Self-blame attributions, control appraisals and distress among cardiac rehabilitation patients

This study examined associations between self-blame attributions, control appraisals and distress among cardiovascular disease patients participating in a cardiac rehabilitation (CR) programme. Questionnaire data were collected from 129 patients at the beginning and end of CR. We found little evidence that characterological self-blame (CSB) affects distress symptoms, but behavioural self-blame at the beginning of CR was positively associated with distress symptoms concurrently, and 12 weeks later. Furthermore, diet- and exercise-focused self-blame was only modestly, positively related to control appraisals concurrently, while CSB was negatively associated with control. Prospectively, we found few significant associations between self-blame and control. Results imply that making any type of self-blame attribution during CR does not aid in adjustment or enhanced control appraisals. Our findings suggest that CR staff should encourage patients to recognise their control over reducing risk for recurrence, but should discourage patients from looking backward and ruminating about factors that may have contributed to disease onset.