Symptom experiences, symptom attributions, and causal attributions in patients following first-time myocardial infarction.

We examined symptom experiences, symptom attributions, and causal attributions reported by patients hospitalized for a first-time myocardial infarction (MI). We also explored the roles of symptoms, negative affect, and risk factors in promoting stress and other causal attributions. Patients (N = 65) completed measures of symptom experiences and attributions, perceived causes of their MI, state and trait negative affect, and risk factors. Patients attributed most of their symptoms to the heart condition, although rates varied from 48% (headaches) to 97% (nausea). The most common causal attribution was stress, followed by high cholesterol, heredity, fat consumption, and hypertension. Stress attributions were positively associated with state anxiety and specific, stress-related symptoms (e.g., fatigue and breathlessness). Anxious mood and stress-related symptoms appear to enhance the plausibility of stress as a cause of MI. Risk factors were moderately correlated with associated causal attributions. For many patients, however, attributions to hypertension, cholesterol, and family history of heart disease were discordant with their clinical data. Causal attributions remained stable over the subsequent 6 months.