title: Lack of relationship between psychological denial and unawareness of illness in schizophrenia-spectrum disorders.
abstract: Numerous theories have been proposed to explain the unawareness of illness that is commonly seen in schizophrenia-spectrum disorders, including the theory that unawareness is the result of a psychological denial mechanism used to mitigate the emotional consequences of having a psychiatric illness. The present study was an attempt to determine whether increased denial (in the form of self-deception) is associated with impaired awareness, consistent with the denial theory. Participants included 40 patients with schizophrenia-spectrum disorders and 25 healthy comparison participants. Patients' levels of awareness and symptom attribution were assessed through interview, and all participants completed self-report questionnaires measuring mood symptoms as well as their use of self-deception. Awareness of negative symptoms was associated with increased depression. However, self-deception was not significantly correlated with awareness measures. When patients were divided on the basis of their awareness and attribution scores, no group differences emerged regarding use of self-deception. The patient group and the healthy comparison group did not differ in their use of self-deception. The current results do not support the psychological denial theory of unawareness of illness in schizophrenia-spectrum disorders.
authors.affiliation: Neuropsychology Program, Department of Psychiatry, Dartmouth Medical School/DHMC, One Medical Center Drive, Lebanon, NH 03756-0001, USA.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Kruck
authors.forename: Laura A
authors.initials: LA
authors.lastname: Flashman
authors.forename: Robert M
authors.initials: RM
authors.lastname: Roth
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Koven
authors.forename: Thomas W
authors.initials: TW
authors.lastname: McAllister
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Saykin
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001364:Awareness / Q000502:physiology*; D003717:Denial, Psychological; D005260:Female; D006801:Humans; D055809:Illness Behavior; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012649:Self Concept; D013223:Statistics as Topic