Effectiveness of an Online Religiously-integrated Cognitive Behavioral Therapy-based Intervention on Death Anxiety

NCT06876103 | Not Yet Recruiting

• 1 other identifier: 2024/04-14
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

There has been growing awareness of the importance of death anxiety (DA) in pathological anxiety. DA is defined as a persistent and unreasonable fear of death and thoughts, fears, and emotions associated with the end of life. DA has been suggested as a core fear that underpins the emergence and perseverance of numerous anxiety disorders. However, previous DA-based treatment studies focus on the elderly, the patients, or health professionals who care for the terminally ill. Therefore, there is a need to examine the effect of psychological interventions on DA and current disorder symptoms in a clinical sample through randomized controlled trials. The current study aims to develop a novel Religiously Integrated Cognitive Behavioral Therapy (RCBT)-based intervention on DA in individuals diagnosed with an anxiety disorder and to compare the effectiveness of RCBT-based intervention with classical CBT-based intervention.

Conditions

Death Anxiety

Keywords

death anxiety; religiously integrated cognitive behavioral therapy; classical cognitive behavioral therapy; randomized control study

Outcome Measures

Primary Outcomes (2)

• Turkish Death Anxiety Scale (TDAS)

  The Turkish Death Anxiety Scale consists of 20 items that are divided into three subscales: (a) ambiguity of death, (b) exposure to death, and (c) agony of death. These subscales exhibit strong internal consistency, with Cronbach's alpha values of .91, .94, .76 respectively, adding up to a total of .95). It consists of a five-point Likert (0 = Never to 4 = Always). Subscale scores are determined by summing the individual item scores, and the total scale score is determined by summing the subscale scores. Total scale scores can be between 0 and 80, and the higher the score, the greater the level of DA. A score range of 0-7 indicates very low-level DA, 8-25 indicates low-level DA, 26-44 indicates medium-level DA, 45-63 indicates high-level DA, and 64-80 indicates very high-level DA.

  Baseline (pretest), Week 7 (posttest), 3-month follow-up

• Abdel-Khalek's Death Anxiety Scale (ASDA)

  Abdel-Khalek's Death Anxiety Scale is a 20-item questionnaire that measures DA. The scale is one-dimensional. Higher scores indicate a greater degree of DA. It consists of a five-point Likert (1 = No to 5 = Very much). The Turkish reliability and validity of the scale were conducted by Sarıçiçek-Aydoğan et al. in 2015 (Cronbach's alpha = .86).

  Baseline (pretest), Week 7 (posttest), 3-month follow-up

Secondary Outcomes (2)

• Generalized Anxiety Disorder-7 (GAD-7)

  Baseline (pretest), Week 7 (posttest), 3-month follow-up

• Patient Health Questionnaire (PHQ-9)

  Baseline (pretest), Week 7 (posttest), 3-month follow-up

Other Outcomes (2)

• Belief in a Day of Judgment Scale

  Baseline (pretest), Week 7 (posttest), 3-month follow-up

• Muslim Practice and Belief Scale

  Baseline (pretest), Week 7 (posttest), 3-month follow-up

Study Arms (2)

Religiously Integrated CBT Group

EXPERIMENTAL

Participants will receive a novel online RCBT-based intervention consisting of 7 weekly 90-minute sessions in a group format.

Other: Religiously-integrated Cognitive Behavioral Therapy

Classical CBT Group

ACTIVE COMPARATOR

Participants will receive an online CBT intervention based on Furer and Walker's (2008) protocol, consisting of 7 weekly 90-minute sessions in a group format.

Other: Classical Cognitive Behavioral Therapy

Interventions

Religiously-integrated Cognitive Behavioral Therapy OTHER

This study aims to assess the efficacy and feasibility of a newly developed online intervention for death anxiety based on Religiously Integrated Cognitive Behavioral Therapy (RCBT). Building upon the framework of Furer and Walker's 2008 intervention protocol, this adaptation incorporates beliefs in an afterlife, aligning with Turkish society's cultural and religious values. The RCBT intervention consists of seven structured group therapy sessions, each lasting 90 minutes. The program is designed to help participants identify and challenge unhelpful thoughts related to death anxiety while integrating religious resources to promote cognitive restructuring. Key components of the intervention include psychoeducation, cognitive restructuring, exposure exercises, the concept of repentance in the context of trust and belief in the afterlife, gratitude, and value-oriented behaviors.

Religiously Integrated CBT Group

Classical Cognitive Behavioral Therapy OTHER

The standard CBT intervention follows the structured protocol developed by Furer and Walker (2008), which targets cognitive distortions, avoidance behaviors, and excessive safety-seeking behaviors contributing to death anxiety. The researcher has adapted the session content to fit the protocol's core components while maintaining fidelity to the original intervention model. Sessions last 90 minutes and are conducted in an online group format. Session Structure: Session 1: Treatment Rationale, Session 2: Reducing Excessive Checking, Reassurance Seeking, and Safety Behaviors, Session 3: Exposure, Session 4: Cognitive Reappraisal, Session 5: Enhancing Enjoyment of Life, Session 6: Healthy Lifestyle, and Session 7: Relapse Prevention.

Classical CBT Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged 18-65
• A score of \> 26 on the Turkish Death Anxiety Scale
• Diagnosed with one of the anxiety disorders
• Believing in life after death

You may not qualify if:

• Diagnosed with schizophrenia, schizophreniform disorder, schizoaffective disorder, and delusional disorder
• Being in an active manic episode
• Possessing a mental disorder that interferes with completing measures or understanding the exercises conducted during sessions
• Extreme symptoms of depression (score of \> 20 on the Patient Health Questionnaire (PHQ-9), and \>1 on the item assessing suicidality)
• Currently receiving therapy.

Sponsors & Collaborators

• Ibn Haldun University: lead

Study Sites (1)

Ibn Haldun University

Istanbul, 34480, Turkey (Türkiye)

Location

Related Publications (2)

• Aydoğan, A. S., Gülseren, Ş., Sarıkaya, Ö. Ö., & Özen, Ç. (2015). Abdel-Khalek ölüm anksiyetesi ölçeği Türkçe formunun üniversite öğrencilerinde geçerlilik ve güvenilirliği. Nöropsikiyatri Arşivi, 52, 371-375.

  BACKGROUND

• Abdel-Khalek AM. A general factor of death distress in seven clinical and non-clinical groups. Death Stud. 2004 Nov;28(9):889-98. doi: 10.1080/07481180490491040.

  PMID: 15493083 BACKGROUND

MeSH Terms

Conditions

Necrophobia

Study Officials

• Büşra Kavla, PhD Student

  Ibn Haldun University

  PRINCIPAL INVESTIGATOR

• Burcu Uysal, Associate Professor

  Ibn Haldun University

  STUDY CHAIR

Central Study Contacts

Büşra Kavla, PhD Student

CONTACT

00905435978136; busra.kavla@stu.ihu.edu.tr

Burcu Uysal, Associate Professor

CONTACT

00905365150970; burcu.uysal@ihu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants will be blinded to whether they are receiving religiously integrated CBT (RCBT) or classic CBT. Additionally, the outcomes assessor will be blinded to participants' pre- and post-treatment scale scores. However, the therapist conducting the intervention will be aware of the treatment allocation. Therefore, the study follows a single-blind design.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This study employs a parallel assignment design, where participants are randomly allocated to either the intervention or control group to compare treatment effects.

Study Record Dates

• First Submitted: March 5, 2025
• First Posted: March 14, 2025
• Study Start: June 1, 2025
• Primary Completion: July 1, 2025
• Study Completion: December 1, 2025
• Last Updated: June 3, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)