Attention versus avoidance: attributional search and denial after myocardial infarction.

OBJECTIVE

In this study the focus was on two strategies: denial (an avoidant strategy) and causal thinking (an attention strategy) and their relationships to affect after myocardial infarction.

DESIGN

Descriptive, correlational.

SETTING

Large rural medical center.

SAMPLE

The sample comprised 152 recently hospitalized patients with first-time myocardial infarction.

MEASURES

A denial scale, a question about causal thinking, and an affect adjective checklist measuring anxiety, hostility, and depression.

RESULTS

Denial had a weak but significant negative correlation with anxiety (r = -0.18, p < 0.05). However, denial was not significantly related to either depression or hostility. Regression analysis indicated that both denial (F = 4.84, p = 0.02) and the interaction of denial with causal search (f = 4.77, p = 0.009) were predictors of affect. The interaction indicated that those with high denial who had not searched for a cause were least anxious. A large number of subjects used both attention and avoidant strategies.

CONCLUSIONS

The main effect for denial suggests that avoidance is a more effective strategy for reducing anxiety after myocardial infarction than causal search, an attention strategy. However, the fact that many subjects used both strategies suggests that they are not mutually exclusive in the process of adaptation after a heart attack.