Causal beliefs about mental illness: A scoping review.

Research on causal beliefs about mental illness-the beliefs people hold about what causes a particular mental illness, or mental illnesses in general-is split across a number of theories and disciplines. Although research on this subject has provided a number of insights and practical applications, the diversity of theories, terminology, and keywords makes it challenging for a new reader to gain a comprehensive understanding. We sought to address this by conducting a systematic scoping review of research on causal beliefs. This review included English-language articles from any year that mentioned causal beliefs for mental illness in their title or abstract. We identified articles in two stages. In the first stage, we used a narrow set of search terms referring specifically to causal beliefs (1227 records identified, 417 included). In the second stage, we used a comprehensive set of terms relevant to research on causal beliefs (10,418 records identified, 3838 included). We analyzed articles qualitatively, organizing them into one of five theories or categories: the common-sense model of self-regulation, explanatory models, mental health literacy, biogenetic causal beliefs, and other research on causal beliefs. We provide a comprehensive summary of these literatures in terms of their history, typical research questions and study design, findings, and practical applications. These theories differ in their theoretical orientation towards causal beliefs, research methods, findings, and applications. However, they broadly share a view of causal beliefs as multifaceted, culturally determined, and relevant for additional psychosocial variables such as mental illness stigma and help-seeking. We conclude by making recommendations for researchers, clinicians, public health messaging, and for individuals with mental illness.

Development and validation of a scale to assess the belief that 'age causes illness'.

OBJECTIVES: Self-directed ageism is the application of stereotypic age-related beliefs to oneself, and is known to negatively impact health-related motivation (Levy, 2003;  2022). This study focused on the specific self-directed stereotype that 'age causes illness' and aimed to develop and test a multi-item measure to assess this implicit, limiting belief. METHODS AND MEASURES: Survey data was collected from N = 347 adults in southeastern Idaho (ages 45-65 years old, 60% female). A variety of measures were used to assess the discriminant, convergent and predictive validity of the Age Causes Illness scale including: socio-demographics (age, sex, education), psychosocial resources (personality, optimism, social support, depressive symptoms), health/aging expectations, and indicators of physical health. RESULTS: The seven-item Age Causes Illness scale is reliable and shows an expected pattern of discriminant and convergent correlations with relevant socio-demographic, psychosocial, and aging-related measures. The belief that 'age causes illness,' as assessed with this new scale, is related to both objective and subjective indicators of physical health. CONCLUSIONS: The Age Causes Illness scale is a brief screening tool, potentially applicable in behavioral health settings as an initial step toward discussion of the implicit, and often unchallenged, belief that age alone determines the onset, progression, and offset of illness.

Causal attributions of failure among post graduate medical residents in exit fellowship examination in Pakistan: A qualitative study.

Background and Objective: Causal attributions are reasons given to certain events in life including failure and success. The objective of this qualitative study was to explore the attributions perceived as the cause of failure by post graduate residents, failing the final clinical exit examination of Fellowship of College of Physicians and Surgeons Pakistan (FCPS). Methods: This exploratory study was conducted from July 2021 to July 2022, at Jinnah Hospital, Lahore. Study population was selected by purposeful maximal variation sampling. A total of ten post graduate residents from four specialties, failing in FCPS part two clinical examination were included. After written informed consent, semi structured face to face, in depth interviews were conducted. Data saturation was achieved after eight interviews after which two more interviews were carried out. All interviews were recorded and transcribed verbatim. Thematic analysis of the data was done by synthesizing codes into categories and themes. Results: A total of 17 attributions noted were grouped into five categories namely 'Inadequate exam preparation', 'Personal factors,' 'Exam related factors,' 'Training related factors and 'Luck'. Two main themes of External and Internal factors emerged from these. Common attributions were; lack of effort (8/10), inadequate knowledge (8/10), family commitments (7/10), luck (8/10) and examiner's attitude (5/10). Conclusions: Most of the residents attributed internal, unstable and controllable factors like inadequate knowledge and lack of effort. In addition, external uncontrollable factors of bad luck and harsh attitude of examiners were considered as contributory factors towards failure.

Erratum: Perception, beliefs, and causal attribution of autism early signs in Ecuadorian general population.

[This corrects the article DOI: 10.3389/fpsyg.2022.915817.].

Does explaining psychogenic nonepileptic seizures using either a biomedical or biopsychosocial framework affect young people's illness representations? An experimental vignette study.

Lay representations of psychogenic nonepileptic seizures (PNES) are important both for understanding public stigma and anticipating patient responses to PNES diagnosis. The current study presents the first evidence of the general public's representations of PNES and the malleability of these understandings to different ways of explaining PNES. An online experimental study exposed participants (n = 193, aged 18-25 years) to a vignette describing a case of PNES in biomedical terms, PNES in biopsychosocial terms, or epilepsy. Subsequent questionnaires assessed participants' illness representations, causal attributions, and stigmatising attitudes regarding the case about which they read. Results suggest that compared with biomedical framings, biopsychosocial explanations increased perceptions of PNES as threatening. While epilepsy was attributed to significantly more biological and less social causes than either of the PNES vignettes, causal attributions did not differ between biomedically- vs. biopsychosocially-framed PNES. Neither were there any differences between the three conditions in stigmatising attitudes towards people who experience seizures. These findings are useful for clinicians delivering a PNES diagnosis and patients disclosing a PNES diagnosis, in helping anticipate responses to these communications. Further research is required to confirm the clinical and societal significance of the study's first insights into the dynamics of lay responses to PNES.

"There is a God or There is No God-It is in the Hands of God:" Fatalistic Beliefs Among Israeli People About Cancer and Their Impact on Behavioral Outcomes.

This qualitative study examined fatalistic beliefs and cancer causal attributions among people without cancer. Participants were 30 Israeli women and men aged 51-70 from diverse sociocultural backgrounds who participated in four focus groups. Three main themes emerged, referring to the variability in fatalistic beliefs of cancer occurrence and cancer outcome, the duality in attributing causality to divine providence and mere luck or chance, and the connection between distinct fatalistic beliefs and health behaviors. Data analysis enabled an expansion of the understanding of cancer fatalism as a multidimensional structure, whereby interactions between causality attribution and different fatalistic beliefs are related to prevention and screening behaviors.

Understanding children's voices about enablers of obesity from a causal attribution's stance: a vignette study.

OBJECTIVE: Childhood obesity is a public health challenge with health, economic and psychosocial consequences. The design of interventions addressing childhood obesity seldom considers children's perspectives on the topic. Weiner's causal attribution framework was used to explore children's perspectives on enablers of obesity. METHODS AND MEASURES: Children (N = 277) responded to a vignette with an open-ended question. Data were analyzed using content analysis. RESULTS: Children perceived internal, unstable and controllable causes (e.g. dietary intake, self-regulation and emotionality) as the main enablers (76.53%) of obesity, while some (11.91%) highlighted external, unstable and controllable causes (e.g. parent food restrictions). A focus on children with healthy body weight showed that they mentioned more internal, stable and controllable causes for obesity than children with unhealthy body weight/obesity did. The latter mentioned more external, unstable and controllable causes than their counterparts. CONCLUSIONS: Understanding children's causal attributions for obesity is expected to deepen our knowledge of obesity enablers and help design interventions matching children's perspectives.

Psychometric Properties of the Causal Attributions Scale for Reading Comprehension / Propiedades psicométricas de la Escala de Atribuciones Causales para la Comprensión Lectora / Propriedades psicométricas da Escala Atribuições de Causas para a Compreensão de Leitura

Causal attributions, achievement goals, and self-efficacy comprise the motivational dimension of self-regulated learning. Due to the absence of scales to assess the causal attributions of Brazilian middle school students, this study aimed to investigate the psychometric properties of the Causal Attributions Scale for Reading Com-prehension. The study involved three samples: one of the expert judges and two composed of students. Evidence of content validity was found through theo-retical and practical representativeness and the intel-ligibility of the scale items. The associations between the attributional causes and psychological dimensions proved validity based on the scale's internal structure. The effects identified in the comparisons between the scale and achievement goals, and the scale and self-efficacy indicated validity based on the relationship with other variables. This instrument can be recom-mended for use by professionals in psychology and education. We also suggest the performance of further studies with the scale.

Las atribuciones causales, los objetivos de logro y la autoeficacia constituyen la dimensión motivacional del aprendizaje autorregulado. Debido a la ausencia de escalas para evaluar las atribuciones causales de estudiantes brasileños de enseñanza fundamental, en este estudio investigamos las propiedades psicométricas de la Escala de Atribuciones Causales para la Comprensión Lectora. Este análisis involucró tres muestras: una de jueces expertos y dos formadas por estudiantes. Se encontró evidencia de validez de contenido a través de la representatividad teórica y práctica, y por medio de la inteligibilidad de los ítems de la escala. Los resultados de las asociaciones entre las causas atribucionales y las dimensiones psicológicas proporcionaron evidencia de validez basada en la estructura interna. Los efectos identificados en las comparaciones entre la escala y metas de logro, y la escala y autoeficacia, indicaron evidencia de validez basada en la relación con otras variables. Este instrumento puede ser recomendado para su uso por profesionales en psicología y educación. También se sugiere la realización de más estudios con la escala

Atribuições causais, metas de realização e autoeficácia constituem a dimensão motivacional da aprendizagem autorregulada. Devido à ausência de escalas para avaliar as atribuições causais de estudantes brasileiros do ensino fundamental, neste estudo investigamos as propriedades psicométricas da Escala Atribuições de Causas para a Compreensão de Leitura. Este estudo envolveu três amostras: uma amostra de juízes especialistas e duas amostras compostas por estudantes. Encontrouse evidência de validade de conteúdo através da represen-tatividade teórica e prática e por meio da inteligibilidade dos itens da escala. Os resultados das associações entre as causas atribuídas e as dimensões psicológicas forneceram evidências de validade com base na estru-tura interna. Os efeitos identificados nas comparações entre a escala e os objetivos de realização, e a escala e autoeficácia indicaram evidências de validade com base na relação com outras variáveis. Recomendamos que este instrumento seja utilizado por profissionais da psicologia e da educação. Outros estudos com a escala também são sugeridos.

Adjustment Mechanisms in the Acute Phase of Myocardial Infarction in Men.

AIM: Stress and Coping Model and Post-Traumatic Growth Theory indicate adjustment procedures concepts after a crisis. The objective of this study was to assess the relationships between causal attributions, coping strategies and post-traumatic growth in male patients with acute myocardial infarction and variable cardiac function severity. METHODS: Seventy-eight male patients surviving a myocardial infarction, were divided into two sub-groups based on left ventricular ejection fraction measurements [Group A (left ventricular ejection fraction: <45%, n = 34), Group B (left ventricular ejection fraction: ≥45%, n = 44)] and were interviewed after the acute phase of myocardial infarction, on the last day of their coronary unit stay. Medical data was obtained from their medical records. Causal Attributions' List, Coping Orientation to Problems Experienced and Post-Traumatic Growth Inventory were used. RESULTS: Causal attributions were found to be related to active coping, emotional support, religious coping and self-blame in both groups. Planning, positive reinterpretation and active coping were the strategies associated positively with most of the post-traumatic inventory subscales in total data analyses. CONCLUSIONS: Diverse coping strategies were associated with posttraumatic growth factors. It is important to assess adjustment mechanisms in the acute phase of myocardial infarction. A tailored scheme therapy, considering patient's needs, has to be planned.

Self-reported causes of cancer among 6881 survivors with 6 tumour types: results from the PROFILES registry.

OBJECTIVE: Our aim was to describe and compare self-reported causal attributions (interpretations of what caused an illness) among cancer survivors and to assess which sociodemographic and clinical characteristics are associated with them. METHODS: Data from five population-based PROFILES registry samples (i.e. lymphoma (n = 993), multiple myeloma (n = 156), colorectal (n = 3989), thyroid (n = 306), endometrial (n = 741), prostate cancer (n = 696)) were used. Causal attributions were assessed with a single question. RESULTS: The five most often reported causal attributions combined were unknown (21%), lifestyle (19%), biological (16%), other (14%), and stress (12%). Lymphoma (49%), multiple myeloma (64%), thyroid (55%), and prostate (64%) cancer patients mentioned fixed causes far more often than modifiable or modifiable/fixed. Colorectal (33%, 34%, and 33%) and endometrial (38%, 32%, and 30%) cancer survivors mentioned causes that were fixed, modifiable, or both almost equally often. Colorectal, endometrial, and prostate cancer survivors reported internal causes most often, whereas multiple myeloma survivors more often reported external causes, while lymphoma and thyroid cancer survivors had almost similar rates of internal and external causes. Females, those older, those treated with hormonal therapy, and those diagnosed with prostate cancer were less likely to identify modifiable causes while those diagnosed with stage 2, singles, with ≥2 comorbid conditions, and those with endometrial cancer were more likely to identify modifiable causes. CONCLUSION: In conclusion, this study showed that patients report both internal and external causes of their illness and both fixed and modifiable causes. This differsbetween the various cancer types. IMPLICATIONS FOR CANCER SURVIVORS: Although the exact cause of cancer in individual patients is often unknown, having a well-informed perception of the modifiable causes of one's cancer is valuable since it can possibly help survivors with making behavioural adjustments in cases where this is necessary or possible.

Causal attributions and OCD treatment response: A linguistic analysis of OCD patients' self-reported etiological explanations in intensive residential treatment.

In the present study, 43 obsessive-compulsive disorder (OCD) patients receiving cognitive-behavior therapy (CBT)/exposure and response prevention (ERP) in an intensive residential treatment program responded to an open-ended question about causal attributions (i.e., personal explanations for the etiology of their OCD) at baseline and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at baseline and treatment discharge. Baseline self-reported responses about causal attributions were qualitatively coded to derive predictors (biological/genetic, environmental, psychological, and interactional attributions). Predictors were entered into a binary logistic regression with Y-BOCS responder status (at least partial response [≥25% pre-post reduction] vs. no response) as the outcome. After controlling for length of stay and number of comorbid psychiatric diagnoses, only biological/genetic attributions uniquely predicted increased odds of treatment response, odds ratio = 10.04, p = 0.03. Biological/genetic attributions may reduce self-blame for symptoms or increase expectancy violation likelihood during treatment, thereby improving odds of response. Clinicians should assess OCD patients' causal attributions as part of routine clinical care to hopefully optimize treatment outcomes.

Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals.

BACKGROUND: There is evidence that culture deeply affects beliefs about mental illnesses' causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking. METHODS: We carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public. RESULTS: More than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p < .001), knowledge (F = 88.7, p < .001), and help-seeking attitudes (F = 32.4, p < .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants. CONCLUSION: Interventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations.

Cross-cultural differences in depression between White British and South Asians: Causal attributions, stigma by association, discriminatory potential.

OBJECTIVES: Numerous facets of public and internalized mental illness stigma have been established. This study focuses on the stigma of being associated with someone with depression and cultural differences between a Western and an Eastern culture. The aim was to compare White British and South Asians living in the United Kingdom regarding their causal explanations for depression, stigma towards people with depression and stigma by association. DESIGN: A cross-sectional design. METHODS: White British and South Asians (N = 137) in the United Kingdom completed a survey measuring attributions about the aetiology of depression, discriminatory potential towards people with depression and stigma by association. RESULTS: Results revealed that South Asians attributed greater supernatural, moral and psychosocial causes to depression, while White British endorsed greater biological beliefs. South Asians reported a greater discriminatory potential towards people with depression (lower willingness for closeness, greater desire for social distance) than White British. They also indicated greater affective, cognitive and behavioural stigma by association. Stigma by association mediated the relationship between cultural group and willingness for closeness as well as desire for social distance. Perceived dangerousness was a mediator for willingness for closeness. CONCLUSIONS: These findings suggest that a greater consideration of the role of culture in the understanding of mental health is important to combat stigma towards individuals with depression and those close to them across Western and Eastern cultures.

The association between pain-related factors and psychological distress in patients with temporomandibular disorder.

Chronic pain is associated with high levels of psychological distress, which can have implications for general functioning, acceptance, quality of life, and compliance with health-promoting behaviour. This study explored the association between pain-related factors and psychological distress in a sample of patients with long lasting temporomandibular disorder (TMD). In this cross-sectional study design, psychological distress was measured in 133 Norwegian patients with long lasting and severe TMD. Participants completed a survey including the hospital anxiety and depression scale (HADS), and questions about pain intensity, pain duration, catastrophizing, and causal attributions of their TMD symptoms along with a clinical interdisciplinary investigation. Higher levels of catastrophizing were associated with psychological distress. Pain intensity was associated with psychological distress in the unadjusted model, but not when controlling for the other variables. The majority attributed their TMD symptoms to physical factors. The findings support psychological interventions aimed at reducing catastrophizing in treatment of TMD. However, the patients emphasized physical causes for their TMD symptoms, suggesting that psychological interventions alone are not sufficient. The findings support a multidisciplinary approach to the treatment of TMD.

Atribuciones sobre las causas de la pobreza general e infantil en Argentina / Attributions on the causes of general and child poverty in Argentina

Resumen El estudio acerca de las causas de la pobreza ha sido influenciado por la teoría de la atribución, lo que permitió identificar los juicios predominantes que las personas establecen sobre tales causas. Los estudios locales sobre las atribuciones causales de la pobreza son escasos y no se ha identificado ninguno referido a las causas de la pobreza infantil, a pesar de las altas tasas de su incidencia en el país. Así, el presente estudio propone evaluar las atribuciones causales de la pobreza general e infantil por parte de adultos de Argentina, empleando dos cuestionarios (uno sobre las causas de la pobreza en general y el otro sobre la pobreza infantil en particular) implementados de manera virtual. La muestra incluyó a 1 659 participantes (17 a 90 años), quienes debieron indicar la importancia de cada ítem como causa de la pobreza en una escala tipo Likert de cinco puntos. En cuanto al cuestionario sobre las causas de la pobreza general, el análisis exploratorio permitió identificar una estructura de tres factores -similar a la identificada en otros estudios: individualista, estructurales y fatalistas-, la cual no fue verificada en el análisis confirmatorio. Con respecto al cuestionario sobre las causas de la pobreza infantil, se identificó y se confirmó un modelo de dos factores (que podrían estar relacionados con atribuciones estructurales y familiares) que representa una nueva evidencia en el campo. Los resultados sugieren diferencias en las atribuciones de las causas de pobreza general e infantil, cuyos posibles mecanismos (e. g., modulación por parte de factores individuales, contextuales y culturales) deberían explorarse en estudios futuros.

Abstract In the last decades, different studies have addressed the perspectives of people regarding the causes of poverty, as they could play a fundamental role in the development of individual and social attitudes, beliefs and expectations towards people living in such a condition, and in the strategies implemented to solve related problems and issues. In addition, many of those studies have investigated the causes of poverty using the theoretical model proposed by Feagin (1972), which suggests three broad explanations: (1) individualistic (i. e., causal attribution is placed on the poor themselves); (2) structural (i. e., poverty is due to external social and economic factors); and (3) fatalistic (i. e., poverty is attributed to factors such as bad luck). Most of those studies have been carried out considering the causes of poverty in general, which means that there is very little research aimed at studying specifically the causes of child poverty. Given the high incidence of poverty in Argentina the knowledge about such perspectives is of interest for multiple basic and applied purposes. In this sense, the present study proposed to evaluate the attributions of the causes of poverty in general and child poverty in particular, by adults from Argentina, through two virtual questionnaires (one asking for the causes of poverty in general, and the other for the causes of child poverty). The sample included responses from 1 659 citizens of Argentina from 17 to 90 years old (M = 45.72, SD = 16.94). The questionnaires included 32 items aimed at evaluating the attribution of causes of general poverty, and 30 items related to child poverty. Participants were asked to indicate the importance of each item as a cause of poverty on a five-point Likert-type scale (1 = does not matter; 5 = extremely important). Exploratory and confirmatory factor analyses were implemented (separately from the general and child questionnaires) and retained items with factor loadings at .40 or above. In addition, for the general questionnaire, a second approach was implemented to analyze if the factorial structure supported by different studies in the literature was confirmed in this sample. For such a purpose, confirmatory factor analyses were implemented. Regarding the questionnaire for the causes of general poverty, the exploratory analysis allowed identifying a three-factor structure (as in the case of other studies) (RMSEA = .071; CFI = .94; TLI = .93), which was not verified in the confirmatory analysis (RMSEA = .103; CFI = .88; TLI = .86). On the other hand, the results of the second approach suggest the confirmation of the two-factor model proposed in the literature (RMSEA = .083; CFI = .96; TLI = .95). This pattern of results suggests sensitivity to the inclusion of new items. In this sense, in future studies it would be important to invest efforts in determining new items from consultations with experts and other social actors. Regarding the questionnaire for the causes of poverty in children, two-factor model was identified and confirmed (RMSEA = .074; CFI = .94; TLI = .93), which is a new piece of evidence in the field, suggesting variability in the attribution of causes of poverty according to the considered age group, and whose potential mechanisms in comparison with the studies on adult poverty should be explored in future research (e. g., individual, contextual and cultural factors). Finally, this study confirms that having valid and reliable instruments to explore the causal attributions of general and child poverty would be important to advance in the understanding of poverty as a complex and multidimensional phenomenon.

Causal Attributions and Perceived Severity as Predictors of Posttraumatic Stress Symptoms after a First Myocardial Infarction / Atribuciones causales y gravedad percibida como predictores de síntomas de estrés post-traumático tras un primer infarto de miocardio

Recent meta-analyses have shown a significant link between symptoms of anxiety and depression, and cardiovascular diseases (CVDs). The presence of these symptoms has a direct impact on the course and the recovery from the CVDs. A less analyzed aspect is the role played by the stress induced by the onset of CVDs conditions and, especially, by acute myocardial infarction (AMI). In this study, we assessed posttraumatic stress symptoms (PTSS), emotional state, health habits, and subjective perception of the event and causal attributions regarding the infarct, in a sample of 76 patients who had suffered an AMI in the previous 48-72 hours. Structural equation analyses and path analyses showed that the severity of PTSS was predicted by the perceived severity of the AMI and by two specific beliefs (i.e., considering that the AMI is a hereditary condition and that the help of others will not be beneficial). The results suggest the possibility of early identification of patients with a higher risk of suffering a high level of stress derived from the AMI. Based on this evidence, we discuss the possibilities of making effective interventions to reduce these symptoms, often ignored in clinical practice, and improve the medical and psychological prognosis of people with AMI.(AU)

Metanálisis recientes han demostrado una asociación significativa entre los síntomas postraumáticos y las enfermedades cardiovasculares (ECV). La presencia de este tipo de síntomas psicopatológicos tiene un impacto directo en el curso y la recuperación de dichas enfermedades. Un aspecto menos estudiado es el papel que juega el estrés provocado por la vivencia de una enfermedad cardiovascular, y, en especial, por el infarto agudo de miocardio (IAM). En este estudio se evaluaron los síntomas postraumáticos, el estado emocional, los hábitos de salud, la percepción subjetiva del suceso y las atribuciones causales respecto al infarto, en una muestra de 76 pacientes que habían sufrido un IAM en las 48-72 horas previas. El análisis de ecuaciones estructurales y el análisis de sendero (path analysis) mostraron que tanto la gravedad percibida del IAM, como dos creencias concretas (considerar que el infarto es un problema hereditario y que la ayuda de otros no es beneficiosa), predecían la gravedad percibida de los síntomas postraumáticos. Los resultados sugieren la posibilidad de identificar precozmente a los pacientes con mayor riesgo de sufrir un alto nivel de estrés derivado del IAM, gracias a sus atribuciones y su percepción de la gravedad del infarto. En base a esta evidencia, se discuten las posibilidades de realizar intervenciones efectivas para reducir estos síntomas y mejorar el pronóstico de las personas que han sufrido un IAM.(AU)

What Causes Cancer in Women with a gBRCA Pathogenic Variant? Counselees' Causal Attributions and Associations with Perceived Control.

Laypersons have a strong need to explain critical life events, such as the development of an illness. Expert explanations do not always match the beliefs of patients. We therefore assessed causal attributions made by women with a pathogenic germline variant in BRCA1/2 (gBRCA1/2-PV), both with and without a cancer diagnosis. We assumed that attributions would be associated with the control experience. We conducted a cross-sectional study of N = 101 women with a gBRCA1/2-PV (mean age 43.3 ± 10.9). Women answered self-report questionnaires on perceived causes and control. Most women (97%) named genes as a causal factor for the development of cancer. Surprisingly, the majority of women also named stress and health behavior (both 81%), environment (80%), and personality (61%). Women with a cancer diagnosis tended to endorse more causes. The attributions to personality (ρ = 0.39, p < 0.01) health behavior (ρ = 0.44, p < 0.01), and environment (ρ = 0.22, p < 0.05) were significantly associated with personal control, whereas attribution to genes showed a small, albeit significant association with treatment control (ρ = 0.20, p < 0.05). Discussing causal beliefs in clinical counseling may provide a "window of opportunity" in which risk factors and health behaviors could be better addressed and individually targeted.

Multilevel causal attributions on transboundary risk: Effects on attributions of responsibility, psychological distance, and policy support.

This study used two randomized experiments in a prospective design (Study 1 N = 297, Study 2 N = 296) to examine how multilevel causal attribution dimensions (internal vs. external to an individual or a country) shape domestic and foreign policy support to counter transboundary risk. Results from Study 1 and 2 showed that external-country (vs. internal-country) causal attribution reduced perceptions of internal-country attributions of responsibility, which had a cross-lagged effect on support for domestic-industry policies to mitigate the risk. In contrast, perceptions of external-country attributions of responsibility increased support for foreign policies in a 2-week follow up. This study offers theoretical insights into the demarcation of multilevel causal attribution dimensions in studying media framing effects. It also highlights some important causal mechanisms of how media frames shape public support for policies aimed at transboundary risk mitigation.

Perception, Beliefs, and Causal Attribution of Autism Early Signs in Ecuadorian General Population.

The identification and diagnosis of children with autism currently rely on behavioral presentation and developmental history. Cultural norms and other socio-demographic factors can influence what is expected or non-expected behaviors in a developing child. Perceptions, beliefs, and causal attribution of early signs can influence families' help-search behaviors. Lack of recognition of autism's first manifestations can critically delay the age of diagnosis, the provision of informed guidance to families, and the implementation of adapted interventions during the critical period of early development. Furthermore, a lack of understanding of early signs as the manifestations of a developmental condition may increase stigma and non-conventional explanations. Still, cultural and socio-demographic factors are largely understudied, particularly in low-and middle-income settings. Based on the hypothesis that non-specialists such as family members and friends are one of the first sources of referral in Latin American contexts, we aimed to study the general population's perceptions and the explanatory causes of autism's early signs. One-hundred-and-eighty-three Ecuadorian adults responded to a questionnaire developed for this study, describing sixteen ASD-related behaviors. Results indicated that, with the exemption of language impairment and self-injurious behaviors, a substantial proportion of participants did not endorse many behaviors as "concerning and requiring professional attention." Also, language impairment was the only behavior identified as related to a developmental disorder. Additionally, most participants attributed the majority of behaviors listed in the questionnaire to causes unrelated to ASD, such as child personality. We discuss the impact of those findings in clinical practice and on awareness programs.

Mujeres abnegadas: The influence of gender expectations on the psychiatric encounter in Mexico.

Theories on the cause of mental and emotional distress contribute to illness course and treatment. The theorizing of women's experience "as problem" has been widely critiqued by feminist psychologists yet continues in clinical practice. This qualitative study reports on data collected in a psychiatric outpatient clinic in south/central Mexico on the culturally embedded causal theories of mental illness among Mexican patients, a family member or caregiver, and their psychiatrists. The author reports on the influence of gender expectations and the view of "women as problem" in Mexico. Specifically, stakeholders considered that the idea of "mujeres abnegadas" (self-sacrificing women) was the cause of illness in female patients diagnosed with depressive or anxiety-related disorders. In the face of gendered violence and abuse, Mexican women were expected to be silent and submissive, to suppress their thoughts and feelings, and to endure ("aguantar") their experiences to conform to gender-based expectations, and psychiatrists expressed little hope of alleviating women's suffering. The author discusses her findings in the context of broader sociocultural factors and globalizing forces in psychological theory and practice and provides future directions to help de-pathologize patients' distress, broaden awareness of the contextual forces that influence distress, and galvanize appropriate resources and support.