Attributions and Adjustment in End-Stage Renal Disease

Martina R. Rich
timoth W. Smith
Alan J. Christensen, University of Iowa

Abstract

Attributions have been found to influence theimpact of stressful life events. This study examined therole of attributions in emotional adjustment toend-stage renal disease (ESRD). The Illness Attributions Inventory (IAI) was developed to access threeattributions for problems created by ESRD and itstreatment -- self-blame, acceptance of responsibility,and other blame. Factor analyses and associations with measures of adjustment and personalitygenerally support the distinctiveness of these threedimensions, but suggested that self-blame and acceptanceof responsibility can also be seen as inversely related components of a single dimension. Inprospective analyses, high acceptance ofresponsibility/low self-blame was associated with betteremotional adjustment.The effects of other blame onadjustmentwere context-specific. Among patients reliant on dialysis staff, otherblame was associated with better adjustment over time.Among patients responsible for their own dialysistreatments, other blame was associated with worse adjustment over time.