INTRODUCTION
Death is the end of the life for any biological organism. Death may refer to
the end of life as either an event or condition. Many factors can cause or contribute
to an organism’s death, including predation, disease, habitat destruction, senescence,
malnutrition and accidents or physical injury. However, the principal causes
of human death in developed countries are diseases related to aging (Kastenbaum,
2006). Hence, death related traditions and beliefs are an important part
of human culture and central to many religions worldwide.
Death is nodal part of the process of natural selection and it is ubiquitous.
Every human being will die and death is an inevitable part of human life.
The fear of death is a universal phenomenon. No matter were you go in
the world, you will always find large numbers of people who are afraid
of dying. The reason for fearing death is obvious: Death is the greatest
mystery of all.
There is good reason to hypothesize that almost all human beings hate death
and fear it. This hate and fear, or any other negative emotion, can be traced
back to the oldest known recorded history, that of Egypt. According to Zandee
(1960, cited in Abdel-Khalek and Lester, 2003), ancient
Egyptians considered death as an enemy. Although they appreciated their mortal
lives with all its delights, they spent a good portion of their lives preparing
themselves for an assured future in the next world (Strouhal,
1992, cited in Abdel-Khalek and Lester, 2003). Life
prolongation and renewal were salient themes not only in The Book of the Dead,
but throughout the ancient Egyptian culture (Kastenbaum and
Casta, 1977). Also, a preoccupation with death features in all religious
and religious individuals are thought to use interpretations of death to provide
meaning to their live. Another reason many people find death so terrifying is
the fact we have to face it alone. Even if are surrounded by hundreds of people
when you die, you must still pass through death by yourself.
However, following the aftermath of World War II, thanatology emerged as a
specialty for scientific inquiry and as a respectable interdisciplinary field
of study. Here indicated that death distress or a negative attitude toward death
is associated with different emotional states, mainly anxiety and fear. The
academic research literature on death-related topics is dominated by studies
purporting to investigate death anxiety (Kastenbaum, 1987).
In the last half century, an extensive body of empirical work has emerged about
the nature, structure, correlates and assessment of death anxiety (Kastenbaum
and Costa, 1977; Neimeyer et al., 2004; Rajabi
and Bahrani, 2001).
Depression is another important feature in death distress. Death depression
is a sort of sadness that reflecting associated with one’s own death,
the death of others and the concept of death more generally (Templer
et al., 2001-1990). Depression in connection
with death is the forth stage of Kubler-Ross, s stages of dying and
clinicians have reported their clinical impression that there is a stage or
a strong element of depression in the dying process (Templer
et al., 1990, cited in Abdel-Khalek et al.,
2006).
Another component of death distress is death obsession which is repetitive
thoughts or rumination, persistent ideas, or intrusive images that are centered
around the death of self or significant others. At the extreme pole of the death
obsession continuum, the individuals become obsessed with the notion of death
(Abdel-Khalek, 1998). Abdel Khalek
(1998, cited in Maltby and Day, 2000a) introduced
the death obsession scale developed among Egyptian undergraduate students, which
is designed to measure a preoccupation, impulses and persistent ideas regarding
death. This scale was developed to complement research areas which have investigated
death anxiety and death depression and is thought to provide a third component
to a general concept of death distress.
Maltby and Day (2000a) used the DOS among English-speaking
samples. They identified three factors: (1) death rumination (items 3, 4, 5,
7, 8, 9, 10 and 12), (2) death dominance (items 1, 2, 6 and 15) and (3) idea
repetition (items 11, 13 and 14). Cronbach’s alpha reliabilities statistics
obtained 0.90 or above for each of the subscales for both samples: death rumination
(0.92 student and 0.90 older adults), death dominance (0.90 students and 0.91
older adults) and death idea repetition (0.92 students and 0.91 older adults).
Maltby and Day (2000a) showed that the DOS is significantly
positively correlated with death anxiety, death depression, obsession, anxiety,
depression and neuroticism as concurrent validity.
Maltby and Day (2000b) showed significant correlations
between the DOS and intrinsic orientation toward religion (negative) and extrinsic-social
orientation toward religion (positive). Three factors were extracted in a Spanish
sample: Death rumination, Death brooding and sudden death dominance (Tomas-Sabado
and Gomez-Benito, 2002). Furthermore, (Abdel-Khalek
et al., 2006) the factor analysis of the Death Obsession Scale (DOS)
15 items among the Palestinian sample yielded one salient factor for women (General
death obsession, 52.48% of the total variance) and three salient factors for
men (Death rumination, Death dominance and Death idea repetition, 64.48% of
the total variance).
The Cronbach’s, s alpha reliabilities of the DOS 15-item were 0.96
and 0.91 for the Kuwaiti and American participants, respectively (Abdel-Khalek
and Lester, 2003). A general factor of death obsession disclosed in the
Kuwaiti sample (62.8% of variance) and two salient factors (death rumination
and death dominance and repetition) in the American sample (59.2% of the total
variance).
Cronbach’s alpha reliabilities of the DOS among Egyptian undergraduates were
0.90 to 0.91 and 1-week test-retest reliabilities were 0.91, 0.92 and 0.92 for
males, females and combined group of males and females, respectively, denoting
both high internal consistency and stability (Abdel-Khalek,
1998).
Among American and Arabic undergraduates, the DOS correlated significantly
with anxiety, obsession-compulsion and pessimism positively and with optimism
negatively (Abdel-Khalek and Lester, 2002). In another
study, Abdel-Khalek (2002) found that Cronbach’s alpha
reliabilities statistics ranged from 0.83 to 0.94 among seven groups of Egyptian
normal (non-clinical), anxiety disordered, schizophrenics (males and females)
and substance abused (males only). Also, he found that both genders with anxiety
disorder had higher and significant means than five others groups. Therefore,
the aim of the present investigation was two fold: (1) to study the psychometric
properties (Cronbach’s, s alpha reliability and concurrent validity)
of the DOS among Iranian undergraduate students and (2) to explore the factorial
structure of its version in Persian language.
MATERIALS AND METHODS
Participants: Participants of the present study were all freshman
undergraduate students in Shahid Chamran university of Ahwaz. The sample
consisted of 200 undergraduate in academic different courses (140 males
(70%) and 60 (30%) females) that were randomly selected from university
dormitories. Their ages ranged from 18 to 23 years (Mean = 19.52, SD =
1.29).
Instrument: The DOS is a 15-item self-report measure devised by
Abdel-Khalek (1998), which was translated into Persian. The new Persian
text was sent to one translator, who was requested to back translate it into
English. Each item evaluated to determine whether the precise meaning of the
items in the original version had been successfully conveyed. All the back translations
conveyed by English version of the scale. Participants had to be responded in
one each item is rated on of the five-point Likert scale ranging from no (1)
to very much (5). The scoring range for DOS was 15 to 75, with higher scores
denoting higher death obsession. The Death Obsession Scale (DOS) along with
the Padua obsessive-compulsion questionnaire were administered anonymously to
students in their dormitory rooms by the educated the testers. All participants
responded voluntarily and without worry. Also, the DOS and the Padua were administered
in Farsi language.
Abdel-Khalek et al. (2006) ranged alpha reliabilities
of the total scale of the 15 DOS items from 0.92, 0.91 to 0.93 for men and women,
respectively, which shows its high internal consistency. Alpha reliability of
the total scale of the 15 items for DOS was 0.90, 0.89 and 0.93 for women and
men; 0.87 and 0.81 for the first and the second extracted factors, respectively,
that indicate its high internal consistency too (Table 4).
Also, concurrent validity coefficient between DOS and Padua obsession-compulsion
questionnaire was statistically significant (r = 0.56, n = 68, p≤0.0001)
RESULTS
Present study describes the findings of statistical analysis’s carried
out to finalist DOS and to checking its reliability and validity via SPSS.13
software.
Item analysis: Item analysis for the DOS was performed by item-total
correlation technique application. The correlations of 15 items for DOS
with total score were found highly significant as indicated in Table
1. The results showed that all items correlated with total DOS score
and were significant at p≤0.0001. Table 1 shows that
mean and standard deviation scores on the DOS are 32 and 11.65, respectively.
Also, Mean scores on each item was used that means for the highest and
lowest is 3 (I fail to dismiss the notion of death from my mind) and 8
(The idea of death overcomes me), respectively.
Construct validity: Table 2 presents the DOS
factor structure (Principal Component Analysis with Promax Rotation) among
Iranian freshman undergraduate students. Items with factor loading of
at least 40 were used to determine each factor and were included in the
scale. The results showed that factor 1 had an Eigen value of 6.59 and
this explained 43.96 of the total variance. The loading range from 0.40
to 0.86. It could be labeled Death Rumination and Dominance. The highest
two loadings in this factor were 3 (I fail to dismiss the notion of death
from my mind) and 4 (Thinking about death preoccupies me) items, respectively.
Factor 2 had an Eigen value of 1.35 and this explained 9.03 of the total
variance, respectively. It was labeled Death Idea Worry and has the highest
loadings, respectively, with items 11 (I fear to be dominated by the idea
of death) and 9 (I have exaggerated concern with the idea of death). The
loading range from 0.46 to 0.85. Total variance explained by the two factors
was 53%.
Confirmatory factor analysis: Floyd and Widaman (1995)
suggested that exploratory factor analysis is most appropriate in the initial
stages of model development whereas confirmatory factor analysis provides a
more powerful tool in the second stage of research when a model has already
been established.
| Table 1: |
Item analysis of the Death Obsession Scale (DBS) (n
= 200, Items = 15) |
|
| *p≤0.0001 |
A confirmatory factor analysis using maximum likelihood estimation
was conducted on the data from all participants in the scale. Two models of
death obsession were tested. As no single universally accepted criterion exists
to judge model fit several widely accepted goodness-of-fit indices were computed
(Table 3). While frequently reported, the ϰ2 statistic
was not used in evaluation of model fit as it is known to be strongly dependent
on sample size (Marsh et al., 1988). The main
criteria used to judge model fit included Bentlers (1990) Comparative Fit Index
(CFI), (GFI), Root Mean Square Error of Approximation (RMSEA), Normed Fit Index
(NFI), (PMR).
The one-factor model showed a poor fit overall (ϰ2 =
247.08, df = 90, p≤.0001, RMSEA = 0.09, CFI = 0.87, NFI = 0.81, GFI
= 0.83 and PMR = 0.03). The two-factor model exhibited a good fit specified
a death rumination and dominance and death idea worry factor (ϰ2
= 108.19, df = 86, p = 0.05, RMSEA = 0.03, CFI = 0.98, NFI = 0.91, GFI
= 0.93 and PMR = 0.09).
| Table 2: |
Promax rotated principal components of the Death Obsession
Scale (DBS) |
|
| *Item retained in the scale |
| Table 3: |
Correlation coefficients between DOS and its subscales
(n = 200) |
|
| DR: Death Rumination D: Dominance, DIW: Death Idea Worry,
DOS: Death Obsession Scale; *p≤0.0001 |
| Table 4: |
Internal consistency coefficients of Death Obsession
Scale (n = 200) |
|
| Table 5: |
Means, standard deviations and t-values of DOS and
its factors for males (n = 140) and females (n = 60) separately |
|
| df = 198, * p≤0.05 |
Regression weights for the 9 items on their death
rumination and dominance average, ranging from to and for the 6 items
death idea worry average, ranging from to, respectively.
Construct validity: As Table 3 shows, the construct
validity of DOS was further by computing correlation between total DOS score
and the empirically determined two subscales which were found to be significantly
correlated with total score. The correlation between DOS score and subscales
of death rumination and dominance and death idea worry were 0.95 and 0.86 (p
= 0.0001), respectively. Also, the correlation between death rumination and
dominance and death idea worry was 0.66 (p≤0.0001).
Internal consistency: In order to examine the internal consistency
for the Persian version of the DOS-15, Cronbach’s, s alpha
were calculated for total 15 items and two extracted factors of DOS. Based
on Table 4, the alpha coefficients for total 15 items
were 0.90 and for two extracted factors of DOS 0.87 and 0.81, respectively.
These findings indicated that the Farsi version of the DOS-15 is internally
consistent (Table 4).
In order to exploration of the possible gender differences on the DOS
and its subscales, a t-value was used. Table 5 show
mean scores and standard deviations for males (Mean = 30.90, SD = 10.99)
and females (Mean = 34.58, SD = 12.80) on DOS. This finding shows that
there is a significant difference in the DOS between male and female students
(t = -2.06, df = 198, p≤0.05). Also, there is significant difference
death idea worry subscale between male and female students (t = -2.23,
df = 198, p≤0.05), while the data indicated a non-significant difference
in death rumination and dominance subscale among them (t = -1.67, df =
198, p = ns).
DISCUSSION
Present studies were conducted to investigation reliability and both of concurrent
and construct validity of DOS in an Iranian university student’s sample. The
DOS reliability was determined by internal consistency method. Findings indicated
that DOS reliability o had high alpha reliabilities in Iranian sample. Based
on this criterion (Kline, 1993), it is safe to conclude
that the DOS has high internal consistency. This finding is consistent with
last-mentioned results and all items correlated with total DOS score and were
significant for university student sample. These findings are exclusively consistent
with earlier results on the DOS (Abdel-Khalek et al.,
2006; Abdel-Khalek, 1998; Maltby
and Day, 2000a; Abdel-Khalek and Lester, 2002, 2003;
Toma-Sabado and Gomez-Benito, 2002, 2003). The significant item correlations
denoted that the item content of the DOS contributes to total scale. These correlations
can be viewed as a measure of item validity and content validity.
The factor analysis of the inter-correlations between the DOS items among
the university students sample yield two salient factors: Death Rumination
and Dominance (DRD) and Death Idea Worry (DIW). The DRD subscale ranged
loadings from 0.40 to 0.86 and accounted for 43.96% of variation, while
DIW subscale ranged from 0.46 to 0.85 and accounted for 9.03% variation
of death obsession.
Interestingly that the two salient factors in student sample replicated the
first and second salient factors which have been disclosed in Palestinian men
(Abdel-Khalek et al., 2006) and in an American
undergraduate students samples (Abdel-Khalek and Lester,
2003). Also, the two factors replicated the same factors in the original
study on the DOS among Egyptians (Abdel-Khalek, 1998),
as well as the same factors in both English university and adult samples (Maltby
and Day, 2000b). Furthermore, three salient factors in a Spanish sample
are consistent with two factors in the present sample (Toma-Sabado and Gomez-Benito,
2002-2003).
Several reasons are to be considered as the sources of differences in the factorial
structure of the DOS in different samples. These differences may be due to the
capricious nature of the exploratory factor analysis, as well as the random
sampling fluctuations, or they may be due to cultural differences. It is also
worth nothing that the different rotation techniques (orthogonal vs. oblique)
might responsible for differences in the factorial structure of the DOS in various
samples. However, the DOS is in a greater need of applying the confirmatory
factor analysis. Because of this discrepancy in the factor structure of the
DOS across countries, researchers cannot depend on the factor scores. The DOS
demonstrates concurrent validity with of the Padua obsessive-compulsion inventory,
denoting that measure each two a unity structure. The significant gender-related
difference on the DOS total scores in the present Iranian students ample was
congruent with pervious findings on Palestinian (Abdel-Khalek,
1998; Abdel-Khalek et al., 2006) and Kuwaiti
(Abdel-Khalek and Lister, 2003) samples, who reported
that females scored significantly higher than males on the total DOS. However,
present gender differences are contradicted with previous investigations such
as Syrian (Abdel-Khalek and Saleh, 1999), Spanish (Tomas-Sabado
and Gomez-Bineto, 2002-2003), American (Abdel-Khalek and
Lister, 2003), British (Maltby and Day, 2000b; Abdel-Khalek,
1998). Accordingly, the DSO appears to be a useful instrument for clinical
and research settings for differentiating between normal and abnormal population
in critical situations.
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