Research On Death Threat And Defense Mechanisms Of Cancer Patients

Under the current scientific background,death is the inevitable result of individual development,so how to deal with death is a basic existentialist topic of human beings.This contradiction prompts people to evolve and derive various strategies to protect themselves from the threat of death,so as to ensure psychological and spiritual adaptability.Terror Management Theory(TMT;Greenberg,Pyszczynski and Solomon,1986)provides a useful theoretical framework to try to explain how human beings resist death-related anxiety and fear,and conversely,if they are not well defended against such anxiety and fear,they will lead to various mental illnesses or mental disorders.Therefore,psychologists have been doing a lot of research on death threats and defensive behaviors,and researchers have gained more understanding of various death defensive behaviors.However,in the past,a large number of studies have focused on the imagined mortality salience and the subsequent mortality salience effect,while few studies have focused on the real death salience and the subsequent defense effect.In this study,cancer patients were selected as the main objects of study,and the effects of various defense mechanisms were systematically explored under the prominence of real death.Through the study of death psychology of cancer patients,TMT theory system is enriched and perfected.Researchers incorporated the five-stage theory of death proposed by Kubler-ross,a pioneer psychologist in the field of death,into the proximal defense mechanism system of TMT theory,and further explored the defensive role of the distal defense mechanism in different proximal defense stages.On the basis of the above studies,the researchers believe that for cancer patients,proximal defense and distal defense do not alternate,but may be parallel to each other.The whole study consists of five parts.The first study is based on the classical death thought accessibility(DTA)measurement paradigm which has been used abroad and DTA measurement version which has been localized in China.A Pinyin DTA measurement tool is developed.The Pinyin DTA measurement tool overcomes the shortcomings of the existing version that the Chinese words directly related to death cannot be included in the measurement scope,resulting in low content validity.Theself-compiled Pinyin DTA measurement tool has four steps: dictionary screening,word frequency screening,preliminary testing and expert evaluation.Finally,13Pinyin-Chinese versions are obtained.The results of the classical MS test are consistent with those of Greenberg's English DTA measurement tools.Under the same experimental conditions as the predecessors,we validate the tool constructed by the new idea and get the same results,which further proves that the Pinyin DTA measurement tool has good reliability and validity.The results also showed that different levels of MS would lead to different DTA values.That is to say,the greater the death threat,the smaller the DTA value,the smaller the death threat,and the larger the DTA value.The second study consists of three experiments.In experiment 1,under different saliency conditions,the intuitive perception of life span of cancer patients was directly measured by quantitative estimation method.The results showed that the subjective perception of life span changed significantly under different saliency conditions.The unexpected result is that cancer patients not only feel less about the future,but also less about the past time subjectively.This means that MS can compress the individual's subjective feelings about the past and future orientation of TE.Researchers believe that it is MS that makes people feel how short their subjective feelings are in their life.On the contrary,if life is highlighted,the life span will expand.Cancer patients' projection of future time is significantly less than that of past time even under the condition of prominent life;health control group's projection of future time is significantly more than that of past time even under the condition of prominent cancer,and the condition of imaginary prominence cannot change their overall feeling of future.In experiment 2,MS was followed by different tasks(non-delayed tasks,delayed tasks and alternating cognitive load tasks).The levels of DTA measured by cancer patients under the conditions of non-delayed task and delayed task were very low,but the levels of DTA increased significantly under the condition of alternating cognitive load tasks.Researchers believe that cognitive load task inhibits the awareness of negative body reactions of toothache patients,reduces anxiety and fear levels,and further reduces the level of DTA in the unconscious level.In experiment 3,the response time of vocabulary decision task was used to measure the DTA level of cancer patients directly.The results showed that the DTA level of cancer patients was significantly higher than that of toothache patients,indicating that cancer patients were significantly more threatened by death than toothache patients.Secondly,subliminal stimuli for cancer patients did not respond differently to death or negative vocabulary judgments because of differentpriming conditions.The interesting result is that cancer patients judged death vocabulary faster than negative vocabulary,and there were significant differences within the group;and cancer patients judged death vocabulary and negative vocabulary faster than toothache patients.This result can be explained in two ways.First,because of the intervention of proximal defense mechanism,in order to avoid or avoid exposure to death-related stimuli for too long,the subjects responded quickly,so that death-related vocabulary disappeared quickly.Secondly,the unconscious level of DTA in cancer patients is not at a lower level,but at a higher level,just like the level of death thought in the conscious level.The third study consists of two experiments.In experiment 4,we examined whether there were differences in the distal defense mechanism of cultural world-view between cancer patients and toothache patients,and explored the differences of cultural world view in different stages of cancer patients' death psychology.The results showed that there was no significant difference in the defense level of cultural world-view between cancer patients in avoidance of death stage and toothache patients without death initiation.This indicated that the defense level of cultural world-view of cancer patients at this stage was relatively low,which was the same as that of toothache patients without MS.In response to this result,the researchers believe that for cancer patients,in the avoidance of death stage,their defense mechanism of cultural world-view has been suppressed by a strong proximal defense role.In the death group,the defense level of cultural world-view rose to the highest level.Although the defense level of cultural world-view in the bargaining stage is not significantly higher than that in the avoidance of death group,researchers observed that the average defense level of cultural world-view in the bargaining group is on the rise.In experiment 5,researchers focused on the self-esteem defense mechanism in distal defense of cancer patients,and the dynamic changes of the relationship between self-esteem and depression and suicide intention.The results showed that there was no significant difference in explicit self-esteem test among cancer patients at different psychological stages of death.However,on implicit self-esteem test,the avoidance of death group was significantly higher than the acceptance of death group,and even significantly higher than the toothache group.The results suggest that for cancer patients,even in the first stage of intense proximal defense activation,distal defense mechanisms are activated and involved in the defense of death threats.This conclusion directly questioned the Greenberg team's conclusion that when the proximal defense mechanism works,thedistal defense mechanism will not be activated.The level of self-esteem of cancer patients who accepted death dropped to the lowest level,significantly lower than the other two stages.In the stage of accepting death,the level of self-esteem of cancer patients dropped to the lowest level,and finally reached a compromise with death,accepting the inevitable reality of death.Lower levels of self-esteem can lead people to approach death.However,unlike depressive patients,cancer patients who accepted death scored the lowest in the suicide intention questionnaire,which indicated that cancer patients at this stage did not have the psychology of seeking death.It was also found that the suicide intention of cancer patients in the bargaining stage was the most significant,mainly because the majority of cancer patients in this stage experienced the process of bargaining failure,reduced self-control and frustrated self-esteem.This process was the gradual depletion of psychological resources.The fourth study mainly focused on third defense mechanism in proximal defense mechanism---intimacy.The results showed that there were significant differences in the need for intimacy among cancer patients at different psychological stages of death.At the avoidance stage,caner patients long for intimacy from people,and the more close people they are with,the safer and more comfortable they feel.But when it comes to bargaining,cancer patients prefer the interpersonal pattern of being crowded but keeping a certain distance from themselves.When cancer patients come to accept death,staying with fewer people who have intimate relationships with them makes them feel more comfortable and safer.Hope that the closest people will stay close to themselves,and the range of emotional choices has narrowed.Plusnin,Pepping and Kashima mentioned that intimate relationship is the third defense mechanism juxtaposed with self-esteem and cultural world-view in their literature review on the defense mechanism of intimate relationship published in 2018.They believe that intimate relationship helps to form and maintain self-esteem,and consolidates and inherits cultural world-view,and is one of the important elements in the construction of meaning system.The researchers believe that intimacy belongs to the system of meaning construction and is more inclined to be divided into distal defense mechanisms.The study also found that the use of intimacy as a defense mechanism has a very good defense effect,and is more likely to enter the stage of accepting death.For cancer patients with insecure attachment,the defense mechanism of non-relational form(i.e.cultural world-view and self-esteem)may be more effective.The fifth study mainly aims to examine whether there are functional changes inbrain mechanisms in cancer patients with mental or psychiatric breakdown caused by dysfunction of the defensive mechanism.Future restricted insight in experimentation 7is an important predictor of cancer recurrence fear.Strong sense of time limitation may make them overly sensitive to changes in their health status and worried about cancer recurrence.Neuroimage results showed that the activity of vmPFC in the strong future time-limited group was significantly lower than that in the weak future time-limited group,and it was negatively activated.However,no difference was found in other brain regions mainly responsible for emotion,such as amygdala and insula.Patients with strong future time limitations and high fear of cancer recurrence are more likely to suffer from mental illness.In summary,the researchers believe that the proximal defense mechanism is rational,while the distal defense mechanism is meaningful.The proximal defense mechanism is the transition from irrationality to rationality,while the distal defense mechanism is the transition from meaninglessness to meaningfulness.Both mechanisms are continuous changing processes.When individuals face high-intensity death threats,defense systems become more complex,contradictory,repetitive and overlapping.For the first time,this study used quantitative estimation to measure the life span.At the same time,it tried to integrate the classical five-stage theory of death and TMT theory,expand the proximal defense mechanism,and preliminarily explore the applicable conditions of the distal defense mechanism and brain mechanism of individuals with disordered defense mechanism by using fMRI technology.It also attempted to obtain some novel and interesting research results.