Attributions of responsibility and recovery within a no-fault insurance compensation system.
OBJECTIVE
Although a great deal of literature supports the negative relationship between postinjury health outcomes and compensation, it has not fully examined the relative influence of the diverse factors that underlie compensable status. In particular, this study sought to understand the relative influence that attributions of responsibility for accidents have on mental and physical health outcomes.


METHODS
Using a structural equation modeling approach, we assessed the strength of relationships between demographic and accident circumstance variables, and postinjury mental and physical health for 934 road-trauma survivors compensated under a single no-fault insurance system.


RESULTS
Analysis of direct and indirect effects demonstrated that although a range of standard demographic and accident circumstance variables influenced health outcomes, by far the greatest effect was generated from perceptions of responsibility for the accident. People who reported lower levels of responsibility for their accident showed significantly poorer mental and physical health outcomes.


CONCLUSIONS
Perceptions of responsibility for accidents are strongly associated with postaccident mental and physical health outcomes within compensable road trauma populations. Future studies should control for attributions of responsibility when assessing the effect of compensation, or any other variable, on health outcomes among injured populations. Mechanisms underlying the effect of attributions of responsibility on outcomes, particularly in relation to its association with self-blame, warrant further exploration.
IMPACT Strategic Research Centre, Deakin University, School of Medicine.
Jason
J
Thompson
IMPACT Strategic Research Centre, Deakin University, School of Medicine.
Michael
M
Berk
Department of Psychiatry, University of Melbourne.
Meaghan
M
O'Donnell
Centre for Women's Mental Health, Royal Women's Hospital.
Lesley
L
Stafford
Norwegian Institute for Alcohol and Drug Research.
Trond
T
Nordfjaern
D000063:Accidents, Traffic / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006304:Health Status; D006801:Humans; D007351:Insurance, Liability; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D017741:Survivors / Q000523:psychology*; D055815:Young Adult