Causal Attribution, Perceived Control, and Recovery from a Heart Attack

At 7 weeks and at 1 year after their first heart attack, 269 men were interviewed about their causal attributions for the attack and their perceptions of personal control over this and future attacks. They and their treating physicians also provided information on the severity of cardiac disease symptoms at 1 year. Attributions to personal behavior, stress, other people, luck, and heredity, and the total number of attributions for the attack, were moderately stable over the time span studied. At each time, subjects accorded relatively greater causal influence to personal behavior and stress. These two attributions were also associated with beliefs that the attack was avoidable and that further attacks could be prevented by personal actions as well. The 7-week attributions and perceived control did not predict illness severity at 1 year. Analyses that controlled for earlier attributions and social class showed that patients with more severe illness at 1 year made greater attributions to other people and to stress and more attributions at 1 year than did patients with less severe illness outcomes. Blaming others at 1 year was also related to less perceived control over future attacks. The 1-year attributions to stress were associated with perceived control over future attacks only among sicker patients. The findings imply that attributions are sensitive to differences in recovery from heart attacks and play a greater role in efforts to restore control when illness symptoms become more severe.