Death Distress and Mental Wellbeing: Serial Mediating Roles of Meaning-Based Coping and Hope

Year 2025, Volume: 12 Issue: 1, 21 - 35

Hasan Kütük , Fatma Betül Yılmaz , Zahide Gül Aktepe , Sinan Okur , Seydi Ahmet Satıcı

https://doi.org/10.30900/kafkasegt.1561275

Abstract

While having an awareness of death may make life more meaningful for some individuals, it might also cause death distress for others. This study aims to understand the effects of death distress as an existential problem on mental health. A novel aspect of this study is the examination of the mediating roles of meaning-based coping and hope in this relationship. In the study, data were collected from 397 adults residing in 51 different Turkish provinces. The age range of the participants was 18 to 57 years old, and the average age was 24.39 years. (SD = 5.42). The participants participated in the study voluntarily through a web-based form. Using structural equation modeling (SEM) and the bootstrapping method, the relationships between variables were determined. All variables in the study were found to be related to each other. Additionally, as a result of the serial multiple mediation analysis, it was determined that meaning-based coping and hope played a full mediating role serially in the relationship between death distress and mental well-being. This finding indicates that death distress predicts mental well-being through meaning-based coping and hope. In conclusion, the findings indicate that meaning-based coping and hope have a beneficial and positive effect on reducing the negative impact of death distress on mental well-being.

Keywords

Mental wellbeing, death distress, meaning-based coping, hope, serial mediation analysis

Ethical Statement

The study protocol has been approved by the Yıldız Technical University's Scientific Research and Ethics Committee (Report Number = 20230402008, Verification Code = 7297f, 05.). The study was performed in accordance with the ethical standards laid down in the 1975 Declaration of Helsinki and its following updates.

References

• Abdel-Khalek, A. M. (2004). A general factor of death distress in seven clinical and non-clinical groups. Death Studies, 28(9), 889-898. doi: 10.1080/07481180490491040
• Abdel-Khalek A. M. (2005). Death anxiety in clinical and non-clinical groups. Death Studies, 29(3), 251-259. doi: 10.1080/07481180590916371
• Abdel-Khalek, A. M. (2011). The death distress construct and scale. Omega, 64(2), 171-184. doi: 10.2190/om.64.2.e
• Al-Sabwah, M. N., & Abdel-Khalek, A. M. (2006). Religiosity and death distress in Arabic college students. Death Studies, 30(4), 365-375. doi: 10.1080/07481180600553435
• Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: a review and recommended two-step approach. Psychological Bulletin, 103(3), 411-423. doi: 10.1037/0033-2909.103.3.411
• Arnau, R. C., Rosen, D. H., Finch, J. F., Rhudy, J. L., & Fortunato, V. J. (2007). Longitudinal effects of hope on depression and anxiety: a latent variable analysis. Journal of Personality, 75(1), 43-64. doi: 10.1111/j.1467-6494.2006.00432.x
• Arslan, G., & Yıldırım, M. (2021a). Coronavirus stress, meaningful living, optimism, and depressive symptoms: a study of moderated mediation model. Australian Journal of Psychology, 73(2), 113-124. doi: 10.1080/00049530.2021.1882273
• Arslan, G., & Yıldırım, M. (2021b). Meaning-based coping and spirituality during the COVID-19 pandemic: mediating effects on subjective wellbeing. Frontiers in Psychology, 12, 646572. doi: 10.3389/fpsyg.2021.646572
• Bagozzi, R., & Yi, Y. (1988). On the evaluation of structural equation models. Journal of the Academy of Marketing Sciences, 16, 74-94. doi: 10.1007/BF02723327
• Batthyany, A., & Russo-Netzer, P. (Eds.). (2014). Meaning in positive and existential psychology. New York: Springer. doi: 10.1007/978-1-4939-0308-5
• Cheng, L., Guo, X., Liu, H., Chen, Q., & Cui, R. (2021). Hope, death anxiety and simplified coping style scores of nursing students during the outbreak of COVID-19: a cross-sectional study. Medicine, 100(34), e27016. doi: 10.1097/MD.0000000000027016
• Counted, V., Pargament, K. I., Bechara, A. O., Joynt, S., & Cowden, R. G. (2022). Hope and wellbeing in vulnerable contexts during the COVID-19 pandemic: does religious coping matter? The Journal of Positive Psychology, 17(1), 70-81. doi: 10.1080/17439760.2020.1832247
• Dadfar, M., & Lester, D. (2020). Death distress constructs: a preliminary empirical examination of the Farsi form in nurses: A brief note. Nursing Open, 1-6. doi: 10.1002/nop2.484
• Dadfar, M., Lester, D., & Bahrami, F. (2016). Death anxiety, reliability, validity, and factorial structure of the Farsi form of the Arabic Scale of Death Anxiety in Iranian old-aged persons. Journal of Aging Research, 2906857. doi: 10.1155/2016/2906857
• Demirtaş, A., & Baytemir, K. (2019). Adaptation of Warwick-Edinburgh Mental Well-Being Scale short form into Turkish: validity and reliability study. Electronic Journal of Social Sciences, 18(70), 654-666. doi: 10.17755/esosder.432708
• Depaola, S. J., Griffin, M., Young, J. R., & Neimeyer, R. A. (2003). Death anxiety and attitudes toward the elderly among older adults: the role of gender and ethnicity. Death Studies, 27(4), 335–354. doi: 10.1080/07481180302904
• Eisenbeck, N., Carreno, D. F., Wong, P. T. P., Hicks, J. A., María, R. G., Puga, J. L., Greville, J., Testoni, I., Biancalani, G., López, A. C. C., Villareal, S., Enea, V., Schulz-Quach, C., Jansen, J., Sanchez-Ruiz, M. J., Yıldırım, M., Arslan, G., Cruz, J. F. A., Sofia, R. M., Ferreira, M. J., … García-Montes, J. M. (2022). An international study on psychological coping during COVID-19: towards a meaning-centered coping style. International Journal of Clinical and Health Psychology, 22(1), 100256. doi: 10.1016/j.ijchp.2021.100256
• Ellis, K. R., Janevic, M. R., Kershaw, T., Caldwell, C. H., Janz, N. K., & Northouse, L. (2017). Meaning-based coping, chronic conditions and quality of life in advanced cancer & caregiving. Psycho-oncology, 26(9), 1316-1323. doi: 10.1002/pon.4146
• Feifel, H., & Branscomb, A. B. (1973). Who's afraid of death? Journal of Abnormal Psychology, 81(3), 282-288. doi: 10.1037/h0034519
• Feldman, D. B., & Snyder, C. R. (2005). Hope and the meaningful life: theoretical and empirical associations between goal-directed thinking and life meaning. Journal of Social and Clinical Psychology, 24, 401-421. doi: 10.1521/jscp.24.3.401.65616
• Field, A. (2016). Discovering statistics using IBM SPSS Statistics. New York: Sage Publications.
• Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science & Medicine, 45(8), 1207-1221. doi: 10.1016/S0277-9536(97)00040-3
• Folkman, S., & Moskowitz, J. T. (2000). Positive affect and the other side of coping. American Psychologist, 55(6), 647-654. doi: 10.1037/0003-066X.55.6.647
• Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39-50. doi: 10.2307/3151312
• Frankl, V. E. (1969). The will to meaning: foundations and applications of logotherapy. Bromborough: Meridian. Gallagher, M. W., & Lopez, S. J. (2009). Positive expectancies and mental health: identifying the unique contributions of hope and optimism. The Journal of Positive Psychology, 4(6), 548-556. doi: 10.1080/17439760903157166
• Geurtsen, L. A. (2010). A multidimensional approach of death anxiety: physical health, gender and psychosocial correlates in a community sample and a clinical sample of Dutch elderly people [Unpublished master's thesis]. Universiteit Utrecht.
• Güder, M., & Kaya, E. (2023). The attitude of generations X, Y and Z to death and the reaction to mourning. Turkish Studies-Social Sciences, 18(1), 161-186. doi: 10.7827/TurkishStudies.64563.
• Halama, P. (2014). Meaning in life and coping: sense of meaning as a buffer against stress. In Batthyany A., Russo-Netzer P. (Eds.), Meaning in positive and existential psychology (pp. 239-250). New York: Springer.
• Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach (2nd Ed.). New York: The Guilford Press.
• Hicks, J. A., & Routledge, C. (2013). The experience of meaning in life: classical perspectives, emerging themes, and controversies. New York: Springer. doi: 10.1007/978-94-007-6527-6
• Hoyle, R. H., & Panter, A. T. (1995). Writing about structural equation models. In R. H. Hoyle (Ed.), Structural equation modeling: concepts, issues, and applications (pp. 158-176). New York: Sage Publications.
• Kandemir, F. (2020). An empirical research on the relationship of Covid-19 pandemic generation’s religiosity and death anxiety in the context of some demographic variables. Tokat Journal of Ilmiyat, 8(1), 99-129. doi: 10.5281/zenodo.3876200
• Keldal, G. (2015). Turkish version of the Warwick-Edinburgh Mental Well-Being Scale: a validity and reliability study. The Journal of Happiness & Well-Being, 3, 103-115.
• Kleiman, E. M., Adams, L. M., Kashdan, T. B., & Riskind, J. H. (2013). Gratitude and grit indirectly reduce risk of suicidal ideations by enhancing meaning in life: evidence for a mediated moderation model. Journal of Research in Personality, 47, 539-546. doi: 10.1016/j.jrp.2013.04.007
• Klein, N. (2017). Prosocial behavior increases perceptions of meaning in life. The Journal of Positive Psychology, 12, 354-361. doi: 10.1080/17439760.2016.1209541
• Lee, S. A., Jobe, M. C., Mathis, A. A., & Gibbons, J. A. (2020). Incremental validity of coronaphobia: coronavirus anxiety explains depression, generalized anxiety, and death anxiety. Journal of Anxiety Disorders, 74, 102268. doi: 10.1016/j.janxdis.2020.102268
• Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002). To parcel or not to parcel: exploring the question, weighing the merits. Structural Equation Modeling, 9(2), 151-173. doi: 10.1207/S15328007SEM0902_1
• Maddi, S. R. (2013). Hardiness as the existential courage to grow through searching for meaning. In J. A. Hicks, & C. Routledge (Eds.), The experience of meaning in life: classical perspectives, emerging themes, and controversies (pp. 227-239). New York: Springer.
• McEwen B. S. (1998). Protective and damaging effects of stress mediators. The New England Journal of Medicine, 338(3), 171-179. doi: 10.1056/NEJM199801153380307
• Menzies, R. E., Sharpe, L., & Dar-Nimrod, I. (2019). The relationship between death anxiety and severity of mental illnesses. The British Journal of Clinical Psychology, 58(4), 452-467. doi: 10.1111/bjc.12229
• Milman, E., Lee, S. A., & Neimeyer, R. A. (2020). Social isolation and the mitigation of coronavirus anxiety: the mediating role of meaning. Death Studies, 46(1), 1-13. doi: 10.1080/07481187.2020.1775362
• Moreno, R., Solana, E. I., Rico, M., & Fernández, L. M. (2008). Death anxiety in institutionalized and non-institutionalized elderly people in Spain. Omega, 58(1), 61-76. doi: 10.2190/om.58.1.d
• Munoz, R. T., Hanks, H., & Hellman, C. M. (2020). Hope and resilience as distinct contributors to psychological flourishing among childhood trauma survivors. Traumatology, 26(2), 177-184. doi: 10.1037/trm0000224
• Nadi, M. A., & Sajjadian, I. (2012). The analytical relations between spiritual concept with spiritual wellbeing, mental happiness, satisfaction with Iife, psychological flourishing, hope for future and purposefulness in the university students. Tolooebehdasht, 10(3), 54-68.
• Nagaraj, M., & Nithyanandan, D. V. (2019). Death anxiety and psychological wellbeing of institutionalized elderly: relationship, association, and influences of demography. Indian Journal of Gerontology, 33(3), 255-267.
• Park, C. L. (2010). Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136(2), 257-301. doi: 10.1037/a0018301
• Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1(2), 115-144. doi: 10.1037/1089-2680.1.2.115
• Reker, G. T., & Wong, P. T. P. (1988). Aging as an individual process: toward a theory of personal meaning. In J. E. Birren, & V. L. Bengtson (Eds.), Emergent theories of aging (pp. 214-246). New York: Springer.
• Satıcı, S. A. (2016). Psychological vulnerability, resilience, and subjective wellbeing: the mediating role of hope. Personality and Individual Differences, 102, 68-73. doi: 10.1016/j.paid.2016.06.057
• Satıcı, S. A., Kayiş, A. R., Satıcı, B., Griffiths, M. D., & Can, G. (2023). Resilience, hope, and subjective happiness among the Turkish population: fear of COVID-19 as a mediator. International Journal of Mental Health and Addiction, 21(2), 803-818. doi: 10.1007/s11469-020-00443-5
• Satıcı, S. A., & Okur, S. (2022). Investigating the link between psychological maltreatment, shyness, hope, and wellbeing. Personality and Individual Differences, 196, 111764. doi: 10.1016/j.paid.2022.111764
• Schueller, S. M., & Seligman, M. E. (2010). Pursuit of pleasure, engagement, and meaning: relationships to subjective and objective measures of wellbeing. The Journal of Positive Psychology, 5, 253-263. doi: 10.1080/17439761003794130
• Semenova, V., & Stadtlander, L. (2016). Death anxiety, depression, and coping in family caregivers. Journal of Social, Behavioral, and Health Sciences, 10(1), 5. doi: 10.5590/JSBHS.2016.10.1.05
• Snyder, C. R. (2002). Hope theory: rainbows in the mind. Psychological Inquiry, 13(4), 249-275. doi: 10.1207/S15327965PLI1304_01
• Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., Yoshinobu, L., Gibb, J., Langelle, C., & Harney, P. (1991). The will and the ways: development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570-585. doi: 10.1037/0022-3514.60.4.570
• Soleimani, M. A., Bahrami, N., Zarabadi-Pour, S., Motalebi, S. A., Parker, A., & Chan, Y. H. (2020). Predictors of death anxiety among patients with heart disease. Death Studies, 44(3), 160-167. doi: 10.1080/07481187.2018.1527416
• Tarhan, S., & Bacanlı, H. (2015). Adaptation of Dispositional Hope Scale into Turkish: validity and reliability study. The Journal of Happiness & Well-Being, 3(1), 1-14.
• Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes, 5, 63. doi: 10.1186/1477-7525-5-63
• Updegraff, J. A., Silver, R. C., & Holman, E. A. (2008). Searching for and finding meaning in collective trauma: results from a national longitudinal study of the 9/11 terrorist attacks. Journal of Personality and Social Psychology, 95(3), 709-722. doi: 10.1037/0022-3514.95.3.709
• Wen, Y. H. (2010). Religiosity and death anxiety. The Journal of Human Resource and Adult Learning, 6, 31-37.
• Wenzel, L., Glanz, K., & Lerman, C. (2002). Stress, coping, and health behavior. In K. Glanz, B. Rimer and F. M. Lewis (Eds.), Health behavior and health education: theory, research and practice. New Jersey: Jossey-Bass.
• Wong, P. T. P., Reker, G. T., & Peacock, E. J. (2006). A resource-congruence model of coping and the development of the coping schema inventory. In P. T. P. Wong, & L. C. J. Wong (Eds.), International and cultural psychology series: handbook of multicultural perspectives on stress and coping (pp. 223-283). New York: Springer.
• Wu, X., Xu, H., Zhang, X., Han, S., Ge, L., Li, X., & Zhang, X. (2021). Self-efficacy, hope as mediators between positive coping and resilience among patients with gastric cancer before the first chemotherapy. Cancer Nursing, 44(1), 79-85. doi: 10.1097/NCC.0000000000000753
• Yıldırım, M., & Güler, A. (2021). Positivity explains how COVID-19 perceived risk increases death distress and reduces happiness. Personality and Individual Differences, 168, 110347. doi: 10.1016/j.paid.2020.110347