Implicit Self-Death Associations and Symptoms of Depression and Anxiety: A Single-Case Experimental Design

Abstract

Death anxiety may operate as a transdiagnostic process underlying anxiety and depressive symptoms. This study used the Death-Implicit Association Task (D-IAT) to index implicit self-death associations (ISDA) and evaluated a brief mindfulness intervention using a concurrent multiple-baseline design with maintenance across four students with prior anxiety/depressive diagnoses. Across 20 daily sessions, D-IAT D-scores and Mini-DASS depression and anxiety scores were collected. Visual analysis suggested reductions in depression and anxiety for several participants, with lower scores often persisting into maintenance. Casewise Tau-b patterns were heterogeneous. Exact randomisation tests showed a significant reduction in anxiety from baseline to intervention ( p = .04), while the reduction in depression was nonsignificant ( p = .08). Neither outcome showed a significant baseline-to-maintenance effect, and D-scores showed no significant reduction. Findings provide partial support for mindfulness-related symptom change but no evidence of corresponding change in ISDA.