Voth Jennifer, Sirois Fuschia M
Department of Psychology, University of Windsor, Windsor, Ontario, Canada N9B 3P4.
Rehabil Psychol. 2009 Feb;54(1):99-108. doi: 10.1037/a0014739.
S. C. Roesch and B. Weiner's (2001) theoretical model of adjustment to chronic illness was adapted to examine the role of attributions, avoidant coping strategies, and disease severity in the psychological adjustment of people with inflammatory bowel disease (IBD). RESEARCH METHOD AND DESIGN: People with IBD (N = 259) completed an online survey including measures of health-related self-blame and responsibility attributions, disease severity, avoidant coping strategies, and psychological adjustment indexes (coping efficacy, acceptance, and helplessness).
Structural equation modeling revealed that avoidant coping mediated the relationship between attributions and psychological adjustment. Attributions of self-blame were directly related to increased avoidant coping, which was in turn associated with poor adjustment. Beliefs about responsibility were associated with decreased use of avoidant coping strategies and subsequently improved psychological adjustment. Higher scores on disease severity were linked to the use of avoidant coping strategies and poor psychological adjustment.
Distinguishing between self-blame and responsibility attributions has important implications for understanding the psychological adjustment of individuals with IBD and may be useful for creating intervention strategies aimed at enhancing the psychological functioning of people with IBD.
采用S.C. 罗斯奇和B. 维纳（2001年）的慢性病适应理论模型，研究归因、回避应对策略和疾病严重程度在炎症性肠病（IBD）患者心理适应中的作用。研究方法与设计：IBD患者（N = 259）完成了一项在线调查，包括与健康相关的自责和责任归因、疾病严重程度、回避应对策略以及心理适应指标（应对效能、接受度和无助感）的测量。
结构方程模型显示，回避应对在归因与心理适应之间起中介作用。自责归因与回避应对增加直接相关，而回避应对又与适应不良相关。对责任的信念与回避应对策略的使用减少相关，进而改善了心理适应。疾病严重程度得分越高，与回避应对策略的使用和心理适应不良相关。
区分自责和责任归因对于理解IBD患者的心理适应具有重要意义，可能有助于制定旨在增强IBD患者心理功能的干预策略。
