Development of a quantitative rating scale to assess denial

The concept of denial is important for the psychosomatic understanding of cardiovascular disease and treatment. This study evaluated denial using several psychometric assessment scales in patients referred for psychiatric evaluations prior to heart transplantation. Surviving patients who had a mean survival of more than 38 months had less denial than nonsurviving patients who had a mean survival of 4 months. These findings are very preliminary, but interesting, and would encourage further investigation of denial in these patients. Denial is a complex psychological variable, only part of which may be applicable to surgery patients.

Section: Discussioncontrasting

confidence: 49%

“…Clinical ly. we have found the scale suggested for use by Hackett and Cassem [3] to be an extended clinical interview which takes at least 1 h to administer comfortably. Heart transplant patients rarely have the luxury of time for their evaluations.…”

Section: Introductionmentioning

confidence: 99%

Denial in Heart Transplant Candidates

Young¹,

Schweiger

Beitzinger

et al. 1991

“…[Beutel, 1984], The defense mecha nisms quoted are those agreed upon by many theorists and roughly correspond to the list of Freud [1946]. Research on chronic disease, however, is mostly restricted to the single mechanism of denial [sometimes used as a generic term for other defense mechanisms, e.g., Hackett and Cassem, 1974;Weisman, 1979], Defense mechanisms arc clearly under represented at the behavioral level, whereas it is easy to think of a large number of behav ioral coping processes. It is further postulated that adaptation efforts in a specific situation occur simultaneously or successively at dif ferent levels, including both coping and de fense processes.…”

Section: Social Supportmentioning

confidence: 99%

Approaches to Taxonomy and Measurement of Adaptation in Chronic Disease

Beutel¹

1985

The concept of adaptation has gained central importance in research on chronic disease. The article reviews recent developments in the major theoretical concepts, coping, defense and social support. A schema for classification is introduced distinguishing coping and defense processes at the individual (cognitive-emotional and behavioral), interpersonal and institutional levels. Some often neglected aspects of the evaluation (concerning temporal orientation, level, areas and perspective of rater) are pointed out. Underlying methodological aspects are briefly reviewed. Applying conceptual demands of theories of adaptation to research on chronic disease shows major research deficits, especially a lack of accepted definitions of adjustment, a preference for static, one-dimensional and cross-sectional research and a lack of adequate assessment procedures. Desiderata for future research are suggested.

“…Measurement and identification of denial are also complex, and have not been uniform in the literature. Authors vary in operational definition of de nial, and techniques for identifying denial [9,10,13,[19][20][21]. Some criticisms of earlier studies have focused upon the label 'denier' in the absence of sufficient interview or fol low-up information [10,19].…”

Section: Problems With Denial Researchmentioning

confidence: 99%

Extreme Denial in Breast Cancer Patients and Capacity for Object Relations

Wool¹

1986

This study tested an assumption of the theoretical hierarchy of defenses: denial reflects primitive ego development. The study hypothesized a positive relationship between extreme denial and immature object relationship functioning. Twenty breast cancer patients who demonstrated extreme denial and delayed help-seeking were compared on a measure of object relations with a group of 30 similar patients who did not manifest denial or delay. The central hypothesis was not supported, although trends suggested possible validity. Further study may improve our understanding of the mechanisms which influence symptom recognition, help-seeking, and emotional adjustment to cancer.