The role of self-blame and responsibility in adjustment to inflammatory bowel disease.

Abstract

Objective: Roesch and Weiner's (2001) theoretical model of adjustment to chronic illness was adapted to examine the role of attributions, avoidant coping strategies, and disease severity in the psychological adjustment of people with inflammatory bowel disease (IBD). Research Method/Design: People with IBD (N = 259) completed an online survey including measures of health-related self-blame and responsibility attributions, disease severity, avoidant coping strategies, and psychological adjustment indices (coping efficacy, acceptance, and helplessness).Results: Structural equation modeling revealed that avoidant coping mediated the relationship between attributions and psychological adjustment. Attributions of self-blame were directly related to increased avoidant coping, which were in turn associated with poor adjustment. Beliefs about responsibility were associated with decreased use of avoidant coping strategies and subsequently improved psychological adjustment. Higher scores on disease severity were linked to the use of avoidant coping strategies and poor psychological adjustment. Conclusions:Distinguishing between self-blame and responsibility attributions has important implications for understanding the psychological adjustment of individuals with IBD, and may be useful for creating intervention strategies aimed at enhancing the psychological functioning of people with IBD.

A Qualitative Study of Perceived Responsibility and Self-Blame in Type 2 Diabetes: Reflections of Physicians and Patients

“…For patients with chronic conditions other than diabetes, self-blame is associated with poor psychological adjustment, depressive symptoms, and ineffectual coping. 53,[56][57][58] In diabetes, self-blame may result from challenges managing the complex self-care regimen along with the potential for poor treatment outcomes, which can amplify a sense of failure and lead to self-blame. 54,59 In our study, patients described feeling a sense of personal failure when not achieving treatment goals.…”

“…Selfblame is not a new concept in chronic disease management. [51][52][53][54][55][56][57] Self-blame may be an unintended consequence of the emphasis on patients' increased involvement in chronic disease management and their accepting greater responsibility for self-care. For patients with chronic conditions other than diabetes, self-blame is associated with poor psychological adjustment, depressive symptoms, and ineffectual coping.…”

Self-Compassion, Stress, and Coping in the Context of Chronic Illness

“…In the context of chronic illness, self-blame is associated with poor adjustment to chronic tinnitus (Sirois et al, 2006), and is linked to poor psychological well-being in patients with IBD (Voth & Sirois, 2009). Given that self-compassionate individuals treat themselves with kindness rather than harsh self-judgment in the face of a stressor, we expect that self-compassion will be negatively related to self-blame coping.…”

“…Optimistic beliefs are linked to better adjustment outcomes in people with arthritis (Fournier, de Ridder, & Bensing, 2002). Similarly, acceptance, predicts better adjustment in both IBD (Voth & Sirois, 2009) and arthritis (Pinto-Gouveia, Costa, & Marôco, 2013). But, in the context of chronic illness distraction coping is not maladaptive as Allen and Leary (2010) suggest, but adaptive (Compas, Jaser, Dunn, & Rodriguez, 2012).…”

“…In patients with arthritis approach coping is linked to better psychological outcomes such as life satisfaction and lower psychological distress and depression (Treharne, Lyons, Booth, & Kitas, 2007;Vriezekolk, van Lankveld, Geenen, & van den Ende, 2011). In contrast, escape-avoidance coping is associated with poor outcomes including psychiatric distress (Jones et al, 2006), helplessness and less illness acceptance (Voth & Sirois, 2009) in patients with IBD, and psychological distress in patients with arthritis (Ramjeet, Smith, & Adams, 2008;Vriezekolk et al, 2011). Evidence is limited for positive reappraisals.…”