Misconceptions about Stroke: Causal Attributions for Stroke-Related Symptoms Reflect the Age of the Survivor

Abstract

With visible disabilities, observers tend to overgeneralise from the disability. In contrast, with invisible disabilities such as traumatic brain injury and stroke, observers often fail to allow for challenges resulting from the disability. Persons who have suffered a stroke claim that people misunderstand their symptoms and stigmatise them as a result of these symptoms. This misunderstanding, which happens particularly with young survivors of stroke, may reflect people's causal attributions for symptoms that follow a stroke. Using a scenario design, this cross-sectional study examined whether people attribute ambiguous symptoms that may result from stroke to other causes (the stroke survivor's personality and age) and whether these attributions reflect the age of the stroke survivor. Participants (N = 120) read scenarios describing a male who was aged either 22, 72, or whose age was unstated and who showed four symptom changes: fatigue, depression, irritability and reduced friendships. For each symptom change, participants rated three causal attributions: the person's age, his personality and stroke. The age of the person in the scenario affected attributions; when the person in the scenario was 22, participants attributed his symptoms significantly more to his personality than to his age or stroke, whereas when he was 72, participants attributed his symptoms more to his age than to his personality or stroke and when his age was unstated, they attributed his symptoms equally to age, stroke and personality. Because misattributions for stroke symptoms hinder rehabilitation, therapy can target people's misattributions to enhance rehabilitation for survivors of stroke.

Enablers and barriers in hospital‐to‐home transitional care for stroke survivors and caregivers: A systematic review

“…Most stroke survivors live with declined functioning such as poor balance, incontinence, swallowing difficulties, visual disturbances and psychological and cognitive disorders (Jokinen et al, 2015;Wainwright et al, 2017). Hospital readmissions are common after discharge and are associated with increased morbidity, mortality and risk of early institutionalisation (Abreu et al, 2020;Reeves et al, 2019).…”

‘I am not who you think I am’: public stigma and invisible brain injury (‘No soy quien creen que soy’: estigma público y daño cerebral invisible)

“…Following the same line of reasoning, other authors (McClure et al, 2008; Wainwright et al, 2017) have found that the public tends to attribute invisible impairments to personality traits of the survivors or the age group to which they belong. Wainwright et al (2017) found that fatigue and depression in group of young people with stroke were attributed to their personality (availability heuristic: ‘he/she is like that’) and not to their stroke. In another study, McClure et al (2008) showed members of the general public photographs of an adolescent survivor of TBI who exhibited behavioural disorders.…”

“…Diversos autores (McClure et al, 2008; Stergiou-Kita et al, 2017; Wainwright et al, 2017) han señalado que las secuelas invisibles luego de un DCA son frecuente fuente de estigma público. El estigma público refiere a aquellas actitudes del público hacia los sobrevivientes de un DCA (Foster et al, 2016), y ha sido definido como un complejo constructo social que se origina de la interacción de cuatro componentes: (1) etiquetar diferencias identificadas en una persona; (2) vincular estas diferencias a estereotipos negativos; (3) categorizar a las personas que tienen esta diferencia dentro del exogrupo (‘ellos, las personas con lesión cerebral’) y distinguirlas del endogrupo (‘nosotros, las personas sin lesión cerebral’); y (4) pérdida de estatus y discriminación a las personas del exogrupo (Link & Phelan, 2001).…”

“…Several authors (McClure et al, 2008; Stergiou-Kita et al, 2017; Wainwright et al, 2017) have pointed out that invisible impairments resulting from ABI are a frequent source of public stigma. Public stigma refers to public attitudes towards ABI survivors (Foster et al, 2016) and has been defined as a complex social construct that originates from the interaction of four components: (1) labelling human differences; (2) associating these differences with negative stereotypes; (3) categorizing people who have this difference into the out-group (‘them, those people with brain injury’) and distinguishing them from the in-group (‘us, people without brain injury’); and (4) loss of status and discrimination of people in the out-group (Link & Phelan, 2001).…”

“…Bernard Weiner (1985) and Patrick Corrigan et al (2003) developed two models that have been widely used in populations with mental health conditions: the attribution theory and the danger appraisal model. In the ABI literature, certain authors (Foster et al, 2016; McClure et al, 2008; Wainwright et al, 2017) have applied these models to explain the stigma attached to ABI survivors. The lack of information and little familiarity the general public has with ABI have also been highlighted as variables that influence the stigmatization of this population (Ralph & Derbyshire, 2013).…”