Attributions and health

People are often motivated to determine the causes of events: the more unexpected and disruptive the event, the more likely is the individual to ask, ‘Why did this happen?’ (Weiner, 1985). As the symptoms and diagnoses of illness are often unexpected and disruptive and may have threatening implications, we can expect health threats to stimulate preoccupation with questions of cause. As social psychologists suggested decades ago (Heider, 1958), causal, i.e. attributional, thinking can clarify the meaning of an event and define its long term implications. In this brief chapter we will address the following questions about the attributional facet of commonsense psychology: 1) do illnesses (symptoms and diagnoses) stimulate causal thinking, i.e. attributions, and when are these attributions most likely to be made? 2) how are attributions for health threats formed? 3) what kinds of attributions do people make? 4) what are the behavioural consequences of these attributions for the management of and adjustment to illness? 5) do attributions have long-term effects on health? Unfortunately, a straightforward review of results for each of these questions would be difficult to complete as there is considerable disagreement among published findings. Existing reviews of the literature in this area have also resulted in conflicting conclusions regarding questions such as the relationship of attributions to adjustment. Hall et al. (2003) reviewed 65 studies and found little evidence of a relationship between attributions and outcomes.