title: Causal attributions among patients undergoing coronary artery bypass surgery: gender aspects and relation to depressive symptomatology.
abstract: Causal attributions made by patients for their coronary heart disease may contribute to gender differences in emotional adjustment. The purpose of this study was to determine gender differences in causal attributions and to analyze the associations between causal attributions and depressive symptomatology in patients undergoing coronary artery bypass graft (CABG) surgery. Nine hundred and seventy-nine patients (mean age 66.8 years, 19.9% women) completed a modified version of the Illness Perception Questionnaire (IPQ) and the depression module of the Patient Health Questionnaire (PHQ-9) 1-3 days before CABG-surgery and 1 year after surgery. Men were more likely to name their health behavior (men: 40.2%, women: 26.9%, P < .001) as a cause of disease, whereas women were more likely to cite destiny (women: 34.7%, men: 25.7%, P = .012). Regression analyses showed cross-sectional and longitudinal associations of attributions with depressive symptomatology which were independent of gender, sociodemographic and clinical variables. Attribution to personality and stress were associated with an increase in depressive symptomatology. Causal attributions may present a valuable approach for identifying patients at risk for depression and the implementation of targeted interventions.
authors.affiliation: Berlin Institute of Gender in Medicine, Charité - Universitätsmedizin Berlin, Luisenstr. 65, 10117 Berlin, Germany. anne.dunkel@charite.de
authors.forename: Anne
authors.initials: A
authors.lastname: Dunkel
authors.forename: Friederike
authors.initials: F
authors.lastname: Kendel
authors.forename: Elke
authors.initials: E
authors.lastname: Lehmkuhl
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Vera
authors.initials: V
authors.lastname: Regitz-Zagrosek
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001294:Attitude to Health; D001026:Coronary Artery Bypass / Q000523:psychology*; D003324:Coronary Artery Disease / Q000523:psychology / Q000601:surgery; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012737:Sex Factors