Illness attributions, perceptions of stigma and coping strategies: Adjusting to inflammatory bowel disease

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The present study examined the personal and perceived illness attributions made by patients with inflammatory bowel disease (IBD) and then investigated the relationships between illness attributions, coping strategies and psychological adjustment. An archival data set of 290 IBD patients included self-reported measures of personal and perceived illness attributions, coping strategies and psychological adjustment. The results demonstrated clear differences between personal and perceived illness attributions. For example, IBD patients were more likely to indicate that other people attributed the cause of their illness to internal and controllable factors, whereas the patients themselves attributed the cause to internal and uncontrollable factors. Attributions were indirectly related to psychological adjustment when IBD patients used avoidant coping strategies. Furthermore, attributions were both directly and indirectly associated with psychological adjustment when either problem-focused or emotion-focused coping strategies were used. Additionally, trait optimism was positively related to beliefs about responsibility for one's health and negatively related to feelings of self-blame, while trait neuroticism was positively related to self-blame. Disease severity was also found to have a negative impact on psychological adjustment, independent of the coping strategy employed. Interpretations of these results suggest the need for interventions that focus on positively reframing illness attributions and symptom management.