Measuring American adults’ perceptions about human existence: A cross-sectional study

Palliat Support Care. 2025 Aug 22;23:e143. doi: 10.1017/S1478951525100497.

ABSTRACT

OBJECTIVES: Awareness of death shapes our existence; it prompts both distress and a maturation process called existential maturation. Presently, direct quantitative measures of existential maturation are unavailable to study treatments for existential distress that enhance psychological well-being. We examined the effect of a mortality salience stimulus on implicit death thoughts over time. We also examined the associations among existing measures of constructs conceptualized as relevant to an eventual measure of existential maturation in a representative sample.

METHODS: A cross-sectional Qualtrics panel of 1,000 adults, representative of the United States’ urban and rural populations, completed a 20-minute survey. The self-report Human Existence survey included an embedded mortality salience stimulus (Death Anxiety Beliefs and Behaviors Scale) and valid, reliable measures of implicit death-thought accessibility (DTA), existential isolation, existential distress, flourishing, transcendence, attachment, connections, peace, and other related constructs.

RESULTS: The DTA measure did not replicate previous research on mortality salience. We found significant positive correlations between existential isolation and existential distress, and between flourishing and transcendence. However, correlations of death anxiety with isolation, flourishing, and transcendence were surprisingly low. In multivariate analysis, avoidant attachment was negatively associated with existential isolation and distress; death anxiety was positively associated with anxious/ambivalent attachment. Transcendence was negatively associated with avoidant attachment and positively associated with being at peace and connections. Flourishing was positively associated with being at peace and connections.

SIGNIFICANCE OF RESULTS: An ineffective death reminder or the DTA online format may have affected DTA results. Striking relationships between attachment style and EM indicators confirm they are interrelated. Measures for existential maturation and related phenomena still lack implicit measures to assess nonconscious components.

PMID:40842354 | DOI:10.1017/S1478951525100497