Spontaneous, elicited and cued causal attributions in the year following a first myocardial infarction.

Objectives. To assess myocardial infarction (MI) patients' causal beliefs, how they change over time and the effects of different assessment methods.

Method. The study used a longitudinal design with a follow-up to 1 year. The participants were 100 MI patients who were recruited within 72 hours of admission. Each participant was interviewed;Ind their causal attributions (spontaneous, elicited and cued) were assessed using four different methods.

Results. 'Stress','smoking', 'it is in the family', 'eating fatty foods' and 'work' items were the most commonly mentioned causes for the MI at all times of measurement and across all measures. On each occasion 'stress' and 'smoking' were selected as the most important causes and patients made fewer attributions over time. Finally, the attributional assessment method used did not affect: type of attributions but fewer attributions were reported using the spontaneous method.

Conclusion. Patients do provide causal attributions following an MI. While many are similar to causal factors identified by medicine, patients appear to place more emphasis on stress'. As predicted by attribution cheery, attributions changed over time. The method of obtaining the attributions does not appear to affect the attributions made but greatly affects their number. While all the methods used have their place, the cued method with a list of possible attributions offers a rich return for effort expended.