Journal of Gerontology: PSYCHOLOGICAL SCIENCES Copyright 2002 by The Gerontological Society of America

2002, Vol. 57B, No. 4, P358–P366

Fear of Death in Older Adults: Predictions From

Terror Management Theory
Victor G. Cicirelli

Purdue University, Lafayette, Indiana.

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Terror management theory asserts that death fear (fear of annihilation) is buffered by self-esteem and beliefs in
literal and symbolic immortality achieved through participation in the cultural system. The aims of this study
were to determine how variables suggested by the theory were related to fear of death measures. Participants
were 123 Black and 265 White elders aged 60 to 100 years; they were assessed on the Multidimensional Fear of
Death Scale (MFODS), self-esteem, religiosity, locus of control, socioeconomic status, social support, and health.
Regression analysis findings ( p , .05) offered partial support to the theory, with greater Fear of the Unknown
(fear of annihilation) related to weaker religiosity, less social support, and greater externality; the effect of self-
esteem was mediated by externality. Other predictors were related to an overall fear score based on the remaining
7 MFODS subscales. Findings are interpreted in terms of changing sources of self-esteem in old age.

F EAR of death, or death anxiety, is a common phenome-

non in all societies and is often regarded as the prime
motivation for human behavior (Becker, 1973). Although
some earlier authors made a distinction between death anxi-
ety and fear of death, most now use the terms interchange-
ably. Additionally, fear of death is now generally regarded
as a multidimensional concept (Lester, 1994; Neimeyer &
Moore, 1994; Wong, Reker, & Gesser, 1994), with most
measuring instruments now assessing several aspects of fear.
Fear of death among older adults is not well understood.
Although existing research is somewhat inconsistent, most
evidence leads to the conclusion that fear of death tends to
be greater among younger age groups and declines with in-
creasing age (Bengtson, Cuellar, & Ragan, 1977; Gesser,
Wong, & Reker, 1987–1988; Neimeyer & Van Brunt, 1995;
Thorson & Powell, 1991, 2000). A recent meta-analysis of
49 studies of fear of death in older adults (Fortner, Nei-
meyer, & Rybarczyk, 2000) found that fear of death was es-
sentially stable over the age range 61–87. The few available
studies of the oldest old (Johnson & Barer, 1997; Tobin,
1991) used interviews rather than quantitative measures and
reported that the oldest old had no fear of death itself al-
though they did fear the dying process.
Overall, the best interpretation of existing findings is that
fear of death declines over the years of middle adulthood
but does not continue declining in old age. This seems para-
doxical in that one might expect elders to have a greater fear
of death than younger people in view of the fact that in-
creasing age and frailty render them ever more vulnerable to
death. To understand why this should be the case, one can
turn to theory in the hope of finding an explanation. At
present, terror management theory (Greenberg, Solomon, &
Pyszczynski, 1997; Solomon, Greenberg, & Pyszczynski,
1991a, 1991b) seems to be the most comprehensive of the
existing approaches dealing with the cause and control of
fear of death (Tomer, 1994) and is supported by extensive
empirical research.
The purpose of the present study was twofold: (a) to ex-
tend the application of the theory to older adults and to fear
of death measured at the level of conscious awareness, and
(b) to test predictions from the theory which would explain
the lower fear of death among older adults.
Terror Management Theory (TMT)
The basic assumption of TMT (Becker, 1973; Greenberg
et al., 1997; Solomon et al., 1991a, 1991b) is that all hu-
mans are instinctively driven toward survival and continued
existence, while at the same time have knowledge of their
inevitable mortality. As a result, there is a potential for them
to consciously experience a terror of death. The core of
death fear is fear of annihilation, which refers to the extinc-
tion of mind, spirit, and soul, as well as the destruction of
the body—that is, total nonexistence. According to these
theorists, the experience of such death terror would be para-
lyzing without some means of suppressing it from aware-
ness. The basic task of the theory is to identify the factors
helping to maintain this suppression.
Terror management theorists (Greenberg, Pyszczynski,
Solomon, Simon, & Breus, 1994; Greenberg et al., 1997;
Solomon et al., 1991a, 1991b) assert that, over time, indi-
viduals in various societies developed cultural worldviews
that characterized the universe or society as having rational-
ity, predictability, and permanence. Socialization into any of
these cultural worldviews provides protection against fear
of annihilation, because it allows people to create standards
of value for a meaningful life as well as ways of transcend-
ing death. If individuals become socialized and meet the
standards valued by the culture, they attain a greater self-
esteem and a promise of immortality.
Self-esteem is regarded as the primary psychological
mechanism whereby culture acts as a buffer to facilitate the
individual’s suppression of death fear (Greenberg et al.,
1994; Greenberg et al., 1997; Solomon et al., 1991a,
1991b). Developing early in life as children interact with

P358
 TERROR MANAGEMENT AND FEAR OF DEATH
and meet the standards of their parents, the process is car-
ried forward into adulthood when individuals maintain or
enhance their self-esteem by learning the teachings of the
culture, participating in cultural rituals, attaining goals val-
ued by the culture, fulfilling cultural roles, experiencing so-
cial validation in personal relationships, and using defensive
responses when self-esteem is threatened.
The culture includes beliefs, values, and norms that allow
the individual to create the illusion of being protected from
death or eventually transcending it (Greenberg et al., 1994;
Greenberg et al., 1997; Solomon et al., 1991a, 1991b). By
believing in the cultural systems, individuals can achieve
both literal and symbolic immortality (Lifton, 1983) and
thus reduce the fear of death. Literal immortality refers to
the belief that a noncorporeal aspect of the individual will
live on indefinitely in some way. It is attained through reli-
gious beliefs concerned with a soul and afterlife. Symbolic
immortality refers to the belief that individuals are repre-
sented by something or someone other than themselves that
will continue to exist after they are dead. Individuals may
continue to live symbolically by viewing children as exten-
sions of themselves that continue through time, by feeling that
they are valued parts of a culture that endures over time and
beyond individual death, by making a permanent mark in the
world through things that they produce or achieve, and so on.
TMT suggests two distinct modes of responding to death
concerns (Pyszczynski, Greenberg, & Solomon, 1999). First,
individuals may use such defense mechanisms as distrac-
tion, distancing themselves, and denying their vulnerability
to help remove death threats from immediate focal aware-
ness. Stimuli initially in awareness lead to suppression of
concerns with death, but such concerns apparently continue
outside of awareness, somehow signaling and motivating
the defenses of self-esteem and faith in the worldview
(Greenberg et al., 1997). It seems that this signal effect fur-
ther suggests that self-esteem and faith in the worldview
might be related to fear of death at the level of conscious
awareness as well as outside of awareness.
However, processes at different levels of awareness ap-
pear to run parallel to one another, dealing with death fears
of different duration and intensity. Terror management theo-
rists seem to admit that there is some kind of connection be-
tween these parallel processes (Greenberg et al., 1994).
Thus, death concerns at the level of immediate awareness
both activate conscious defense mechanisms and signal the
need for mechanisms to deal with fear of annihilation out-
side the level of awareness. In such a two-step theory, fear
of annihilation experienced at the level of awareness in re-
sponse to death stimuli may be incompletely suppressed by
transitory defense mechanisms or maintained in conscious-
ness for a longer duration before being reduced to a man-
ageable level by mechanisms that were signaled and elicited
to deal with fear outside the level of awareness.
Extension of TMT to Fear at the Level
of Conscious Awareness
Assuming that death is made salient and fears are aroused
at the level of conscious awareness by the administration of
a fear of death instrument, then the study of fear of death at
the level of awareness would be justified as an extension of
P359
the ideas of TMT. Variables related to the suppression of
fear by adhering to the standards and values of the culture
and through the promise of literal and symbolic immortality
(self-esteem, religious belief, locus of control, social sup-
port, and status within society) may be hypothesized to also
mitigate fears that come to awareness from time to time.
Within this context, one might examine existing research on
fear of death in older adults to see if there is any empirical
evidence that TMT variables are related to fear of death
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assessed at the level of awareness.
Unfortunately, only a few studies relate to major TMT
variables. (Most studies of fear of death in old age have fo-
cused on the relationship of fear to age and various demo-
graphic and health variables.) With regard to self-esteem, no
studies of older adults were found, but there was evidence
that among college students, those with higher self-esteem
had less fear of death (Davis, Martin, Wilee, & Voorhees,
1978); this may also be true for older adults. Existing evi-
dence regarding locus of control is mixed, with some
studies linking externality to greater death anxiety and inter-
nality to less death anxiety and other studies reporting no re-
lationship (Hayslip & Stewart-Bussey, 1986–1987; Hunt,
Lester, & Ashton, 1988; Schulz, 1978). The effects of reli-
gion on fear of death are complex, depending on whether re-
ligious behaviors or intrinsic religiosity (faith in God and an
afterlife) are measured. Studies of fear of death in older
adults (Clement, 1998; Fortner et al., 2000) support the rela-
tionship between intrinsic religiosity and reduced fear of
death. No empirical studies were found linking socioeco-
nomic status (SES) and fear of death. The only study deal-
ing with social support involved AIDS patients; those with
more family support had less fear of death (Catania, Turner,
Choi, & Coates, 1992).
Beyond the five major TMT variables discussed above, it
can be argued that women and ethnic minority group mem-
bers have less accessibility to the rewards and acceptance of
the culture, implying less belief in the values of the culture,
and ultimately a greater fear of death. Existing studies offer
only slight support to this contention. In general, although
many fear of death studies found no gender differences,
whenever differences were found, women reported greater
fear than men (Neimeyer & Van Brunt, 1995). With regard
to gender differences in old age, the meta-analysis of Fort-
ner and colleagues (2000) failed to find a significant gender
effect. Studies of ethnic differences between Whites and
Blacks have had mixed findings (Cicirelli, 2000; Neimeyer
& Van Brunt, 1995). Overall, no clear findings exist regard-
ing fear of death in relation to either gender or ethnicity.
It can be argued that two other variables, poor health and
loss of spouse, imply a sense of increasing vulnerability to
death, with the increased salience of death associated with
greater fear. Existing studies offer some evidence for a
greater fear of death among those in poor health. Mullins
and Lopez (1982), in a study of nursing home patients,
found that fear of death was greater among an older, sicker
group than among those who were younger and healthier.
Although some mixed findings regarding health exist, the
Fortner and colleagues (2000) meta-analysis found that
greater physical and mental health problems were found to
predict higher levels of death anxiety.
P360 CICIRELLI

Study Hypotheses programs serving retirement housing complexes. I visited

Even though not all of them are supported by the limited
existing literature, major hypotheses based on TMT are as
follows:
1. Individuals with more positive self-esteem will have less
fear of death.
2. Individuals with an internal locus of control are expected
to experience less fear of death, and, conversely, individ-
uals with an external locus of control orientation are pre-
each center during a regularly scheduled group meeting,
explained the study, and asked for participants. All who
consented were scheduled to be interviewed at the center
at a convenient time. Participation rates at the 20 centers
ranged from 40% to 85%, with an overall participation rate
of 66%.
Of 460 people who consented to participate in the study,
447 were interviewed (13 began the interview process, but

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declined to continue). The sample used for the analyses re-
dicted to have greater fear of death. ported here consisted of 388 older people for whom all data
3. Individuals with a strong support group of others with
were complete, ranging in age from 60 to 100 (M 5 72.65,
similar cultural beliefs will have less fear of death.
SD 5 7.73). There were 285 women (73%) and 103 men
4. Individuals of higher SES levels within the society will
(27%), 265 Whites (68%) and 123 Blacks (32%), and 293
have less fear of death.
from Indianapolis and 95 from Lafayette. All Blacks in the
5. Individuals with stronger religious beliefs will have less
sample were from Indianapolis. (Preliminary analyses by
fear of death.
Cicirelli, 1997, indicated only minor differences between
In addition, several predictions are made regarding the Lafayette White and Indianapolis White samples, so
health and demographic variables. Increasing age and poor samples from the two sites were combined for further analy-
health would each seem to imply increasing nearness to sis.) With regard to marital status, about 35% of participants
death, with a heightened sense of vulnerability, and, conse- were married with a living spouse, with the remainder either
quently, greater fear of death. Similarly, loss of spouse widowed, divorced, separated, or never married. The mean
through widowhood or divorce may leave the survivor with educational level (M 5 4.42, SD 5 1.45) was between that
an increased sense of vulnerability and greater fear of death. of a high school graduate and a high school graduate with
Finally, women and minority group members are expected some additional training. The mean occupational level (M 5
to have greater fear of death. 3.72, SD 5 1.55) was between that of a skilled manual oc-
The present study examined the relationship of the hy- cupation and a clerical, technical, or salesclerk occupation.
pothesized TMT variables to fear of death. By so doing, the The mean health rating of participants (M 5 4.35, SD 5
study not only increases the understanding of factors influ- 0.90) was between “good” and “very good.” The means and
encing fear of death at the level of conscious awareness in standard deviations of study participants on background and
old age, but also advances existing knowledge of fear of psychosocial variables are summarized in Table 1.
death by investigating its relationship to personality and When I compared the sample of 388 elders who com-
background variables that either have not been investigated pleted all measures with the total sample of 447 study
in older adults or have not been studied in a sample contain- participants on key demographic variables, there was no dif-
ing large numbers of elders beyond age 75 years. ference in gender composition, ethnic composition, or self-
rated health. However, those persons completing all mea-
METHODS sures were slightly younger (72.6 compared to 73.2 years),
of higher educational level (4.4 compared to 4.2), and of
Sample higher occupational level (3.7 compared to 3.6) than the
I obtained the sample of 388 study participants from two total group. Overall, there was little difference between
sites: a medium-sized Midwestern city (Greater Lafayette, the two samples.
IN, with approximately 100,000 residents) and a large urban
area (Indianapolis, IN, with a population of approximately
1,250,000). Study participants were at least 60 years of age,
Table 1. Means and SDs of Total Group (N 5 388)
were living in private homes or apartments in the commu- on Study Variables
nity, and were alert, oriented, and of sufficient cognitive
ability to respond to the interview-questionnaire (as judged Variable Mean SD Item Meana Item SD
by the interviewer or the senior center director). Age 72.65 7.73
I sampled elders through seniors’ organizations, first se- Educational Level 4.42 1.45
curing a representation of such organizations in each site Occupational Level 3.72 1.55
and then interviewing elders within organizations. I col- SES 43.71 15.55
lected data at 20 different centers, 16 in Indianapolis and 4 Health 4.35 0.90
Religiosity 14.14 2.33
in Lafayette, selected to represent different geographic areas Externality 55.92 17.54
of the two cities and thus a wide range of socioeconomic Self-Esteem 32.35 4.66
status levels. The Indianapolis site included 12 senior pro- Social Support 1.14 0.36
grams in community centers and 4 multidenominational Total Fear of Death 102.35 23.33 2.77 0.63
church-operated centers; 11 of the 16 centers served both Fear of the Unknown 10.30 4.54 2.06 0.91
Black and White seniors. The Lafayette site included one Note: SES 5 socioeconomic status.
community-operated senior center serving the entire city, aEach item mean equals the corresponding scale mean divided by the number

one interdenominational church-operated center, and two of items in the scale.

 TERROR MANAGEMENT AND FEAR OF DEATH
Measures
Fear of death.—To assess fear of death in the present
study, I used the Multidimensional Fear of Death Scale
(MFODS; Hoelter, 1979; Neimeyer & Moore, 1994). The
instrument consists of 42 5-point items yielding eight sub-
scales. The subscales include Fear of the Dying Process
(including painful or violent deaths), Fear of the Dead (in-
cluding avoidance of human or animal bodies), Fear of Be-
ing Destroyed (including cremation or dissection of the
body for autopsy or organ transplants), Fear for Significant
Others (including apprehension about the impact of the re-
spondent’s death on others), Fear of the Unknown (includ-
ing fear of nonexistence and lack of knowledge about after-
life), Fear of Conscious Death (including concerns about
falsely being declared dead), Fear for the Body After Death
(including concern about decay and isolation of the body),
and Fear of Premature Death (concerns about being unable
to accomplish desired goals or experiences). Appropriate
items are summed to yield subscores, with items coded so
that a high score indicates greater fear of death. Neimeyer
and Moore (1994) reported internal consistency reliabilities
(Cronbach’s a) for the subscales ranging from .65 to .82 and
test–retest reliabilities over a 3-week period ranging from
.61 to .81. In addition, they reported factor analytic evidence
for the subscales as well as evidence for construct validity.
Cronbach’s a for the participants in the present study
ranged from .65 to .81 for the subscales, values considered
adequate for studies involving group comparisons.
In an effort to reduce the eight dependent variables of the
study (the MFODS subscores) to a smaller number, I carried
out a principal components analysis with varimax rotation
(see Table 2). One strong factor labeled Fear of the Known
(on which seven of the eight subscores had loadings above
0.3), and one weak factor (on which Fear of the Unknown
had the only loading above 0.3), were identified. Accord-
ingly, I used two MFODS scores as dependent variables in
the analysis: Fear of the Unknown and Fear of the Known
(the sum of the remaining seven MFODS subscores).
Fear of the Unknown most closely approximates fear of
annihilation, the core fear of TMT. The remaining subscales
are concerned with fears of various known aspects of death,
dying, and the fate of the body, but do not deal with the fear
of annihilation of the self. Fear of the Unknown differs in
Table 2. Factor Loadings of Eight MFODS Subscores
Factor
MFODS Subscore I II
Fear of Dying Process .79
Fear of the Dead .69
Fear of Being Destroyed .47
Fear for Significant Others .62
Fear of Conscious Death .68
Fear for the Body After Death .73
Fear of Premature Death .65
Fear of the Unknown .21
Eigenvalue 3.23
% of variance explained 40.34
Note: MFODS 5 Multidimensional Fear of Death Scale.
P361
that it reflects fear and uncertainty that transcendence of the
noncorporeal self will take place following death. Thus, one
might expect the set of predictor variables derived above
from TMT to be more strongly related to Fear of the Un-
known than to the Fear of the Known factor comprising the
other MFODS subscales.
Religiosity.—To assess subjective (or intrinsic) aspects
of religiosity, three items drawn from the work of Markides
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(1983) and Krause (1993) were used: importance of religion
(a 5-point item), God (a 6-point item), and private prayer in
the respondent’s life (a 5-point item). The score is the sum
of the item scores and could range from 3 to 16 for subjec-
tive religiosity, with a high score indicating greater religios-
ity. Cronbach’s a for the participants in this study was .79.
Self-esteem.—The measure of self-esteem used was the
Rosenberg (1965) Self-Esteem Scale. The scale consists of
10 items, each with a 4-point response scale; the total score
is the sum of the item scores, with a high score indicating
greater self-esteem. Estimates of internal consistency reli-
ability for the instrument range from .77 to .88, with test–
retest reliability ranging from .82 to .85. Cronbach’s a for
the participants of this study was .78. Considerable evidence
for the convergent and discriminant validity of the scale ex-
ists (Robinson, Shaver, & Wrightsman, 1991).
Locus of control.—Levenson’s (1981) Multidimensional
Locus of Control measure was used to assess respondents’
locus of control beliefs. The measure consists of 24 items,
each with a 7-point response scale indicating degree of
agreement. Scores for Internality, Powerful Others, and
Chance, obtained by summing the appropriate eight items in
each case, indicate belief in internal control of events, con-
trol by powerful others, and control by chance. Scores on
each subscale could range from 8 to 56, with a high score
indicating belief that the locus of control was of the given
type. Levenson reported Cronbach’s a for the three sub-
scales ranging from .64 to .73, as well as evidence for the
scales’ validity. In addition to the above subscores, the Pow-
erful Others and Chance scores can be summed to yield a
total Externality score. Cronbach’s a of the three subscores
for the participants of this study ranged from .69 to .75;
Cronbach’s a for Externality was .86. Because Internality
had negligible relationships with the Fear of Death sub-
scores in preliminary analysis whereas Externality had
stronger correlations, only the Externality score was used in
this study.
.15
Perceived social support.—One indicator of social sup-
2.14 port is the number and closeness of people perceived by an
2.29 individual to be in his or her support network. To assess this,
2.08 the circles technique from Antonucci and Akiyama’s (1987)
.16 Social Networks in Adult Life Survey was used. The investi-
.15 gator asks respondents to identify persons who are “close
.21
.79
and important” to them at each of three levels of closeness
depicted by concentric circles, with the inner circle includ-
1.04 ing those persons who are very close, the middle circle in-
13.04
cluding those who are close, and the outer circle including
those who are not so close. Scores consist of the number of
P362 CICIRELLI

persons named at each level (inner, middle, and outer). Evi-
dence for validity includes the expected correlations with
indicators of psychological health, and a correlation be-
tween respondents’ and their significant others’ reports of
social support. For the present study, I used the sum of scores
for the inner and middle levels as an indicator of the size of
the respondent’s close support network. Because the distri-
bution of scores on this measure was skewed, I applied a log
transformation before data analysis.
18 participants who had visual impairments or who suffered
from arthritis which made writing difficult.
RESULTS
Differences in Fear of Death Scores
The means and standard deviations of the two fear of death
factors are presented in Table 1. The means for Fear of the
Known and Fear of the Unknown are not directly compara-

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Health.—A single-item self-rating of health was used,
with ratings on a 6-point scale ranging from 1 (very poor) to
6 (excellent). Although participants also completed the In-
strumental Activities of Daily Living (IADL) measure
(Lawton, 1972), the mean IADL score was very low, indi-
cating little or no functional impairment for most study par-
ticipants. For this reason, I did not use the IADL score in
data analysis.
Demographic background.—I assessed several demo-
graphic variables: ethnicity (0 5 White; 1 5 Black), gender
(0 5 male; 1 5 female), chronological age in years, marital
status (0 5 married; 1 5 widowed, divorced, or unmarried),
educational level, and occupational level (using occupation
before retirement). Educational level and occupational level
were coded using the 7-point Hollingshead (1957) scales,
with 7 representing the highest levels. I computed Hollings-
head’s SES index as the sum of 4 3 the educational level 1
7 3 the occupational level.
Procedure
Interviewers administered interview-questionnaires to
study participants in a separate activity room at the senior
center which they attended. Most elders completed the
interview-questionnaire independently in a small group set-
ting (from 3 to 10 persons), with two interviewers present to
answer any questions or to clarify misunderstandings. De-
pending on the number of elders who wished to partici-
pate at a given site, interviewers arranged to administer the
interview-questionnaire at several convenient times. On av-
erage, the interview-questionnaire took about an hour and a
half to complete. Individual interviews were conducted for
ble because they contain differing numbers of items; there-
fore, each mean score was divided by its respective number
of items to get a corresponding item mean for comparison
purposes. When the item means are compared, it can be
seen that participants’ Fear of the Known is stronger (M 5
2.77) than Fear of the Unknown (M 5 2.06).
Correlations of Fear of Death Scores With
Background and Psychosocial Variables
As a first step in examining the relationship of the back-
ground variables (ethnicity, gender, age, health, and marital
status) and the psychosocial variables (religiosity, external-
ity, self-esteem, social support, and SES) with two fear of
death scores, I computed intercorrelations of the study vari-
ables. These are presented in Table 3.
Looking at the relationship with Fear of the Unknown
first, all 5 TMT variables were significantly correlated ( p ,
.05), although the correlations with self-esteem and SES
were very weak. The correlation of religiosity with Fear of
the Unknown (r 5 2.45) was the strongest of all correla-
tions obtained. Those elders with greater religiosity, more
positive self-esteem, more social support, higher SES, and a
less external locus of control had less Fear of the Unknown.
None of the 5 background variables (ethnicity, gender, age,
health, and marital status) were significantly related.
In the case of Fear of the Known, 4 of the 5 TMT vari-
ables were significantly correlated, although the correlations
with religiosity, self-esteem, and SES were very weak.
Those elders with a less external locus of control, greater re-
ligiosity, more positive self-esteem, and higher SES had less
Fear of the Known. Of the background variables, only gen-
der and health were significantly related. Men and those in
better health had less Fear of the Known.

Table 3. Intercorrelations of MFODS Scores, Background Variables, and Psychosocial Variables (N 5 388)
Variable 1 2 3 4 5 6 7 8 9 10 11 12
1. Fear of the Known —
2. Fear of the Unknown 35** —
3. Ethnicity 205 01 —
4. Gender 17** 208 209 —
5. Age 203 201 225** 11* —
6. Health 212* 203 213* 04 06 —
7. Marital Status 05 06 201 34** 17** 203 —
8. Religiosity 210* 245** 19** 20** 03 202 06 —
9. Externality 30** 31** 202 201 12* 206 08 207 —
10. Self-Esteem 211* 211* 11* 04 210 21** 03 03 221** —
11. Social Support 07 224** 201 14** 207 03 210 23** 210* 06 —
12. SES 213* 210* 226** 208 202 24** 211* 206 229** 16** 11* —

Note: MFODS 5 Multidimensional Fear of Death Scale; SES 5 socioeconomic status.

*p , .05; **p , .01.
 TERROR MANAGEMENT AND FEAR OF DEATH P363

Table 4. Summary of Multiple Regression Analyses for Variables variable, while at the same time the relationship of self-
Predicting Fear of the Known and Fear of the Unknown (N 5 388) esteem to the dependent variable was reduced or eliminated
Variable B SE B b R Adj. R2
in the presence of the mediating variable. Neither religiosity
nor social support met the first criterion, because the corre-
Fear of the Known lation of self-esteem with religiosity was only .03 and the
Marital status 20.70 2.61 2.01
Ethnicity 22.12 2.66 2.04
correlation of self-esteem with social support was only .06.
Health 22.91 1.31 2.11* However, self-esteem was significantly related to externality
Age 20.24 0.16 2.08 (r 5 2.21, p , .01), and externality was in turn signifi-
Gender 10.08 2.88 .19** cantly related to Fear of the Unknown (r 5 2.30). (A sim-

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Externality 0.38 0.07 .29** ple path analysis including only externality and self-esteem
Social support 5.60 3.59 .08 as independent variables was carried out to further verify
Self-esteem 20.17 0.26 2.03
Religiosity 21.22 0.51 2.12*
the indirect effect of self-esteem on Fear of the Unknown.
SES 20.06 0.08 2.04 The direct path coefficients were .30 for externality and
.40** .14 2.07 for self-esteem. Thus, the direct relationship between
self-esteem and Fear of the Unknown was reduced from its
Fear of the Unknown
Marital status 0.44 0.46 .05
correlation of 2.11 between these variables in the absence
Ethnicity 0.78 0.47 .08 of externality to 2.07 when externality was present. The in-
Health 0.04 0.23 .01 direct effect of self-esteem on Fear of the Unknown when
Age 20.02 0.03 2.04 mediated by externality was 2.06. The size of the indirect
Gender 0.13 0.50 .01 effect was the product of the coefficients for the effect of
Externality 0.07 0.01 .28** self-esteem on externality and the effect of externality on
Social support 21.22 0.60 2.10*
Self-esteem 20.04 0.04 2.04
Fear of the Unknown, or 2.21 3 .30. This small but signifi-
Religiosity 20.83 0.09 2.43** cant effect still has relevance from a theoretical perspec-
SES 20.01 0.01 2.01 tive.) Therefore, one can conclude that self-esteem had an
.56** .29 effect on Fear of the Unknown which was mediated by ex-
Note: SES 5 socioeconomic status.
ternality. That is, higher self-esteem was associated with a
*p , .05; **p , .01. less external locus of control, which was in turn associated
with a lower Fear of the Unknown.

Fear of the Known.—Of the 5 TMT variables, only ex-

Regression of Fear of Death Scores on Background
and Psychosocial Variables
Multiple regression analysis was used to determine the
relationship between the background and psychosocial vari-
ables and the two dependent variables: Fear of the Unknown
and Fear of the Known. These analyses are summarized in
Table 4.
Fear of the Unknown.—Of the 5 TMT variables, only 3
were significant predictors (p , .05) of Fear of the Un-
known in the multiple regression analysis: religiosity (b 5
2.43), externality (b 5 .28), and social support (b 5
2.10). Self-esteem and SES were not significantly related.
Greater Fear of the Unknown was predicted by lower religi-
osity, a more external locus of control, and weaker social
support. None of the background variables were significant
predictors. Overall, the multiple regression coefficient R
was .56, with the adjusted R2 of .29 indicating that the 3
TMT variables accounted for 29% of the variance of Fear of
the Unknown.
It was puzzling that self-esteem, a core variable in TMT,
was not a significant predictor of Fear of the Unknown in
view of the fact that it had a significant, although weak,
univariate correlation with the fear variable. One possibility
was that the effect of self-esteem might have been mediated
by one of the other TMT variables. Therefore, I examined
each of the three significant predictors in turn for this possi-
bility. To qualify as a mediating variable for self-esteem,
self-esteem needed to be significantly related to the mediat-
ing variable, which was in turn related to the dependent
ternality (b 5 .29) and religiosity (b 5 2.12) were signifi-
cant (p , .05) predictors of Fear of the Known. Self-
esteem, social support, and SES were not significantly re-
lated. A more external locus of control and lower religiosity
were related to greater Fear of the Known. Of the five back-
ground variables, only gender (b 5 .19) and health (b 5
2.11) were significant predictors. In this case, women and
those in poorer health had greater Fear of the Known. Over-
all, the multiple regression coefficient R was .40, with the
adjusted R2 of .14 indicating that the 2 TMT variables and 2
background variables accounted for 14% of the variance of
Fear of the Known.
Using a similar procedure to that used for Fear of the Un-
known, externality was also found to act as a mediating vari-
able for self-esteem in its effect on Fear of the Known. Higher
self-esteem was associated with a less external locus of con-
trol, which was associated in turn with less Fear of the Known.
DISCUSSION
Findings of this study provide partial support for the hy-
pothesis that cultural worldview variables suggested by
TMT are related to fear of death assessed at the level of im-
mediate awareness. Predictions regarding the relationships
of religiosity, externality, and social support to fear of anni-
hilation were supported. However, one important element of
the hypothesis, that higher self-esteem would be associated
with less fear of annihilation (as assessed by Fear of the Un-
known on the MFODS), was only partially supported. Al-
though a very weak correlation (r 5 2.11) between self-
esteem and fear of annihilation was found, self-esteem was
P364 CICIRELLI
not a significant predictor of Fear of the Unknown in the re-
gression analysis. However, it did have an indirect effect
mediated by externality.
One possible explanation for the weak effect of self-
esteem is that, on the one hand, its effect in suppressing fear
of annihilation takes place only outside of conscious aware-
ness, and that different variables are important in dealing
with fear at the level of immediate awareness.
On the other hand, self-esteem may not be an important
variable in relation to fear of death in a population of older
adults except in terms of its indirect effect. Further research
is needed here. Several aspects of the roles of self-esteem
and fear of death in the lives of elderly persons seem puz-
zling. In a recent chapter, McCoy, Pyszczynski, Solomon,
and Greenberg (2000) pointed out that although one would
expect aging adults to have increased fear of death accom-
panying their greater vulnerability in view of increasing age,
illness, and general frailty, fear of death studies have consis-
tently shown them to have a reduced fear of death compared
to younger adults. At the same time, one would expect de-
fenses against fear of annihilation to weaken because many
sources of self-esteem are no longer available to aging indi-
viduals. They are no longer able to meet the standards of the
culture due to declines in certain physical and cognitive
abilities, obsolescence of previous roles in life that are no
longer valued in a time of technological advances, loss of
control over events, and the erosion of contemporary social
supports making it more difficult to achieve social valida-
tion. According to McCoy and colleagues (2000), “The el-
derly face a chronic state of mortality salience coupled with
a possible lessened capacity to use the cultural worldview or
resulting self-esteem to maximally protect the self” (p. 45).
Yet, existing research (Bengtson, Reedy, & Gordon, 1985;
Dietz, 1996) indicates that self-esteem remains high for
most older adults.
McCoy and cohorts (2000) go on to suggest that older
adults use alternative routes for self-esteem maintenance
other than through the consensual worldview favored by
younger adults. These include socioemotional selectivity
(Carstensen, 1992) to minimize contact with those threaten-
ing the self-concept, selective optimization with compensa-
tion (Baltes, 1997), downward adjustment of standards to
minimize discrepancy between real and ideal self (Ryff,
1991), cognitive reframing of events with optimistic reinter-
pretation, and reduced reliance on social consensus. Addi-
tionally, elders are able to maintain self-esteem as well as
gain a sense of death transcendence through generativity, in
which they seek to help future generations. However, the
question remains: If self-esteem is maintained throughout
old age, why isn’t it directly related to fear of death at the
level of immediate awareness?
Another puzzling aspect of the relation of self-esteem to
fear of death is elders’ apparent willingness to acknowledge
the inevitability of death and deal with it at the level of im-
mediate awareness. In this regard, Galt and Hayslip (1998)
found that, compared to younger adults, older adults evi-
denced higher levels of overt death fear but lower levels of
covert fear. If so, they may deal with fear by more direct
means and gradually come to an acceptance of death. Feifel
(1990) also viewed fear of death at different levels: a con-
scious level, a level of fantasy or imagery, and a noncon-
scious level. The way of thinking about TMT in relation to
fear of death at the level of immediate awareness as dis-
cussed in this article fits in with Feifel’s thinking; it is an ex-
tension of the theory to the level of immediate awareness
without denying its basic tenets regarding fear of death out-
side of awareness. Certainly more research into the relation-
ship between these levels of awareness and the role of self-
esteem in dealing with fear of death at each level in an older
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population is needed.
Although generativity can aid in maintaining self-esteem,
it is also a means of achieving symbolic immortality
through transmission of one’s achievements in the culture to
future generations (Solomon et al., 1991a). TMT also holds
that religious faith leads to the promise of literal immortal-
ity, the continuation of life in some form after bodily death.
Expectations of both symbolic and literal immortality
achieved through participation in the cultural worldview are
hypothesized to reduce fear of death. This expectation was
supported by the findings regarding religiosity. Not only did
the older adults of this study manifest high intrinsic religios-
ity, but it was substantially related to lower fear of annihila-
tion. Further research should attempt to more carefully dis-
tinguish sources of literal and symbolic immortality (Lifton,
1983) and to include adequate measures of each in order to
determine the contribution of each type of belief on fear of
annihilation.
Feifel (1990) is concerned with the multidimensionality
of fear of death, as are most contemporary researchers,
whereas TMT is concerned only with the basic fear of anni-
hilation. Thus, in applying the theory when using multi-
dimensional measures, one would expect the set of predic-
tors to be more strongly related to the fear of annihilation
(Fear of the Unknown on the MFODS) than to other fears.
Study findings confirmed this expectation, providing further
evidence in support of TMT.
Although the 5 background variables (ethnicity, gender,
age, marital status, and health) were unrelated to Fear of the
Unknown (annihilation), gender and health were related to
the Fear of the Known (a composite of other subscales of
the MFODS), supporting the universality of TMT across
various levels of these background variables.
Predictors suggested by TMT accounted for a much
greater portion of the variance in Fear of the Unknown
(29%) than in Fear of the Known (14%), thereby supporting
the proposition that identification with the culture serves to
buffer the individual against fear arising from awareness of
vulnerability to total annihilation.
The role of locus of control in reducing fear of death was
supported by the findings regarding externality. That is, fear
of death was greater among those elders who felt that envi-
ronmental events came about by chance or were controlled
by others who had power over them. Although this finding is
not unexpected in view of previous literature (e.g., Hayslip
& Stewart-Bussey, 1986–1987; Hunt et al., 1988; Schulz,
1978), the lack of a relationship between fear of death and in-
ternality in preliminary correlations is puzzling. However,
high internal control might imply invulnerability to death (and
low fear) for some, whereas for others death might be viewed
as uncontrollable (with higher fear). Also, some studies have
 TERROR MANAGEMENT AND FEAR OF DEATH
found that people become more external in locus of control
as they grow older (Schulz, 1986; Siegler & Gatz, 1985).
If one is serious about extending TMT to fear of death at
the level of immediate awareness (while maintaining the ba-
sic theory of processes taking place outside of awareness),
further theoretical formulation is needed as to how the dif-
ferent levels of awareness may be coordinated and how self-
esteem and religious faith may be related to fear of death at
each level of awareness. These topics need to be investi-
gated further from an empirical point of view, as well. Care-
fully planned studies manipulating mortality salience and
measuring self-reported fear of death might tease out differ-
ences in death thoughts at different levels of awareness and
accessibility (see Harmon-Jones et al., 1997).
More research is also needed to identify aspects of the
culture that are related to self-esteem and faith in the world-
view, as recommended by Greenberg and colleagues (1997).
Finally, TMT needs elaboration in relation to the multivari-
ate conceptions of fear of death. Presumably the fear of an-
nihilation is basic and all other fears are derived from it. Is
it possible that, under different conditions and with differ-
ent age groups, the derivative fears also may have im-
portance for the theory? The relative strength of Fear of the
Known as compared to Fear of the Unknown indicates
the importance of other aspects of fear of death for older
people, as does the relationship of certain MFODS sub-
scales to elders’ end-of-life decisions (Cicirelli, 1997). The
need to deal both theoretically and empirically with the var-
ious dimensions of fear of death (even if derivative) is un-
derscored by recent research (Tomer, Eliason, & Smith,
1997) that not only found that the relationship of predictor
variables to death anxiety depended on the dimension con-
sidered, but that the dimensionality of death anxiety itself
varied with age.
The limitations of this article are acknowledged. It is rec-
ognized that the older people participating in the study rep-
resent a specialized population of elders who take part in ac-
tivities at community senior centers, and this may influence
findings. These elders might be better integrated into the
larger culture than elders who are loners with few ties to the
community; whether they are as well integrated into the cul-
ture as elders who participate in other community organiza-
tions and have many social ties is open to question. Also,
better measures of some of the variables hypothesized to be
related to fear of death might reveal stronger relationships.
Another limitation is that self-response measures of fear
of death may suffer from social desirability effects, with re-
spondents reporting less fear than they actually feel. Cer-
tainly, if fear of annihilation is regarded as the core fear of
death in TMT, then further testing of the theory requires a
more fully developed measure of this aspect of death fear
than the 5-item Fear of the Unknown subscale of the MFODS.
It was assumed in this study that Fear of the Unknown was
an adequate indicator of fear of annihilation, but this needs
to be demonstrated using a better measure of the concept.
In general, if a valid extension of TMT is to be attempted
integrating processes occurring both within and outside of
awareness, then one can only view this study as exploratory,
and far more refined thinking regarding the mechanisms in-
volved and their testing needs to be done.
P365
Acknowledgments
This article is based in part on a study supported by the AARP Andrus
Foundation.
Address correspondence to Victor G. Cicirelli, Department of Psycho-
logical Sciences, Purdue University, West Lafayette, IN 47907-1364. E-mail:
victor@psych.purdue.edu
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Received January 31, 2001
Accepted September 10, 2001
Decision Editor: Margie E. Lachman, PhD