This study explores the relationship between existential anxiety and mental health among Iranian university students, with a specific focus on three dimensions of existential anxiety: death, meaninglessness, and guilt. Drawing on a sample of 256 students aged 18 to 30, the research employed quantitative analyses to assess how these existential components relate to emotional, psychological, and social well-being. The study’s tools included the existential anxiety and the Mental Health Questionnaire. Results revealed a strong negative correlation between existential anxiety and mental health, with meaninglessness emerging as the most significant predictor. Regression analyses confirmed that each subcomponent independently contributed to reduced well-being, with distinct patterns across mental health dimensions. These findings underscore the multidimensional nature of existential anxiety and its place within broader existential moods such as guilt and meaninglessness. By examining these dynamics in a non-Western, non-clinical population, the study extends cross-cultural understanding in humanistic and existential psychology and highlights meaning as a vital determinant of mental health.
AkbariM.RezaeianM.HelmP. J.BeckerK. (2023). How existential therapy may help people who are suicidal. European Journal of Psychotherapy & Counselling, 24(1), 1–15. https://doi.org/10.1080/13642537.2023.2175888
2.
AlshehriH.AlturkestaniR.HijanB.AlmalkiS.AlobaidiR.AlmuftiS.BaduwailanA. O.ButtN. S.AlghamdiW. A.Al ZabenF.KoenigH. G.TayebH. O.AbdulghaffarH. K. (2024). The prevalence of existential anxiety and its association with depression, general anxiety, and stress in Saudi university students. Middle East Current Psychiatry, 31(1), Article 47. https://doi.org/10.1186/s43045-024-00435-4
3.
AnE.LoC.HalesS.ZimmermannC.RodinG. (2018). Demoralization and death anxiety in advanced cancer. Psycho-Oncology, 27(11), 2566–2572. https://doi.org/10.1002/pon.4843
4.
ArianM.KhanjaniM. S.EbadiA.YounesiS. J.AzkhoshM.HosseinzadehS.NikoofarA. (2023). Existential guilt in cancer patients: A concept analysis. International Journal of Cancer Management, 16(1), e136219. https://doi.org/10.5812/ijcm-136219
5.
ArnettJ. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. https://doi.org/10.1037/0003-066X.55.5.469
6.
AzadarmakiT.BaharM. (2006). Families in Iran: Changes, challenges and future. Journal of Comparative Family Studies, 37(4), 589–608. https://doi.org/10.3138/jcfs.37.4.589
7.
BeckerE. (1973). Denial of death. Free Press.
8.
BinswangerL. (1963). Being-in-the-world: Selected papers of Ludwig Binswanger (NeedlemanJ., Ed. & Trans.). Basic Books. (Original work in German, selected essays published 1942–1960)
9.
BoelenP. A. (2021). Symptoms of prolonged grief disorder as per DSM-5-TR, posttraumatic stress, and depression: Latent classes and correlations with anxious and depressive avoidance. Psychiatry Research, 302, Article 114033. https://doi.org/10.1016/j.psychres.2021.114033
10.
BrownM. E.AlliegroM. C.PrinceM. A. (2023). College students’ experiences of freedom, isolation, meaninglessness, and death: A qualitative examination. Journal of Humanistic Psychology. Advance online publication. https://doi.org/10.1177/00221678231210153
CooperM. (2003). Between freedom and despair: Existential challenges and contributions to person-centered and experiential therapy. Person-Centered and Experiential Psychotherapies, 2(1), 43–56. https://doi.org/10.1080/14779757.2003.9688292
13.
CostelloA. E.LongA. E. (2014). Existential isolation and its psychological and physical health correlates [Poster presentation]. 122nd Annual Convention of the American Psychological Association, Washington, DC, United States.
14.
de BeauvoirS. (1949). The second sex (ParshleyH. M., Trans.; Ed.). Librairie Gallimard.
15.
DeciE. L.RyanR. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268. https://doi.org/10.1207/S15327965PLI1104_01
16.
EdwardsM. E.BookerJ. A.CookK.MiaoM.GanY.KingL. A. (2025). Hope as a meaningful emotion: Hope, positive affect, and meaning in life. Emotion, 25(6), 1365–1380. https://doi.org/10.1037/emo0001513
17.
EtemadJ.Dehghan MenshadiZ.MozafariN. (2016). Psychometric properties of existential anxiety scale in the elderly. Salmandshenasi, 1, 39–48. https://doi.org/10.18869/acadpub.joge.1.3.39. (in Persian)
18.
EvramG.Çakici EşA. (2020). Investigation of personal factors affecting existential anxiety: A model testing study. Current Psychology, 39(5), 1535–1542. https://doi.org/10.1007/s12144-020-00947-2
19.
FairlambS.CourtneyE. (2024). An existential perspective on interpersonal closeness and social distancing during the COVID-19 pandemic. Psychology and Health, 39(8), 1059–1076. https://doi.org/10.1080/08870446.2022.2129052
20.
FranklV. E. (1959). Man’s search for meaning. Beacon Press. (Original work published 1946)
21.
FuJ.WangT.WangL. (2023). Existential meaninglessness as a predictor of suicidal ideation and loneliness during COVID-19. Personality and Individual Differences, 214, Article 112346. https://doi.org/10.1016/j.paid.2023.112346
22.
GiannoneD. A.KaplinD. (2020). How does spiritual intelligence relate to mental health in a western sample?Journal of Humanistic Psychology, 60(3), 400–417. https://doi.org/10.1177/0022167817741041
23.
GlawX.KableA.HazeltonM.InderK. (2017). Meaning in life and meaning of life in mental health care: An integrative literature review. Issues in Mental Health Nursing, 38(3), 243–252. https://doi.org/10.1080/01612840.2016.1253804
24.
GreenbergJ.PyszczynskiT.SolomonS. (1986). The causes and consequences of a need for self-esteem: A terror management theory. In BaumeisterR. F. (Ed.), Public self and private self (pp. 189–212). Springer. https://doi.org/10.1007/978-1-4613-9564-5_10
25.
GrossmanC. H.BrookerJ.MichaelN.KissaneD. (2018). Death anxiety interventions in patients with advanced cancer: A systematic review. Palliative Medicine, 32(1), 172–184. https://doi.org/10.1177/0269216317722123
26.
HeideggerM. (1962). Being and time. Harper & Row. (Original work published 1927)
27.
HeineS. J.ProulxT.VohsK. D. (2006). The meaning maintenance model: On the coherence of social motivations. Personality and Social Psychology Review, 10(2), 88–110. https://doi.org/10.1207/s15327957pspr1002_1
28.
HelmP. J.GreenbergJ.ParkY. C.PinelE. C. (2018). Feeling alone in your subjectivity: Introducing the state trait existential isolation model (STEIM). Wiley Online Library, 3(3), 146–157. https://doi.org/10.1002/jts5.41
29.
HelmP. J.LifshinU.ChauR.GreenbergJ. (2019). Existential isolation and death thought accessibility. Journal of Research in Personality, 82, Article 103845. https://doi.org/10.1016/j.jrp.2019.103845
30.
HuangY.GuanZ.YanF.WileyJ. A.ReynoldsN. R.TangS.SunM. (2022). Mediator role of presence of meaning and self-esteem in the relationship of social support and death anxiety. Frontiers in Psychology, 13, Article 1018097. https://doi.org/10.3389/fpsyg.2022.1018097
31.
Jamal LivaniH.JafariM.AlimohammadzadehK. H. (2020). The role of social support on elderly death anxiety through self-efficacy mediation. Journal of Gerontology, 4(4), 11–18. https://sid.ir/paper/381970/en. (in Persian)
32.
KarataşZ.UzunK.TagayÖ. (2021). Relationships between the life satisfaction, meaning in life, hope and COVID-19 fear for Turkish adults during the COVID-19 outbreak. Frontiers in Psychology, 12, Article 633384. https://doi.org/10.3389/fpsyg.2021.633384
33.
KarimaF. H.DemartotoA.MurtiB. (2023). Effects of social support, perceived threat, and witnessing death on the risk of post-traumatic stress disorder: Meta-analysis. Journal of Epidemiology and Public Health, 8(3), 396–409. https://doi.org/10.26911/jepublichealth.2023.08.03.10
34.
KesebirP.PyszczynskiT. (2011). The role of death in life: Existential aspects of human motivation. In RyanR. M. (Ed.), The Oxford handbook of human motivation (pp. 43–64). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780195399820.013.0004
35.
KeyesC. L. M.ShmotkinD.RyffC. D. (2002). Optimizing well-being: The empirical encounter of two traditions. Journal of Personality and Social Psychology, 82(6), 1007–1022. https://psycnet.apa.org/buy/2002-02942-010
36.
KeyesC. L. M.WissingM.PotgieterJ. P.TemaneM.KrugerA.Van RooyS. (2008). Evaluation of the Mental Health Continuum–Short Form (MHC– SF) in Setswana-speaking South Africans subjective well-being: Something positive. Clinical Psychology and Psychotherapy, 15, 181–192. https://doi.org/10.1002/cpp.572
37.
Khalili VarnakshiA. (2015). Psychometric properties of Keyes’ Mental Health Questionnaire (short form-14 items) and its relationship with Happiness Questionnaire. Azad University, Tehran Center Unit (Thesis-in Persian).
38.
LeungH. T.ChewP. K. H.CaltabianoN. J. (2024). Do pandemics trigger death thoughts?Journal of Humanistic Psychology. Advance online publication. https://doi.org/10.1177/00221678241273422
39.
LiP. F. J.WongY. J.McCulloughK. M.JinL.WangC. D. C. (2022). Existential meaninglessness scale: Scale development and psychometric properties. Journal of Humanistic Psychology, 66, 235–269. https://doi.org/10.1177/00221678211072450
40.
LiftonR. J. (1979). The broken connection: On death and the continuity of life. Simon & Schuster.
41.
LloydC. S.af KlintebergB.DeMarinisV. (2015). Psychological and existential vulnerability among clinical young women: A quantitative comparison of depression-related subgroups. Mental Health, Religion and Culture, 18(4), 259–272. https://doi.org/10.1080/13674676.2015.1021313
42.
MartelaF.RyanR. M.StegerM. F. (2018). Meaningfulness as satisfaction of autonomy, competence, relatedness, and beneficence: Comparing the four satisfactions and positive affect as predictors of meaning in life. Journal of Happiness Studies, 19(5), 1261–1282. https://doi.org/10.1007/s10902-017-9869-7
43.
MaslowA. H. (1968). Toward a psychology of being (2nd ed.). Van Nostrand.
44.
MayR. (1958). Contributions of existential psychotherapy. In MayR.AngelE.EllenbergerH. F. (Eds.), Existence: A new dimension in psychiatry and psychology (pp. 37–91). Basic Books.
45.
MenziesR. E.SharpeL.Dar-NimrodI. (2019). The relationship between death anxiety and severity of mental illnesses. British Journal of Clinical Psychology, 58(4), 452–467. https://doi.org/10.1111/bjc.12229
46.
ÖnolS.EnginE. (2022). Existential anxiety and sense of guilt for mental health. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi, 13(3), 263–267. https://doi.org/10.14744/phd.2022.38268
47.
PellensH.DezutterJ.LuytenP.VanhoorenS. (2022). To be scared or scared to be: Existential anxiety as a mediator between meaning experience and depression. Journal of Humanistic Psychology. Advance online publication. https://doi.org/10.1177/00221678221140617
48.
PyszczynskiT.KesebirP. (2011). Anxiety buffer disruption theory: A terror management account of posttraumatic stress disorder. Anxiety, Stress and Coping, 24(1), 3–26. https://doi.org/10.1080/10615806.2010.517524
49.
RobahK. (2017, June). Determinants of existential death anxiety: A cross-sectional survey study on the effect of age, gender and religious affiliation on death anxiety (pp. 1–40). https://essay.utwente.nl/72696/
50.
SameerY.EidY.VeenhovenR. (2022). Perceived meaning of life and satisfaction with life: A research synthesis using an online finding archive. Frontiers in Psychology, 13, Article 957235. https://doi.org/10.3389/fpsyg.2022.957235
51.
SartreJ.-P. (1957). The transcendence of the ego: An existentialist theory of consciousness (Vol. 114). Macmillan.
52.
SchnellT. (2009). The Sources of Meaning and Meaning in Life Questionnaire (SoMe): Relations to demographics and well-being. Journal of Positive Psychology, 4(6), 483–499. https://doi.org/10.1080/17439760903271074
53.
SokolL. L.TroostJ. P.BegaD.PaulsenJ. S.KlugerB. M.ApplebaumA. J.FrankS.NanceM. A.AndersonK. E.PerlmutterJ. S.DeppC. A.GrafmanJ.CellaD.CarlozziN. E. (2023). Death anxiety in Huntington disease: Longitudinal heath-related quality-of-life outcomes. Journal of Palliative Medicine, 26(7), 907–914. https://doi.org/10.1089/jpm.2022.0160
54.
StegerM. F.FrazierP.KalerM.OishiS. (2006). The meaning in life questionnaire: Assessing the presence of and search for meaning in life. Journal of Counseling Psychology, 53(1), 80–93. https://doi.org/10.1037/0022-0167.53.1.80
55.
TillichP. (1952). The courage to be. Yale University Press.
56.
TomaszekK.Muchacka-CymermanA. (2020). Thinking about my existence during COVID-19, I feel anxiety and awe – The mediating role of existential anxiety and life satisfaction on the relationship between PTSD symptoms and post-traumatic growth. International Journal of Environmental Research and Public Health, 17(19), Article 7062. https://doi.org/10.3390/ijerph17197062
57.
TommasiF.ToscanoF.GiusinoD.CeschiA.SartoriR.DegenJ. L. (2022). Meaningful or meaningless? Organizational conditions influencing doctoral students’ mental health and achievement. International Journal of Doctoral Studies, 17, 301–321. https://doi.org/10.28945/5011
58.
VailK. E.GoncyE. A.EdmondsonD. (2019). Anxiety buffer disruption: Worldview threat, death thought posttraumatic stress symptom samples. Psychological Trauma: Theory, Research, Practice, and Policy, 11(6), 647–655. https://doi.org/10.1037/tra0000441
59.
van BruggenV.VosJ.WesterhofG.BohlmeijerE.GlasG. (2015). Systematic review of existential anxiety instruments. Journal of Humanistic Psychology, 55(2), 173–201. https://doi.org/10.1177/0022167814542048
60.
van TilburgW. A. P.IgouE. R.MaherP. J.LennonJ. (2019). Various forms of existential distress are associated with aggressive tendencies. Personality and Individual Differences, 144, 111–119. https://doi.org/10.1016/j.paid.2019.02.032
61.
Van TongerenD. R.Showalter Van TongerenS. A. (2021). Finding meaning amidst COVID-19: An existential positive psychology model of suffering. Frontiers in Psychology, 12, Article 641747. https://doi.org/10.3389/fpsyg.2021.641747
62.
VosJ. (2023). Existential psychological therapies: An overview of empirical research Thérapies existentielles: une revue de la recherche empirique. Pratiques Psychologiques, 29(4), 211–229. https://doi.org/10.1016/j.prps.2023.06.001
63.
VosL. (2015). Meaning and existential givens in the lives of cancer patients: A philosophical perspective on psycho-oncology. Palliative & Supportive Care, 13, 885–900. https://doi.org/10.1017/S1478951514000790
64.
WeemsC. F.CostaN. M.DehonC.BermanS. L. (2004). Paul Tillich’s theory of existential anxiety: A preliminary conceptual and empirical examination. Anxiety, Stress & Coping, 17(4), 383–399. https://doi.org/10.1080/10615800412331318616
65.
WeemsC. F.RussellJ. D.NeillE. L.BermanS. L.ScottB. G. (2016). Existential anxiety among adolescents exposed to disaster: Linkages among level of exposure, PTSD, and depression symptoms. Journal of Traumatic Stress, 29(5), 466–473. https://doi.org/10.1002/jts.22128
66.
WolframH. J. (2023). Meaning in life, life role importance, life strain, and life satisfaction. Current Psychology, 42(34), 29905–29917. https://doi.org/10.1007/s12144-022-04031-9
YalomI. D. (1980). Existential psychotherapy. Basic Books.
69.
ZhouX.LiuJ.ChenC.YuZ. (2008). Do children transcend death? An examination of the terror management function of offspring. Scandinavian Journal of Psychology, 49(5), 413–418. https://doi.org/10.1111/j.1467-9450.2008.00665.x
