Thanatology is a recent field that contemplates death studies and employs an interdisciplinary approach to practice. This science emerged in a historical context marked by intense social, economic, and political changes that contributed to the concept of death being excluded from social life. This literature review aims to outline the history and evolution of thanatology in Western society, delineating the contextual circumstances that led to its origin and drawing special attention to current works on death education. In our post-modern society, the call for studies in the field of thanatology appears to be increasing. However, although there have been significant contributions and promising research is underway, there are still many questions to be answered.

Objective: This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression.Method: The first phase involved 219 healthy participants, while the second encompassed 30 cancer patients. Each participant completed the Personal Meaning Profile (PMP), the Testoni Death Representation Scale (TDRS), the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). The primary analyses comprised (1) correlation analyses between the overall scores of each of the instruments and (2) path analysis to assess the indirect effect of the PMP on DT score through anxiety and depression as determined by the HADS.Results: The path analysis showed that the PMP was inversely correlated with depression and anxiety, which, in turn, mediated the effect on distress. Inverse correlations were found between several dimensions of the PMP, the DT, and the HADS–Anxiety and HADS–Depression subscales, in both healthy participants and cancer patients. Religious orientation (faith in God) was related to a stronger sense of meaning in life and the ontological representation of death as a passage, rather than annihilation.Significance of Results: Our findings support the hypothesis that participants who represent death as a passage and have a strong perception of the meaning of life tend to report lower levels of distress, anxiety, and depression. We recommend that perceived meaning of life and representation of death be more specifically examined in the cancer and palliative care settings.

Since the borders between natural life and death have been blurred by technique, in Western societies discussions and practices regarding death have became infinite. The studies in this area include all the most important topics of psychology, sociology, and philosophy. From a psychological point of view, the research has created many instruments for measuring death anxiety, fear, threat, depression, meaning of life, and among them, the profiles on death attitude are innumerable. This research presents the validation of a new attitude scale, which conjoins psychological dimensions and philosophical ones. This scale may be useful because the ontological idea of death has not yet been considered in research. The hypothesis is that it is different to believe that death is absolute annihilation than to be sure that it is a passage or a transformation of one’s personal identity. The hypothetical difference results in a greater inner suffering caused by the former idea. In order to measure this possibility, we analyzed the correlation between Testoni Death Representation Scale and Beck Hopelessness Scale, Suicide Resilience Inventory-25, and Reasons for Living Inventory. The results confirm the hypothesis, showing that the representation of death as total annihilation is positively correlated to hopelessness and negatively correlated to resilience.

Studies that have examined pet loss hypothesize that attachment, representations of death, and the belief in an afterlife for animals may influence owners’ bereavement and depressive outcomes. The following instruments were administered to 159 Italian participants recruited through snowball sampling: the Lexington Attachment to Pets Scale (LAPS), the Pet Bereavement Questionnaire (PBQ), the Testoni Death Representation Scale (TDRS), and Beck’s Depression Inventory II (BDI-II). Questions concerning pet euthanasia-related issues and the relationship between owners and veterinarians were also submitted to the participants. A path model was conducted, showing that the representation of death and the attachment to a pet had a direct effect on pet grief, which in turn had a direct effect on depression. The results show a positive correlation between the LAPS and PBQ factors, particularly with the PBQ factor Grief. The LAPS factors positively correlated with the TDRS representation of Death as a Passage and negatively correlated with the TDRS representation of Death as Annihilation. The LAPS People Substituting factor positively correlated with the total score and the Cognitive-Affective factor of the BDI-II. The PBQ factors positively correlated with the BDI-II, whereas only the TDRS Death as Annihilation factor positively correlated with the BDI-II. Belief in a transcendent dimension was associated with higher scores on the PBQ Guilt factor and the TDRS factors of Death as a Passage and Death as Change, whereas these beliefs were associated with lower scores on the TDRS factor Death as Annihilation. The results indicated that the sensitivity of the veterinarian and a veterinarian who helps owners make conscious and informed decisions for their pet and choose the right time to perform euthanasia are important variables in the management of pet loss. However, these factors are not sufficient and psychological support should be improved to help owners better cope with grief.

This study describes the psychological effects of an experience of death education (DE) used to explore a case of suicide in an Italian high school. DE activities included philosophical and religious perspectives of the relationships between death and the meaning of life, a visit to a local hospice, and psychodrama activities, which culminated in the production of short movies. The intervention involved 268 high school students (138 in the experimental group). Pre-test and post-test measures assessed ontological representations of death, death anxiety, alexithymia, and meaning in life. Results confirmed that, in the experimental group, death anxiety was significantly reduced as much as the representation of death as annihilation and alexithymia, while a sense of spirituality and the meaning of life were more enhanced, compared to the No DE group. These improvements in the positive meaning of life and the reduction of anxiety confirmed that it is possible to manage trauma and grief at school with death education interventions that include religious discussion, psychodrama and movie making activities.

This study describes the psychological effects of death education in reducing the fear of death in a large cohort of Italian adolescents. Following the constructs of “distal defenses” and “mortality salience” of Terror Management Theory, this research intervention also evaluated the proposition that spirituality and belief in an afterlife could provide an effective buffer against fear of death. Five hundred thirty-four Italian high school students participated in a school-based death education program with an experimental group and a nonrandomized control condition. Using a pre/post-course design, we assessed fear of death, alexithymia, and representations of death and spirituality for both groups. Results confirmed that the course reduced death fears and the representation of death as annihilation while also enhancing spirituality. In particular, the older participants in the death education course increased their spirituality and decreased their fear of death, whereas females reduced their conviction that death was an absolute annihilation. Finally, the structural model suggested that alexithymia mediates the relationships among fear of death and spirituality; in particular, fear of death predicted more alexithymia and more alexithymia predicted lower spirituality.