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OMEGA, Vol.

22(4) 287-299,1990-91

BUGENS COPING WITH DEATH SCALE:


RELIABILITY AND FURTHER VALIDATION

ROSEMARY A. ROBBINS
The Pennsylvania State University at Harrisburg

ABSTRACT
Bugens Coping with Death Scale, originally found to reflect gains in a death
and dying seminar, was found in the present study to be. internally consistent
and stable on retest. It was negatively associated with the Templer and
Collett-Lester scales, providing some convergent validation. It was not
associated with Social Desirability but was associated with general anxiety;
thus, discriminant validity was mixed. Individuals who had written wills,
planned estates, planned their funerals, and signed organ donor cards scored
higher on the Coping with Death Scale. Organ donors also reported less
anxiety on the Templer and all four Collett-Lester scales. Since Coping with
Death scores were more consistently different in those who prepare for death,
this scale may help in efforts to predict those who will engage in such
behaviors.

It is almost axiomatic that ours is a death-denying culture [1, 21. A growing


literature explores the implications of death anxiety and death avoidance [3-51.
Despite the lack of literature on death competence, we obviously manage to cope
effectively with death in many respects, completing a whole variety of behaviors
associated with death and dying. Although no theorist has previously been con-
cerned specifically with death competence, the notion of general competence has
been explored [6]. Banduras theoretical construct of perceived self-efficacy
appears to be related to the notion of competence [7-91. He argued and success-
fully demonstrated that such perceived self-efficacy is a better predictor of a
variety of outcomes than is anxiety level. Such reasoning may be equally valid in
the area of death concern. Perhaps death competency variables may have different
implications than measures of death anxiety, including improved prediction of
certain death-related behaviors.

287

(0 1991, Baywood Publishing Co.,Inc.

doi: 10.2190/HNTD-RWRW-Y3YN-VWX1
http://baywood.com
288 / ROBBINS

An example of focusing on death competency variables is the work of Bugen


[lo] who concluded that research into the benefits of death education produced
inconclusive results, a finding echoed in other reviews [3, 51. In analyzing this
problem, Bugen suggested that unreliable and invalid instruments, inflated ex-
pectations, and lack of sensitivity to outcome criteria were possible sources of
the inconsistencies in the literature. As an alternative, he attempted to construct
what he considered a more sensitive measure based on coping as a desirable
outcome of a death education experience that would reflect real student gains. To
assess the effects of a death and dying seminar he developed the Coping with
Death Scale, consisting of thirty 7-point Likert scales reflecting personal gains
reported by previous students. Individuals who participated in a full length death
and dying seminar demonstrated increased coping on twenty-three of thirty items
while control individuals who participated in only 14 percent of the seminar
showed increased coping on only one item. These changes were assessed by
t-tests calculated on each of the thirty items, but no attempt was made to assess
the appropriatenessof considering these items to be a scale. In conclusion, Bugen
suggested that the relative success of coping items in reflecting changes as
contrasted with the dearth of evidence validating positive benefits from death
education may in part be due to an excessive focus on attitudes toward bioethical
issues and trait measures of death concern. These curriculum goals may not be
as sensitive to change as is coping [lo, p. 1801. While this coping
measure points to a possible strategy for assessing intervention approaches, it
has limitations from a psychometric standpoint, since internal consistency
and test-retest reliability have not been evaluated. Further, Bugen argued follow-
ing Knott [ll]that educating people to cope with death should result in effective-
ness in coping with living, but no direct evidence was provided on this
issue. Finally, it is not clear whether the construct of coping can be general-
ized to other aspects of behavior that represent effectiveness in the face of death,
such as writing a will or donating ones organs. Given the potential of Bugens
scale to reflect changes as a result of death education, the present study was
designed to address the questions outlined above in an attempt to further its
usefulness.

RELlABILlTY
Most of Bugens scale items were developed to reflect the experiences of
participants in a death and dying seminar. No evidence was presented in Bugens
[lo] initial work to justify considering this set of items to be a scale, however.
Such justification would require, minimally, evidence for internal consistency and
test-retest reliability. Bugen initially argued for a scale more sensitive and less
stable than trait measures, but psychometric considerations require evidence of
test-retest reliability.
BUGENSCOPING WITH DEATH SCALE / 289

CONVERGENT AND DISCRIMINANTVALIDITY


Coping with Death should bear some convergent relationship with scales of
death anxiety (negative correlation) but also be discriminable from death anxiety
scales given the differential emphasis on coping or effective action.
Templers Death Anxiety Scale is a reliable and valid self-report questionnaire
that is presently one of the most popular measures of death concern [12]. Given its
prominence and the wealth of related literature [3], there appears to be merit in
exploring the relationship of this scale to the construct of Coping with Death. The
Collett-Lester Fear of Death Scale represents a popular alternative strategy to that
of Templer [13]. It consists of four subscales: Fear of Death of Self, Fear of Death
of Others, Fear of Dying of Self, and Fear of Dying of Others. It is expected that
these subscales may be differentially related to the Coping with Death construct
and provide further information on what the latter scale is measuring.
Kastenbaum and Costa argued that studies of death concern should control for
both social desirability and general anxiety, since both of these factors have been
found to be associated with death concern scales [4]. In the present study these
constructs will be operationalized as the State-Trait Anxiety Inventory [14]and
the Marlowe-Crowne Scale of Social Desirability [U].Coping with Death should
be minimally correlated with both of these scales, demonstrating discriminant
validity.

RELATIONSHIP

To Effectiveness in Living
A review of the literature [16-201 led to speculation that learning to cope
effectively with death bight well be associated with effectiveness in living as
Bugen speculated, at least insofar as effectiveness can be measured by self-
reports. Given time limitations, it was impossible to include all scales suspectedof
relating to effectiveness in living. Therefore 7-point Likert items were constructed
to reflect those dimensions thought to be relevant: competence to handle life,
commitment to work, assertiveness, purpose in life, and commitment to family.
While this approach has limitations psychometrically, this effort was viewed as
exploratory.

To Death-PreparatoryBehaviors
Kastenbaum and Costa suggested that evidence for denial of death might be
sought especially among groups where it has practical significance such as those
who dont have wills, but life insurance, or have medical checkups [4]. Actually,
because of the importance of planful actions in preparation for death, perhaps it
would bevaluable to study these actions for their own sake, rather than simply in
a search for denial of mortality. What prompts an individual to write a will or
290 / ROBBINS

purchase life insurance? It may be that Coping with Death as a construct can play
a role in helping to predict which individuals will take action to prepare for death.
The literature on death concern is strangely silent on psychological factors
associated with planning for death. An exception is a study by Rainey and Epting
comparing members of a society who preplanned their funerals with comparable
control individuals who had not preplanned [21].The dependent variable was the
Threat Index, drawn from Kellys personal construct psychology [22],which is a
measure of how threatening death is to a given individual. The authors found
preplanners to report significantly less threat than control individuals. However,
this study appears to stand alone in exploring the relationship between psychologi-
cal factors and funeral preplanning.
Additional studies are available on the psychological factors related to organ
donation. Claxton, in his doctoral dissertation [23],explored psychological fac-
tors predicting the signing of an organ donor card and discovered that death
anxiety as measured by Templers [12]scale was unrelated to card signing.
Hessing and Elffers explored the relationship between physical self-esteem,
general self-esteem, and the signing of a donor card [24].They found that for
persons with negative physical self-esteem, fear of death (as measured by the
Semantic Differential) was related to card signing, while this relation was absent
for persons with negative general self-esteem. These authors replicated this
finding [25]and found that fear of being declared dead too soon was negatively
associated with organ donation regardless of physical self-esteem.
Hessing and Elffers used the Semantic Differential to measure death concern
rather than a scale of death anxiety [25].Thus, despite a sizable literature on death
anxiety, the only reported relationship between a death anxiety scale and
preparatory behaviors is Claxtons negative finding regarding Templers scale and
organ donation. No evidence has been found that any sQlt of coping with death
scale has been evaluated for a relationshipwith death-preparatorybehaviors.
In choosing behaviors of interest, the literature clearly suggests the relevance of
organ donation and funeral preparation. Otherwise, behaviors were chosen that
seemed important to the author in the absence of previous research. The choice of
behaviors included: making a will, planning ones estate, planning ones funeral,
purchasing life insurance, and signing an organ donor card.

Hypothesis I -The Coping with Death Scale will be found to possess accept-
able levels of internal consistency and test-retest reliability.

Hypothesis 2 - The Coping with Death Scale will be negatively correlated


with the Templer Death Anxiety Scale and the Collett-Lester scales in the
midrange, reflecting convergent validity but with some unshared variance. The
Coping with Death Scale will be minimally correlated with State Anxiety, Trait
Anxiety, and Social Desirability reflecting discriminant validity.
BUGENS COPING WITH DEATH SCALE / 291

Hypothesis 3 -The Coping with Death Scale will be associated positively with
those items reflecting effectiveness in living.
Hypothesis 4 - Individuals differing on whether they have completed death-
preparatory behaviors will differ on Coping with Death from preparers scoring
higher on coping.

METHOD
Ninety-four undergraduateand graduate students participated. They were tested
in group sessions and received coum credit. All materials were administered
stapled in a single packet in a constant order. First, participants completed a
demographicquestionnaire that included 7-point Likert items regarding effective-
ness in living, which included: I feel very competent to handle my life; I am
deeply committed to my work; I am very assertive; I am very certain about my
purpose in life; and I am deeply committed to my family. Direction of the poles
was reversed for alternate items to control for response set. The questionnairewas
followed by the Marlowe-Crowne Scale of Social Desirability [15], Templers
Death Anxiety Scale [12], the State Anxiety Inventory [14], Bugens Coping with
Death Scale [lo], the Trait Anxiety Inventory [14],and, finally, the items related
to death-preparatory behaviors. These items read have you written a will; have
you planned the management of your estate; do you have plans for your funeral;
have you purchased life insurance; and have you completed a card or form stating
that you wish to donate your organs in the event of your death?

RESULTS
Sixty-eight women (Mean age = 30.1, sd = 10.0) and twenty-six men (Mean
age = 28.5,sd = 9.9) who did not differ in mean age, participated.

Hypothesis 1
Internal consistency analysis on Bugens Coping with Death Scale yielded a
Cronbachs AIpha of .89 (p c .001). A subsample of fifty-three participants was
retested after eight weeks, yielding a test-retest reliability estimate of .91 (p c
301). The Coping with Death Scale is significantly correlated with age in the
present sample as may be seen in Table 1,with older individuals scoring higher in
coping. The mean Coping with Death Scale score for women was 4.55 (sd = .90),
while that for men was 4.67 (sd = .73,t(92) = .61, ns). Further, no significant
differences in Coping with Death were found based on marital status or having
children.
292 / ROBBINS

Table 1. Correlations of Coping with Death with Other Factors

Coping with Death


Variable r

1. Age .36*
2. Ternplers Death Anxiety Scale -,51-

Collett-Lester
3. Fear of Death of Self -,54*
4. Fear of Death of Others -.m*
5. Fear of Dying of Self -.49*
6. Fear of Dying of Others -.56*
7. State Anxiety -.34-
8. Trait Anxiety -.51*
9. Social Desirability .17

-p<.oo1.

Hypothesis 2
As may also be seen in Table 1, Coping with Death is significantly
negatively correlated with both the Templer and Collett-Lester scales. Cor-
relations range from -.49 to 40, indicating midrange relationships and
supporting convergent validity with some differentiation. Coping with Death is
also significantly negatively associated with both State and Trait Anxiety. Its
correlation with TraitAnxiety is in the same range as the correlation with the
scales of death concern, offering no evidence for discriminant validity. Its correla-
tion with State Anxiety is slightly lower, suggesting possible differentiation that
would require further replication. Finally, Coping with Death bears no significant
relationship to Social Desirability and is discriminated from this scale in the
present sample.

Hypothesis 3
Table 2 reports the associations of the death concern scales and other per-
sonality measures with the five Likert-type items used to assess effectiveness in
life. As revealed in the table, Coping with Death is positively associated with four
out of five of these items, while neither the Templer nor Collett-Lester scales bear
any relationship to any of these items. The scales of general anxiety are also
associated with these items, however. In fact, Trait Anxiety is more strongly
associated (negatively) with these same four items in most cases than is Coping
BUGEN'S COPING WITH DEATH SCALE I 293

Table 2. Correlations of Death Concern and Personality Scales


with Items Reflecting Effectiveness in Life

Competent Committed Purpose Committed


to to Assertive in to
Handle Life Work Life Family

1. Coping .25*+ -00 .2P .41- .23*

2. Templer's Death -.01 .14 -.06 -.04 .08


Anxiety Scale

Collett-Lester

3. Fear of Death of .08 .08 -.11 -.06 .03


Self

4. Fear of Death of -.05 .17 -.14 -.08 .13


Others

5. Fear of Dying of -.06 .03 -.08 -.05 .15


Self
I
6. Fear of Dying of -.11 .08 -.08 -.13 -.09
Others

7. State Anxiety -.24* -.07 -.16 -.23* -.12

8. Trait Anxiety -.45* -.17 -.47* -.56" -.23*

9. Social -05 -.04 .20 .20 .17


Desirability

10. Partial correla- -.06 -.14 -.02 .10 -10


tions with
Coping control-
ling for Trait
Anxiety and
State Anxiety

* p < .05.
**p<.01.
- p < ,001.
294 / ROBBINS

Table 3. Coping with Death and Death Anxiety in Groups


Who Have and Have Not Prepared for Death

purchase
Written Planned Planned Life Organ
Will Estate Funeral Insurance Donor

1. Coping .28* 31- .41* .ll .33-

2.Templers Death -.09 -.07 -.lo .03 -.w


Anxiety Scale

Collett-Lester

3.Fear of Death of Self -.09 -.03 -.P .05 -.25*

4.Fear of Death of Others -.20* -.23* -.19* -.05 -33-

5. Fear of Dying of Self -.18* -.14 -.11 -.W -.w


6. Fear of Dying of Others -.06 -.08 -.02 -.02 -.1P

7. State anxiety -.07 -.11 -.07 -.17 -.06

8.Trait Anxiety -.12 -.21* -.18* -.12 -.09

9. Social Desirability -04 .05 .02 .20* -.08

Partial Correlation with Coping

10.Controlling for Trait .26* .22* .39- .oo .34-


Anxiety and State
Anxiety

11. Controlling for .2F .3F .4F .15 .21*


Templers DAS

12.Controlling for the .13 .15 .36- .24* -.29


Collett-Lester Scales

* p < .05.
= p < .01.
-p<.oo1.
BUGENS COPING WITH DEATH SCALE I 295

with Death. As may be noted in Table 2, partial correlations of these effectiveness


in life items, which control for Trait and State Anxiety, with Coping are near zero.
The Coping with Death Scale shares no variance with these effectiveness in life
items that is unaccounted for by general anxiety.

Hypothesis4

Table 3 reports correlations of Coping with Death and Death Anxiety Scales
with death preparatory behaviors. Those participants who have wills score higher
on Coping with Death. They also score lower on Fear of Death of Self and lower
on Fear of Death of Others although the magnitudes of these correlations are not
as great. The writing of wills is not significantly associated with the Templer
Scale, with general anxiety, or with Social Desirability. However, the partial
correlation controlling for the Collett-Lester Scales is non-significant. This indi-
cates that the association of Coping with will writing can also be accounted for in
part by the Collett-Lester Scales.
Those individuals who have planned their estates score higher on Coping with
Death. In addition they score lower on Fear of Death of Others and lower on Trait
Anxiety although the magnitude of these correlations are not as great. Estate
planning is unassociated with Templers Scale, State Anxiety, and Social
Desirability. The partial correlation between estate planning and Coping, which
controls for State and Trait Anxiety, remains significant. When the Collett-Lester
Scales are partialled out, however, the association between Coping and estate
planning is no longer significant. Thus,the association between Coping and estate
planning is accounted for in part by the Collett-Lester Scales.
Participants who have planned their funerals are higher in Coping with Death.
They are also lower in Fear of Death of Self, Fear and Death of Others, and Trait
Anxiety although the magnitude of these correlations are not as great as that for
Coping. Partialling out these variables does not, however, eliminate the strong
associationbetween Coping and funeral planning.
Purchasing life insurance is positively associated with Social Desirability but is
unassociated with any other variable, including Coping, death concern and
general anxiety.
Organ donor card signing is associated with higher scores on Coping and lower
scores on a11 of the death concern scales of roughly equivalent magnitude. How-
ever, donor card signing is unassociated with general anxiety or Social
Desirability. When the effects of Templers DAS are partialled out, the associa-
tion between Coping and Organ Donation remains significant. When the effects of
the Collett-Lester Scales are partialled out the correlation between Coping and
Organ Donation becomes negative, a result that is difficult to interpret in a useful
or meaningful way.
296 / ROBBINS

DISCUSSION

Bugens Coping with Death Scale is both internally consistent and stable over
time in the present sample. Such evidence is supportive of the contention that this
group of items can be considered a scale that is stable over time in the absence of
intervention. The finding that Coping with Death is moderately negatively
associated with both the Templer and Collett-Lester Scales is suggestive of
its convergent validity as a measure of death concern. Moderate and sig-
nificant correlations with scales of general anxiety raise questions, however, as to
whether an independent dimension is being measured and requires further
exploration.
Interestingly, Coping with Death is associated with increasing age in this
sample but is unassociated with gender. This is a reversal of the typical finding
related to Templers Death Anxiety Scale, which tends to reflect greater anxiety
for females but be unassociated with age [12], a finding obtained in the present
sample as well. The Coping with Death Scale can be further differentiated from
the Templer and Collett-Lester in that it is associated with four out of five of the
Likert items reflecting effectiveness in life, while the other scales are not. Of
course, this result is called into question by the association of Trait and State
Anxiety with these same effectiveness in life items; when general anxiety is
partialled out, Coping and these items are no longer significantly associated.
Again this points to the need for further exploration of the relationship between
Coping with Death and general anxiety.
The most interesting finding in the present effort is the relationship of Coping
with Death to death-preparatorybehaviors. Both the Templer and all four Collett-
Lester scales are significantly negatively associated with organ donation, a finding
that contradicts that of Claxton [23] who found no relationship. In addition,
Coping with Death is significantly associated with organ donation as well as
writing a will, planning ones estate, and planning ones funeral. In the case of will
writing, estate planning, and funeral planning, the magnitude of the correlation
with Coping is greater than the correlation with any other scale. Partial correla-
tions controlling for the effects of Trait and State Anxiety are still highly sig-
nificant. Further, partial correlations controlling for Templers DAS remain high-
ly significant as well. Only the Collett-Lester Scales appear to provide a
measurement alternative to the Coping with Death Scale, at least when predicting
will writing and estate planning. It is interesting to note that the Collett-Lester
Scales include items that would qualify as coping items such as I would visit a
friend on hisher deathbed and I would not mind having to identify the
corpse of someone I knew. In contrast, the Templer Scale is much more
consistent in focusing only on anxieties. As a result, it is not surprisingthat
Coping and the Collett-Lester Scales are often related to death preparatory
behaviors, while the Templer is not related to any of the behaviors except organ
donation.
BUGENS COPING WITH DEATH SCALE / 297

Coping with Death gains further support for its construct validity through
its association with death-preparatory behaviors. It is interesting to note that
the relationship of the Coping with Death Scale to preparation for death is
independent of its shared variance with general anxiety. It must be con-
cluded that the relationship of Coping with Death and general anxiety is
quite complex and requires further exploration. It appears that Coping with
Death bears a concurrent relationship to death2preparatory behaviors that is
superior to that of the other scales in question, making it potentially useful in
predicting these behaviors. Predictive validation is obviously a matter for
future research.
The concern in the present research with death-preparatory behaviors may be
seen as implying that preparing for death is desirable. While there are clearly
people who do not need a will, estate plan, or life insurance, most adults have
responsibilities that call for attention to these matters, while preplanning ones
funeral seems more a matter of personal choice. In the case of organ donation, the
demand for transplantable organs greatly exceeds the supply [26],so that any
increase in those signing and carrying donor cards could produce a social benefit.
While no moral judgment is implied regarding preparing for death, it appears that
there would be social benefits from increases in these behaviors. If future studies
continue to indicate that the Coping with Death Scale is related to these behaviors,
it may be pointing to a more generalized competence.
In addition to the discriminant validity issues mentioned above, a limita-
tion of the present effort lies in its reliance on self-report. While there is no reason
to distrust the present participants, actually checking on donor cards, wills, and
life insurance policies would strengthen the results obtained. Even stronger
evidence could be provided if participants were to engage in death-preparatory
behaviors in the presence of the experimenter and such behavior were predicted
by the Coping with Death Scale. Future efforts will be aimed at addressing these
issues.
A further limitation may be the seemingly tautological nature of the
Coping with Deathlcoping behavior relationship. Does such a relationship
actually increase our understanding? Certainly the data presented here are not
conclusive. However, if the Coping with Death Scale can help us predict who
will sign a donor card or prepare a will, then the practical implications are
obvious and just as useful as Bugens [lo] original finding of gains on the scale
as a function of death education. Future efforts in this regard should of course
continue to compare the power of the Coping with Death Scale with scales of
death anxiety and or general anxiety in making this type of prediction. The
construct of Coping with Death casts some of the issues of the death and dying
literature in a different light. Perhaps it would be helpful to emphasize coping
rather than anxiety when attempting to predict outcomes that are focused on
death related competencies. This may be particularly true given the inconsistent
relationship between death anxiety and behavioral outcomes.
298 / ROBBINS

REFERENCES
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2. E.Kubler-Ross, On Death andDying, Macmillan, New York, 1968.
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Review of Psychology, 28, pp. 225-249,1977.
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6. R. White, Lives in Progress: A Study of the Natural Growth of Personality (3rd
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Erlbaum, Hillsdale, New Jersey, 1982.
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23. R. N. Claxton, A Study of Attitude and Other Variables in the Prediction of Commit-
ment Behavior Regarding Human Organ Donation, Unpublished doctoral dissertation,
George Peabody College for Teachers, Memphis, 1974.
BUGENS C,OPlNGWITH DEATH SCALE / 299

24. D. J. Hessing and H. Elffers, General and Physical Self-Esteem and Altruistic
Behavior, PsychologlealReports, 56, p. 930,1985.
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Soon, and Donation of Organs after Death, Omega, 122, pp. 115-126,1986-87.
26. K. Perkins, The Shortage of Cadaver Donor Organs for Transportation: Can Psychol-
ogy Help?, American Psychologist, 42:10, pp. 921-930,1987.

Direct reprint requests to:


Rosemary A. Robbins
The Pennsylvania State University
W157 Olmsted
Middletown, PA 17057

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