisms
that the ego employs to cope with loss. In addressing the relationship
between mourning and anxiety, Freud (1926) noted that mourning and pain
result from the loss of an object, while anxiety is a reaction to the
danger of losing the object.

Klein’s (1940) contributions to psychoanalysis also extend to the
process of mourning, as she theorized that mourning is a process of
disorganization and of subsequent reorganization of one’s inner world, and
the reestablishment of links with the external world.

Bowlby (1961) is another theorist who has made substantial contribu—
tions to our understanding of the process of mourning. Bowlby posited

that there are three distinct phases in mourning, the first of which he

l3

termed Protest. Bowlby defined Protest as the initial reaction of the
survivor to the loss which sometimes borders on denial, accompanied by the
desire to re-establish the relationship. He noted that weeping and anger
are the two primary aspects of Protest. Bowlby also linked the denial
with the self-blame that is typical of loss, in which castigation, anger,
and repeated disappointments reflect the hope that the lost object may
still be recovered. Bowlby defined the second and final phases of mourn-
ing to be those of Despair and Detachment. According to Bowlby, Despair
occurs when the impossibility of reunion becomes clearer, which is paral-
leled by a disorganization of behavior. In this regard, Bowlby’s second
phase of mourning incorporates much of Klein’s perspective in this area.
The last phase is Detachment, in which acceptance of the loss occurs in
healthy mourning, with identification and incorporation of values being
the links by which a connection is maintained with the lost object. In
summary, Bowlby has made important contributions to the understanding of
mourning which foreshadowed the work of Kubler-Ross, who is best known for
uncovering the processes in coping with one's own death.

Kubler-Ross’ (1981) formulations were derived from her work with dying
patients, from whom she identified five stages of coping with death. The
first stage is termed the "No, not me” stage, in which the initial reac-
tion is one of shock and denial. Kubler-Ross notes that only when the
dying person can talk about his imminent death with another, can he
progress to the next stage, which is one of rage and anger, and which is
defined as the “th me" stage. KublerRoss defined the third stage as one
of ”Bargaining,“ in which the individual has stopped saying, "No, not

me." People at this stage appear to be at peace, but they are far from

14

it. For Kubler-Ross, they are still attempting to find some way of extri-
cating themselves from the inevitable, and achieve a kind of temporary
truce. Increased acceptance of mortality occurs in the latter part of
this phase, when they begin to put their business in order. The patient
then typically proceeds to the next stage, which Kubler-Ross termed the
"Yes me" stage or one of depression. She notes that patients tend to go
through two types of depression, the first of which is a kind of reactive
depression. During this time, past losses are mourned, as are the diffi-
culties of dealing with the current situation. Kubler-Ross described the
next type of depression as a silent or preparatory grief. People in this
part of the stage begin to mourn their own death, as well as the things
that will never be. Kubler-Ross notes that people at this stage tend to
want to say good-bye to their loved ones, and to die quietly. The final
stage is one of "Acceptance", which is marked by an inner peace in which
the individual has accepted that he is finite, and that life is to be
enjoyed for today. Kubler-Ross suggests that acceptance is akin to a
feeling of victory and serenity, acquiescing to the inevitable order of
life. In essence, as in many phases of human behavior, the process of
mourning proceeds along a series of stages, which parallels not only one’s
understanding of death, but also one's acceptance of the inevitability of
death. The latter appears to proceed along a fixed sequence as well,
which is illustrated by the commonalities that exist in the theories of
Bowlby and Kubler-Ross. An additional omnipresent variable is denial,
which speaks to the difficulty that we have in facing death, and which is
a great obstacle that must be overcome in fully addressing one’s own

death. As previously outlined, mourning is also an inevitable aspect of

15

life, as all relationships that we have are destined to end. This exis-
tential issue will be next examined relative to the philosophies of
Kierkegaard and Heidegger, who have made their own significant contribu-
tions to the issue of death.
E . I l' ] II

Kierkegaard was a Danish philosopher whose major work occurred in the
middle of the nineteenth century. He is generally regarded as the founder
of the formal school of Existentialism (Yalom, 1980), and his work
primarily addressed the meaning of existence for the individual. For
Kierkegaard, that which exists is constantly involved in change or coming
to be in different ways. He posited that to exist means to be free and to
have the responsibility of one’s own becoming. With regard to the issue
of death, Kierkegaard (1964) maintained that one dreads losing oneself and
becoming "no thing," which he defined as an essential aspect of
existence. Moreover, he posited that man limits himself in order to avoid
the awareness of death. Kierkegaard (1964) noted that the result of deny-
ing death is despair, which he defined as a sickness of the spirit that
may be expressed in three ways: in despair in not being conscious of
having a self; in despair at not willing to be oneself; and in despair in
being willing to be oneself." For Kierkegaard, despair is tempered by
self-reflection, however, it does not provide refuge, as despair increases
as consciousness increases. Redemption is achieved by pursuing the true
vocation of man, which is ”to will to be oneself" (Kierkegaard, 1964).
Kierkegaard also emphasized the role of faith, which he maintained
provides possibility. For Kierkegaard (1964), in facing death one comes
to experience life as the "possibility of possibility."

16

The work of Heidegger is also salient, as he too spoke of the impor-
tance of death in existence. Essentially, Heidegger addressed the issue
of being, which he paraphrased as Dasein. Heidegger (1962) conceived of
Dasein as having empirical and transcendental qualities, as Dasein repre-
sents man’s search for meaning and is simultaneously the known. Heidegger
also noted that Dasein may occur either authentically or inauthentically,
with the latter being defined as "absorption in the world" of appearances,
or as a more general state of one’s familiarity with the world. For
Heidegger, however, when one is totally involved in the familiar world of
appearances, one is alienated from one’s existential situation. Hhen this
occurs, he posited that anxiety arises as a guide to lead one back to
authentic existence. With regard to death, Heidegger (1962) maintained
that death is Dasein’s "ownmost possibility." Heidegger noted that by a
process of deepest self-examination, which he referred to as "unconceal-
ment," do we recognize that we are finite beings, who must die, and who
are free - a freedom from which we cannot escape. He must also come to
grips with a fundamental aspect of our existence, in that we are alone in
a world where there is no inherent meaning. In summary, these issues are
central to existentialism, which has also had a significant impact on
psychoanalysis, as illustrated by the work of Boss and Binswanger.
MW

Boss and Binswanger were analysts who are identified with the area of
Existential Analysis, which has its foundation in psychoanalysis. Boss’s
work was greatly influenced by Heidegger, and his contributions have been
largely in the areas of authenticity and guilt. According to Boss (1957),

man is able to transcend his immediate situation because he has the capa-

17

city for understanding his being and taking responsibility for it. In
this regard, Boss posited that guilt arises when one fails to be
authentic.

The work of Binswanger also follows the philosophical doctrine of
being that was developed by Heidegger. In contrast to psychoanalysis,
Binswanger replaced the construct of the libido with dasein, and main-
tained that the primary source of anxiety is existence itself. Binswanger
emphasized the significance of the types of relationships that the self
transacts across time, which he defined as existential modes. He also
maintained that understanding that which exists must be placed relative to
that which is, and examined across time. With regard to psychotherapy,
Binswanger’s mode of treatment involves a tracing of the patient’s life
history, and an elaboration of the thema and aspects of relating that
exist for the patient, based on the underlying structure of the patient’s
being.

E . . ] l'l I

In order to more fully summarize the place of death in psychoanalysis
and existentialism, a review of the salient research literature will be
conducted, which will begin with a review by Stolorow (1966). The latter
is especially pertinent, as Stolorow completed a review of death in psycho-
analysis and existential philosophy. Stolorow initially examined the
theory that death anxiety is a derivative of castration fear, and cited
the work of Bromberg and Schilder (1933) in support of the latter. A more
contemporary study that was not cited by Stolorow is that of Sarnoff and
Corwin (1958), who also examined the relationship between castration

anxiety and death anxiety. Essentially, Sarnoff and Corwin hypothesized

18

that participants with high castration anxiety would display more fear of
death following their exposure to sexually arousing stimuli than individ-
uals with low castration anxiety. Consequently, the study measured the
interaction of castration anxiety and sexual stimulation in determining
the fear of death. In order to facilitate the examination of these vari-
ables, Sarnoff and Corwin developed an Opinion Scale, which measured the
basal levels of subjects on fear of death and morality. A measure of
their participant’s level of castration anxiety was obtained by presenting
the subjects with the castration anxiety card of the Blacky Test (Blum,
1949).

The latter depicts two dogs, one that is standing blindfolded over
which a large knife appears to be about to descend on his outstretched
tail. The other dog observes what is occurring. The participants were
presented the card and asked to rank three summary statements that best
summarized the situation that was depicted. They were subsequently
assigned to three categories, based on their level of castration anxiety,
as derived from their summary statement. Next, they were presented with
the sexually arousing stimulus. The latter included a condition of High
and Low sexual arousal, which involved the use of photographs of nude
women and photographs of fashion models, respectively. Finally, the
participants were asked to complete a measure of death anxiety. The
results were in the expected direction, and Sarnoff and Corwin concluded
that HCA (High Castration Anxiety) subjects showed a significantly greater
increase in fear of death than LCA (Low Castration Anxiety) subjects after
exposure to the sexually arousing stimuli of the HAS (High Arousal

Situation) condition. There were no significant differences in mean FDS

19

(Fear of Death Score) shift scores between HCA and LCA subjects under the
LAS (Low Arousal Situation) condition. In summary, the latter study
provides support for the theory that the fear of death is related to the
fear of castration. However, the issue of etiology is still unclear, as
repression of death is a significant variable which is not easily overcome
in research.

Stolorow next examined the theory that death anxiety is a derivative
of the fear of separation or object loss. With regard to the latter, he
noted the content of a poem of an analysand who was dying, and cited
another study by Bromberg and Schilder (1936). Stolorow also presented
the work of Anthony (1940), which has been previously discussed, and that
of Natterson and Knudson (1965), who also found that death anxiety is
associated with separation anxiety in children. This study is signifi-
cant, in that the process of separation relative to the fear of death was
examined in a population of fatally ill children and their mothers.
Natterson and Knudson (1965) studied 33 children, ages four to twelve, who
were selected according to the following criteria: (a) children who were
admitted to the City of Hope between June, 1956 to August, 1958; (b)
parents of children who had consented to have themselves and their termin-
ally ill child followed for at least two weeks; (c) children who died at
City of Hope during the latter period; and (d) children who were diagnosed
to have cancer, leukemia, or blood disease. The children and their
mothers were under the observation of the hospital staff, which included
physicians, nurses, a school teacher, an occupational therapist, and a
social worker. The focus of the staff’s observations was on three

stressors: the child’s separation from his or her mother, the traumatic

 

20

procedures that each child endured, and the response of the child to the
deaths of other children. The observations were partially retrospective;
however, efforts were made to note the latter immediately, often on the
patient’s medical chart. Natterson and Knudson found that children were
most distressed by their mother’s absence. It appears that the separation
from their mother was most severe in children below the age of five, with
children in increasing age groups being most distressed by the reaction to
the procedures (i.e., bone marrow aspirations) and to the deaths of other
children, respectively. Natterson and Knudson concluded that the fear of
death is related to other fears in a maturational manner, paralleling the
cause of distress in the children.

The last theory that Stolorow presented was the derivation of death
anxiety from superego dynamics. In this regard, Stolorow discussed the
findings of Chadwick (1929), and Zilboorg (1938). A related study is that
of Greenberger (1965), who addressed this issue by studying the fantasies
of terminally ill women relative to controls. In addition, Greenberger’s
study tested the salience of five psychoanalytic theories with regard to
death: I) disbelief in death; 2) death as punishment for either
aggressive or incestuous wishes; 3) death as separation from the mother;
4) death as reunion with the mother; and 5) death as a lover. In
reference to the first theory, disbelief in death speaks to the denial
that has been discussed in the body of this study, which is elaborated in
the work of Kubler-Ross. As to the issue of death as a punishment,
Greenberger addressed the issue of castration anxiety, as outlined in clas-
sical psychoanalytic theory. The theory of death as a separation from the

mother speaks to separation anxiety, which was addressed by both Freud and

21

Bowlby. Death as a reunion with the mother is drawn from the work of Rank
who, as previously indicated, theorized that death is experienced as a
desire to return to the womb. Finally, the view of death as a lover
speaks to a less well known perspective, which is illustrated by Freud’s
interpretations in "The Theme of the Three Caskets" (1925). Greenberger
used the Thematic Apperception Test (TAT) in her study, for which she
devised a scoring system to measure the fantasies of women based upon the
aforementioned perspectives. She conducted two studies, the first
involving 25 female patients who were hospitalized for a confirmed or
suspected case of cancer, and a similar matched set of controls. The
second study included female patients who were hospitalized for a variety
of severe illnesses (i.e., heart ailments) to augment the results of the
first study. A control group was employed for the latter, which was
similar in many respects to that of the first study. It should be noted
that Greenberger sought to maximize the degree of concern with death in
her experimental group; thus, these patients were tested at periods of
extreme stress (i.e., patients were tested one day prior to their
surgery). On the other hand, the control group was tested at points of
minimal stress (i.e., towards the end of their course of treatment), as
the author sought to decrease concern with death in this group. The
results of the study were that the first experimental group had signifi-
cantly more fantasies of death as a punishment for aggressive or inces-
tuous wishes than the control group. In addition, the perspective of
death as a lover received some support, with less support for the theory
of separation. Greenberger also found that cancer patients did not

significantly differ from controls in their tendency to repress or deny

22

thoughts of death, despite her attempt to control for this variable. In
this regard it is possible that the level of repression of death was
significant and in even measure for each group, despite the situation that
the patients in the experimental group were facing. A methodological
weakness also exists in Greenberger's design, as she used a different set
of TAT cards in her second study. As a result, she limited the compar-
ability of her two studies, with the second study having only one signi-
ficant finding as compared to the first. Hence, the issue of the
reliability of the findings of the first experiment is brought into
question. Finally, data is unavailable as to the level of pain that the
first experimental group experienced. This issue is salient, as the first
group is likely to have been in the most pain as a result of their condi-
tion, which may have strongly colored their responses on the projective
test, and their concerns about punishment. In summary, Greenberger’s
study lends support for the theory that one’s reaction to one’s own death
may be linked to superego dynamics; however, the latter is limited as a
result of methodological difficulties.

With regard to the work of the existentialists, Stolorow noted that
each writer stressed the importance of authentically dealing with non-
being, which contributes to a heightened sense of being, and psychological
growth. Stolorow also broadly defined death anxiety as a multifaceted
construct, which appears to be evidenced by the research literature.
Finally, in an effort to stimulate research in the area, Stolorow posed
the following questions: (1) Do people with death anxiety fear the pro-
cess of dying or the state of death, or both? (2) Do people relate death

anxiety to a fear of unification or individuation, or both? (3) Does the

23

ability to work through death anxiety contribute to an increased sense of
being, or a greater appreciation or life, or both? (4) Are pe0ple who
exhibit psychopathology unable to work through death anxiety? and (5) Are
certain ego defense mechanisms directed against death anxiety?

With regard to Stolorow’s questions, the work of Bromberg and Schilder
(1933), which was referenced so frequently by Stolorow, is applicable as
their work addressed questions 1 and 3. To reiterate, Bromberg and
Schilder (1933) examined the attitudes of normal and neurotic subjects
toward death through the use of a questionnaire. Hith regard to the
subjects who were studied, the population was comprised of 70 "normal"
subjects, which included participants in psychology groups at New York
University, Columbia University, medical students at New York University,
and members of the community. Bromberg and Schilder’s population ranged
in age from 20 to 52 years, and primarily consisted of women. As to the
population of "neurotic" subjects, the authors used 10 patients who had
been treated on the wards of Bellevue Hospital, and in whom thoughts of
death were prominent. However, additional information is unavailable as
to the latter subjects’ background. In essence, Bromberg and Schilder
asked their subjects 32 questions about death, examples of which include
the following: ”1. How often do you think about death? 7. Are you
afraid of dying? Of death? Of being dead? (and) 14. Do you have
fantasies of how it feels to be actually dying? Hhat do you imagine you
see and hear?” After the completion of their study, Bromberg and Schilder
opted to provide collective impressions rather than statistical analyses,
as they believed that this would be the clearest method of reporting. The
authors found that most participants reacted strongly to the first

24

question, and that they were most afraid of dying. This finding was
interpreted as providing support for the perspective that the fear of
death is related to a fear of separation. Bromberg and Schilder also
addressed Stolorow’s third question, which examines the way in which
people think about death. They found that participants tended to have
abstract ideas of death, and that for some participants, the religious
belief of reward for goodness was maintained.

As to the last two questions that Stolorow (1966) recommended for
further study (Are people who exhibit psychopathology unable to work
through death anxiety? and Are certain ego defense mechanisms directed
against death anxiety?), the work of Searles is relevant, as his work with
schizophrenic patients has illuminated the relationship that exists with
this disorder and death. According to Searles (1961), schizophrenia may
be seen as an unconscious attempt to ward off anxiety associated with
life’s finitude. Searles (1961) summarized his findings thusly: "a
person cannot bear to face the prospect of inevitable death until he has
had the experience of fully living, and the schizophrenic has not fully
lived.” Thus, Searles’ work suggests that a direct relationship exists
between the inability to move through death (anxiety) and the presence or
degree of psychopathology, and that schizophrenia appears to be associated
with particular modes of defense against death anxiety. Indeed, Searles’
theories recall the formulations of Rank (1929), who posited that the
neurotic limits himself in order to avoid death.

The work of Teixeira is also useful in understanding the relationship
that exists between psychopathology and the issue of death. As to the
etiology of schizophrenia, Teixeira (1984) maintained that the pathogenic

25

environment in which a schizophrenic is raised becomes internalized and
forms the pathological experiential models that the schizophrenic has of
the world, others, and of himself. Teixeira also noted that the affect
related to this pathological model leads to the formation of a set of
conditioned expectations, which become the foundation of annihilation
anxiety, and which form the basis for the pathological internal world of
the schizophrenic. Teixeira described Sullivan's (1953) conception of the
"not-me" as one way in which the latter has been integrated into theory.
Finally, Teixeira suggested that annihilation anxiety is more experien-
tially similar to traumatic anxiety than to signal anxiety; and that it
may be more correctly described as terror. In this regard, Teixeira’s
formulations parallel those of Hurvich (1988), and further underscore the
significance of annihilation anxiety.

However, Stolorow's question: Do people relate death anxiety to a
fear of unification or individuation, or both? remains unanswered.
Essentially, the fear of individuation parallels the formulations of Rank
and the existentialists, who emphasized the solitude into which man is
born. Stolorow’s question also addresses the issue of relationships,
which relative to the antecedents of death anxiety, have been interpreted
within varying frameworks. An additional variable is that raised by
Natterson and Knudson (1965), who posited that the fear of death is
related to the maturation of consciousness. In this regard, how one per-
ceives death is central. Another salient issue is the meaning that one
derives of life. In the research literature, such issues have been more
generally examined relative to the areas of death anxiety and purpose in

life (Durlak, I972; Nehrke, Bellucci, & Gabriel, 1978). Life satisfaction

26

has also been associated with Humanistic and Ego Psychology, and the con-
tributions of Frankl and Erikson. With regard to the work of the former,
Frankl was an analyst whose focus was on the significance of meaning in
life. For Frankl, being human involves being directed outward, which is a
dimension that provides for the transcendence of self. Echoing the formu-
lations of the existentialists Frankl maintained that one is complete only
after life has been completed by death. An early study that examined
Frankl's theories is that of Durlak (1972). Durlak focused on Frankl’s
(1965) postulate that an individual must find meaning in his suffering and
mortality in order to have meaning in life. Durlak hypothesized that a
negative relationship would exist between purpose in life and fear of
death. He employed two college and one high school sample in his study,
and utilized the Purpose in Life test (Crumbaugh & Maholick, 1964), and
the Fear of Death Scale (Lester, 1967) to examine his hypothesis.

Durlak’s hypothesis was confirmed across all participants, which be
replicated with another college population, thus, providing support for
Frankl’s postulate.

Blazer (1973) also investigated Frankl’s theories regarding the
importance of meaning in existence. His study involved participants who
were over 18 years of age, and who were equally divided with regard to
gender. Blazer used the Purpose in Life test and the Fear of Death
Scale. Like Durlak (1972), he too found a negative and significant
correlation between purpose in life and fear of death. An additional
finding was that there were only marginal differences between the sexes,
ages, or marital conditions of the participants. Finally, Blazer concluded

that in assessing a person’s meaning in life, it is important to look at

27

his attitude about death. This perspective also echoes the formulations
of the existentialists.

A related study is that of Neimeyer and Chapman (1980), who examined
the Sartrean concept of choice in existence. Essentially, Sartre (1972)
maintained that in life, man chooses himself. Neimeyer and Chapman drew a
parallel between the latter concept and the establishment of one’s iden-
tity, as they noted that by means of active investment in the attainment
of personal goals, people evolve for themselves substantial identities
during the course of their lives. Death ends this process, making life
either actualized or incomplete. Neimeyer and Chapman posited that
individual’s whose life plans are incomplete would experience greater
death anxiety than those who have fulfilled their major projects.
Neimeyer and Chapman’s study involved 101 participants, who were from
three community groups: 39 crisis line counselors (9 men, 32 women), 50
public school teachers (39 men and 18 women), and 12 members of a Lutheran
Church death and dying study group (5 men and 7 women). The participants
ranged in age from 14 to 68, and were from diverse demographic and educa-
tional backgrounds. Neimeyer and Chapman utilized the Threat Index
(Kelly, 1972), the Collet-Lester Fear of Death Scale (Lester, 1974), and
the Death Anxiety Scale (Templer, 1970). In order to test the hypothesis
that participants with incongruent perceived ideals would exhibit more
fear of death than participants who displayed greater self-ideal congru-
ence, the total group of participants were divided into two subgroups
(high and low self/ideal congruence) based on their performance on the
Threat Index (TI). Neimeyer and Chapman’s hypothesis was strongly

supported, which supports the positions of the existentialists.

28

In order to more fully assess the salience of an existential
perspective, Mullins and Lopez (1982) hypothesized a result that is at
direct variance with that of Neimeyer and Chapman (1980). In essence,
Mullins and Lopez sought to discern if a comparable difference exists in
the level of death anxiety among the "young-old" and "old-old" residents
in nursing homes, as defined by Neugarten (1974). The authors also sought
to assess the predictive value of education, gender, subjective health,
functional ability, social support, and length of stay with regard to
death anxiety among the latter groups. Mullins and Lopez hypothesized
that death anxiety would be greater among the young-old than among the
old-old participants, and that death anxiety would be greater among those
participants who were more highly educated. In this regard, the authors
posited that the participants would value higher levels of education;
hence, death was predicted to result in a greater loss, the prospect of
which would result in greater angst. As previously indicated, this
hypothesis is at variance with the existential position. The authors also
hypothesized that the female participants would experience greater death
anxiety than the male participants, that death anxiety would be greater
for those participants who were found to have declining functional
ability, and/or who subjectively assessed themselves as having poor
health. Finally, Mullins and Lopez hypothesized that death anxiety would
be greater for those participants with greater social support and among
those participants who had longer lengths of stay in the nursing home.

Mullins and Lopez examined 228 participants with an average age of
75.18 years. They utilized the Death Anxiety Scale (Templer, 1970) to

assess conscious death anxiety, three items from the OARS questionnaire

29

(Pfeiffer, 1975), which they noted are the most important questions
concerning perceived health in that instrument, the Langley-Porter
Self-Maintenance Scale (Lawton & Brody, 1969) to assess each participant’s
functional ability, and an index derived from items developed by Bachman,
Kahn, Davidson and Johnston (1973), to subjectively assess the extent of
social support the participant received from others.

The results were that the older residents were significantly more
likely to have greater death anxiety than the younger residents. In
addition, three of the authors’ hypotheses were supported among the
younger residents. These include the findings that death anxiety was
greater among those participants with poor functional ability, poor
subjective health, and longer stays in the institution. Three hypotheses
were also supported among the older residents, as death anxiety was found
to be greater among those with higher education, poor functional ability,
and poor subjective health. In summary, the two most discriminating
variables relative to death anxiety were subjective health and functional
ability, which are likely to figure prominently in the assessment of one’s
satisfaction with one’s own life. Unfortunately, this factor was not
assessed by Mullins and Lopez (1982), nor was that of ego development,
which has been shown to be an important issue in this population.

A more contemporary study is that of Florian and Snowden (1989), who
assessed the universality of the inverse relationship that has been demon-
strated relative to the fear of death and purpose in life. Their sample
consisted of 325 students, who were divided into seven groups based on
participants’ self-definition of ethnicity. The sample was also divided

across religion, yielding six distinct groups. Florian and Snowden util—

30

ized the Fear of Personal Death Scale (Florian & Kravetz, 1983), and the
Life Regard Index (Battista & Almond, 1973) to test their hypotheses. The
first measure consists of 32 items which are answered on a 7-point Likert
scale. The test-retest reliability of the Fear of Personal Death Scale is
reported to range from .50 to .90 (Florian & Snowden, 1989), with the
score being a simple summation of the entries made. In this scale, a high
score reflects high death anxiety. The Life Regard Index (LR Index)
consists of 28 items that have a 5-point scale. The LR Index is divided
into two subscales: Framework and Fulfillment. Each scale is composed of
14 items, half phrased negatively and half positively, with the sum termed
the Life Regard (LR) Index. The LR Index is reported to have a
test-retest reliability of .94, and its two subscales are highly
correlated (r=.76) (Battista & Almond, 1973). Florian and Snowden found
that fear of personal death was inversely related to positive life regard
for White Christians (comprised of a variety of interdenominational
sects), for Blacks (although to a lesser degree than for whites), and
marginally among Vietnamese. A relationship was not found to occur for
the remaining ethnic groups: Mexicans, Chinese and Jews. As to the
variable of religion, Buddhist subjects were most different, scoring the
highest fear of personal death score, and the lowest score on the LR
Index. The authors interpreted this finding as consistent with the
Buddhist view of life, of which reincarnation is a central aspect.

The authors also posited that the Buddhists’ responses to the LR Index may
be similarly affected, as a Western perspective of what is satisfying in
life may not be valid either for the spiritual outlook of Buddhism, or of
those cultures outside of the United States. The authors concluded that

31

the existential importance of fear of death appears to be most relevant
for Hhite Christians, and that future studies in this area would of
necessity require measures that are more sensitive with regard to culture.
Another area that has relevance to this area is that of loss, which
was demonstrated by a study conducted by Pfost and Stevens (1989). The
authors examined the relationship of purpose in life to grief experiences
regarding the death of a significant other. Previous research in this
area has demonstrated that individuals who experience low purpose in life
tend to use more emotion- based strategies in dealing with death, and have
much difficulty in accepting the loss. Pfost and Steven’s sample consist-
ed on 13 males and 27 females, who ranged in age from 18 to 38 years, and
who had lost a significant other between 1 to 36 months prior to their
involvement in the study. The rationale for the latter time frame was to
ensure that the mourning process remained a salient issue. As to methodo-
logy, both the Purpose in Life test (Crumbaugh & Maholik, 1964) and the
Grief Experience Inventory (Sanders, Mauger & Strong, 1979) were employed,
the latter of which consists of nine bereavement scales which measure
specific aspects of grieving (i.e., despair, anger and guilt). The parti-
cipants were initially divided into two groups, based on a median split of
their Purpose in Life scores. In this regard, individuals who had a score
of 108 or above were placed in the high purpose in life group, and those
who had scores below this were placed in the low group. It should be
noted that there were 19 participants in the high group and 21 in the low
group, and that there were no significant differences between groups with
regard to ratings of either degree of emotional trauma relative to the

loss, or intimacy of the participant with the deceased. The results of

32

the study were in the hypothesized direction, as mourners who reported
little meaning in their lives appeared to experience more intense anger in
response to the death of a significant other, which reflects their
difficulty in accepting losses.

The importance of loss as an issue was also demonstrated by Florian
(1989), who examined the issues of meaning and purpose in life in bereaved
parents. Florian studied the impact of loss in 26 parents, whose child
had died in a military campaign 11 years prior to their involvement in the
study, and in 26 parents who had lost their child two years prior to their
involvement in the study. He included a matched-control group of 52
parents, and utilized the Meaning in Life Scale (Florian, 1985), and the
Purpose in Life test (Crumbaugh & Maholick, 1964). The Meaning if Life
Scale (MIL) is a multi-dimensional measure that is comprised of 11 items
reflecting aspects of life that are thought to provide meaning in life.
Each item is answered on a 5-point scale, with a high score reflecting
high meaning in life. The Purpose in Life test (PIL) has been previously
discussed in this review, and as indicated by its title, its purpose is to
measure the extent to which an individual experiences purpose in life.
Florian found that nonbereaved parents score significantly higher than
bereaved parents on both measures. In addition, the two groups of
bereaved parents did not significantly differ with regard to their scores
on either measure; hence, the length of time after the loss did not
differentiate the two groups. Bereaved parents also tended to rate
themselves as less physically healthy than nonbereaved parents, which
further illustrates the significance of the loss. Florian interpreted his

results as providing support for Frankl’s theories, and suggested that the

33

bereaved parents may have experienced what Frankl (1963) termed an
"existential vacuum." Frankl (1963) defined this state as one in which
there is a loss of meaning of segments of experience, including the loss
of joy of living and motivation to continue the struggle for survival. In
summary, it appears that bereavement is an extremely complex process,
which may possibly not be overcome by some individuals, and which may
indeed worsen rather than improve as time goes by (Rando, I983; Roskin,
1984).

An area that is centrally related to loss and culture is that of ego
development. Nehrke, Bellucci, and Gabriel (1978) examined the relation-
ship between ego development, death anxiety, and purpose in life relative
to Erikson’s (1963) theories of development. Erikson posited the exis-
tence of eight stages of psychosocial development, the final stage being
ego integrity vs. despair. According to Erikson, ego integrity is
characterized by a recognition that one’s life is one’s responsibility,
and that life is more broadly tied with the lives of all who have preceded
him. Integrity is also reflected in the acceptance of the flaws of those
that one has encountered in life.

In contrast, Erikson defined despair as the feeling that life is too
short, and that one has lost the chance to do things differently. Erikson
notes that an individual at this stage is filled with a contemptuousness,
which may be evidenced by misanthropy. Nehrke, Bellucci, and Gabriel
hypothesized that individuals who have attained ego integrity would
demonstrate satisfaction with life and would not fear death, as opposed to
individuals who have not achieved such integration. Their hypothesis was

predicated on the idea that Erikson’s final stage of development may be

34

summarized as an individual’s perspective about death, in which they made
the further assumption that a measure of ego integrity may be obtained by
assessing the level of one’s death anxiety. Nehrke, et al, attempted to
empirically assess the latter through the use of the Locus of Reinforce-
ment Control scale (Rotter, 1966), the Life Satisfaction Index A
(Neugarten, Havighurst, & Tobin, 1961), the Fear of Death Scale (Boyar,
1964), and the Death Anxiety Scale (Templer, 1970). Their study involved
120 participants, who were all over 60 years of age. A third each were
from private nursing homes, public housing units, and the community, with
each group being balanced for gender. The authors found that Erikson’s
theory was generally supported. There were no significant sex differences
with regard to death anxiety, nor was there a relationship between death
anxiety and years of education. However, age was found to be negatively
related to death anxiety for the total sample.

Hoods and Hitte (1981) also examined Erikson's final stage of
development (ego integrity vs. despair) relative to death anxiety and
purpose in life. The authors used the Life Satisfaction Index-A, Death
Anxiety Scale, to assess the respective variables. Hoods and Hitte
hypothesized a negative correlation between performance on the Life
Satisfaction Index-A and the Death Anxiety Scale. The authors also
examined Erikson’s postulate that resolution of earlier conflicts in
psychosocial development would enhance one’s progression through future
stages of development. Hoods and Hitte used the Ego Identity Scale
(Rasmussen, 1974) to examine previous resolution of conflicts, and
hypothesized that a positive correlation would exist for performance on

both the Life Satisfaction Index-A and the Ego Identity Scale, and that a

35

negative correlation would exist for performance on the Death Anxiety
Scale and the Ego Identity Scale. Their sample was comprised of 29 men
and 71 women, who were between 61 and 89 years of age. The Life
Satisfaction Index-A and the Ego Identity Scale were alternately presented
first and last with the Death Anxiety Scale presented secondly, in order
to lessen any potential emotional impact of the scales. The results
supported Erikson’s postulate that the final stage of psychosocial develOp-
ment is likely to be reached by individuals who have successfully resolved
earlier developmental stages, as evidenced by the positive correlation
between measures of ego identity and life satisfaction. However, only
partial support was obtained for the remaining hypotheses that were
tested. More specifically, negative correlations between fear of death
and ego identity and between fear of death and life satisfaction were
found for men but not for women. The authors attributed this discrepancy
to sex-roles, as they suggested that the issue of retirement may be more
salient for men than for women, who may experience the latter as an
identity crisis.

A more contemporary study is that of Richardson and Sands (1987), who
examined the relationship of death anxiety and Erikson’s (1963) theories
in a population of 74 middle-aged women. More specifically, the authors
attempted to assess the importance of intimacy, generativity, integrity,
and identity in predicting attitudes about death in mid-life. Richardson
and Sands also sought to assess the utility of direct and indirect
measures of death concern, and employed a multidimensional approach
relative to death. The authors used the Death Anxiety Scale (OAS)

(Temple, 1970) as their direct measure of death concern, and four cards

36

from the Thematic Apperception Test (TAT) (Murray, 1943) as their indirect
measure. Three additional items were included to facilitate the assess-
ment of death attitudes from a developmental perspective (i.e., “Compared
with other people my age, I think about death more than others, about the
same as others, or less than others."). Developmental level was assessed
by evaluating the participants’ developmental concerns (i.e., in reference
to intimacy - - "I am interested in developing an intimate relationship
with someone.”). It should be noted that the authors cautioned that the
ability of such an approach to predict developmental level has not been
established; hence, their results must be tentatively accepted.

Richardson and Sands also performed assessments of concurrent and
construct validity for the DAS and TAT, as well as a factor analysis, in
which a regression analysis of the factors was used to clarify their
findings. As to the validity assessment, the authors found that the
relationship between measures was complementary, and that frequently,
conflicting results occurred. Hence, they concluded that the TAT and the
OAS are likely to measure different aspects of death anxiety.

This issue was further clarified in the factor analysis, in which 7
factors were derived, the strongest of which was entitled "Death
Concern.” The authors noted that this factor represented the traditional
death anxiety construct, and they found that the variables with the
strongest loadings for this factor came from the DAS. The DAS also pri-
marily contributed to the loadings for the factors of "Death in Physical
Terms,” "Death Denial,“ and "Death as a Dimension of Time" which provides
support for the validity of the DAS, and the complexity of the issue of

death awareness.

37

Richardson and Sands found that the developmental concerns of
integrity and generativity were more predictive of death concern than age,
which they argued confirmed the inverse relationship that has been demon-
strated between purpose in life and death anxiety. The second factor that
was analyzed was Death as Interpersonal Loss, which was primarily related
to the developmental factors of identity and intimacy. More specifically,
participants who were struggling with identity appeared to be concerned
about issues of loss, as did those who reported that they were not looking
for an interpersonal relationship.

The next factor that was related to developmental issues was that of
Death Denial, which was primarily related to age. An interesting finding
occurred with this, as the younger group of women exhibited more
variability with regard to their fear of death that the older group of
women. However, the older women as a whole reported greater denial of
death. Finally, the last factor was entitled Death as a Dimension of
Time, and was accounted for primarily by the construct of integrity. In
clarifying the latter, the authors reasoned that those in search of
meaning appeared to be concerned about time passing too quickly, and those
who had meaning were not bothered by the passage of time. In summary,
Richardson and Sands concluded that death attitudes are complex and
multidimensional, and that developmental issues are related to
consciousness of death.

A related study is that of Frazier and Foss-Goodman (1988), who
examined the relationship between death anxiety and personality in a
population of 161 undergraduates. Frazier and Foss-Goodman used a

comprehensive questionnaire, rather than single measures presented

38

jointly, in order to diminish the extent to which participants would frame
their responses based on their reaction to one of the measures. The
authors’ questionnaire included the Death Anxiety Scale (Templer, 1970),
the Fear of Death Scale (Sarnoff and Corwin, 1959), the Eysenck
Personality Inventory (Eysenck & Eysenck, 1968), the Jenkins Activity
Survey (Jenkins, Zyzanski & Rosenman, 1979), and a modification of the
Social Readjustment Rating Scale (Holmes 8 Rahe, 1967). In reference to
the preceding measures, the Eysenck Personality Inventory (EPI) was
designed to assess personality along the dimensions of extraversion-
introversion, and neuroticism. More specifically, the variable of
extraversion-introversion taps the tendency of the individual to be
impulsive and sociable, as compared to being introspective and

restrained. The dimension of neuroticism is measured along a low-high
continuum, and reflects the respondent’s tendency to emotionally overreact
to situations. The Jenkins Activity Survey was designed to obtain an
index of one’s day-to-day activities (i.e., recreation, interaction with
others).

The measure also discriminates between Type A and Type B personality
variables. Type A individuals are described as being driven, and extremely
competitive individuals, who are also thought to have much stress associat—
ed with their pursuits. Type 8 individuals are at the opposite extreme,
and are basically laid-back, and less focused on being the best. As
previously indicated, a modified version of the Social Readjustment Rating
Scale was employed, which assesses the significance of events that have
occurred in the preceding year and one’s anticipation of future events.

Finally, the questionnaire that was employed consisted of 84 items, each

39

of which had a 7-point scale with endpoints labeled "strongly agree’ and
"strongly disagree." The results were in the anticipated direction, as
characteristics of neuroticism and Type A personality variables displayed
a positive and significant correlation between death anxiety for both the
DAS and FODS. In this regard, the authors maintained that participants
who displayed a sense of time urgency, and who were more emotive and
aggressive possessed greater death anxiety.

The construct of Locus of Control is another variable that has been
examined relative to death anxiety and purpose in life. Locus of control
was developed by Rotter (1966), and speaks to the perception that one has
as to whether one’s actions are contingent on one’s behaviors (internal
control), or due to others or external events (external control).
Hickson, Housley, and Boyle (1988), proposed that an individual’s LOC may
serve as a moderating variable in relation to anxiety. One hundred and
twenty-two adults participated in the study, who ranged in age from 61 to
80. The instruments that were employed included the Internal-External
Locus of Control Scale (Rotter, 1966), the Philadelphia Geriatric Center
Morale Scale (Lawton, 1972), and the Death Anxiety Scale (Templer, 1970).
The Internal-External Locus of Control Scale is a 23 item forced choice
questionnaire, which is scored in the external direction. The
Philadelphia Geriatric Center Morale Scale, consists of 22 items to which
the respondent either agrees or disagrees. A high score reflects the
presence of high morale, with life satisfaction reflected in the scale by
positive self-regard, acceptance of reality, and striving for mastery. The
last measure, the Death Anxiety Scale, has been previously reviewed.

Hickson, et al, found a general relationship between the variables of

40

death anxiety and life satisfaction, such that high life satisfaction
correlated significantly with low death anxiety regardless of the
participant’s LOC.

It should be noted that this relationship was significant for the females,
who comprised the majority of the sample, and for the following age
groups: 61 to 65 and 71 to 75. Additional analyses exhibited significant
main effects of sex and LOC, and a significant interaction between age and
LOC, such that females were found to have lower life satisfaction, and
higher death anxiety. Another interesting finding was that internal
control was significantly associated with life satisfaction. The authors
concluded that the perception that the elderly have with regard to their
control of reinforcing events is a central factor affecting their degree
of life satisfaction. As to the sex differences that were uncovered,
Hickson, et al, posited that females may have learned more "helpless
attitudes" at younger ages than their male cohorts.

A study that was conducted by Robbins (1989) helps to further clarify
the issue of gender and death anxiety. Robbins reviewed the relevant
literature in this area, and demonstrated the reliability of the finding
that women tend to have significantly higher scores on measures of death
anxiety than males.

She reported that the latter has been chiefly found on responses to the
Death Anxiety Scale (Templer, 1970), and inconsistently found on another
popular measure of death anxiety, the Collet-Lester Fear of Death Scale
(Lester, 1974). As a result, she attempted to explore the relationship of
sex-role stereotypes to the gender differences on these measures. Robbins

also included the Bem Sex-Role Inventory (Bem, 1981), the Marlowe-Crowne

41

Social Desirability Scale (Crowne & Marlowe, 1960), Spielberger’s State
Anxiety Inventory (Spielberger, 1983), and Spielberger’s Trait Anxiety
Inventory (Spielberger, 1983). The last two measures were used to assess
the role of general anxiety with regard to the variables under investiga-
tion, which was also the reason for inclusion of the Marlowe-Crowne
Social Desirability Scale. The author hypothesized that females would
report more death anxiety than males on the DAS, and that if sex differ-
ences occurred on the CLFODS, they would also be in the same direction.
The second hypothesis was that intercorrelations would occur between
measures of death anxiety and state anxiety, trait anxiety, and to a
lesser extent with social desirability. The final hypothesis was that
sex—role stereotypes, as indicated by the Bem Sex-Role Inventory, would
help account for the variance in scales of death concern associated with
gender. Their sample was comprised of 67 women and 25 men who were all
undergraduate students. Robbins found that females reported more death
anxiety on the DAS than males, which was also the case on two of the four
CLFODS subscales ("Fear of Others" and "Fear of Dying of Self"). Positive
correlations were found between both measures of death anxiety and
measures of general anxiety, which provided support for the second hypo-
thesis. It should be noted that none of the scales was associated with
social desirability, which has been found by others (Kastenbaum 8 Costa,
1977). Finally, women had significantly higher scores on the Bem
Femininity Scale, and men had higher scores on the Bem Masculinity Scale.
Robbins interpreted these findings as providing support for the impact of
sex-role stereotypes in the assessment of death anxiety.

Issues of gender are clearly important in examining death anxiety and

42

life satisfaction. Such issues may be more generally subsumed under the
area of ego development, which has also been demonstrated to be a
significant issue.

To this point, ego development has been primarily examined relative to
the theories of Erikson, and the developmental formulations of other
psychoanalytic theorists. Loevinger (1985) presents a more contemporary
model, that represents an integration of common elements in the models of
Erikson (1963) and other theorists. Loevinger’s theories address ego
development comprehensively along character, cognitive, moral, and social
lines. She and her colleagues have also developed a measure of ego
development that has been hailed as one of the most empirically based and
best designed measures of ego development (Vaillant (1987). Loevinger
posited the existence of seven basic stages of ego development, and three
transitional phases. As in Erikson’s psychosocial model, each stage is
successively more complex than the one preceding it, and evolves in an
invariant and hierarchical order. The first stage (1-1) is comprised on
two phases, which are termed the Presocial and Symbiotic Phases, respec-
tively. Essentially, the Presocial phase is marked by the egocentricity
of early childhood, and its primary task is for the child to achieve
object constancy. Attachment is the focus of the Symbiotic phase, during
which further differentiation between self and other occurs.

The Impulsive (1-2) Stage is next, in which the child further affirms
his or her own separate identity. However, the child continues to
perceive the world in egocentric and concrete terms. In addition, the
child’s assessment of its actions are based on the consequences which

result, with rules being followed only when it is advantageous for the

43

child to do so. The third stage (Delta) is one that is ”self-protective,"
in that one’s energies are directed to whatever is advantageous to oneself
regardless of rules, morality, or relationships. Relationships are
correspondingly less dependent than those of the Impulsive Stage, and an
increased understanding of rules is paralleled with increased efforts to
avoid getting into trouble. Following the Delta Stage is the first
transitional phase, which is termed Delta/3. The latter progresses into
the Conformist Stage. in which increased importance is placed on following
rules, with interpersonal relationships being seen in terms of concrete
events and actions, rather than on internal events. The second
transitional phase occurs at this time, and is termed 1-3/4. This phase
marks the initial aspects of responsibility, self-awareness, and
self-criticism. As a result, one is less constrained by the norms of
one’s group, as is typical of the Conformist Stage, and increased
flexibility exists in one’s relationships with others. The next stage is
the Consciencious Stage (1/4), which is marked by the internalization of
morality. In contrast to the concrete perspective of the Conformist
Stage, relationships are now perceived in terms of feelings and motives,
rather than on actions. The latter results in the maturation of one’s
interactions with others, so that relationships become more meaningful and
vivid. The third transitional phase occurs at this time, and is termed
I-4/5. Individuals at this phase exhibit an enhanced ability to tolerate
paradoxes, which is reflected in their ability to engage in increasingly
complex relationships, and the increased value that is placed on relation-
ships. The sixth stage is termed the Autonomous Stage (1-5), in which an

increased appreciation occurs relative to the individual decisions that

44

are confronted by all of us. Paralleling the latter is the increased
ability of individuals to cope with their inner conflicts. As a result,
interpersonal relationships are marked by one’s recognition of his or her
interdependence with others, as well as the need for autonomy that others
have. The final stage is termed the Integrated Stage (1-6), which
Loevinger (1966) described as involving the reconciliation of conflicting
demands, and the acceptance that everything cannot be attained. In this
stage, the differences of individuals are cherished, rather than merely
tolerated.

Loevinger’s final stage of ego development reflects a world view that
has much in common with that of Erikson (1963). Kubler-Ross maintained a
similar prosaic view of life in her final stage, as she spoke of the
tranquility and increased understanding that occurs after one has come to
grips with one’s mortality. Existential philosophy provides a less
ethereal perspective, as anxiety is viewed as an aspect of life that is
inescapable. In this viewpoint, living authentically, which may be
equated with such levels of ego development is related to coming to grips
with one’s mortality. Increased meaning in life is also presented as a
derivative of authentic existence. Indeed, these two basic tenets of
existentialism have received empirical support. In comparing existential-
ism with psychoanalysis, the construct of the ego most directly reflects
the concept of dasein. As a result, the issues of death anxiety and
purpose in life will be examined relative to the issue of ego development
in this study, in order to provide an integration of the perspectives and

research literature that has been reviewed.

45

Hypothesjs_1: Participants with a high purpose in life will have less

death anxiety than those individuals who have a low purpose in life.

Hypothesjs_2: Participants who have successfully reached the latter
stages of psychosocial development will have a greater purpose in life and
less death anxiety than those participants who have reached lesser stages

of development.

Hypothesj§_3: Participants who have had significant losses will have

greater death anxiety than those who have not had a significant loss.

METHOD

Subjects

Recruited by the author in Lansing, Michigan from the Foster
Grandparent’s Group, the St. Lawrence Hospital Auxiliary, and the Waverly
39er’s Senior Citizen’s Group, 87 women and 13 men participated in the
study. The limited number of men was partly a function of their lesser
availability and interest in attending the experiment, and in completing
the questionnaires. Participants ranged in age from 60 to 89 years, and
varied with respect to a number of demographic/life experience variables,
as shown in Table 1. Analyses of the differences between the mean
responses of men and women were performed for each variable. Only on the
Purpose in Life (PIL) test was there a significant difference E (1, 98) =
4.27, p < .05. As a result, the responses of both sexes were aggregated

in the analyses that were performed.

maxim

Individuals were advised of this study through postings on their
respective group’s bulletin boards. These gave a brief description of the
study, and a sign-up sheet for interested participants. The sign-up sheet
listed the date, time, and location for participation. Volunteers were
informed of this study’s purpose by the author, who described it as an

investigation of attitudes about death. Subjects were provided with a

46

47

Table 1
If” .1. Hi. 0 I' .010] .. I‘uoc .9] ' - .l‘r‘l - ._ .1:
Women Men

(0 = 37) (n = 13)
Lariable Mean SD Mean 50
Age 73.00 6.76 73.54 6.79
Education 12.47 3.08 13.69 3.52
Religiositya 7.31 1.99 7.18 1.72
Death Educationb .39 .49 .46 .52
Deathsc .55 .50 .39 .51
Health Ratingd 7.27 1.30 6.85 1.99
Recreational Activitiese 1.67 .47 1.83 .39
Death Anxiety Test Score 40.37 11.54 36.31 10.38
Sentence Completion Test Rating 6.94 1.43 7.15 1.07
Purpose in Life Test Score 81.74 9.49 87.54 9.07

aScore was obtained by self-rating on a 10-point scale, with high scores
reflecting stronger degrees of religious beliefs.

bScore was quantified by l for those who reported receiving death
education from their parents and 0 for those who did not.

cScore quantified by 1 for those who had reported experiencing a death
in the past 3 years, and 0 for those who had not.

dScore was obtained by self-rating on a lO-point scale, with high scores
reflecting better degrees of health.

eScore was quantified by 1 for those who reported participating in
active recreation and 0 for those who did not.

48

questionnaire that included a cover letter (Appendix A; page 70), a
Departmental Research Consent Form (Appendix 8; page 71), and a Personal
Data Form, which solicited identifying information (Appendix C; page 72),
as well as the following measures: the Death Anxiety Scale (OAS)
(Appendix 0; pages 73 through 74), the Sentence Completion Test (SCT)
(Appendix E; pages 75 through 81), and the Purpose in Life (PIL) test
(Appendix F; pages 82 through 84). Participants were read the following
as a group before they began the study:

This is a study that is designed to learn about the attitudes and
feelings that people have about death. You will be asked to answer
several questions, some of which are of a highly personal nature.
Please be aware that your name will not appear on any of the
questionnaires that you complete, rather, a code will be used which
will facilitate an analysis of your responses. Thus, your responses
are completely anonymous, and no one, except myself, will have access
to your responses. In addition to the questionnaire, an introduction
sheet is provided, as well as a consent form for this research.

If you do not feel comfortable about participating at this time, or if
you have changed your mind in any way, please feel free to not
participate any further. Please hand in your materials, and feel free
to leave at this time.

If you do wish to participate, please read the consent form and sign
and date it at the bottom. Hhen answering the questionnaire, please do
not leave out any questions or parts. Although instructions are
included in your packet, please feel free to raise your hand to ask
questions at any time. After you have completed all of the materials,
please hand in your consent forms separate from your questionnaire.
Are there any questions? Please begin.

Instruments
The Death Anxiety Scale (DAS) is a 15-item questionnaire listing

different fears that a person may have about death (Appendix 0; pages 73
through 74). For this study, the original DAS true-false options were

converted to a Likert scale format, with higher values indicating that one

 

49

"strongly agrees" with the item in question. This modification has been
shown to not effect the reliability of the measure (Richardson & Sands,
1987), and to facilitate factor analysis of DAS data. More generally, the
test-retest stability of the original scale was .83 after a 3-week
interval, which according to Templer (1970), reflected an acceptable
level. Finally, its concurrent validity was supported by a substantial
correlation (r = .74, N = 70) with Boyar’s (1964) Fear of Death Scale
(Templer, 1970).

The Sentence Completion Test (SCT) is a measure that was developed
over a decade by Loevinger and her colleagues (1985). It was founded on
Loevinger’s theories of ego development and provides 36 sentence stems to
be completed by the subject. Essentially, the SCT is scored by a rating
of the subject’s responses to the sentence stems, resulting in an overall
rating of ego development. The scoring paradigm assumes that each person
has a core level of ego functioning that will be reflected in their SCT
response. Loevinger, Hessler, and Redmore (1970) have reported interrater
reliability ratings for the core ego level at .85, and median interrater
correlations as .75, for both Loevinger’s group and trained raters. I was
the only rater in the present study, and my proficiency in rating sentence
stems was assessed by my accuracy in rating 100 sample sentence stems
provided by Loevinger (1970). My rating of the developmental level
reflected by the sample sentence completions matched those assigned by
Loevinger (1970) 83 times out of 100. The frequency distribution of my
ratings for the present women and men participants is provided in Appendix
G (page 85).

The Purpose in Life Test (PIL) was developed by Crumbaugh and Maholick

50

(1968) to test Frankl’s theory of existential frustration, which is
posited to occur when the individual’s meaning in life is diminished.
Essentially, PIL addresses the degree to which the individual perceives
her/his life to be meaningful. PIL is comprised of 20 Likert type
statements, accompanied by responses that range from low purpose (1) to
high purpose (7). As to reliability, the split-half (odd-even)
correlation of PIL was .85 (N . 120, Crumbaugh, 1972). Furthermore, its
correlations with the Collett-Lester Fear of Death Scale (Collet & Lester,
1969) were found to be .54 (N a 120) and .68 (N = 94) in two populations
of college students (Durlak, 1972). Finally, the PIL has been found to be
significantly correlated with the depression scale of the MMPI (r - -.65,
N - 143; Crumbaugh, 1972).

RESULTS

The first hypothesis addressed the relationship between death anxiety
and purpose in life. Participants with high ”purpose in life” scores were
posited to have less death anxiety than those with lower "purpose in life"
scores. To estimate the potential effect of PIL gender differences,
separate correlational analyses were conducted for each sex. However,
neither correlation was statistically significant at the .05 level by the
two-tailed test (women’s r = .16; and men’s r - -.09). Consequently, the
first hypothesis was rejected.

The second hypothesis pertained to ego development. Those whose
responses indicated higher levels of SCT ego development were posited to
have a greater purpose in life and less death anxiety than those whose
scores reflected lower developmental stages. Based on respondents’ PIL
and DAS scores, two groups of approximately equal size were formed for all
participants. Those scoring 83 or less on the PIL constituted the low
purpose in life group, and those scoring above 83 comprised the high
purpose in life group. Similarly, persons scoring 41 or below on the DAS
made up the low death anxiety group, and those scoring above 41 were
placed in the high death anxiety group. The means of the pertinent
variables are shown in Table 2. Multiple Analysis of Variance (MANOVA)
was employed to test this hypothesis, as displayed in Table 3. Although a

significant relationship was found between DAS and SCT, a significant

51

52

TABLE 2
u‘-l .‘Ic ._Ic._ a I' .. 0| 0 I; .I0_ ' I ‘ .I .;I. A
Lew_EIL_fireun Hieh_EIL_Gneun
74.30 (8.38) 88.27 (9.85)
Len_DA§_§£eun Higb_DA§_fireun
32.97 (17.19) 49.56 (7.52)
TABLE 3
I u .l I I a 0 II In I. o 1 l'
Seuree_ef_!ariatien SS 9: MS E Sie_e£_E
HITHIN CELLS 20.83 90 -.23
Regression .00 l .00 .00 .97
PIL .70 2 .35 1.51 .23
OAS 1.36 2 .68 2.93 .05
PIL by OAS .58 4 .15 .63 .64

B i E 1 . E IITI' C 1] |

Denendent_!ariahle: SCT

Cexariate B Beta Ste_Err I;Malue Sie_e£_l
Sex -.01 -.oo .15 -.04 .97
Cexariate Lener.:25% CL_;_Unner

Sex -.31 .30

53

interaction did not occur between OAS and PIL. Hence, this hypothesis was
rejected.

To clarify all relationships among responses to the OAS, SCT, PIL, and
questionnaire variables, an exploratory factor analysis was conducted. A
principal components method with varimax rotation to simple structure was
used. A priori factors were created for the OAS and PIL to facilitate com-
parisons of the present results with those of other researchers (i.e.,
Richardson & Sands, 1987). In this regard, the OAS variables included
death denial (Dden), death concept (Ocon), death in physical terms (Dphy),
sense of finitude (Fini), and death in metaphysical terms (Omet). Factor
variables derived from the PIL included one’s sense of life purpose
(Lper), life assessment (Lasses), meaning of life (Mlife), and self-
perception (Sper). Taken from responses to the demographic and life ex-
perience questionnaires, other variables were also assessed for their
possible impact on ego development (see Tables 4a and 4b). These
included: Educational 1evel (Educ), experience with death in the last
three years (Losses), assessment of religiosity (Relig), marital status
(Marit), spousal status (Spouse), assessment of health (Health), current
residence (Resid), and experience with death education (OeathEd). All
factor variables were rotated (varimax), yielding the factor loadings
displayed in Table 5. Factor 1, labeled Death Anxiety, was comprised of
the majority of OAS variables, including overall OAS scores, Ocon, Oden,
Ophy, Fini, Omet, and Health (negatively). Labeled Marital Issues, Factor
2 included positive loadings for marital status (Marit) and residence
(Resid), but an inverse loading for the death of one’s spouse (Spouse).

Factor 3, labeled Purpose in Life, had only positive loadings for one’s

54

TABLE 48
-. 0 u: ' I I-“to .All ' - ‘0‘ ‘1 - ._ .7. - .Ic -. 0
Variables
EACIQR_1 EACIQR_Z EACIQB_3 EACIQR_4

Education -.12 -.24 -.10 .72a
Losses -.01 .33 -.05 -.26
Religiosity -.06 -.28 -.37 .38
Marital Status -.10 .91a -.01 .03
Spouse’s Status .11 -.87b .11 .07
Health -.409 .16 -.01 -.21
Residence .02 .47c -.02 -.45c
Death Educ .01 -.11 .09 .14
PIL .02 -.07 .83a .08
OAS .99a -.07 -.06 -.06
Oden .85c -.08 -.16 .13
Dcon .87” .09 -.04 .03
Dphy .80d -.13 .14 -.20
Fini .61f -.20 -.03 -.04
Omet .62e .09 -.01 -.14
Lper .09 .02 .10 -.17
Mlife -.06 .04 .70c .44d
Lasses -.12 -.11 .82” -.10
Sper .01 .11 .13 .62”

Note. Superscript identifies variables loading .40 or above on each
actor.

55

TABLE 4b
. . I. ‘, . I-“pt ...' ' . ,.- '-, - . ’.. - .I. . .
We;
EAClQRJ EAClQLE EACIQBJ

Education .10 .33 .16
Losses .10 .12 -.81a
Religiosity -.15 .03 .08
Marital Status -.03 .06 -.11
Spouse’s Status .05 .19 .05
Health -.48” .33 .18
Residence .11 .07 .59b
Death Educ -.13 .86a -.11
PIL .37 .03 .03
OAS .08 .03 .03
Dden .02 .14 -.Ol
Ocon -.13 -.13 -.07
Ophy .08 -.09 -.07
Fini .27 -.11 .30
Omet .26 .41” .06
Lper .89a -.04 .02
Mlife -.36 -.09 .04
Lasses -.04 .11 .01
Sper -.09 -.04 -.02

Note. Superscript identifies variables loading .40 or above on each
actor.

YABIABLELQMMILNALIII
.75

.86
.39
.85
.83
.61
.79

Education
Losses
Religiosity
Marital Stat
Spouse’s Stat
Health
Residence

Death Educ

PIL

OAS

Oden
Ocon
Ophy
Fini
Dmet
Lper

Mlife

Lasses

Sper

.81
.85
.99
.80
.81
.74
.59
.66
.85
.82
.73
.42

56

TABLE 5

57

score on PIL (PIL), assessment of life (Lasses), and sense of meaning in
life (Mlife). Factor 4, labeled Education, loaded positively for educa-
tional level (Educ), self-perception (Sper), and meaning in life (Mlife),
but negatively on residence (Resid). Labeled Perception of Life, Factor 5
was comprised of perception of life (Lper), and negatively on health
(Health). Factor 6 consisted of death education (Oeated), and death in
metaphysical terms (Omet), and was labeled Death Education. Factor 7,
labeled Losses, was comprised of one’s experience with death (Losses), and
inversely with residence (Resid).

To assess the significance of these seven factors relative to SCT
rating, a regression analysis was conducted, as shown in Table 6. The
multiple 3 for this test indicated that Factors 1 and 6 contributed
significantly to the prediction of SCT ratings E (7, 52) - .55. As indi-
cated, Factor 1 was comprised of the majority of OAS variables. These
variables were found to be statistically related to ego development as a
whole, which suggests that the relationship that exists is an inclusive
one. This result was further elaborated by the significance of Factor 6,
featuring variables associated with death education. The findings support
the existential position that facing death is associated with ego
development.

The last hypothesis involved the issue of loss, as participants who
have had more losses (as identified in the questionnaire) were posited to
have higher death anxiety levels than those who have experienced fewer
losses. However, the correlation was not statistically significant [r
(98) - .06] by the two-tailed test, and this hypothesis was not supported.

Finally, to examine the more focal relationships between SCT level,

Multiple R .54
R 2 .29
Adjusted R .20
Standard Error 1.13
E 1 . E M .

df
Regression 7
Residual 52
M . I] . II E 1'
Variable B
Losses -.19
Death Education .46

Perception of Life -.22

Education .27
Purpose in Life -.05
Marital Issues .03

Death Anxiety .32

58

TABLE 6

Sun.et.§euares
28.11
66.49
S£_B Beta
.15 -.15
.15 .36
.15 -.18
.15 .21
.15 -.04
.15 .02
.15 .25

Mean_§euares
4.02
1.28
I Sie_et_I

-1.3 .23
3.13 .00
-1.52 .14
1.83 .07
-.35 .73
.18 .86
2.19 .03

59

performance on the OAS and PIL, and the questionnaire variables, a correla-
tional analysis was conducted. To assess gender differences, separate
analyses were conducted for women and men, as displayed in Table 7.

Women’s SCT level correlated positively and significantly with both death
education (1 - .32; p < .01), and general education (r - .30; p < .05). A
similar correlation was found between women’s PIL responses and death edu-
cation (3 = .25; p < .05). Hence, education and death education were prin-
cipally associated with women’s SCT response, with death education also
related positively to their PIL responses. Homen’s OAS scores correlated
negatively with both their health status (p < .05), and age (p < .05),
indicating that for this sample, death anxiety increased with impaired
health, and declined with age. Among these men, health correlated posi-
tively and significantly with both SCT level (n - .67; p < .05) and educa-
tion (1 - .48; p < .05), but negatively with age (I a -.47; p < .05).
Clearly, health was a more meaningful variable for men, in which a classic
relationship was found between declining health and increasing age.

Due to this small sample of men, confidence in the stability of pertin-
ent intermeasure differences is limited. However, examination of these
differences yields interesting results. Health correlated positively and
significantly with men’s SCT level, but negatively with women’s SCT level
(L - -.16). A similar relationship occurred with health and education
(men’s r - .66; women’s r - -.21). Health and age were significantly and
negatively correlated (-.64) for men, but not for women (n - .16). It
appears that health may symbolize a sense of strength for men but may be
less culturally meaningful for women. Men’s death education and PIL

scores correlated negatively (r = -.36), as opposed to their significant

60

TABLE 7
D. "* INII‘E E "L“ 11.41..”
OAS PIL EOUC HEALTH
SCT .21 .01 .30** -.16
OAS - .16 .03 -.34**
PIL - .04 .01
EOUC - -.21
HEALTH -
AGE
OEATHEO

**p <.01, two-tailed.

*p <.05, two-tailed.

AGE

-.12
-.22

*

.16

-.13

.16

OEATHEO
.32**
.04
.25*
.14
.17

-.Ol

Cerrelatjens_ter_13_MenLs_Seeres_en_Measures_and_Rat1nes_en

n I' II'E E . I! . I]
OAS PIL EOUC HEALTH
SCT .18 -.25 .48 .67*
OAS - -.09 —.23 -.24
PIL - -.50 -.37
EOUC - .66*
HEALTH -
AGE
OEATHEO

*p <.05, two-tailed.

AGE
-.47
-.36

.19
-.47
-.64

*

DEATHED
.43
-.07
-.36
-.O3
.28
.01

LOSSES
.20
-.O3
-.06
-.10
-.08
.06
.18

LOSSES
.46
.34
.24

-.28
.13

-.18
.07

61

positive correlation among women (r . .25). In this regard, it appears
that women are better able to come to terms with death than men, with

declining health being more likely to significantly disrupt men’s lives.

DISCUSSION

Death Anxiety scores alone were found to be unrelated to response to
the Purpose in Life (PIL) questionnaire. Based on prior research that had
reported a negative correlation between these measures of Death Anxiety
and Purpose in Life, an inverse relationship between these measures had
been posited. The present findings also failed to confirm the posited
interaction between these two variables relative to SCT level. Death
Anxiety responses, but not Purpose in Life responses, were associated
mildly but significantly with SCT level of ego development. Increased
purpose in life has also been associated with the final stages of
Erikson’s (1963) theory of ego development. However, the present measure
of Purpose in Life was found to be of only marginal relevance to measures
of Death Anxiety and levels of SCT ego development. As a result, it may
be fruitful to reconsider the construct of purpose in life.

From a psychoanalytic perspective, purpose in life may be viewed as
synonymous with one’s Heltanschauung (world view). In this regard, pur—
pose in life is primarily a function of the ego. Hence, it is likely to
be overshadowed by ego development consistent with the present findings.
From the existential perspective, life has no inherent meaning, and
reality is marked by the presence of inescapable anxieties.
Existentialism sets living authentically as the primary life goal of

humans, implying a distinct sense of individuality. Authentic living is

62

63

associated with coming to terms with one's mortality, which results in
anxiety and despair. If one who has reached the final stages of ego
development lives authentically, then anxiety about death is likely to be
elevated, rather than diminished. This also fits with the present
findings.

I had originally hypothesized that as ego development increased, the
effectiveness and sophistication of defense mechanisms or processes for
coping with anxiety and related issues, would also increase. Thus, the
impact of such issues was thought to be diminished as reflected by decreas-
ing death anxiety but increasing purpose in life. Instead, the present
measure of Death Anxiety was unexpectedly found to associate positively,
although mildly (r - .21) with SCT level of ego development. This sug-
gests that facing death, and attempting to understand that experience, was
positively associated with ego development. It should be noted that
gender differences were found, with women appearing better able to cope
with death than men. Indeed, women’s level of ego development and their
PIL responses were found to correlate positively and significantly with
death education. In contrast, men’s PIL responses correlated negatively
with their death education experiences. In summary, the relationship
between purpose in life and death anxiety appears considerably more com-
plex than posited, with purpose in life at least as presently measured,
being less relevant than theorized, and gender differences playing an
important role.

In addressing the disparity between the current findings and the prior
research literature, attention will first be directed to the works of

Durlak (1973) and Blazer (1973), who reported a negative correlation

64

between death anxiety and purpose in life. Because both investigated only
college students, sample appears a salient issue. Issues of purpose in
life and death anxiety appear decidedly different for 70 year~olds than
for 20 year-olds. Thus, by virtue of age alone, 70 year-olds are much
more likely to have had direct experiences with death than 20-year olds.
The importance of this issue is illustrated by Florian’s (1989) explora-
tion of differences between bereaved and nonbereaved parents. Nonbereaved
parents scored significantly higher on PIL, as well as on another life
satisfaction measure.

The generational issue is also evident in the work of Richardson and
Sands (1987), who also examined the issue of gender. They assessed the
importance of developmental stages relative to issues of purpose in life
and death anxiety among mid-life women. Although college students, their
sample ranged in age from 30 to 49. Richardson and Sands formulated
measures of four of Erikson’s (1963) developmental stages: Identity,
Intimacy, Integrity, and Generativity. They defined the stage of Inte-
grity as one in which the individual displays a wholeness of personality,
with life being meaningful and purposeful. Generativity was defined as
providing for the next generation. These authors found that the develop-
mental stages of Integrity and Generativity were highly predictive of
concerns with death, which they argued supported Ourlak’s (1972) negative
correlation between responses to the Death Anxiety and Purpose in Life
measures. In examining their results more closely, it appears that those
who reached the developmental stage of Integrity directly faced issues of
death, as reflected by their high levels of death concern. Richardson and

Sands identified the sense that life has purpose and meaning as an aspect

65

of Erikson’s highest developmental stage; thus, it too was positively
associated with high levels of death concern and in conflict with Ourlak’s
(1973) finding. These authors correctly interpreted their results with
regard to Generativity, concluding that death was an important issue among
their sample of mid-life women with generative needs. Richardson and
Sands’ results mirror the current findings with regard to the importance
of coming to terms with death and ego development.

Gender and generational differences were also found by Hoods and Hitte
(1981), who examined the relationships between life satisfaction, death
anxiety, and ego development in a mixed-sex sample. They used Rasmussen’s
(1964) Ego Identity Scale (EIS) to assess participants’ level of ego devel-
opment, as well as to test the theory that the resolution of previous con-
flicts is a precondition for continued ego development. Hoods and Hitte
hypothesized a positive correlation between responses to the Life Satisfac-
tion Index - A (LSI-A) and the EIS. The results supported Erikson’s
theory that individuals who have successfully resolved earlier develop-
mental stages are more likely than others to reach the stage of ego inte-
grity. Hoods and Hitte (1981) further hypothesized a negative correlation
between Death Anxiety Scale (OAS) responses and the EIS; also a negative
correlation for performance on the LSI-A and the EIS. These hypotheses
were only partially supported, as life satisfaction correlated positively
with ego identity for both sexes. Only among the males, however, did fear
of death correlate significantly and negatively with ego identity and life
satisfaction. Hoods and Hitte attributed their findings to gender
differences, suggesting that retirement may be more salient for men than

for women, with men being likely to experience retirement as an identity

66

crisis. Comparisons of the present findings with those of Hoods and Hitte
are limited, due to the use of different measures to address the con—
structs of ego development and purpose in life, also the present work’s
use of the Likert conversion of the Death Anxiety Scale. Nevertheless, a
cursory review reveals that the present sample was much more highly
educated (mean education of males was 13.7 years) than Hoods and Hitte’s
(mean education of males was 7.9 years). Men and women’s mean scores did
not vary appreciably on the measures employed by Hoods and Hitte (1981).
For the present sample, in contrast, women’s mean OAS scores exceeded
those of men and women’s mean PIL scores were significantly above men’s.
Such variations may speak to the conflicting findings of these two studies
and also, as suggested by Hoods and Hitte, to the gender differences.
Gender and generational differences were also found by Hickson,
Housley, and Boyle (1988), who examined the issue of locus of control rela-
tive to issues of purpose in life and death anxiety. Their participants
ranged in age from 61 to 80. Hickson et al. used the Rotter Internal-
External Locus of Control Scale (Rotter, 1966), the Life Satisfaction
Index (Havighurst, Newgarten, & Tobin, 1961), and the OAS to assess each
respective issue. They found that high life satisfaction correlated
significantly with low death anxiety only for women, regardless of locus
of control (LDC), and for specific age groups. As a group, women evidenc-
ed lower life satisfaction and higher death anxiety. Hickson et al.
posited that such levels may be due to social conditioning, as girls are
more likely to learn helpless attitudes. In review, it is noteworthy that
each study yielded different results, which speaks to the heterogeneity of

the variables of purpose in life and death anxiety and use of different

67

measures. Gender and generational differences were also demonstrated to
be important variables.

Concerning limitations of the present study, perhaps most notable was
the dearth of men. Although this precluded assessing for sex differences,
this sample appeared reasonably homogeneous, as the subsamples of men and
women differed significantly only in their PIL responses. Consequently,
the responses of both sexes were aggregated for most analyses. Targeting
all available male senior citizens groups for participation in this study
would have eliminated this issue. Such an approach may indeed be neces-
sary given the finding that men have difficulty in facing death. If the
current results are representative, men are likely to avoid participating
in a study assessing death anxiety.

Another issue was the use of only single measures of life purpose and
death anxiety. As Ebersole and Quiring (1991) suggest, employing two
measures of purpose in life may have more adequately assessed this con-
struct. These authors advocate use of the Meaning in Life Depth (MILD)
measure by Ebersole and Sacco (1983), addressing the cognitive aspects of
meaning in life. Although it may have proven useful to include such a
measure, as well as an alternate measure for the OAS, a concern was the
length of the questionnaire employed in this study. Completion of this
questionnaire took approximately 50 minutes, which appeared to be a fairly
lengthy time for some participants. An intermission and providing refresh-
ments might well have made the task of completing the questionnaire less
burdensome. Such actions may have also increased the number of partici-
pants’ willing to complete the questionnaire.

Another important limitation is that the participant’s mental health

 

68

was not assessed, a variable that Chessick (1991) has recently argued to
be critical in the development of being and sense of purpose of life.
Although this too may have lengthened the questionnaire, a significant
variable appears to have been overlooked. Future research in this area
seems likely to profit from inclusion of mental health. The three-year
time frame employed to assess the issue of loss is another consideration.
This period was borrowed from Pfost and Stevens (1989), who argued that 36
months would ensure that this variable remained salient. However, Florian
(1989) demonstrated that the time of the loss may not be that critical, as
he found that bereaved parents who lost their child two years prior to the
study did not differ meaningfully with parents who had lost their child 11
years prior to the study. Differences in life stage at the time of the
loss may also bear on this issue, which is another variable that may be
useful to assess. A final limitation is that the author was the only one
rater of the measures, which has particular relevance to SCT scores. This
precluded a rigorous assessment of interrater consistency which might have

strengthened confidence in the accuracy of SCT ratings.

 

SUMMARY AND CONCLUSIONS

My findings are suggestive of meaningful relationships between ego
development and death-related issues. The present results seem consistent
with a basic tenet of existential philosophy, that facing death, and
attempting to understand it is significantly related to (ego) develop-
ment. Support was also provided for Rank’s (1929) theories, as he
regarded death as a crucial variable, which if handled creatively may
maximize development. The importance of coming to grips with death was
also espoused by Piaget (1955), who credited a knowledge of the fact of
death with opening the door to logical thinking. Understanding death may
be integral to ego development, and it is perhaps this quality that most
acutely reflects the humanness of men and women. Also noteworthy were
several gender differences suggesting that older women may be better able
to cope with death than older men. Finally, and in contrast to previous
reports, the present measure of purpose in life was found largely

irrelevant.

69

 

APPENDICES

APPENDIX A

Introduction

The purpose of this study is to learn about the attitudes and feelings
that people have about life and death. This will involve use of four
questionnaires, which include questions that are of a personal nature, and
which will take approximately 45 minutes to complete. Please be aware
that your name will not appear on any of the questionnaires that you
complete, rather a code will be used which will facilitate an analysis of
your responses. Thus, your responses are completely anonymous, and no
one, except myself, will have access to the information that you provide.
In addition to the questionnaires, an introduction sheet is provided, as
well as a consent form for this research. If you do not feel comfortable
about participating at this time, or if you have changed your mind in any
way, please feel free to not participate any further. Please hand in your
materials, and feel free to leave at this time.

If you do wish to participate, please read the consent form and sign and
date it at the bottom. Please try to answer all questions. Although
instructions are included in your packet, please feel free to raise your
hand to ask questions at any time. After you have completed all of the
forms and questionnaires, please hand in your consent forms separate from
your questionnaires. Are there any questions? Please begin.

70

APPENDIX B

Departmental Research Consent Form

1 have freely consented to take part in a scientific study being
conducted by Charles Gutierrez, under the supervision of Dr. Bertram
Karon.

The study has been explained to me and I understand the explanation
that has been given and what my participation will involve.

I understand that I am free to discontinue my participation in the
study at any time without penalty.

I understand that the results of the study will be treated in strict
confidence and that I will remain anonymous. Hithin these
restrictions results of the study will be made available to me at my
request.

I understand that my participation in the study does not guarantee any

beneficial results to me.

I understand that if I want to talk about any questions or concerns
that I have after 1 complete the questionnaires, that I can address

these with Charles Gutierrez who will discuss these with me after this

session.
I understand that I can receive information on the results of the

study by contacting the office with which I am affiliated after August
30, 1990.

Signed:

 

Dated:

 

71

 

APPENDIX C

Personal Data Form

Please complete the following:

Identification Number
Sex: _________
Date of Birth:
Marital Status:
If married, is your spouse still alive?
If your spouse is deceased, please note what year he or she passed
away?

Residence Status (i.e., living in your own home, apartment complex for
older adults, living with relatives):

Educational Level:

Religion:
Please rate how religious you consider yourself to be (on a scale in
which 10 is very religious and 1 is not at all religious)?

Birth Order (i.e., oldest child):

Did you; parents ever talk to you about death (i.e., what happens when you

ie ?
If so, please note how old you were when this happened?

Have you had any family members or others close to you who have died in

the last three years?

If so, please note how old you were when this happened?

Please note the reason for their death:
Has this a loss that you expected to occur at that time? _______
Please note what feelings you have about this loss at the present
time?

Please rate how healthy you consider yourself to be (on a scale in which
10 is extremely healthy and 1 is very poor health)? ________

Do you currently have any health problems (i.e., diseases for which you
take medication)?

If so, please state what they are, and how long this has been a

problem for you.
If you do take medication, please note which medication(s) you are
currently taking

Hhat do you do for recreation?

 

 

 

 

 

 

 

 

 

 

 

 

72

 

APPENDIX D

Death Anxiety Scale

Please answer the following questions based on how they apply to you at
this time. Read each question carefully, and circle whichever number
applies to you most in answering each question. For example, if you feel
that the question applies to you, you would circle a number on the right,
with 5 reflecting that you believe that this question applies very much to
you.

1. I am very much afraid to die.

1 2 3 4 5
This does not apply This applies very
at all to me much to me
2. The thought of death seldom enters my mind.
1 2 3 4 5
This does not apply This applies very
at all to me much to me
3. It doesn’t make me nervous when people talk about death.
I 2 3 4 5
This does not apply This applies very
at all to me much to me

4. I dread to think about having to have an operation.

 

1 2 3 4 5
This does not apply This applies very
at all to me much to me
5. I am not at all afraid to die.
1 2 3 4 5
This does not apply This applies very
at all to me much to me
6. I am not particularly afraid of getting cancer.
1 2 3 4 5
This does not apply This applies very
at all to me much to me
7. The thought of death never bothers me.
1 2 3 4 5
This does not apply This applies very
at all to me much to me
73

10.

11.

12.

13.

14.

15.

1

I fear dying a painful death.
1 2

1

I am really scared of having a heart attack.

1

2
This does not apply
at all to me

This does not apply
at all to me

2
This does not apply
at all to me

2
This does not apply
at all to me

3

3

3

1 am often distressed by the way time flies
3

so very rapidly.
4

This applies very
much to me

4
This applies very
much to me

The subject of life after death troubles me greatly.
4

This applies very
much to me

4
This applies very
much to me

I often think about how short life really is.

1

l

1

1

2
This does not apply
at all to me

This does not apply
at all to me

This does not apply
at all to me

2
This does not apply
at all to me

3

I feel that the future holds nothing for me to fear.
3

74

This applies very
much to me

I shudder when I hear people talking about a Horld Har III.
2 3

4
This applies very
much to me

The sight of a dead body is horrifying to me.
2 3

This applies very
much to me

4
This applies very
much to me

5

5

5

5

5

5

5

Sentence Completion for Men

Instructions: Complete the following sentences.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. Hhen a child will not join in group activities
2. Raising a family
3. Hhen I am criticized
4. A man’s job
5. Being with other people
6. The thing I like about myself
7. My mother and I
8. Hhat gets me into trouble is
9. Education
10. Hhen people are helpless
11. Homen are lucky because

 

 

 

 

78

12.

A good father

 

 

 

 

13.

A girl has the right to

 

 

 

 

14.

Hhen they talked about sex

 

 

 

 

15.

A wife should

 

 

 

 

16.

I feel sorry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17. A man feels good

18. Rules are

19. Crime and delinquency could be halted if
20. Men are lucky because

21. I just can’t stand people who

22. At times he worried about

23. I am I

24. A woman feels good when

 

 

 

 

79

25.

My main problem is

 

 

 

 

26.

A husband has the right to

 

 

 

 

27.

The worst thing about being a man

 

 

 

28.

A good mother

 

 

 

 

 

29.

Hhen I am with a woman

 

 

 

 

30.

Sometimes he wished that

 

 

 

 

31.

My father

 

 

 

 

32.

If I can’t get what 1 want

 

 

 

 

33.

Usually he felt that sex

 

 

 

 

34.

For a woman a career is

 

 

 

 

35.

My conscience bothers me if

 

 

 

 

36.

A man should always

 

 

 

 

80

APPENDIX F

Purpose in Life Test

For each of the following statements, circle the number that would be most
nearly true for you. Note that the numbers always extend from one extreme
feeling to its opposite kind of feeling. "Neutral" implies no judgment
either way. Try to use this rating as little as possible.

1. I am usually:

1 2 3 4
completely (neutral)
bored

2. Life to me seems:
I 2 3 4
always exciting (neutral)

3. In life I have:
1 2 3 4
no goals or aims at all (neutral)

4. My personal existence is:
1 2 3 4

utterly meaningless, (neutral)
without purpose
5. Every day is:
1 2 3 4
constantly new (neutral)

and different

6. If I could chose, 1 would:
1 2 3 4
prefer never to (neutral)
have been born

7. After retiring, I would:
1 2 3 4
do some of the exciting (neutral)
things I have always
wanted to do

8. In achieving the life goals I have:

1 2 3 4
made no progress (neutral)
whatsoever

9. My life is:
1 2 3 4
empty, filled only (neutral)

with despair

81

5 6 7
exuberant
enthusiastic
5 6 7

completely routine

5 6 7
very clear goals and aims

5 6 7
very purposeful and
meaningful

5 6 7

exactly the same

5 6 7
like nine more lives just
like this one

5 6 7
loaf completely the rest
of my life

5 6 7
progressed to complete
fulfillment

5 6 7
running over with exciting
good things

 

 

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

If I should die today, I would feel that my life has been:
1 2 3 4 5 6 7
very worthwhile (neutral) completely worthless

In thinking of my life, I:
1 2 3 4 5 6 7
often wonder why I exist (neutral) always see a reason for my
being there

As I view the world in relation to my life, the world:

1 2 3 4 5 6 7

completely confuses me (neutral) fits meaningfully with
my life
I am a:

1 2 3 4 5 6 7
very irresponsible person (neutral) very responsible person
Concerning man’s freedom to make his own choices, I believe man is:

1 2 3 4 5 6 7
absolutely free to make (neutral completely bound by
all life choices limitations of heredity

and environment

Hith regard to death, I am:

1 2 3 4 5 6 7
prepared and unafraid (neutral) unprepared and frightened
Hith regard to suicide, I have

1 2 3 4 5 6 7
thought of it seriously (neutral) never given it a second
as a way out thought
I regard my ability to find a meaning, purpose or mission in life as

1 2 3 4 5 6 7
very great (neutral) practically none
My life is:

1 2 3 4 5 6 7
in my hands and I am (neutral) out of my hands and
in control of it controlled by external

factors
Facing my daily tasks is:

1 2 3 4 5 6 7
a source of pleasure and (neutral) a painful and boring
satisfaction experience
I have discovered:

I 2 3 4 5 6 7
no mission or purpose (neutral) clear-cut goals and a
in life satisfying life purpose

82

Value

\DGNO‘

Value

tooouos

uI 4

Frequency
22
11
17
25
11
1

Frequency

1

4501M

APPENDIX G

Percent Cumulative Percent
25.3 25.3
12.6 37.9
19.5 57.5
28.7 86.2
12.6 98.9
1.1 100.0
I' ' i'llL‘l '- '-_l
Percent Cumulative Percent
7.7 7.7
15.4 23.1
38.5 61.5
30.8 92.3
7.7 100.0

83

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84

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