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The Lancet. Planetary Health Oct 2020
Topics: Animals; Biodiversity; Communication; Denial, Psychological; Economic Development; Extinction, Biological; Humans; Politics; Science
PubMed: 33038313
DOI: 10.1016/S2542-5196(20)30229-1 -
Advances in Psychosomatic Medicine 2012The term illness behavior was introduced by Mechanic and Volkart to describe the individuals' different ways to respond to their own health status. Pilowsky's concept of... (Review)
Review
The term illness behavior was introduced by Mechanic and Volkart to describe the individuals' different ways to respond to their own health status. Pilowsky's concept of abnormal illness behavior encompasses several clinical conditions characterized by a maladaptive mode of experiencing, perceiving, evaluating and responding to one's own health status. The concept of somatization was criticized because it implies the presence of psychological distress or an underlying psychiatric disturbance when an organic cause for somatic symptoms is not found. Thus, more atheoretical terms , such as functional somatic symptoms and medically unexplained symptoms, were introduced. Both Kellner's Symptom Questionnaire and Derogatis' Symptom Checklist-90 include a scale for somatic symptoms, and other questionnaires were specifically designed to measure their frequency and severity. Kellner's Illness Attitude Scales appear to be the gold standard for the measurement of the hypochondriacal spectrum, which includes several clinical conditions, such as nosophobia, thanatophobia and health anxiety. The assessment of illness denial should consider that a certain degree of denial may sometimes prevent patients from overwhelming psychological distress resulting from life-threatening or stigmatized diseases. Denial may concern both physical and psychiatric symptoms. Specific instruments are available for both types of denial. The cognitive and emotional representations developed by subjects when they have to cope with an illness or a perceived health threat are subsumed under the concept of illness perception and may be assessed by the Brief Illness Perception Questionnaire.
Topics: Adaptation, Psychological; Attitude to Health; Awareness; Denial, Psychological; Humans; Hypochondriasis; Illness Behavior; Mental Disorders; Personality Assessment; Personality Inventory; Psychophysiologic Disorders; Somatoform Disorders
PubMed: 22056904
DOI: 10.1159/000330015 -
Journal of Hospice and Palliative Care Sep 2021End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress,... (Review)
Review
End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.
PubMed: 37674559
DOI: 10.14475/jhpc.2021.24.3.135 -
Journal of General Internal Medicine Feb 2019When suicide happens close to doctors, students, and faculty, to our families, friends, colleagues, students, residents, fellows and patients, it challenges us as... (Review)
Review
When suicide happens close to doctors, students, and faculty, to our families, friends, colleagues, students, residents, fellows and patients, it challenges us as individuals and as members of institutions that seek to provide safety and support. The US suicide rate has increased and suicide remains difficult to predict or to prevent despite its association with depression and addiction. It is less common in medical students and residents than in the general, age-matched population but generates troubling, complex aftershocks for us. Individuals react according to their history and style, through stages, psychological defenses, and difficult affects. Grief, shock, anger, denial, and guilt are prevalent. People responding to a close suicide seek information, asking "why", "what if" and "if only", despite the speculative nature of attempting to understand what happened and why. Nearby suicide may be more challenging for us in the medical profession because the helplessness it evokes undermines our sense of omniscience and omnipotence. Thus, we engage in retrospection and a search for preventive interventions that may or may not be evidence based, salutary, or healing.
Topics: Faculty, Medical; Female; Grief; Humans; Male; Patients; Physicians; Social Support; Students, Medical; Suicide; Suicide Prevention
PubMed: 30426344
DOI: 10.1007/s11606-018-4734-x -
Translational Andrology and Urology Aug 2017The objectives of patient selection and counseling are ultimately to enhance successful outcomes. However, the definition for success is often narrowly defined in... (Review)
Review
The objectives of patient selection and counseling are ultimately to enhance successful outcomes. However, the definition for success is often narrowly defined in published literature (ability to complete surgery, complications, satisfaction) and fails to account for patient desires and expectations, temporal changes, natural history of underlying diseases, or independent validation. Factors associated with satisfaction and dissatisfaction are often surgery-specific, although correlation with pre-operative expectations, revisions, and complications are common with most procedures. The process of appropriate patient selection is determined by the integration of patient and surgeon factors, including psychological capacity to handle unsatisfactory results, baseline expectations, complexity of case, and surgeon volume and experience. Using this model, a high-risk scenario includes one in which a low-volume surgeon performs a complex case in a patient with limited psychological capacity and high expectations. In contrast, a high-volume surgeon performing a routine case in a male with low expectations and abundant psychiatric reserve is more likely to achieve a successful outcome. To further help identify patients who are at high risk for dissatisfaction, a previously published mnemonic is recommended: CURSED Patient (compulsive/obsessive, unrealistic, revision, surgeon shopping, entitled, denial, and psychiatric). Appropriate patient counseling includes setting appropriate expectations, reviewing the potential and anticipated risks of surgery, post-operative instruction to limit complications, and long-term follow-up. As thorough counseling is often a time-consuming endeavor, busy practices may elect to utilize various resources including educational materials, advanced practice providers, or group visits, among others. The consequences for poor patient selection and counseling may range from poor surgical outcomes and patient dissatisfaction to lawsuits, loss of credibility, or even significant patient or personal harm.
PubMed: 28904893
DOI: 10.21037/tau.2017.07.19 -
Journal of General Internal Medicine Apr 2015Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external... (Review)
Review
Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture that emphasizes perfectionism, denial of personal vulnerability, and delayed gratification. Professional coaching, long utilized in the business world, provides a results-oriented and stigma-free method to address burnout, primarily by increasing one's internal locus of control. Coaching enhances self-awareness, drawing on individual strengths, questioning self-defeating thoughts and beliefs, examining new perspectives, and aligning personal values with professional duties. Coaching utilizes established techniques to increase one's sense of accomplishment, purpose, and engagement, all critical in ameliorating burnout. Coaching presumes that the client already possesses strengths and skills to handle life's challenges, but is not accessing them maximally. Although an evidence base is not yet established, the theoretical basis of coaching's efficacy derives from the fields of positive psychology, mindfulness, and self-determination theory. Using a case example, this article demonstrates the potential of professional coaching to address physician burnout.
Topics: Burnout, Professional; Directive Counseling; Humans; Physicians; Stress, Psychological
PubMed: 25527340
DOI: 10.1007/s11606-014-3144-y -
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 -
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 -
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 -
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