Is denial a maladaptive coping mechanism which prolongs pre-hospital delay in patients with ST-segment elevation myocardial infarction?

Fang, XY; Albarqouni, Loai; Rothe, Alexander von Eisenhart; Hoschar, Sophia; Ronel, Joram; Ladwig, Karl‐Heinz

doi:10.1016/j.jpsychores.2016.10.008

Cited by 21 publications

(15 citation statements)

References 32 publications

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“…In particular, we focused on two types of concerns based on their importance suggested in previous literature (Moser et al , ): (1) concerns related to the serious consequences of delaying help‐seeking in case it is needed (i.e., in case one is actually experiencing a heart attack) and (2) social concerns related to the consequences of seeking medical attention in the case of a false alarm (i.e., in case one is not suffering a heart attack). For example, fear about what could happen (Bray et al , ), experiencing serious symptoms (Fang et al , ), or attributing symptoms to a serious condition (Abed, Khalil, & Moser, ) have been linked to a shorter delay. In particular, patients who attribute their symptoms to a cardiac cause as opposed to temporal anxiety, musculoskeletal pain, or other less serious symptoms, wait on average one hour less before seeking medical attention for their symptoms (Abed et al , ; McKee et al , ; McKinley et al , ).…”

Section: Introductionmentioning

confidence: 99%

Psychosocial markers of pre‐hospital decision delay and psychological distress in acute coronary syndrome patients

Arrebola‐Moreno

Petrova

Garrido

et al. 2020

British J Health Psychol

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Objectives. Both pre-hospital decision delaythe time patients wait before seeking medical attention after symptoms have startedand high psychological distress after the cardiac episode predict poor prognosis of patients with acute coronary syndromes (ACS). We aimed to identify psychosocial markers of these prognostic factors. Design.A cross-sectional study of 102 consecutive, clinically stable ACS survivors.Methods. Participants completed a questionnaire measuring pre-hospital decision delay, psychological distress, and several known psychosocial factors related to cardiovascular health: type D personality, resilience, social support, and concerns during the cardiac event. Multiple linear regression and mediation analyses were conducted.Results. Type D personality and fewer concerns about the serious consequences of delaying help-seeking were related to more psychological distress post-ACS, and these relationships were mediated by longer pre-hospital decision delay. In contrast, resilience was related to lower psychological distress. Social support and social concerns about help-seeking were not related to the outcome variables.Conclusions. Type D personality may be a risk factor for more delayed help-seeking for an ACS and higher psychological distress after the cardiac event. Resilience, in contrast, emerged as a potential protective factor of patients' mental health after the cardiac event. Pre-hospital decision delay was related to thinking about serious consequences (e.g., complications, protecting one's family) but not about social concerns (e.g., wasting other people's time) during the cardiac episode.

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Section: Introductionmentioning

confidence: 99%

Psychosocial markers of pre‐hospital decision delay and psychological distress in acute coronary syndrome patients

Arrebola‐Moreno

Petrova

Garrido

et al. 2020

British J Health Psychol

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“…Some argued that denial is associated with faster recovery, better psychosocial readjustment, and lower mortality, but evidence for these claims is potentially confounded by many medical, psychological, and social factors. 19 – 23 One study that explored post-MI coping experiences through a grounded-theory approach postulated that it was not easy to integrate treatment-related behavior patterns into one’s everyday life or to give up old habits, as the need for change is influenced by both behavioral and psychosocial factors. 24 The influence of MI on patients depends on their perception of the illness and coping abilities.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia

Ganasegeran¹,

Rashid²

2017

PPA

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BackgroundAlthough evidence-based practice has shown the benefits of prescribed cardioprotective drugs in post-myocardial infarction (MI) survivors, adherence rates remain suboptimal. The aim of this study was to determine the prevalence and factors associated with medication nonadherence among post-MI survivors in Malaysia.Materials and methodsThis cross-sectional study was conducted from February to September 2016 among 242 post-MI survivors aged 24–96 years at the cardiology outpatient clinic in a Malaysian cardiac specialist center. The study utilized an interviewer-administered questionnaire that consisted of items adapted and modified from the validated Simplified Medication Adherence Questionnaire, sociodemographics, health factors, perceived barriers, and novel psychological attributes, which employed the modified Confusion, Hubbub, and Order Scale and the Verbal Denial in Myocardial Infarction questionnaire.ResultsThe prevalence of medication nonadherence was 74%. In the multivariable model, denial of illness (AOR 1.2, 95% CI 0.9–1.8; P=0.032), preference to traditional medicine (AOR 8.7, 95% CI 1.1–31.7; P=0.044), lack of information about illness (AOR 3.3, 95% CI 1.1–10.6; P=0.045), fear of side effects (AOR 6.4, 95% CI 2.5–16.6; P<0.001), and complex regimen (AOR 5.2, 95% CI 1.9–14.2; P=0.001) were statistically significant variables associated with medication nonadherence.ConclusionThe relatively higher medication-nonadherence rate in this study was associated with patient-, provider-, and therapy-related factors and the novel psychological attribute denial of illness. Future research should explore these factors using robust methodological techniques to determine temporality among these factors.

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“…Denial affected life satisfaction independently of psychiatric symptoms such as depression and anxiety. The positive relationship between denial and life satisfaction may indicate that denial leads individuals to rate their subjective life satisfaction as high [33,34]. Denial is often described as a defense mechanism that protects one's subjective perception of traumatizing and stressful aspects of given situations [35,36].…”

Section: Discussionmentioning

confidence: 99%

Associations between Defense Mechanisms and Life Satisfaction among North Korean Refugees

Lee

Jun

et al. 2020

Preprint

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Background The present study investigated associations between defense mechanisms and life satisfaction among North Korean refugees living in South Korea.Methods A total of 178 North Korean refugees completed the Korean version of the Defense Style Questionnaire, a revised version of the Ways of Thinking of North Korean Defectors scale, the Center for Epidemiologic Studies Depression Scale, and the State–Trait Anxiety Inventory. Multiple stepwise regression analysis was performed to investigate the defense mechanisms associated with North Korean refugees’ life satisfaction in South Korea. Results Among defense mechanisms, denial most strongly predicted higher overall and economic satisfaction among North Korean refugees living in South Korea (β = 0.145, p < 0.01; β = 0.137, p = 0.03, respectively) after controlling for age, gender, anxiety, depression, and number of traumatic events experienced. Furthermore, resignation predicted lower overall (β = –0.206, p < 0.001) and economic satisfaction (β = –0.134, p = 0.02). However, the association between resignation and life satisfaction was not significant after controlling for depression, anxiety, and number of traumatic events experienced. Conclusions Specific defense mechanisms such as high denial and low resignation were associated with life satisfaction in South Korea among North Korean refugees. Our findings suggest that refugees’ psychological defense mechanisms may affect their satisfactory resettlement.

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Is denial a maladaptive coping mechanism which prolongs pre-hospital delay in patients with ST-segment elevation myocardial infarction?

Abstract: Denial not only contributes to less suffering from acute heart related symptoms and negative affectivity but also leads to a clinically significant delay in the prevalent group.

Cited by 21 publications

References 32 publications

Psychosocial markers of pre‐hospital decision delay and psychological distress in acute coronary syndrome patients

Psychosocial markers of pre‐hospital decision delay and psychological distress in acute coronary syndrome patients

The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia

Associations between Defense Mechanisms and Life Satisfaction among North Korean Refugees

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