Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Social Work


Social Work

First Advisor

Dr. Julie Cerel


Virtually every mental health problem carries stigma, but suicide appears to run so counter to our accumulative, achievement-oriented society, that it poses even greater threat of stigma. While suicide is inherently troubling in that it opposes the fundamental human instinct for self-preservation, the tendency to stigmatize and reject individuals affected by suicide appears to be counterproductive and excessive. Hence, the purpose of this three-manuscript dissertation is to gain a more nuanced understanding of suicide attitudes from an exploratory and terror management theory perspective. More specifically, this dissertation attempts to answer three general questions: (1) how do suicide attitudes differ from other stigmatized deaths – namely, unintentional opioid overdose, (2) does death anxiety and baseline self-esteem impact attitudes toward suicide, and (3) can the effects of death anxiety on suicide attitudes be reversed by temporarily boosting self-esteem? To address the first question, Study 1 compares suicide attitudes to attitudes toward opioid overdose death – another type of stigmatized death that has emerged as a major public health issue in the U.S. in recent years. Study 2 addresses the second question by examining the effect of mortality salience on attitudes toward suicide and by investigating whether participants’ baseline self-esteem will moderate this effect, in keeping with the theory’s claim that self-esteem buffers against death anxiety. Building on the theoretical assumptions of the second study, Study 3 tests whether the effects of death anxiety on suicide attitudes can be reversed by temporarily bolstering the participant’s self-esteem using experimental manipulation. In other words, can cultural worldview validation and self-esteem enhancement inhibit the awareness of personal death and promote prosocial attitudes and behavior? All three proposed studies used quantitative research strategies to examine the research questions detailed above. Study 1 used a traditional questionnaire method to explore and compare attitudes toward suicide and drug overdose death; whereas Study 2 and 3 employed an experimental design to test the MS hypothesis on suicide attitudes. Participants were recruited online using an inexpensive crowdsourcing service called Amazon MTurk. Findings from these studies could have important implications for how we understand the psychological underpinnings of suicide stigma and contribute to the growing body of evidence of the role of existential mortality concerns in hostile attitudes and discriminatory behavior. Not only are we confronted with death reminders in our everyday lives, the topic of suicide is inherently a reminder of death – making the problem of death anxiety even more relevant and unavoidable. These findings could expand our understanding of how cultural worldview and self-esteem are relevant to mitigating death anxiety, and the relationship between death anxiety and suicide.

Digital Object Identifier (DOI)

Funding Information

Funding was provided by the University of Kentucky College of Social Work.