Exploring fear of death and psychosis proneness: positive schizotypy as a function of death anxiety and maladaptive coping

ABSTRACT

Objectives

Death anxiety has been implicated in the development and continuation of various psychiatric conditions, although few studies have focused on the relationship between death anxiety and psychosis. The present study investigated whether this relationship extends to positive schizotypy, thus exploring death anxiety as a risk factor along a psychosis continuum. The study also explored whether the relationship is moderated by maladaptive coping.

Method

Relationships between death anxiety, maladaptive coping and positive schizotypy were investigated in a non-clinical sample (N = 61).

Results

As hypothesised, hierarchical regression analysis showed that death anxiety significantly predicted positive schizotypy. Furthermore, this relationship was moderated by maladaptive coping. That is, there was a significantly stronger positive association between death anxiety and positive schizotypy at higher versus lower levels of maladaptive coping.

Conclusion

These novel findings indicate that a relationship between death anxiety and psychosis may exist along a psychosis continuum; and this is especially pronounced for those who more often engage in maladaptive coping strategies. The findings are discussed within the framework of Terror Management Theory. Future experimental research is required to inform an accurate model of the role of death anxiety in the development of psychosis, thereby guiding effective interventions for those at risk.

KEY POINTS

What is already known about this topic:

1. Evidence suggests death anxiety is a construct underlying numerous psychiatric conditions.

2. Previous research has suggested a relationship between death anxiety and psychosis.

3. Psychotic-like experiences are considered as maladaptive coping mechanisms used in efforts to buffer death anxiety.

What this topic adds:

1. Death anxiety was found to predict positive schizotypy – this effect was stronger with respondents who reported utilising higher levels of maladaptive coping.

2. Current results support the transdiagnostic nature of death anxiety and suggest death anxiety exists as a risk factor along a psychosis continuum.

3. Findings may support the application of novel interventions to target death anxiety.

KEYWORDS:

• Coping
• death anxiety
• delusions
• psychosis
• positive schizotypy
• terror management theory

Acknowledgements

We are grateful to all participants who shared their time, efforts and experiences for this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data supporting the findings of this study are available in the supplementary material of this article.

Additional information

Funding

This study was part of a broader project on stress and cognition, which was supported by the Alfred Medical Research and Education Precinct (AMREP) Collaborative Seed Grant and the Barbara Dicker Foundation. S.L.R. holds a Senior National Health and Medical Research Council (NHMRC) Fellowship (GNT1154651). C.G. received funding from the NHMRC (GNT546262).