Causal attribution and life-threatening disease

Our plain-English summary of Causal attribution and life-threatening disease, by C. Mumma, R. McCorkle (International Journal of Psychiatry in Medicine, 1982).

The study

• Authors: C. Mumma, R. McCorkle
• Journal: International Journal of Psychiatry in Medicine
• Published: 1982;12(4):311-9
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

When individuals are confronted with a diagnosis of serious disease, they try to understand why it has happened to them. The degree to which any individual can control his or her susceptibility to disease is not clear, but different diseases carry with them varying degrees of implied personal responsibility. For example, certain diseases (heart attack, stroke, cancer) have associated risk factors. Presumably, avoiding these risk factors will have some effect on a person's chance of developing those diseases. The purpose of this secondary analysis was to describe patients' attributed causes for two groups of individuals recently diagnosed with either lung cancer or myocardial infarction. Content analysis was done on the responses to an open-ended question about the cause of their disease for 108 subjects at Interview 1 and for 100 subjects at Interview 2. The most frequent causal explanations given by post myocardial infarction subjects in this study were related to life style, which could be interpreted as self-blame or self responsibility for what had happened to them. In contrast, the subjects with lung cancer more consistently said that they did not know what caused their disease, or mentioned a combination of life style (smoking) and external factors (exposure to noxious fumes or asbestos).

In plain English

This was a secondary analysis of interview data from a project on coping with lung cancer or myocardial infarction (heart attack). It obtained 67 newly diagnosed lung cancer patients from radiation departments and 71 newly diagnosed heart attack patients from coronary care units in a Northwest metropolitan area. Of these, 56 and 65 completed interviews about one and two months after diagnosis. Patients were asked what they believed brought about their illness; answers were analyzed for 108 subjects at the first interview and 100 at the second. Asbestos exposure was not measured. It appeared only in one answer category, "noxious fumes, chemicals, asbestos." At the first interview, lung cancer patients gave 75 responses: "don't know" (27), smoking (24) and that category (12). At the second they gave 62: smoking (26), "don't know" (15) and that category (8). Counts are responses, not patients; some people named several causes. The authors concluded that heart attack patients mainly named life-style causes, while lung cancer patients tended to name smoking or noxious fumes or asbestos at work.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Secondary analysis of interview data, using a short-term longitudinal design that compared two disease groups on two occasions
• Who was studied: 67 people newly diagnosed with lung cancer, recruited from the radiation departments of four medical centers, and 71 people newly diagnosed with myocardial infarction, recruited from coronary care units in the same Northwest metropolitan area. 56 cancer and 65 heart attack patients completed interviews at both occasions, about one and two months after diagnosis. Answers about cause were analyzed for 108 subjects at Interview 1 and 100 at Interview 2.
• Exposure: No asbestos or other exposure was measured. The study recorded patients' own beliefs about what caused their disease. Asbestos appears only as part of one category of patient answers: exposure to noxious fumes, chemicals, asbestos.
• Main results:
  • Lung cancer patients, Interview 1 (75 responses): don't know (27), smoking (24), noxious fumes, chemicals, asbestos (12; printed as "1 2" in the scan)
  • Lung cancer patients, Interview 2 (62 responses): smoking (26), don't know (15), noxious fumes, chemicals, asbestos (8)
  • Myocardial infarction patients: at Interview 1 (125 responses) stress/worry/tension (30), don't know (20), smoking (15); at Interview 2 (96 responses) stress/worry/tension (28), don't know (15), smoking (14), weight/diet (14)
  • All subjects combined: Interview 1 gave 190 causal explanations from 108 subjects, most often don't know (47), smoking (39) and stress/worry/tension (33). Interview 2 gave 158 from 100 subjects, most often smoking (40), don't know (36) and stress/worry/tension (30).
  • Seeing themselves as at least somewhat responsible for their disease: at Interview 1, 31 lung cancer subjects (from a total of 65 with complete data) and, for myocardial infarction subjects, a number the article prints as "forty-two to sixty". At Interview 2, 29 of 55 cancer subjects and 41 of 55 myocardial infarction subjects.
  • Lung cancer patients (n = 56) and myocardial infarction patients (n = 65) did not differ significantly in mean Acknowledged Awareness scores. Cancer patients scored 7.57 at Interview 1 and 7.34 at Interview 2; heart patients scored 6.68 and 7.05.
• The authors' conclusion: The authors concluded that post-myocardial infarction patients most often gave life-style explanations, which could be interpreted as self-blame or self-responsibility. Lung cancer patients tended to attribute their disease to smoking or to noxious fumes or asbestos at work. The authors also wrote that more lung cancer than myocardial infarction patients consistently said they did not know the cause. They suggested it would be useful for professionals to gather such information from patients.
• Limitations the authors state:
  • The awareness measure captured only what subjects were willing to tell interviewers. It could not separate patients who were aware but denying from those who were unaware.
  • Income figures may be misleading because twenty subjects did not report their incomes.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Attribution, Lung Cancer.

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