The role of denial in recovery from coronary heart disease

J. Levine, S. Warrenburg, R. Kerns, G. Schwartz, R. Delaney, A. Fontana, A. Gradman, S. Smith, S. Allen, R. Cascione

Research output: Contribution to journalArticlepeer-review

154 Scopus citations


This longitudinal study investigated the relationship between denial of illness and the course of recovery in patients with coronary heart disease. Using a newly developed interview instrument, the Levine Denial of Illness Scale (LDIS), the level and modes of denial were assessed in 45 male patients who were hospitalized for myocardial infarction or for coronary bypass surgery, of whom 30 were followed for 1 year after discharge. The reliability, internal consistency, and validity of the LDIS were found to be satisfactory. Furthermore, the LDIS showed discriminant validity from trait measures of denial. LDIS scores were not associated with severity of illness or risk factors. High deniers spent fewer days in intensive care and had fewer signs of cardiac dysfunction during their hospitalization relative to low deniers. However, in the year following discharge, high deniers adapted more poorly than low deniers: high deniers were more noncompliant with medical recommendations and required more days of rehospitalization. The findings suggest that denial of illness is adaptive during acute hospital recovery, but is maladaptive in the long-run after hospital discharge.

Original languageEnglish (US)
Pages (from-to)109-117
Number of pages9
JournalPsychosomatic medicine
Issue number2
StatePublished - 1987

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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