Goldbeck R
Carswell House, Glasgow, UK.
J Psychosom Res. 1997 Dec;43(6):575-93. doi: 10.1016/s0022-3999(97)00168-2.
Denial is a concept often encountered in literature describing patients' psychological responses to physical illness. Definitions and theories of denial have drawn on clinical, cognitive, psychodynamic, organic, and interpersonal frameworks. Denial is related to other concepts such as lack of insight, self-deception, and anosognosia. Empirical studies have yielded mixed results with regard to the adaptive properties of denial. These results require interpretation in the light of: (1) the definitional complexities of denial; (2) the diversity of methods used for its assessment; and (3) the choice of different clinical samples and heterogeneous outcome measures. The clinical management of maladaptive denial poses a challenging problem which requires consideration of factors pertaining to the patient, the illness, the treating clinician, as well as the patient's social environment. To achieve further clarification of the role of denial in physical illness, future research would benefit from clearer definitions and more refined, consistent methods of assessment. A number of recommendations are outlined.
否认是一个在描述患者对身体疾病心理反应的文献中经常遇到的概念。否认的定义和理论借鉴了临床、认知、心理动力学、器质性和人际关系等框架。否认与其他概念相关，如缺乏洞察力、自我欺骗和疾病失认症。关于否认的适应性属性，实证研究得出了喜忧参半的结果。这些结果需要根据以下几点进行解读：（1）否认定义的复杂性；（2）用于评估否认的方法的多样性；（3）不同临床样本的选择和异质性结果测量。适应不良否认的临床管理是一个具有挑战性的问题，需要考虑与患者、疾病、治疗临床医生以及患者社会环境相关的因素。为了进一步阐明否认在身体疾病中的作用，未来的研究将受益于更清晰的定义和更精细、一致的评估方法。本文概述了一些建议。
