Illness understanding, causal attributions and emotional reactions in wives of myocardial infarction patients

This study addresses lay illness understanding and attributions, including attribution of blame, in wives of myocardial infarction (MI) patients concerning the causes of MI. The present study also investigates the association between illness attributions and emotional adjustment, and the associations of relevant third variables with illness attributions. A sample of 37 wives were interviewed during the acute phase of the illness, three months and 10 years post-index MI. Attributions of the MI to multiple causes were common with an strong emphasis on psychosocial risk factors, but attributional content showed a low consistency over time. In retrospect, the wives believed they could have done more to prevent the MI, but self-blame was not a significant issue. However, they blamed the patient for not taking preventive actions. Attributions were not related to background and illness characteristics or denial in any strong and consistent manner. In a short-term perspective, attributing the MI to stress causes and husbands' personality was associated with worse emotional adjustment. Also, the use of magical explanations and blame of the patient were related to a poorer emotional outcome for the wife. The causal attributions made by the wives during the acute phase did not influence the emotional adjustment after 10 years.