The Effectiveness of an Online Self-Delivered Death Anxiety Intervention

March 12, 2026 updated by: Yinyin Zang, PhD, Peking University

The Effectiveness of an Online Self-Delivered Death Anxiety Intervention: A Pilot Randomized Controlled Trial

The goal of this clinical trial is to examine the effectiveness of the online self-delivered death anxiety intervention developed by our team in the general population with a randomized controlled trial. The study will recruit 50 participants, with 25 randomized to the death anxiety intervention group and 25 randomized to the control group (waiting list). The online intervention on death anxiety consists of 4 phases that take about 2 hours in total. The primary outcome DAS (Death Anxiety Scale) and DABBS (Death Anxiety Beliefs and Behaviors Scale) will be administered on baseline, post-treatment, 1-week follow-up, and 2-week follow-up assessments.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
47

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Beijing Municipality
      • Beijing, Beijing Municipality, China, 100871
        • Peking University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 18-65 years of age
  • Normal literacy skills and ability to use a smartphone proficiently
  • Higher death anxiety that is above the cutoff of our measurement
  • Voluntarily participate in this intervention and be able to provide informed consent.

Exclusion Criteria:

  • Severe depressive state or risk of suicidal self-injury, i.e., the total score of Patient Health Questionnaire 9-item ≥19 or the score of 9th item ≥2
  • Diagnosed within 6 months with schizophrenia, depression, bipolar disorder, and other psychiatric disorders
  • Have received any intervention for death anxiety or CBT intervention on any topic within the past 6 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Death anxiety
Behavioral: Online self-delivered death anxiety intervention

The online self-guided death anxiety intervention developed in this study is based on the Death Education and CBT framework. It took approximately two hours to complete the full intervention. The main content includes:

  1. Emotional reactions and behavioral manifestations about death, fear management theories, and Chinese cultural attitudes toward death;
  2. Imagine what you would like to say to yourself at the end of your life, and learn about various attitudes towards death through numerous examples;
  3. Expressive writing, with moderate emotional exposure to stimulate reflection, accompanied by breathing exercises and positive thinking about death, to improve tolerance and control of death anxiety, and finally to correct biased perceptions by examining bad beliefs about death;
  4. Prioritize the importance of things and make a practical action plan to enrich your life.
Other: Waiting-List (WL) condition
Participants assigned to WL will be asked not to use our death anxiety intervention or seek additional help related to death anxiety during the 1-week intervention period. After the one-month follow-up of the experimental group, the WL group will receive the same intervention for death anxiety. WL participants will also be given contact information to use in case of increasing distress.
Behavioral: Waiting-List (WL) condition
Participants assigned to WL will be asked not to use our death anxiety intervention or seek additional help related to death anxiety during the 1-week intervention period. After the one-month follow-up of the experimental group, the WL group will receive the same intervention for death anxiety. WL participants will also be given contact information to use in case of increasing distress.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Templer Death Anxiety Scale (T-DAS)
Time Frame: baseline, post treatment (only for intervention group), 1 week, 2 weeks
The T-DAS consists of 15 items, describing the experiences that individuals feel when facing death. The Chinese version suggests a 5-point scale according to the later extended version of the scale, ranging from 1 "Strongly Agree" to 5 "Strongly Disagree", with higher scores representing more severe death anxiety. The higher the score, the more serious the death anxiety, and a total score greater than 43 according to the rules can be considered to have a high level of death anxiety. The Chinese version of T-DAS has been widely used and has shown good reliability and validity.
baseline, post treatment (only for intervention group), 1 week, 2 weeks
Death Anxiety Beliefs and Behaviors Scale (DABBS)
Time Frame: baseline, post treatment (only for intervention group), 1 week, 2 weeks
The DABBS consists of 18 entries describing overall feelings about death (4 entries), thoughts and beliefs related to death (7 entries), and avoidance behaviors related to death (7 entries), with the scale being scored on a 5-point scale ranging from 1, "Strongly Disagree/Never Have This Thought/Never Avoid This Behavior" to 5 "Strongly agree/always have this thought/always avoid this behavior," with higher scores representing the severity of the individual's adverse beliefs and behaviors regarding death.
baseline, post treatment (only for intervention group), 1 week, 2 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Patient Health Questionnaire 9-item
Time Frame: baseline, 1 week, 2 weeks
Patient Health Questionnaire 9-item (PHQ-9), a self-report measure for depressive symptoms in the past two weeks, comprises 9 items rated from 0 (not at all) to 3 (nearly every day). The PHQ-9 has good psychometric properties in Chinese adolescents.
baseline, 1 week, 2 weeks
Generalized Anxiety Disorder 7-item
Time Frame: baseline, 1 week, 2 weeks
Generalized Anxiety Disorder 7-item (GAD-7) scale is a 7-item self-report measure to assess anxiety symptoms in the past two weeks. Each item is rated from 0 (not at all) to 3 (nearly every day). The Chinese version GAD-7 score has good psychometric properties among adolescents.
baseline, 1 week, 2 weeks
Insomnia Severity Index (ISI)
Time Frame: baseline, 1 week, 2 weeks
The ISI consists of seven items that assess the severity of subjective insomnia in the past two weeks, including, for example, difficulty in falling asleep, sleep satisfaction, impairment of daytime functioning, etc. The total score ranges from 0-28, with higher scores representing more severe insomnia. The Chinese version of ISI has been shown to have good reliability and validity.
baseline, 1 week, 2 weeks
4-dimensional anxiety scale
Time Frame: baseline, 1 week, 2 weeks
This is a 40-item scale for measuring multi-dimensional anxiety, which includes 4 dimensions (emotional, physiological, cognitive, and behavioral) and 9 subscales (emotional, psychosomatic, autonomic, general cognitive, phobia, over-committed, repetitive, social, and avoidance). The higher the score on this scale, the more severe the anxiety in a certain area.
baseline, 1 week, 2 weeks
Ryff's Psychological Well-being Scale (PWS)
Time Frame: baseline, post treatment (only for intervention group), 1 week, 2 weeks
The short version used in this study contains 18 entries, including six dimensions of positive relations, autonomy, environmental mastery, personal growth, purpose in life, and self-acceptance. The six dimensions of self-acceptance are scored on a 6-point scale ranging from 1 "not at all" to 6 "very much", with higher scores representing higher psychological well-being. The Chinese version of PWS has been translated by Taiwanese scholars and has been proven to have Good reliability and validity.
baseline, post treatment (only for intervention group), 1 week, 2 weeks

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Adverse Childhood Experiences
Time Frame: baseline
An adverse childhood experiences questionnaire measuring the adverse childhood experiences with 13 items. A higher number of adverse childhood experiences represents worse childhood experiences.
baseline
Social support
Time Frame: baseline, 1 week, 2 weeks
The 12-item Multidimensional Scale of Perceived Social Support (score from 1 to 7, and total score varies from 12 to 84). A higher score represents better social support.
baseline, 1 week, 2 weeks
Post-traumatic responses scale - Flight subscale
Time Frame: baseline, 1 week, 2 weeks
This is a 9-item subscale measuring flight responses of the Post-traumatic responses scale, which is a 5-point Likert scale (score from 0 to 4, and total score varies from 0 to 36). A higher score represents a higher post-traumatic avoidance tendency.
baseline, 1 week, 2 weeks
Irritability
Time Frame: baseline, 1 week, 2 weeks
A 17-item irritability measurement scale, the Peking irritability scale, measures impulsive emotions, thoughts, and behaviors on a 5-point Likert scale (score from 1 to 5, and total score varies from 17 to 85). A higher score represents higher irritability.
baseline, 1 week, 2 weeks
A sense of stability
Time Frame: baseline, 1 week, 2 weeks
A 7-item 6-point Likert scale that measures the subjective feeling of being settled and fulfilled in one's current life. The higher the score on the scale, the stronger the sense of stability.
baseline, 1 week, 2 weeks
Alexithymia
Time Frame: baseline, 1 week, 2 weeks
A 23-item Peking alexithymia scale measures thoughts and behaviors that prevent people from feeling or recognizing negative emotions on a 5-point Likert scale (1 to 5, and total scores vary from 23 to 115). A higher score represents more severe alexithymia.
baseline, 1 week, 2 weeks
Emotion regulation
Time Frame: baseline, 1 week, 2 weeks
An 18-item cognitive emotion regulation questionnaire measures the ability of emotion regulation on a 5-point Likert scale (1 to 5, and total scores vary from 18 to 90). A higher score represents better emotion regulation.
baseline, 1 week, 2 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Peking University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
101 Institute, Ministry of Civil Affairs of the People's Republic of China

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 14, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 4, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 4, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 24, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 24, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 30, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 16, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 12, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
April 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • Facing death anxiety pilot

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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