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Published Online:https://doi.org/10.1176/jnp.14.1.52

This study explored the proposition that denial of addiction is often more a product of cognitive failure due to cerebral dysfunction than an emotion-driven rejection of the truth. Forty-four subjects were studied in an inpatient alcohol rehabilitation program. Denial was defined as the proportion of standardized denial-related treatment goals established at admission that remained unachieved at discharge. Cognitive deficiencies were identified through neuropsychological assessments. Persistent denial was significantly correlated with greater impairment of executive function, verbal memory, visual inference, and mental speed.