Death anxiety is becoming one of the greatest challenges facing HIV/AIDS patients. Confronting death and the anxiety generated by knowledge of its inevitability is a universal psychological quandary for humans (Lehto & Stein, 2009). What individuals believe to be true of his or her existence could be a significant factor in moderating his or her level of death anxiety. Carpenito-Moyet (2008) defined death anxiety as the state in which an individual experiences apprehension, worry, or fear related to death and dying. Moorhead, Johnson, Maas and Swanson (2008) on the other hand posit death anxiety as vague uneasy feeling of discomfort or dread generated by perceptions of a real or imagined threat to one’s existence.
Greenberg, Pyszczynski, Solomon, Simon and Breus, (1994) posit death anxiety to have six attributes: Emotion, cognitive, experiential, developmental, socio-cultural shaping and source of motivation. Lehto and Stein (2009) noted that its characteristics may overlap and cluster in three identified categories: Stressful environments such as war or the experience of unpredictable circumstances, diagnosis of a life-threatening illness or the experience of a life threatening event, and experiences with death and dying.
However, studies has pointed out that there exists a positive association between Human Immune Deficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) status and death anxiety (Hintze, Templer, Cappelletty & Frederick, 1993; Catania, Turner, Choi, & Coates, 1992; Franks, Templer, Cappelletty, & Kauffman, 1990; Hayslip, Luhr, & Beyerlein, 1991; Hintze, Templer, Cappelletty, & Frederick, 1993).). HIV/AIDS has been a topic of interest, greatly discussed and researched due to its’ impact on human beings. Lehto and Stein (2009) indicated HIV/AIDS as a life-threatening illness which can trigger death anxiety. It is transmitted through direct contact with infected blood, use of unsterilized sharp objects, sexual contact, oral, anal or vaginal, direct contact with semen or vaginal and cervical secretion, through infected mothers to infants during pregnancy, delivery and breastfeeding.
People living with HIV/AIDS are most likely to face some psychological, physical and social challenges. The psychological effects of living with HIV or being a HIV positive includes: Fear, loss, grief, guilt, denial, anger, anxiety, low self-esteem, stigmatization, depression, suicidal behaviour and thinking. Additional negative correlates of stigmatization for HIV-positive people are depression, anxiety, loneliness, suicidal ideation, and poor treatment adherence (Murphy, Austin, Greenwell, 2006; Relf, Mallinson, Pawlowski, Dolan, & Dekker, 2005).
They see themselves as undesirable by others who view them as “contagious”. This in itself is an emotional situation that can cause infected people to withdraw, not disclose their feelings, and become socially isolated. Inevitably this may lead to an emotional breakdown because these feelings continue to be suppressed. Infected persons are normally in fear because they have to adjust to a new lifestyle.
In this study, locus of control is also one of the variables of interest to be highlighted. The term locus of control was first introduced in the 1950’s by a psychologist Julian Rotter. In conceptualizing the term locus of control refers to a person’s basic belief system about the influences that affect outcomes in their lives. In the field of psychology, Locus of control is considered to be an important aspect of personality. Locus of control is a belief about whether the outcomes of our actions are contingent on what we do (internal control orientation) or on events outside our personal control (external control orientation) (Zimbardo, 1985). It is classified into internal and external locus of control. Osterman, Bjorkqvist, Lagerspetz, Charpentier, Caprara, Pastorelli (1999) affirmed that internal locus of control is composed of dependent events mostly related to one’s permanent characteristics and external locus of control is related to the feeling that outcomes are a result of fate, luck, chance, or in control of others.
Osterman and colleagues (1999) noted that locus of control is correlated with negative attributes such as conduct disorder, psychological maladjustment, job pressure, depression and anxiety, suicidal behaviours. Hyams, Domino, and Spencer (1982) also noted that a significant relationship exists between external locus of control and concern about death. Hickson, Housley, and Boyle (1988) on the other hand, reported a significant interaction between locus of control and age in relation to death anxiety. Osterman and colleagues (1999) indicated that individuals who possess an internal locus of control are likely to appear more effective in dealing with both the physical outer environment as well as the inner environment, and as well, exhibit a more favorable death attitude.
A substantial body of research has addressed the relationship between religious affiliation and death attitudes. Wong, Reker and Gesser (1994) noted five different death attitudes to include: (a) Neutral Acceptanc-
e, involving the view that death is an integral part of life, (b) Approach Acceptance, a positive outlook on death rooted in the belief in a happy afterlife, (c) Escape Acceptance, in which death is a welcome alternative for a life full of pain and misery, (d) Fear of Death, involving feelings of fear evoked by confrontations with death, and (e) Death Avoidance, involving avoidance of thinking or talking about death in order to reduce death anxiety.
Studies also pointed out a link between religion and death, and some scholars’ even state that if there were no death, there would be no religion (Becker, 1973; Weisman, 1972). As observed and indicated by Spilka, Hood, Hunsberger and Gorsuch (2003) religion is often seen as a way of coping with the unpredictable.
Statement of the Problem
Death anxiety; morbid and abnormal fear of death or dying has triggered a lot of questions in this present time. It has been identified to be initiated by an increase awareness of death (reminders of personal mortality), stressful environment, experience of unpredictable circumstances and life-threatening illnesses (Letho & Stein, 2009). Thus, it is therefore the interest of this study to find answer (s) to the following questions:
- Will HIV/AIDS status be a significant factor in death anxiety among adults in Nsukka Local Government Area?
- Will locus of control be a significant factor in death anxiety among adults in Nsukka Local Government Area?
- Will religious affiliation be a significant factor in death anxiety among adults in Nsukka Local Government Area?
Purpose of the Study
The purpose of this study is to find out whether:
- HIV/AIDS status will be a significant factor in death anxiety among adults in Nsukka Local Government Area.
- Locus of control will be a significant factor in death anxiety among adults in Nsukka Local Government Area.
- Religious affiliation will be a significant factor in death anxiety among adults in Nsukka Local Government Area.
Operational Definition of Terms
Death anxiety: Death anxiety in this study refers to the state of vague uneasy feeling of discomfort, fear, apprehension or worry an individual exhibits as it relates to death or dying. It is measured using Death Anxiety Scale (Templer, 1970).
HIV/AIDS Status: HIV status in this study refers to persons’ infected with Human Immune Deficiency Virus disease (HIV). It has two categories: HIV negative and HIV positive.
Locus of control: Locus of control in this study refers to whether an individuals’ outcome is dependent on their action/ability (internal control) or outside/ beyond their control (external control) as measured by Rotters Locus of Control Scale (1966).
Religious affiliation: Religious affiliation in this study refers to the level of ones devotion/involvement or attachment to his or her religion such to include, frequency of attendance and participating in religious activities, religious conviction and how it guides one’s actions. This is measured using the Religious Affiliation Scale (Omoluabi, 1995).