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Psychiatria Danubina 2021Denial of Pregnancy is a women's subjective lack of awareness of being pregnant. It can be partial (from 20 weeks but lifted before delivery) or complete (the women... (Review)
Review
INTRODUCTION
Denial of Pregnancy is a women's subjective lack of awareness of being pregnant. It can be partial (from 20 weeks but lifted before delivery) or complete (the women notice she's pregnant when labour starts). The prevalence is around 1/500 for partial denial and 1/2500 for complete denial. This article's aim is to review the literature broadly on the subject of pregnancy denial, its psychopathological hypothesis and the state of knowledge on the outcome for mothers and children.
METHODS
26 references have been selected bases on a research on pubmed database and through bibliography on the selected papers.
RESULTS
Despite a lot of psychopathological hypothesis and some epidemiological studies, no objective knowledge can lead to know what kind of women will deny their pregnancy and how to prevent it. After all the studies on mother characteristics, it seems there are no "clear-cut" explanations on why a woman denies a pregnancy or what type of women could be at risk of denial. There are no official guidelines on how to manage the condition and care for the patient long term. The first elements of research on the developmental outcome for infant seem to show a delay in psychomotor skills and possible speech disorder. They have been significant advancement on the subject of children development after pregnancy denial in the last year but the psychological and developmental impact of pregnancy denial on children and mothers is still majorly unknown. With a clinical picture known for so long, to have so little objective information on how to manage it and on the possible consequences is surprising.
CONCLUSION
More research needs to be conducted to objectively know the long term effects of pregnancy denial on the whole family. International consensus should be found on the definition and care management of pregnancy denial.
Topics: Child; Female; Humans; Infant; Mothers; Pregnancy
PubMed: 34185733
DOI: 10.24869/psyd.2021.140 -
Public Understanding of Science... May 2024Despite scientific consensus on climate change, climate denial is still widespread. While much research has characterised climate denial, comparatively fewer studies...
Despite scientific consensus on climate change, climate denial is still widespread. While much research has characterised climate denial, comparatively fewer studies have systematically examined how to counteract it. This review fills this gap by exploring the research about counteracting climate denial, the effectiveness and the intentions behind intervention. Through a systematic selection and analysis of 65 scientific articles, this review finds multiple intervention forms, including education, message framing and inoculation. The intentions of intervening range from changing understanding of climate science, science advocacy, influencing mitigation attitudes and counteracting vested industry. A number of divergent findings emerge: whether to separate science from policy; the disputed effects of emotions and the longitudinal impacts of interventions. The review offers guiding questions for those interested in counteracting denialism, the answers to which indicate particular strategies: identify the form of climate denial; consider the purpose of intervention and recognise one's relationship to their audiences.
Topics: Attitude; Climate Change; Denial, Psychological; Public Opinion
PubMed: 38243813
DOI: 10.1177/09636625231223425 -
Social Science & Medicine (1982) May 2022Gaslighting is a type of abuse aimed at making victims question their sanity as well as the veracity and legitimacy of their own perspectives and feelings. In this...
Gaslighting is a type of abuse aimed at making victims question their sanity as well as the veracity and legitimacy of their own perspectives and feelings. In this article, we show how gaslighting can operate as a key, yet underexamined strategy of obstetric violence, or the institutional and interpersonal violation of women's rights during pregnancy, childbirth, and postpartum. We draw on forty-six in-depth, semi-structured interviews with mothers who experienced a traumatic childbirth to examine how obstetric providers gaslight mothers before, during and after childbirth when they deny - and thereby destabilize - mothers' realities. We identify and examine four core types of denials: denials of 1) mothers' humanity, 2) mothers' knowledge as valid, 3) mothers' judgements as rational and 4) mothers' feelings as legitimate. All four denials work to render mothers noncredible and their claims illegible within clinical encounters. In explicitly naming, theorizing, and examining obstetric gaslighting, our aims are threefold: 1) to uncover and theorize an underexamined mechanism of obstetric violence through a sociological lens, 2) to offer a typology of obstetric gaslighting's manifestations to aid scholars and practitioners in recognizing when obstetric gaslighting is occurring and 3) to advance a growing research program on gaslighting in medicine.
Topics: Delivery, Obstetric; Female; Gaslighting; Humans; Mothers; Parturition; Pregnancy; Violence
PubMed: 35395611
DOI: 10.1016/j.socscimed.2022.114938 -
Plastic and Reconstructive Surgery.... Oct 2023Despite evidence documenting the physical and psychological benefits of breast reduction, third-party payer approval remains a cumbersome process. The objective of this...
BACKGROUND
Despite evidence documenting the physical and psychological benefits of breast reduction, third-party payer approval remains a cumbersome process. The objective of this study was to assess differences in medical necessity criteria for reduction mammaplasty among US insurance carriers while analyzing trends in claim denials and appeals.
METHODS
The medical necessity criteria for reduction mammaplasty were retrieved from seven large health insurance carriers. Data were extracted from each policy, including claim requirements for approval. Additionally, prospective data on claims and denials submitted from January through August 2022 were collected from The Auctus Group, a medical consulting firm.
RESULTS
All the policies have been updated since January 2020. Five of the seven policies specifically listed what documentation was required for preauthorization approval, with five third-party payers requiring photograph documentation. Policies required documentation of one to three symptoms lasting from 6 weeks to 1 year. All companies reported a tissue resection estimate threshold, but cutoffs varied. Of 380 reduction mammaplasties performed, 158 (41.6%) received a denial on initial insurance submission. Considering appeals, a total of 216 denials were reviewed with an average of 1.37 denials per patient. Of the 158 initial denials, 104 (65.8%) of these were from claims that received preauthorization. In 12 cases, third-party payers stated that no prior authorization was necessary yet still denied the claim.
CONCLUSIONS
Wide variability exists in medical necessity criteria for reduction mammaplasty policies among major insurance carriers. These nuances introduce inefficiencies for practices contributing to high denial and appeal rates while delaying surgical care for patients.
PubMed: 37900990
DOI: 10.1097/GOX.0000000000005361 -
Jornal Brasileiro de Pneumologia :... 2022To investigate factors that influence or promote disbelief and negative attitudes toward COVID-19.
OBJECTIVE
To investigate factors that influence or promote disbelief and negative attitudes toward COVID-19.
METHODS
This was cross-sectional study involving 544 males and females ≥ 18 years of age in Greece between December of 2020 and January of 2021. All participants were informed about the purpose of the study, protection of anonymity, and volunteer participation. Participants completed an online anonymous 40-item questionnaire. Analysis of data included the identification of correlations and use of t-tests and ANOVA.
RESULTS
The level of knowledge regarding COVID-19 transmission routes, manifestations, and prevention was high in our sample. Women appeared to have a more positive attitude toward COVID-19 prevention and management than did men (p = 0.032 and p = 0.018, respectively). Younger people (18-30 years of age) seemed to deny the validity of scientific data and mass media reports about ways to deal with the pandemic more commonly than did those > 30 years of age (p = 0.003 and p = 0.001, respectively). People who resided in cities more commonly believed in scientific announcements than did those living in villages (p = 0.029).
CONCLUSIONS
In order to minimize cases of denial of and disbelief in COVID-19 and to promote vaccination, a series of actions are required. Governments should implement a series of measures to contain the disease, taking into consideration the psychological and social aspects of those policies.
Topics: Adult; COVID-19; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Pandemics; SARS-CoV-2; Surveys and Questionnaires
PubMed: 36169560
DOI: 10.36416/1806-3756/e20220228 -
International Journal of Nursing Studies Feb 2024Unclear illness perceptions are common in heart failure. The self-regulation model of illness behaviour highlights factors that may impact how people with chronic...
BACKGROUND
Unclear illness perceptions are common in heart failure. The self-regulation model of illness behaviour highlights factors that may impact how people with chronic illness choose to cope with or manage their condition and has been used to study pre-hospital delay for stroke and acute myocardial infarction. The principles of self-regulation can be applied in heart failure to help illuminate the link between unclear illness perceptions and sub-optimal symptom self-management.
OBJECTIVE
Informed by the self-regulation model of illness behaviour, this study examines the role of illness perceptions in coping responses that lead to delayed care-seeking for heart failure symptoms.
DESIGN
Mixed-methods phenomenological study.
SETTING(S)
Quaternary referral hospital - centre of excellence for cardiovascular care and heart transplantation.
PARTICIPANTS
Seventy-two symptomatic patients with heart failure participated in a survey assessing illness perceptions. A subset of fifteen individuals was invited to participate in semi-structured interviews.
METHODS
Illness perceptions were assessed using the Brief Illness Perception Questionnaire. In-depth semi-structured interviews were conducted to elicit previous care-seeking experiences and decision-making that led to a passive, or active coping response to worsening symptoms. Descriptive statistics were used to report questionnaire findings, and open-ended responses were grouped into descriptive categories. Interpretative phenomenological analysis was undertaken on interview transcripts.
RESULTS
Participants perceived little personal control over their condition and mostly attributed heart failure to lifestyle factors such as diet and lack of activity. Cognitive dissonance between perceived self-identity and heart failure-identity led to a highly emotional response which drove coping towards avoidance strategies and denial.
CONCLUSIONS
This study demonstrates the use of the principles of self-regulation in heart failure and offers a framework to understand how patient representations and emotional responses can inform behaviour in illness. Findings highlight the value of empowering patients to take control of their health and the need to help align values (e.g. independence) with behaviours (e.g. actively addressing problems) to facilitate optimal symptom self-management.
Topics: Humans; Adaptation, Psychological; Heart Failure; Patient Acceptance of Health Care; Emotions; Surveys and Questionnaires; Qualitative Research
PubMed: 38016267
DOI: 10.1016/j.ijnurstu.2023.104644 -
The Spanish Journal of Psychology Feb 2021In recent years, there has been an increasing interest in the consequences of conspiracy theories and the COVID-19 pandemic raised this interest to another level. In...
In recent years, there has been an increasing interest in the consequences of conspiracy theories and the COVID-19 pandemic raised this interest to another level. In this article, I will outline what we know about the consequences of conspiracy theories for individuals, groups, and society, arguing that they are certainly not harmless. In particular, research suggests that conspiracy theories are associated with political apathy, support for non-normative political action, climate denial, vaccine refusal, prejudice, crime, violence, disengagement in the workplace, and reluctance to adhere to COVID-19 recommendations. In this article, I will also discuss the challenges of dealing with the negative consequences of conspiracy theories, which present some opportunities for future research.
Topics: Apathy; Attitude; Attitude to Health; COVID-19; Climate Change; Communicable Disease Control; Crime; Culture; Denial, Psychological; Guideline Adherence; Health Behavior; Humans; Personnel Loyalty; Politics; Prejudice; SARS-CoV-2; Vaccination Refusal; Violence
PubMed: 33612140
DOI: 10.1017/SJP.2021.10 -
Journal of Forensic Sciences Mar 2023While denial of pregnancy and neonaticide are rare, they are potentially associated and share some risk factors. Neonaticide has been proposed as the extreme outcome of...
While denial of pregnancy and neonaticide are rare, they are potentially associated and share some risk factors. Neonaticide has been proposed as the extreme outcome of a denial of pregnancy. However, the process leading to such a possible outcome is not yet fully understood. The primary goal of this essay is to examine the various definitions and ambiguities surrounding the denial of pregnancy. The case of a young woman with a history of two denied pregnancies with diverse characteristics and outcomes, the latest of which resulted in neonaticide, is then reported and examined. A forensic psychiatric evaluation was also performed to reconstruct the woman's mental state at the time of the crime. The forensic pathological analysis of the newborn, abandoned near the sea while still alive, is described. The victim's body showed signs of shaken baby syndrome. We contend that differing levels of awareness during a denial of pregnancy might not be predictive of the potential delivery outcome in terms of threat to the newborn's survival, according to the forensic pathological and psychopathological data of the current case. Early identification of women affected by denial of pregnancy who pose a danger of committing infanticide is hampered by both intrinsic traits (dissimulation, unawareness, low propensity to seek assistance) and environmental factors (isolation, low socioeconomic level, poor education.). A previous history of denial of pregnancy should activate health and support services to reduce the potential risks for the mother and the child.
Topics: Pregnancy; Infant, Newborn; Child; Female; Humans; Infanticide; Denial, Psychological; Mothers; Forensic Medicine
PubMed: 36683010
DOI: 10.1111/1556-4029.15202 -
Sante Publique (Vandoeuvre-les-Nancy,... Aug 2023In Morocco, maternal mortality is a crucial public health problem with a current rate of 72.6/100000 live births. This phenomenon is emotionally overwhelming, and the...
INTRODUCTION
In Morocco, maternal mortality is a crucial public health problem with a current rate of 72.6/100000 live births. This phenomenon is emotionally overwhelming, and the midwife’s experience of this drama is disordering.
PURPOSE OF RESEARCH
To explore how midwives experience maternal death, the resulting consequences, and the coping strategies used to overcome it.
RESULTS
19 midwives were interviewed and reported 39 cases of maternal death. The results show that no midwife remains indifferent to maternal death. The experience is painful, and the grief of the families is transferred to the midwife. Sadness, denial, fear, feelings of guilt and failure have characterized almost all the victims. In the face of her suffering, the midwife mobilizes coping strategies. The consequences are diverse: psychological, somatic, and professional.
CONCLUSIONS
The experience of maternal death associated with unfavorable working conditions and lack of recognition increases stress and leads to the intention to abandon the profession. The improvement of working conditions, the focus on teamwork, the implementation of discussion groups, professionalize the experience of maternal death.
Topics: Pregnancy; Female; Humans; Midwifery; Maternal Death; Maternal Mortality; Adaptation, Psychological; Surveys and Questionnaires; Qualitative Research
PubMed: 37558619
DOI: 10.3917/spub.232.0139 -
Medical Humanities Mar 2022Oppressive stereotypes of invalidity and tragedy have positioned loss and grieving as contested issues in the field of disability studies. Ascriptions of 'denial' are...
Oppressive stereotypes of invalidity and tragedy have positioned loss and grieving as contested issues in the field of disability studies. Ascriptions of 'denial' are rejected by many disabled people, as a reductive medicalisation of their lived reality. For these and other reasons, this paper asserts that disabled people are afforded limited or awkward social spaces for grief, be it to do with social positioning, embodiment, or any other aspect of human experience. This is significant because grieving may have an important relationship with political mobilisation, both personal and collective. The paper presents autoethnographic material from the life of the second author, who has lived with quadriplegia for more than three decades. Using ideas from critical psychoanalysis it traces how political, relational and intrapsychic mechanisms constrain and sanction his expression of feelings of loss, contributing to a relational predicament of , analogous to that attributed to subordinated racial groups. Here, one is forced to strive for assimilation into an unattainable, ideal social role, while simultaneously being alienated from one's inner experience, with implications for both creativity and personal power. The paper concludes that, paradoxically, stereotypes are countered not by dissociation from grief, but rather the claiming of it.
Topics: Disabled Persons; Grief; Humans; Negotiating; Power, Psychological; Psychoanalysis
PubMed: 34088801
DOI: 10.1136/medhum-2020-011860