Rossi Ferrario Silvia, Giorgi Ines, Baiardi Paola, Giuntoli Laura, Balestroni Gianluigi, Cerutti Paola, Manera Marina, Gabanelli Paola, Solara Valentina, Fornara Roberta, Luisetti Michela, Omarini Pierangela, Omarini Giovanna, Vidotto Giulio
Psychology Unit, Istituti Clinici Scientifici Maugeri SpA SB, Veruno, NO, Italy.
Psychology Unit.
Neuropsychiatr Dis Treat. 2017 Mar 23;13:909-916. doi: 10.2147/NDT.S128622. eCollection 2017.
Interest in assessing denial is still present, despite the criticisms concerning its definition and measurement. We tried to develop a questionnaire (Illness Denial Questionnaire, IDQ) assessing patients' and caregivers' denial in relation to their illness/disturbance.
After a preliminary study, a final version of 24 dichotomous items (true/false) was selected. We hypothesized a theoretical model with three dimensions: denial of negative emotions, resistance to change, and conscious avoidance, the first two composing the actual Denial and the last representing an independent component of the illness denial behavior. The IDQ was administered to 400 subjects (219 patients and 181 caregivers) together with the Anxiety-Depression Questionnaire - Reduced form (AD-R), in order to assess concurrent validity. Confirmatory factor analysis (CFA), internal consistency indices (Cronbach's α and McDonald's ω), and test-retest analysis were performed.
CFA and internal consistency indices (Cronbach's α: 0.87-0.96) indicated a clear and meaningful three-factor structure of IDQ, for both patients and caregivers. Further analyses showed good concurrent validity, with Denial and its subscale negatively associated with anxiety and depression and avoidance positively associated with anxiety and depression. The IDQ also showed a good stability ( from 0.71 to 0.87).
The IDQ demonstrated good psychometric properties. Denial of negative emotions and resistance to change seem to contribute to a real expression of denial, and conscious avoidance seems to constitute a further step in the process of cognitive-affective elaboration of the illness.
尽管对否认的定义和测量存在批评，但对评估否认的兴趣依然存在。我们试图开发一份问卷（疾病否认问卷，IDQ），以评估患者及其照顾者对自身疾病/障碍的否认情况。
经过初步研究，最终选定了一份包含24个二分制项目（是/否）的问卷。我们假设了一个具有三个维度的理论模型：对负面情绪的否认、对改变的抗拒以及有意识的回避，前两个维度构成实际的否认，最后一个维度代表疾病否认行为的一个独立组成部分。IDQ与简化版焦虑-抑郁问卷（AD-R）一同施用于400名受试者（219名患者和181名照顾者），以评估同时效度。进行了验证性因素分析（CFA）、内部一致性指标（克朗巴赫α系数和麦克唐纳ω系数）以及重测分析。
CFA和内部一致性指标（克朗巴赫α系数：0.87 - 0.96）表明，IDQ对于患者和照顾者均呈现出清晰且有意义的三因素结构。进一步分析显示出良好的同时效度，否认及其子量表与焦虑和抑郁呈负相关，而回避与焦虑和抑郁呈正相关。IDQ还显示出良好的稳定性（范围为0.71至0.87）。
IDQ显示出良好的心理测量学特性。对负面情绪的否认和对改变的抗拒似乎有助于真正表达否认，而有意识的回避似乎构成了对疾病进行认知-情感加工过程中的进一步阶段。
