Different types of denial account for short and long term recovery of coronary patients

Research on denial of stressful life-events has become sensitive to questions of what is being denied, when it is adaptive, and how it is measured. Denial of personal relevance, vulnerability and responsibility of coronory patients, were examined according to a model developed by Breznitz. At the central medical center in southern Israel, 89 male patients, under 60, admitted after their first myocardial infarction (MI), were interviewed four times within six months. Denial was measured in an open interview within the first 48 hours while the patient was in the Coronary Intensive Care Unit and, by a Q sort administered shortly before he was released from the hospital. Short-term recovery was measured at the end of hospitalization, and at the first follow-up clinic visit, one month later. Long-term rehabilitation was measured at the follow-up clinic, about six months after the MI. An additional paper-and-pencil follow-up was carried out 18 months after the MI. The denial of personal relevance accounted for better performance at the end of hospitalization and at the short-term convalescence. The denial of responsibility correlated negatively with all recovery measures, and a balanced attitude towards vulnerability and responsibility accounted for better rehabilitation, even when severity of the MI and level of education were controlled. These findings support the 'multi-denial hypothesis' in stressful life events. They futher indicate that at different stages of the MI, different kinds of denial become 'adaptive'. The practical aspects of these findings are hereby discussed.