Foster, Emma; (1998) Concept of death in adults with learning difficulties. Doctoral thesis (D.Clin.Psy.), UCL (University College London).

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Abstract

Seventy four adults with learning disabilities were interviewed using Piagetian tasks, the British Picture Vocabulary Scale (BPVS) and an adapted version of Smilansky's (1987) concept of death questionnaire. Demographic information and details of any death-related experience were gained from carers or relatives. Analyses indicated that cognitive ability (as measured by the BPVS), awareness of personal mortality and certain death-related experiences (i.e. seeing a dead animal and having attended a funeral) all influenced participants' understanding of the concept of death. There was no evidence of a significant link between age, sex, Piagetian level or other death-related experiences and comprehension of death. The sequence of acquisition of the sub-components of the death concept was investigated. Variation was found according to object of reference (human or animal). However in both human and animal death, the sub-components of causality and finality were significantly more difficult to understand than irreversibility, old age and inevitability. This finding supports the observational-hypothetical principle suggested in the child literature (i.e. mastery of death's sub-components form a continuum with those which are observable being more readily understood than those which are more abstract or hypothetical). This principle was also present within the sub-component of finality. Comparison with developmental sequences previously reported in the child literature indicates that adults with learning disabilities develop an understanding of the concept of death in a similar manner to children without learning disabilities. The clinical and research implications of these findings are discussed.

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