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Using a modified version of the Hackett-Cassem denial scale we measured preoperative denial in 121 patients scheduled for CABG surgery. A significant inverse relationship was found between the denial scale and Hamilton Anxiety measures four days postoperatively (p less than .02). Longitudinal assessments were carried out using the Spielberger State Anxiety Inventory (SSAI), the Zung Self-Rating Depression Scale (Zung SDS) and the Psychosocial Adjustment to Illness Scale (PAIS). Six months following the surgery, significant negative relationships between denial and these self-report outcome measures were observed as follows: denial and SSAI (p less than .001), denial and Zung SDS (p less than .01), and denial and PAIS (p less than .01). However, the same analysis at twelve months showed no statistically significant correlations between denial and these psychologic outcome measures. Our findings suggest that denial serves as an adaptive mechanism, especially in the immediate postoperative period. Furthermore, higher levels of denial may be predictive of improved psychologic outcome for up to six months following surgery. Subsequently, however, other events, unrelated to the surgery, may be of greater importance than preoperative denial in determining psychological outcome from CABG surgery.

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Personality disorders frequently are seen among depressed psychiatric in‐patients. In a group of 73 depressed psychiatric outpatients, this study identified 85% whose response to the Millon Clinical Multiaxial Inventory (MCMI) suggested a personality disorder. On retest 12 weeks later, only 64% manifested a response style consistent with the DSM‐III personality disorders. These findings are discussed in relation to methodology, characteristics of the MCMI, and the response style of the depressed patient, which may lead to an overidentification of personality disorders on a self‐report measure. Related aspects of the diagnostic criteria for personality disorders also are discussed.