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Are religiousness and death attitudes associated with the wish to die in older people?

Published online by Cambridge University Press:  24 August 2015

Anke Bonnewyn*
Affiliation:
University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
Ajit Shah
Affiliation:
University of Central Lancashire, Preston, UK
Ronny Bruffaerts
Affiliation:
University Psychiatric Centre, University of Leuven, Belgium
Koen Demyttenaere
Affiliation:
University Psychiatric Centre, University of Leuven, Belgium
*
Correspondence should be addressed to: Anke Bonnewyn, MA. University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Phone: +32 16 34 80 00; Fax: +32 16 34 87 00. Email: [email protected].
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Abstract

Background:

A wish to die is common in older persons and is associated with increased mortality. Several risk factors have been identified, but the association between religiousness and a wish to die in older adults has been underexplored, and the association between death attitudes and the presence of a wish to die has not been investigated yet. The aim of this study is to explore the relationship between religiousness and death attitudes on the one hand and wish to die on the other hand, adjusting for clinical factors such as the presence of depression or somatic disorder.

Methods:

The sample comprised 113 older inpatients (from a psychiatric and somatic ward) with a mean age of 74 years. Psychiatric diagnoses were assessed by the Structured Clinical Interview for DSM-IV Disorders, and logistic regression analyses estimated the unique contribution of religiousness and death attitudes to the wish to die, controlling for socio-demographic variables, depressive disorder, and somatic symptoms.

Results:

Both religiousness and death attitudes were associated with a wish to die in univariate models. Adding these variables in a multivariate logistic hierarchical model, death attitudes remained significant predictors but religiousness did not; 55% of the pseudovariance of the wish to die was explained by these variables, with an effective size of 0.89. Major depressive episode, somatic symptoms, Fear of Death, and Escape Acceptance were the most important predictors of the wish to die.

Conclusions:

This study suggests that how older adults perceive death partly determines whether they have a wish to die. There may be a clinical, patient-oriented benefit in discussing with older patients about how they perceive death, as this can play a role in the early detection (and prevention) of death or suicide ideation and associated behaviors in older adults.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Ardelt, M. and Koenig, C. S. (2006). The role of religion for hospice patients and relatively healthy older adults. Research on Aging, 28, 184215.Google Scholar
Baca-Garcia, E. et al. (2011). Estimating risk for suicide attempt: are we asking the right questions? Passive suicidal ideation as a marker for suicidal behavior. Journal of Affective Disorders, 134, 327332.Google Scholar
Beck, A. T., Steer, R. A. and Ranieri, W. F. (1988). Scale for Suicide Ideation: psychometric properties of a self-report version. Journal of Clinical Psychology, 44, 499505.Google Scholar
Bonnewyn, A. et al. (2014). Reflections of older adults on the process preceding their suicide attempt: a qualitative approach. Death Studies, 38, 612618.Google Scholar
Britton, P. C. et al. (2008). Reasons for living, hopelessness, and suicide ideation among depressed adults 50 years or older. American Journal of Geriatric Psychiatry, 16, 736741.CrossRefGoogle ScholarPubMed
Cicirelli, V. G. (1997). Relationship of psychosocial and background variables to older adults’ end-of-life decisions. Psychology and Aging, 12, 7283.Google Scholar
Daaleman, T. P. and Dobbs, D. (2010). Religiosity, spirituality and death attitudes in chronically ill older adults. Research on Aging, 32, 224243.Google Scholar
Dennis, M. S., Wakefield, P., Molloy, C., Andrews, H. and Friedman, T. (2007). A study of self-harm in older people: mental disorder, social factors and motives. Aging Ment Health, 11, 520525.Google Scholar
Derogatis, L. R., Lipman, R. S. and Covi, L. (1973). SCL-90: an outpatient psychiatric rating scale – preliminary report. Psychopharmacology Bulletin, 9, 1328.Google Scholar
Derogatis, L. R., Rickels, K. and Rock, A. F. (1976). The SCL-90 and the MMPI: a step in the validation of a new self-report scale. British Journal of Psychiatry, 128, 280289.Google Scholar
Dezutter, J., Luyckx, K., Bussing, A. and Hutsebaut, D. (2009). Exploring the link between religious attitudes and subjective well-being in chronic pain patients. International Journal of Psychiatry in Medicine, 39, 393404.Google Scholar
Falkenhain, M. and Handal, P. J. (2003). Religion, death attitudes, and belief in after life in the elderly: untangling the relationships. Journal of Religion and Health, 42, 6776.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washington, DC: American Psychiatric Press.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Gesser, G., Wong, P. T. P. and Reker, G. T. (1987). Death attitudes across life-span: the development and validation of the death attitude profile. Omega, 18, 113128.CrossRefGoogle Scholar
Hundsdoerfer, A. K. and Wink, M. (2005). New source of genetic polymorphisms in Lepidoptera? Zeitschrift für Naturforschung. Teil C: Biochemie, Biophysik, Biologie, Virologie, 60, 618624.Google Scholar
IBM Corp. 2012. IBM SPSS Statistics for Windows. 21.0 ed. Armonk, NY: IBM Corp.Google Scholar
Jahn, D. R., Poindexter, E. K., Graham, R. D. and Cukrowicz, K. C. (2012). The moderating effect of recent negative life events on the relation between intrinsic religiosity and death ideation in older adults. Suicide and Life-Threatening Behavior, 42, 589601.Google Scholar
Juurlink, D. N., Herrmann, N., Szalai, J. P., Kopp, A. and Redelmeier, D. A. (2004). Medical illness and the risk of suicide in the elderly. Archives of Internal Medicine, 164, 11791184.Google Scholar
Koenig, H., Parkerson, G. R. Jr. and Meador, K. G. (1997). Religion index for psychiatric research. American Journal of Psychiatry, 154, 885886.Google Scholar
Lapierre, S. et al. (2012). Daily hassles, physical illness, and sleep problems in older adults with wishes to die. International Psychogeriatrics, 24, 243252.Google Scholar
Maxfield, M. et al. (2007). Age-related differences in responses to thoughts of one's own death: mortality salience and judgments of moral transgressions. Psychology and Aging, 22, 341353.CrossRefGoogle ScholarPubMed
Neimeyer, R. A., Currier, J. M., Coleman, R. A., Tomer, A. and Samuel, E. (2011). Confronting suffering and death at the end of life: the impact of religiosity, psychosocial factors, and life regret. Death Studies, 35, 777800.CrossRefGoogle ScholarPubMed
Neimeyer, R. A., Wittkowski, J. and Moser, R. P. (2004). Psychological research on death attitudes: an overview and evaluation. Death Studies, 28, 309340.Google Scholar
Nisbet, P. A., Duberstein, P. R., Conwell, Y. and Seidlitz, L. (2000). The effect of participation in religious activities on suicide versus natural death in adults 50 and older. Journal of Nervous and Mental Disease, 188, 543546.Google Scholar
O’Connell, H., Chin, A. V., Cunningham, C. and Lawlor, B. A. (2004). Recent developments: suicide in older people. BMJ, 329, 895899.Google Scholar
Raue, P. J. et al. (2010). The wish to die and 5-year mortality in elderly primary care patients. American Journal of Geriatric Psychiatry, 18, 341350.Google Scholar
Rurup, M. L., Deeg, D. J., Poppelaars, J. L., Kerkhof, A. J. and Onwuteaka-Philipsen, B. D. (2011a). Wishes to die in older people: a quantitative study of prevalence and associated factors. Crisis, 32, 194203.Google Scholar
Rurup, M. L. et al. (2011b). Understanding why older people develop a wish to die: a qualitative interview study. Crisis, 32, 204216.Google Scholar
Rushing, N. C., Corsentino, E., Hames, J. L., Sachs-Ericsson, N. and Steffens, D. C. (2012). The relationship of religious involvement indicators and social support to current and past suicidality among depressed older adults. Aging Ment Health, 17, 366374.Google Scholar
Thorson, J. A. and Powell, E. C. (1994). A revised death anxiety scale. In Neimeyer, R. A. (ed.), Death Anxiety Handbook (pp. 31–43). Washington DC: Taylor & Francis.Google Scholar
Tsai, Y. F., Wong, T. K., Ku, Y. C. and Liu, W. C. (2012). Reasons for living among older male Chinese residents of veterans’ homes. Journal of Advanced Nursing, 68, 19781987.Google Scholar
Wink, P. and Scott, J. (2005). Does religiousness buffer against the fear of death and dying in the late adulthood? Findings from a longitudinal study. Journal of Gerontology, 60B, 207214.Google Scholar
Wong, P. T. P., Reker, G. F. and Gesser, G. (1994). Death attitudes profile-revised: a multidimensional measure of attitudes toward death. In Neimeyer, R. A. (ed.), Death Anxiety Handbook: Research, Instrumentation, and Application (pp. 121148). Washington DC: Taylor & Francis.Google Scholar