Death Studies, 32: 445–460, 2008
Copyright # Taylor & Francis Group, LLC
ISSN: 0748-1187 print/1091-7683 online
DOI: 10.1080/07481180801974752

PERSONAL FEAR OF DEATH AND GRIEF
IN BEREAVED MOTHERS
PETER BARR
Royal Alexandra Hospital for Children, Sydney, Australia
JOANNE CACCIATORE
Arizona State University, Phoenix, Arizona, USA

The study explored the relation of fear of death (Multidimensional Fear of Death
Scale) to maternal grief (Perinatal Grief Scale-33) following miscarriage, stillbirth, neonatal death, or infant=child death. The 400 women participants were
recruited from the website, e-mail lists, and parent groups of an organization that
supports bereaved parents. Fear of death had a statistically significant relation
with maternal grief. Fear of the Unknown, Fear of Premature Death, and Fear
of Conscious Death made significant unique contributions to the variance in
maternal grief. The fear of death operative in maternal grief seems to be the fear
of personal extinction.

‘‘We fear death—and that is why we reproduce after our kind’’
(Kastenbaum, 1974, p. 63).

The fact that the death of a loved one should threaten selfhood and
trigger personal death anxiety may seem self-evident on theoretical
grounds (Raphael, 1983), but very little empirical research has
focused on the relation of personal fear of death to grief (Bonanno
et al., 2002). In particular, the untimely and unexpected death of a
child should unravel the self (Furman, 1978) and void important

Received 10 November 2006; accepted 10 June 2007.
We are grateful to Professor Beverley Raphael and Professor Robert Kastenbaum for
their comments on an earlier draft of this article and to Dr. Robert Halliday for automating
the relative mean substitution method for inserting missing Likert scale values into SPSS.
Address correspondence to Dr. Peter Barr, Department of Neonatology, The Children’s
Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia. E-mail:
peter@chw.edu.au

445

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P. Barr & J. Cacciatore

defenses against death anxiety, such as narcissistic maternal omnipotence (Leon, 1990), symbolic immortality (Firestone, 1994;
Florian & Mikulincer, 1998; Lifton, 1973), and birth’s ‘‘victory of
life over death’’ (Deutsch, 1945, p. 1), yet empirical study of the
relation between fear of death and maternal grief has been meager
(Tolstikova, Fleming, & Chartier, 2005).
To cope with the fear of death, people ‘‘erect defenses
against death awareness, defenses that are based on denial, that
shape character structure, and that, if maladaptive, result in . . .
psychopathology’’ (Yalom, 1980, p. 27). In this context, the fear
of death can be considered a maladaptive personality trait with relevance to all manner of psychopathology, including generalized
anxiety, anxiety conditions such as obsessive-compulsive disorder
and agoraphobia, hypochondriasis, and depression (Becker, 1973;
Firestone, 1994; Meyer, 1975; Neimeyer, Wittkowski, & Moser,
2004; Pettigrew & Dawson, 1979; Yalom, 1980). The fact that dysfunctional personality traits and mental ill health have been shown
to correlate with maternal grief (Barr, 2004; Lasker & Toedter,
2000; Robinson & Marwit, 2006) presupposes the possibility of
an important relationship between dispositional fear of death and
maternal grief.
According to adult attachment theory (Mikulincer, Shaver, &
Pereg, 2003; Shaver & Tancredy, 2001), chronic grief is more
likely to afflict individuals with dysfunctional attachment styles
compared with people with a secure attachment style (Archer,
1999; Bonanno & Kaltman, 1999; Weiss, 2001). Likewise, in
relation to the fear of death, Florian and Mikulincer (1998;
Mikulincer & Florian, 2000; Mikulincer, Florian, & Tolmacz,
1990) have reported positive correlations between ambivalent
and avoidant attachment styles and death salience. In relation to
attachment theory, therefore, one might anticipate a significant
relationship between fear of death and maternal grief.
The foregoing theoretical considerations and the lack of
empirical investigation of the relation between death anxiety
and grief prompted the present research, which was designed
to explore the hypothesis that personal fear of death has a significant correlation with maternal grief following bereavement
owing to miscarriage, stillbirth, neonatal death, or infant=child
death.

Fear of Death and Maternal Grief

447

Methods
Procedure
The study was posted on the Mothers in Sympathy and Support
(M.I.S.S.) Foundation website from March 2005 through August
2006. The website usually registers more than one million visits
per month. The M.I.S.S. Foundation is a non-profit tax-exempt
charitable organization that provides crisis and long-term support
for families after the death of a child (M.I.S.S. Foundation, 2006).
In addition, Foundation members and affiliates were notified of
the study through Internet links, e-mail lists, and bereaved parent
organizations and support groups. The study questionnaires could
be completed online or downloaded and mailed on completion to
the Foundation for online data entry. The data from the HTML
web form were saved to a MySQL database using PHP scripting
language and an Apache web server (Birnbaum, 2004).
Prospective participants were invited to take part in a study
that sought to understand the relation between fear of death (‘‘personal attitude to death’’) and grief (‘‘present thoughts and feelings
about your loss’’) following bereavement from miscarriage, stillbirth, neonatal death, or infant=child death. Participants were
advised that the study was anonymous and personally identifying
information was not sought. The study was considered to involve
no more than minimal-risk to participants’ well-being (Kraut
et al., 2004), though they were informed that participation in the
study might be an exacting emotional experience, albeit shortlived (Cook, 2001). Participants were invited to contact the study
investigators should they have queries about the study or concerns
about their personal well-being. A pledge was made to post a
plain-English version of the results of the research on the M.I.S.S.
Foundation website, once the study had been peer-reviewed
for publication. The respondents’ continued participation was
considered to constitute informed consent (Kraut et al., 2004).
The participants responded first to a request for information
concerning demographic variables, including gender, age, ethnicity, education, domestic living arrangement, and child bereavement history, and then they answered a series of six self-report
questionnaires. The first and last of these questionnaires were

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P. Barr & J. Cacciatore

germane to the present study and they were the Perinatal Grief
Scale-33 (PGS-33; Potvin, Lasker, & Toedter, 1989) and the Multidimensional Fear of Death Scale (MFODS; Hoelter, 1979;
Neimeyer & Moore, 1994), respectively.
Participants
The participants were recruited from the following sources:
M.I.S.S. Foundation website (n ¼ 238, 59.5%), M.I.S.S. Foundation member e-mail list (n ¼ 81, 20.3%), and other (n ¼ 81,
20.3%). The ‘‘other’’ source consisted of participants from the
Foundation’s support groups and other bereaved parent organizations and support groups and from the Foundation’s non-member
bereaved parent e-mail list. The study questionnaires were mailed
to this group of participants on request and they completed the
questionnaires and returned them to the Foundation for online
data entry. The study was directly available online for a short period of time using Internet search engines and this may have been
the point of entry for some participants.
Although 612 respondents completed the PGS-33, only 414 of
these completed the MFODS and 400 of this latter group were
women. The 400 women who completed both the PGS-33 and
MFODS comprise the study population. The women who completed the PGS-33 and MFODS compared with women who only
completed the PGS-33 were not statistically significantly different
with respect to their measured grief intensity and the previously
mentioned demographic variables.
The women ranged in age from 19 to 54 years (M ¼ 32.7,
SD ¼ 7.12). Their ethnicity was reported as follows: European
American (n ¼ 288, 72%), African American (n ¼ 6, 1.5%), Native
American (10, 2.5%), Asian American (n ¼ 3, 0.8%), Hispanic
(n ¼ 13, 3.3%), and other (non-American) (n ¼ 80, 20%). The
women’s reported highest level of education was as follows: Year
11 or earlier (n ¼ 26, 6.5%), high school diploma (n ¼ 109,
27.3%), associate degree or certificate (n ¼ 89, 22.3%), bachelor’s
degree (n ¼ 112, 28%), master’s degree (n ¼ 43, 10.8%), and
Ph.D. or advanced professional degree (n ¼ 21, 5.3%). The
women’s relationship status included: married or cohabiting
(n ¼ 360, 90%), single (n ¼ 14, 3.5%), separated (n ¼ 11, 2.8%),
and divorced (n ¼ 15, 3.8%).

Fear of Death and Maternal Grief

449

Although a history of more than one child bereavement was
relatively common, the time lapse since the most recent death
(TRD) was the independent variable used in the statistical analyses.
The most recent category of death with the total number of child
deaths for the category in parentheses was as follows: miscarriage
58 (107), stillbirth 171 (447), neonatal death 77 (146) and infant or
child death 94 (187). The median TRD was 8 months (range 0–343
months).
Measures
PERINATAL GRIEF SCALE-33 (PGS-33)

The intensity of women’s grief was measured with the PGS-33
(Potvin et al., 1989), which is a short version of the Perinatal Grief
Scale (PGS; Toedter, Lasker, & Alhadeff, 1988). The PGS items
were gleaned from the Expanded Texas Inventory of Grief
(Zisook, Devaul, & Click, 1982), the neonatal grief scale used by
Kennell, Slyter, and Klaus (1970), and facets of grief considered
unique to reproductive loss (Borg & Lasker, 1988). The discriminant validity of the PGS has been established by confirming
hypothesized correlations with variables previously known to be
associated with the grief of reproductive loss, such as gestation
and pre-loss mental health (Toedter et al., 1988).
The PGS-33 is a self-report questionnaire with three factor
analyzed 11-item subscales referred to as Active Grief, Difficulty Coping and Despair (Toedter et al., 1988). The Active Grief subscale
contains items that reflect lament over the death of a baby, such
as ‘‘I cry when I think about the baby’’. The Difficulty Coping subscale contains items that denote social withdrawal, difficulty with
normal day-to-day activities and depression, such as ‘‘I find it difficult to make decisions since the baby died’’. The Despair subscale
contains items concerned with feelings of helplessness and hopelessness, such as ‘‘I try to laugh, but nothing seems funny anymore’’. The questionnaire items are presented as statements that
seek responses on a 5-point Likert scale that ranges from 1 (strongly
agree) to 5 (strongly disagree) with a neutral midpoint. Thirty-one of
the 33 items are negatively valenced and these scores are reversed
before aggregating the individual item scores to obtain the total
and subscale scores such that higher scores indicate more intense
grief.

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P. Barr & J. Cacciatore

TABLE 1 Descriptive Statistics for PGS-33 Grief and MFODS
Measure
PGS-33 Grief
Fear of the Dying Process
Fear of the Dead
Fear of Being Destroyed
Fear for Significant Others
Fear of the Unknown
Fear of Conscious Death
Fear for the Body after Death
Fear of Premature Death

M
110.1
14.1
17.0
11.5
9.9
15.3
17.8
21.7
9.9

(14.9)
(19.7)
(13.8)
(13.6)
(14.9)
(23.0)
(24.6)
(12.3)

SD
22.92
5.75
5.13
4.48
3.48
4.89
5.09
5.74
3.88

(5.96)
(5.02)
(4.74)
(4.95)
(4.11)
(5.26)
(4.67)
(4.22)

Cronbach’s a
.94
.82
.68
.73
.67
.69
.80
.78
.73

Note. N ¼ 400. Cronbach’s a value for Fear of the Unknown was .88 when the item ‘‘I am
afraid of meeting my creator’’ was omitted. PGS-33 ¼ Perinatal Grief Scale-33;
MFODS ¼ Multidimensional Fear of Death Scale. The M and SD values in parentheses
are data from Neimeyer and Moore (1994).

Women who had experienced the death of an infant or
child beyond the neonatal period were included in the present
study and therefore the PGS-33 was modified by replacing the
word baby in the item statements with the compound word baby=
child with the permission of the scale’s authors. Only the total score
for PGS-33 Grief was used in the present study. The internal
reliability coefficient (Cronbach’s a) for PGS-33 Grief was .94
(Table 1).

MULTIDIMENSIONAL FEAR OF DEATH SCALE

The intensity of the women’s fear of death was measured
using the MFODS (Hoelter, 1979; Neimeyer & Moore, 1994).
The validity and reliability of the MFODS has been established
by testing convergent validity with other measures of death anxiety, confirming correlations with demographic variables known
to be associated with death anxiety, analyzing individuals’ narrative accounts of the meaning of death, evaluating internal
reliability, and test–retest reliability, and performing exploratory
factor analysis (Neimeyer & Moore, 1994; Walkey, 1982).
The MFODS is a 42-item self-report questionnaire with eight
factor analyzed scales representing different facets of the fear of
death: Fear of the Dying Process (6 items) contains items, such

Fear of Death and Maternal Grief

451

as ‘‘I am afraid of dying very slowly’’; Fear of the Dead (6 items)
includes items, such as ‘‘I am afraid of things which have died’’;
Fear of Being Destroyed (4 items) consists of items, such as ‘‘I do
not like the thought of being cremated’’; Fear for Significant
Others (6 items) contains items, such as ‘‘I have a fear of people
in my family dying’’; Fear of the Unknown (5 items) includes
items, such as ‘‘I am afraid that death is the end of one’s existence’’;
Fear of Conscious Death (5 items) comprises items, such as ‘‘I am
afraid of being buried alive’’; Fear for the Body after Death (6
items) consists of items, such as ‘‘The thought of my body decaying
after I die scares me’’; and Fear of Premature Death (4 items) contains items, such as ‘‘I am afraid I will not live long enough to
experience everything I want to’’. Participants respond to the item
statements on a 5-point Likert scale that ranges from 1 (strongly
agree) to 5 (strongly disagree) with a neutral midpoint. Five of the
42 items are positively valenced and these scores are reversed prior
to aggregating the individual scale items, such that lower scores
indicate greater fear of death.
The Cronbach’s a values for the eight MFODS individual
scales are shown in Table 1. Three scales had Cronbach’s a values
of <.70 (but >.65): Fear of the Dead (.68); Fear for Significant
Others (.67); and Fear of the Unknown (.69). The Cronbach’s a
value for the Fear of the Unknown scale increased to .88 when
the item ‘‘I am afraid of meeting my creator’’ was deleted and,
consequently, this item was omitted (Neimeyer & Moore, 1994;
Walkey, 1982). Item deletion did not improve the internal
reliability of the other scales.
Statistical Analysis
The relative mean substitution method was used to treat the 1–2
missing values in the PGS-33 (n ¼ 11) and MFODS (n ¼ 29) Likert
scales (Raaijmakers, 1999). The relative mean substitution method
involved computing a participant’s relative position in the dataset
by dividing the mean of the participant’s valid data by the mean
of the valid data for the remainder of the participants. To estimate
a missing value in an item, the previously mentioned ratio was
multiplied by the mean of all of the valid data for the particular
item (Raaijmakers, 1999). The TRD variable was highly positively

452

P. Barr & J. Cacciatore

skewed and therefore the values were logarithmically transformed
(Log-TRD).
Exploratory factor analysis of the MFODS was performed
using principal-components analysis with orthogonal (varimax)
rotation and the forced extraction of eight factors. Hierarchical
multiple regression analysis was performed in two blocks: LogTRD was introduced at Step 1 and the MFODS individual scales
were introduced at Step 2. All statistical computations were carried
out using SPSS for Windows version 14.0 (SPSS, 2005).
Results
Descriptive Statistics
The descriptive statistics for PGS-33 Grief and the eight MFODS
individual scales are shown in Table 1. The mean value for PGS33 Grief was in accord with the values reported in the literature
(Toedter, Lasker, & Janssen, 2001). Although the mean value for
each MFODS individual scale was within an SD of the value
reported by Neimeyer and Moore (1994), the present study’s participants compared with the women reported by Neimeyer and
Moore (1994) had somewhat greater Fear for Significant Others,
Fear of Conscious Death, and Fear of Premature Death (Table 1).
Principal-Components Analysis MFODS
A summary of the results of the MFODS factor analysis is shown in
Table 2. The factor analysis generally revealed the expected factor
structure (Neimeyer & Moore, 1994; Walkey, 1982). The eightfactor solution explained 54.7% of the variance. Seven of the eight
scales loaded as predicted, though there were six significant
additional loadings on other factors (0–2 per scale ".30, Table 2).
Fear for the Body after Death (Factor 8) had a less satisfactory
loading pattern because there were five additional loadings >.30
on Fear of Conscious Death (Factor 1, Table 2).
Bivariate Correlations
The correlation matrix for PGS-33 Grief, Log-TRD, and MFODS
is shown in Table 3. There was a moderate bivariate correlation

453

Fear of Death and Maternal Grief
TABLE 2 Principal-Components Exploratory Factor Analysis MFODS
Measure
Fear
Fear
Fear
Fear
Fear
Fear
Fear

of the Dying Process
of the Dead
of Being Destroyed
for Significant Others
of the Unknown
of Conscious Death
for the Body after Death

Fear of Premature Death

M
(range)

Factor

N

2
4
5
7
3
1
8

6=6
6=6
4=4
5=6
4=4
5=5
5=6

.63
.58
.72
.60
.84
.68
.49

6

4=4

.66 (.43–.78)

(.52–.71)
(.50–.67)
(.53–.84)
(.34–.85)
(.74–.89)
(.52–.78)
(.31–.71)

Additional
loadings (Factor)
.31 (1), .35 (1)
.30 (1), .30 (8)
.37 (2), .39 (4)

.33 (2), .35 (1),
.42 (1), .51(1), .
53 (1), .54 (1)

Note. N ¼ number of actual loadings=number of predicted loadings; Factor ¼ Factor
number; M ¼ mean value for actual loadings; MFODS ¼ Multidimensional Fear of Death
Scale.

between PGS-33 Grief and Log-TRD (r ¼ ".40). The correlations
between PGS-33 Grief and the MFODS individual scales were
mostly small (r ¼ ".05– ".27). The MFODS individual scale intercorrelations were negligible to moderate (r ¼ .01–.48), except for
TABLE 3 Correlation Matrix for Regression Variables
Measure

PGS-33 Log-TRD FODP FOD FOBD FFSO FOU FCD FFBD FOPD

PGS-33
Log-TRD
FODP
FOD
FOBD
FFSO
FOU
FCD
FFBD
FOPD

—
".40###
".18###
".24###
".17###
".05
".20###
".27###
".26###
".22###

—
.01
.15##
.10#
.09
".07
".01
.04
".01

—
.33###
.18###
.21###
.26###
.47###
.48###
.52###

—
.20###
.29###
.16##
.22###
.33###
.32###

—
.14##
—
.10#
.07
—
.23### ".09
.25### —
.38###
.05
.35### .60### —
.01
.21### .27### .32### .39###

—

Note. PGS-33 ¼ Perinatal Grief Scale-33 Grief; Log-TRD ¼ Log time lapse since most
recent death; FODP ¼ Fear of the Dying Process; FOD ¼ Fear of the Dead; FOBD ¼ Fear
of Being Destroyed; FFSO ¼ Fear for Significant Others; FOU ¼ Fear of the Unknown;
FCD ¼ Fear of Conscious Death; FFBD ¼ Fear for the Body after Death; FOPD ¼ Fear
of Premature Death.
#
p < .05; ## p < .01; ### p < .001.

454

P. Barr & J. Cacciatore

large correlations between Fear of the Dying Process and Fear of
Premature Death (r ¼ .52) and between Fear of Conscious Death
and Fear for the Body after Death (r ¼ .60).
Hierarchical Multiple Regression
The result of the hierarchical multiple regression of PGS-33 Grief
on Log-TRD and MFODS is shown in Table 4. The multiple R
value was significantly different from zero at both steps. LogTRD explained 17% of the variance in PGS-33 Grief (adjusted
R2 ¼ .17, p < .001). MFODS controlled for Log-TRD explained
a further 12% of the variance in PGS-33 Grief (DR2 ¼ .12,
p < .001). After all variables were entered in the regression, LogTRD (b ¼ #.41, p < .001) and three MFODS individual scales,
namely Fear of the Unknown (b ¼ #.13, p < .01), Fear of Conscious Death (b ¼ #.17, p < .01) and Fear of Premature Death
(b ¼ #.12, p < .05), made significant unique contributions to the
variance in PGS-33 Grief.
A second hierarchical multiple regression omitting Fear of
Conscious Death showed that the unique contribution made by
TABLE 4 Hierarchical Multiple Regression of PGS-33 Grief on MFODS
Variable
Step 1
Log-TRD
Step 2
Log-TRD
Fear of the Dying Process
Fear of the Dead
Fear of Being Destroyed
Fear for Significant Others
Fear of the Unknown
Fear of Conscious Death
Fear for the Body after Death
Fear of Premature Death

B

SE B

b

t

#14.55

1.61

#.41

#9.02$$$

#14.38
.15
#.38
#.29
.25
#.57
#.77
#.11
#.70

1.54
.22
.22
.24
.31
.20
.26
.24
.31

#.41
.04
#.08
#.06
.04
#.13
#.17
#.03
#.12

#9.34$$$
.68
#1.76
#1.20
.81
#2.79$$
#3.02$$
#.46
#2.29$

Note. Step 1: R ¼ .41 F(1, 398) ¼ 81.32, p < .001, R2 ¼ .17, Adjusted R2 ¼ .17. Step 2:
R ¼ .54, F(9, 390) ¼ 18.07, p < .001, R2 ¼ .29, Adjusted R2 ¼ .28. DR2 ¼ .12,
F change ¼ 8.61, p < .001. Log-TRD ¼ Log time lapse since most recent death. PGS-33 ¼
Perinatal Grief Scale-33. MFODS ¼ Multidimensional Fear of Death Scale.
$
p < .05; $$ p < .01; $$$ p < .001.

Fear of Death and Maternal Grief

455

Fear for the Body after Death to the variance in PGS-33 Grief
approached but did not reach statistical significance (b ¼ #.10,
t ¼ #1.86, p ¼ .06).
Discussion
The present research showed there was a significant relationship
between women’s fear of death and their grief following bereavement from miscarriage, stillbirth, neonatal death, or infant=child
death. The particular (MFODS) fears of death that were correlated
with maternal grief were fear of the unknown, fear of premature
death, and fear of conscious death. These findings echo those of
Feifel and Branscomb (1973) who reported that consciously experienced fear of death was described in terms of fear of the unknown
and fear of premature death. Similarly, Florian and Mikulincer
(1997) showed that university students who had recently experienced a ‘‘significant other’’ bereavement compared with those
not recently bereaved exhibited more fear related to the ‘‘unknown
nature of death’’ and ‘‘loss of self-fulfillment’’. Florian and Mikulincer (1997) also noted that the recently bereaved had more ‘‘fear of
self-annihilation’’, but the present study failed to show a statistically
significant relationship between (MFODS) fear for the body after
death and maternal grief. However, this particular scale’s factor
structure was problematic because there were dual loadings on
the fear of conscious death factor, which itself had a significant
relationship with maternal grief. In any event, the fear of death that
is operative in relation to maternal grief seems to be the existential
‘‘fear of personal extinction’’, which is captured by fear of the
unknown and fear of premature death, rather than fears that ‘‘lie
on this side of death’’ (Yalom, 1980, p. 43), such as fear of the
dying process and fear for significant others. The side-of-death
metaphor may help explain the lack of an expected correlation
between fear for significant others and grief, because grieving
mothers not infrequently express concern for the safety and wellbeing of their surviving children (Raphael, 1983). Alternatively, a
bereaved mother’s fears for her other children or her worry about
their concerns for her may be thought of as rational short-lived
state or mood responses to an existential reality rather than a possibly pathogenic manifestation of a personality trait based on a
particular fear of death.

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P. Barr & J. Cacciatore

The cross-sectional and correlational design of the study
precludes any conclusion regarding direction of causality. Consequently, the fear of death may have been an antecedent, concomitant, and=or consequence of maternal grief. In other words,
although a dispositional fear of death might have exacerbated
maternal grief, it is equally possible that a mother’s fear of death
might have been triggered by the death of her child, or, indeed,
the relationship may have been bidirectional. Alternatively, the
association between fear of death and maternal grief might have
been fortuitous by way of a correlation in common with an unmeasured third variable, such as a dysfunctional attachment style.
Importantly, none of the PGS-33 items had fear of death specific
face validity and the correlations between the PGS-33 and
MFODS were small, thereby suggesting the scales measured
different constructs.
The PGS-33 and MFODS are rating-scale item measures and
therefore open to the usual criticisms directed at this form of data
acquisition, including participant acquiescence, indecisiveness and
extreme responsiveness (Rust & Golombok, 1999; Stone et al.,
2000). In addition, the study format did not control for social desirability (Baldwin, 2000) or the desire to appear psychologically
healthy (Shedler, Mayman, & Manis, 1993).
The predominantly Internet-based format of the present study
permitted low-cost access to a large number of bereaved parents
who could choose if, when, how much, and, to some extent, where
they participated in a survey that was amenable to online research
(Kraut et al., 2004; Reips, 2002). There was no attempt to avoid or
control multiple submissions, though the final dataset was scrutinized for obvious duplications and none was found (Reips,
2002). The fact that only two-thirds of the respondents completed
both the PGS-33 and the MFODS was evidence of a moderate
drop-out rate (Reips, 2002). The unwanted presence of drop-out
and the resultant commitment bias was offset by the likely minimization of shallow or mendacious responses and the reassurance
that complete datasets collected online are usually accurate (Reips,
2002). Nonetheless, caution should be exercised in generalizing the
results of the present study to other populations of bereaved
mothers.
Despite the aforementioned methodological limitations, there
was a significant correlation between dispositional fear of death

Fear of Death and Maternal Grief

457

and maternal grief. In their review of the psychotherapeutic facilitation of ‘‘normal’’ grieving, Raphael, Minkov, and Dobson (2001)
included ‘‘expressing the various affects of grief’’ (p. 600). The
present study suggests that personal fear of death, perhaps presenting covertly as generalized anxiety, agoraphobia, or depression,
may be among the various affects of grief that needs to be
expressed, understood, psychologically reframed and assimilated
by bereaved mothers, though it should be noted that expressing
negative affect per se may be of limited benefit or even counterproductive in bereavement counseling (Bonanno & Kaltman, 1999).
A functionalist view of emotion would posit an adaptive function for death anxiety (Barrett & Campos, 1987; Stolorow, 1973;
Yalom, 1980). Certainly, from the purview of existential philosophy ‘‘the physicality of death destroys man, [but] the idea of death
saves him’’ (Yalom, 1980, p. 30), because the awareness of one’s
mortality may encourage, even demand, self-actualization (Tomer,
1994). Although the present study did not address the adaptive
value of death anxiety in maternal grief, awareness of personal finitude may be a motivating factor in some women’s post bereavement commitment to a more authentic life (Kohner & Henley,
2001, pp. 141–156; Shaver & Tancredy, 2001; Yalom, 1980).
Before his death, Rabbi Zusya said ‘‘In the coming world, they will not ask
me: ‘Why were you not Moses?’ They will ask me: ‘Why were you not
Zusya?’ ’’ (Buber, 1975).

References
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