Dimensions of verbal denial in myocardial infarction: Correlates to 3 denial scales

The concept of denial in medical patients was reviewed, and problems in the past research on denial was noted. A questionnaire developed to assess different aspects of denial in myocardial infarction was tested in a group of 367 patients. A factor analysis of the questionnaire gave 3 independent factors, termed Denial of Illness, Denial of Impact, and Suppression. This finding gave support to the model that guided the construction of the questionnaire, and also casted some doubt on the validity of using either single specific or global criteria in assessing denial. Multiple regression analyses, including a series of medical, psychological and social variables, showed that social desirablity and external health locus of control contributed to the prediction of high scores on all 3 scales. Denial of Illness was furthermore associatd with less previous cardiac disease and a less severe index MI, whereas Denial of Impact was related to indicators of more optimistic attitudes. Suppression was related to indicators of lower socio-economic status and less cardiac health knowledge. The 3 scales should be further examined in relation to outcome after a myocardial infarction.