Scale development and psychometric properties of the Cardiac Self-Blame Attributions scale in patients with cardiovascular disease
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Updated: Feb 6, 2026

In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
Kadie M Harry1, Kymberley K Bennett1, Jacob M Marszalek1
1University of Missouri-Kansas City, USA.
Insights
This study introduces a new scale to measure how patients with cardiovascular disease attribute blame to their behaviors or character. The Cardiac Self-Blame Attributions scale offers a reliable tool for understanding patient perspectives on their heart disease.
Area of Science:
- Cardiology
- Psychology
- Health Outcomes Research
Background:
- Cardiovascular disease patients may attribute their condition to behaviors or character.
- Previous research on self-blame effects on health outcomes is mixed.
- A lack of validated, multiple-item measures may explain inconsistent findings.
Purpose of the Study:
- To develop and validate a reliable and multi-item scale measuring cardiac self-blame attributions.
- To differentiate between behavioral and characterological self-blame in cardiovascular disease patients.
- To provide a psychometric tool for future research on cardiac attributions.
Main Methods:
- Development and testing of an 11-item Cardiac Self-Blame Attributions scale.
- Data collection via questionnaires from 121 patients with cardiovascular disease.
- Factor analysis to determine scale structure, reliability, and validity.
Main Results:
- The Cardiac Self-Blame Attributions scale demonstrated a robust two-factor structure.
- The scale explained 65% of the variance in self-blame attributions.
- The scale exhibited good reliability and discriminant validity.
Conclusions:
- The developed Cardiac Self-Blame Attributions scale is a reliable and valid psychometric instrument.
- The scale can be utilized to investigate how patients attribute their cardiovascular disease.
- This tool may help clarify the impact of self-blame on health outcomes in cardiovascular disease.
Abstract:
Patients with cardiovascular disease may attribute their cardiovascular disease to their behaviors (behavioral self-blame) or to their dispositions (characterological self-blame). However, findings are mixed on the effects of behavioral self-blame and characterological self-blame on health outcomes, possibly because there are no validated, multiple-item measures. This study developed and tested an 11-item Cardiac Self-Blame Attributions scale via questionnaire data from 121 patients with cardiovascular disease. Results yielded a two-factor structure that explained 65 percent of the variance, with good reliability and discriminant validity. Findings suggest that the scale is reliable and valid and can be used to understand the cardiac attributions patients create.
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