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Journal of Advanced Nursing Aug 2006This paper reports an exploration of the terms acceptance and denial by exploring the literature, with the aim of understanding the implications of using these concepts... (Review)
Review
AIM
This paper reports an exploration of the terms acceptance and denial by exploring the literature, with the aim of understanding the implications of using these concepts to categorize people's responses to living with chronic illness.
BACKGROUND
People learning to live with a chronic illness or condition may be judged and labelled by others as being in denial, particularly when they do not adhere to prescribed treatment regimes.
METHOD
A literature search for the period between 1989 and 2003 was conducted using the electronic databases Medline, CINAHL, PSYCArticles, Health Source Nursing/Academic Edition, Academic Search Elite and Sociological Abstracts. Key terms used were 'acceptance and denial' and variations of such themes as 'chronic illness', 'disability', 'adjustment', 'illness discourse', 'medical discourse', 'illness experience', 'labelling', 'self' and 'identity'.
DISCUSSION
The theoretical background of the common constructs 'acceptance and denial' are discussed using the psychoanalytic theories of Freud and Kubler-Ross's work on death and dying. Healthcare professionals and lay people commonly refer to the terms acceptance and denial when describing a person's response to chronic illness. Those whose understanding of the illness experience relies on the acceptance-denial framework may not listen when people with chronic illness attempt to tell their own unique story of how they have experienced life with illness. Instead, their listening antennae may be focused on fitting aspects of the experience with stages of adjustment. When others use labels of acceptance and denial, people who are learning to live with a chronic illness may internalize these labels as reflections of the self. This may be most likely when the person using the label is perceived to have authority, such as a healthcare professional. The internalization of negative information associated with these labels may obstruct the reshaping of self-identity that is fundamental when making a transition to living well with chronic illness.
CONCLUSION
Healthcare professionals are urged to challenge the stage model of adjustment as a way of understanding the response to illness and to listen instead to the stories people tell. They are encouraged to privilege the person's experience as the basis for developing a sensitive, client-focussed response that takes into account the wider social context of people's lives as well as the medical aspects.
Topics: Adaptation, Psychological; Attitude of Health Personnel; Chronic Disease; Denial, Psychological; Humans; Life Change Events; Social Adjustment
PubMed: 16866841
DOI: 10.1111/j.1365-2648.2006.03942.x -
The British Journal of Medical... Jun 1998This work is aimed at analysing the motivated reasoning underlying denial of some piece of information. Denial is first distinguished from both repression and biased...
This work is aimed at analysing the motivated reasoning underlying denial of some piece of information. Denial is first distinguished from both repression and biased interpretation; then an analysis is provided of the reasoning devices typical of denial. The rules on which reasoned denial is based are similar to those governing the individual's normal cognitive activity. Reasoned denial is here represented in the form of if-then implications, where the to-be-denied belief plays the role of a consequence drawn from a given premise. So, in order to deny such a consequence one may either deny its premise, or search an alternative consequence, or search an alternative premise, or deny the very relation of implication, and so on. Each type of reasoning is logically biased, while at the same time psychologically plausible and convincing. A typical feature shared by all the reasoning strategies considered is the identification of 'unproven' with 'false'.
Topics: Defense Mechanisms; Denial, Psychological; Humans; Logic; Motivation; Problem Solving; Repression, Psychology
PubMed: 9617468
DOI: 10.1111/j.2044-8341.1998.tb01375.x -
Stroke May 1993The effects of stroke on classically nondominant hemisphere functions have received less attention than those on the dominant hemisphere, but visuospatial neglect and... (Review)
Review
BACKGROUND
The effects of stroke on classically nondominant hemisphere functions have received less attention than those on the dominant hemisphere, but visuospatial neglect and denial of illness both produce significant morbidity.
SUMMARY OF COMMENT
The early literature on denial of illness is discussed and the etiological theories are examined. These are explanations based on deficits of higher mental function, impaired sensory input (especially proprioceptive), an abnormal representation of body image, psychodynamic defense mechanisms, and/or premorbid personality factors.
CONCLUSIONS
Denial of illness is an important consequence of stroke. No explanation thus far proposed is entirely satisfactory. The consequences on rehabilitation and strategies for therapy have not been adequately investigated.
Topics: Cerebrovascular Disorders; Denial, Psychological; Humans
PubMed: 8488533
DOI: 10.1161/01.str.24.5.757 -
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 -
Science (New York, N.Y.) Mar 2013
Topics: Denial, Psychological; Disasters; Humans; Risk
PubMed: 23471373
DOI: 10.1126/science.1236756 -
Birth (Berkeley, Calif.) Dec 1995This paper describes the characteristics of women who deny awareness of their pregnancies, the underlying causes and conflicts, and specific interventions required to... (Review)
Review
This paper describes the characteristics of women who deny awareness of their pregnancies, the underlying causes and conflicts, and specific interventions required to address these issues. Case reports illustrate this complication of pregnancy. The absence of many physical symptoms of pregnancy, inexperience, general inattentiveness to bodily cues, intense psychological conflicts about the pregnancy, and external stresses can contribute to the denial in otherwise well-adjusted women. Assessment should include the possible contribution of painful reactivation of memories concerning childhood or adult trauma and the effect of dissociative states on the development of denial of pregnancy. Psychotherapy is recommended to resolve these conflicts, and to prevent future pregnancy denials and child abuse or neglect. Denial of pregnancy is easier to understand in women with psychosis or serious cognitive impairment than in those without such disorders. The underlying illness requires treatment by a psychiatrist. Psychological conflicts also exist in psychotic women, such as the intense wish to have a baby while fearing loss of the infant to child-protection services. Acknowledging the conflict and supporting the mother despite her puzzling behavior is an important task for health caregivers.
Topics: Adult; Conflict, Psychological; Denial, Psychological; Female; Humans; Mental Disorders; Nursing Assessment; Pregnancy; Psychotherapy
PubMed: 8573237
DOI: 10.1111/j.1523-536x.1995.tb00262.x -
Health Policy (Amsterdam, Netherlands) Dec 2007AIDS denial has long been viewed as the obstacle to forging effective response in many Asian countries. This article examines the dimensions and roots of this... (Review)
Review
AIDS denial has long been viewed as the obstacle to forging effective response in many Asian countries. This article examines the dimensions and roots of this phenomenon. It identifies seven types of views, attitudes, or tendencies that can be described as denial, dissent, disagreements, or doubts. Three major factors underlying the AIDS denial are discussed. These are (1) historical impressions that STDs are Western diseases, (2) desire of some Asian leaders to forge Eastern points of view, and (3) long-held negative image towards the peoples or groups who happened to be at the front-line of the population groups exposed to the epidemic. The third factor is the most important source of denial. AIDS denial is not a new and isolated phenomenon but the one shaped by the global and historical institutions. Asian AIDS denial reflects the authoritarian and moralist grievances arising from the perceived deterioration of traditional moral order.
Topics: Acquired Immunodeficiency Syndrome; Asia; Attitude to Health; Denial, Psychological; Health Policy; Humans
PubMed: 17548124
DOI: 10.1016/j.healthpol.2007.04.011 -
CMAJ : Canadian Medical Association... Aug 1992OBJECTIVE: To examine the extent and the significance of the psychologic mechanism of denial in coronary heart disease. This problem is known to be frequent, but its... (Review)
Review
OBJECTIVE: To examine the extent and the significance of the psychologic mechanism of denial in coronary heart disease. This problem is known to be frequent, but its significance remains controversial. DATA SOURCES: From the bibliographies of recent publications, the author traced 21 empirical studies on denial in coronary heart disease published during the last 25 years. STUDY SELECTION: For a chronologic and historical approach all the studies were retained. The oldest had a qualitative and descriptive approach; the most recent used a scale of measurement. DATA EXTRACTION: This review examines the clinical data found in the publications and does not critically analyse the measurement tools. RESULTS: The results show that the ambiguity of the question arises from three aspects that have to be clarified: (1) there is a difference between the short-term effect and the long-term effect of denial in coronary heart disease; (2) part of the contradictory results could be linked to the scale of measure; and (3) the concept of denial is a notion that is used in an equivocal way that is not clarified even by the precision of the scale of measurement. CONCLUSIONS: Persistence of denial would have negative effects in the long term. The scale of Hackett and Cassem is useful in measuring denial in the acute stage but not in the rehabilitation stage. The very notion of denial is used ambiguously in several of the studies examined.
Topics: Coronary Disease; Denial, Psychological; Humans
PubMed: 1643597
DOI: No ID Found -
Psychopathology 2019Denial of pregnancy (DOP) is a challenging condition with poorly understood psychopathology. DOP is reported to be associated with problems such as severe psychological...
Denial of pregnancy (DOP) is a challenging condition with poorly understood psychopathology. DOP is reported to be associated with problems such as severe psychological conflicts, obstetric complications, risks to the newborn, and difficulties in bonding with the infant. In this paper, we present and discuss the clinical manifestations of a severe form of DOP that lasted until the time of delivery with resultant multifaceted complications. Our paper highlights the severity of psychopathology and the need for coordinated management. Descriptions from different cultural backgrounds would improve the conceptual understanding of DOP.
Topics: Adult; Denial, Psychological; Female; Humans; Pregnancy; Pregnancy Complications; Psychopathology
PubMed: 31593965
DOI: 10.1159/000503151 -
Nature Medicine Mar 2010
Topics: Attitude; Denial, Psychological; Humans; Knowledge; Science
PubMed: 20208495
DOI: 10.1038/nm0310-248a