Cognitive factors in adjustment to cancer: attributions of self-blame and perceptions of control

We examined attributions of behavioral and characterological self-blame and perceptions of control over disease progression and recurrence as predictors of symptoms of psychological distress in a sample of adult men and women with cancer. Data were obtained near the time of diagnosis and a 4-month follow-up. Initial levels of behavioral and characterological self-blame were unrelated to concurrent psychological distress. Initial characterological self-blame as well as the interaction of characterological and behavioral self-blame was predictive of psychological distress 4 months later. Perceptions of control over cancer recurrence were unrelated to psychological distress near diagnosis or at follow-up, and control beliefs did not function as a mediator of self-blame. Initial levels of psychological distress predicted characterological but not behavioral self-blame at follow-up, suggesting a reciprocal relationship between characterological self-blame and distress.