Causal Attributions Research Articles

Examining illness perceptions over time: an exploratory prospective analysis of causal attributions in individuals with depressive symptoms

BackgroundAccording to the Common-Sense Model of Illness Representations, illness beliefs, such as causal attributions, can influence the way people assess and cope with their illness and vice versa. To date, causal attributions in people with depressive symptoms have been studied mainly cross-sectionally, quantitatively and independently. The purpose of this study is to examine the causal attributions of people with depressive symptoms in terms of their stability over time, dependence on treatment experience, and differentiation of causal concepts.MethodsIn a population-based prospective sample, people with at least mild depressive symptoms (PHQ-9 Score ≥ 5) were interviewed via telephone at T0 and twelve months later (T1). Causal attributions were assessed using the Brief Illness Perception Questionnaire. After the open responses were qualitatively analysed using a deductive-inductive approach, stability over time was assessed for causal attributions and concepts by comparing answers between the two time points. Subsequent exploratory quantitative analyses were conducted using chi-square tests, t-tests, and logistic regression analyses.ResultsA total of 471 individuals (age M = 53.9, 53.6% female) with a mean PHQ-9 Score of 8.4 were included in the analyses. Causal attributions related to participants’ social environment, workplace, and past are the most stable over time. However, individuals with and without a time-stable causal concept showed no differences in terms of sociodemographic characteristics, severity of depressive symptoms, risk of comorbidity, and treatment experiences. Overall, the causal concepts of people with depressive symptoms appear to be very diverse. Those with treatment experience (M = 2.21, SD = 0.80) named significantly more causal attributions compared to people without treatment experience (M = 1.98, SD = 0.81, t(471) = -3.060, p < 0.01). In addition, logistic regression analyses revealed that treatment-experienced respondents were more likely to attribute “childhood/youth/parental home” and “predisposition”.ConclusionsOur study reveals that people with treatment experience tend to report treatment-congruent causal attributions, such as childhood and family environment, as well as predisposition, more frequently. Understanding how causal attributions and concepts are formed and change can be helpful for addressing causal attributions in treatment. Future studies should take into account the benefits of employing qualitative survey methods for exploring causal attributions.

Attribution to Classroom Disruptive Behavior: Insights from Secondary Teachers

Disruptive behavior in the classroom is a significant concern for teachers in schools across the globe. Extensive research has conclusively shown that effectively managing disruptive behavior in the classroom is a crucial factor that enhances the quality of instruction. The successful management of disruptive behavior in the classroom is influenced by various factors, including the causal attribution that a teacher assigns to the behavior. This study explored teachers’ perspectives on the factors contributing to disruptive behavior in the classroom. The study employed an interpretive paradigm and a qualitative approach with a case study research design. Data was generated via semi-structured interviews with six members of the School Management Team and a focus group interview with seven teachers from four purposively chosen Quintiles Three secondary schools. The findings showed that teachers attribute classroom disruptions to the characteristics and attributes of learners, contextual elements within schools, and external factors. The study concludes that these factors should be considered when developing classroom behavior strategies.

Risk of Acute Kidney Injury Following IV Iodinated Contrast Media Exposure: 2023 Update, From the AJR Special Series on Contrast Media.

Iodinated contrast material (ICM) has revolutionized the field of diagnostic radiology through improvements in diagnostic performance and the expansion of clinical indications for radiographic and CT examinations. Historically, nephrotoxicity was a feared complication of ICM use, thought to be associated with a significant risk of morbidity and mortality. Such fears often precluded the use of ICM in imaging evaluations, commonly at the expense of diagnostic performance and timely diagnosis. Over the past 20 years, the nephrotoxic risk of ICM has become a topic of debate, as more recent evidence from higher-quality studies now suggests that many cases of what was considered contrast-induced acute kidney injury (CI-AKI) likely were cases of mistaken causal attribution; most of these cases represented either acute kidney injury (AKI) caused by any of myriad other known factors that can adversely affect renal function and were coincidentally present at the time of contrast media exposure (termed "contrast-associated AKI" [CA-AKI]) or a manifestation of the normal variation in renal function that increases with worsening renal function. This Special Series Review discusses the current state of knowledge regarding CI-AKI and CA-AKI, including the incidence, risk factors, outcomes, and prophylactic strategies in the identification and management of these clinical conditions.

Simulation with a standardised patient to reduce stigma towards people with schizophrenia spectrum disorder among nursing students: A quasi-experimental study

ObjectivesThis study examined the effectiveness of simulation with a standardised patient on the perception of stigma associated with schizophrenia among undergraduate nursing students. It also assessed the reliability of the AQ-27 questionnaire in this context. MethodA quasi-experimental study without a control group was conducted on a non-probabilistic sample. The simulation programme used a standardised patient portrayed by a nurse with mental health experience. ResultsAfter simulation, statistically significant stigma improvements were found in six out of nine dimensions; anger and help obtained larger effect sizes (r = 0.392 and 0,307, respectively). Regarding gender, the intragroup analysis revealed that simulation improved stigma among women in six dimensions and among men in four dimensions, with anger and fear showing the highest effect size (r = 0.414 and 0.446, respectively).Regarding previous contact with mental illness among the study participants, the intergroup analysis did not show differences. In the intragroup analysis, simulation improved fear only in the contact group (p = 0,040, r = 0.353). In contrast, simulation changed the response in six dimensions in the no-contact group, similar to the entire group. ConclusionSimulation with a standardised patient is an effective teaching tool for reducing the stigmatisation of people with schizophrenia, thus reducing people's perception of internal causal attribution. It allows for experiencing situations that may be anticipated in clinical practice and reflectively addressing emerging aspects during simulation.

The efficacy of automated feedback after internet-based depression screening (DISCOVER): an observer-masked, three-armed, randomised controlled trial in Germany

Despite the availability of effective treatments, most depressive disorders remain undetected and untreated. Internet-based depression screening combined with automated feedback of screening results could reach people with depression and lead to evidence-based care. We aimed to test the efficacy of two versions of automated feedback after internet-based screening on depression severity compared with no feedback. DISCOVER was an observer-masked, three-armed, randomised controlled trial in Germany. We recruited individuals (aged ≥18 years) who were undiagnosed with depression and screened positive for depression on an internet-based self-report depression rating scale (Patient Health Questionnaire-9 [PHQ-9] ≥10 points). Participants were randomly assigned 1:1:1 to automatically receive no feedback, non-tailored feedback, or tailored feedback on the depression screening result. Randomisation was stratified by depression severity (moderate: PHQ-9 score 10-14 points; severe: PHQ-9 score ≥15 points). Participants could not be masked but were kept unaware of trial hypotheses to minimise expectancy bias. The non-tailored feedback included the depression screening result, a recommendation to seek professional diagnostic advice, and brief general information about depression and its treatment. The tailored feedback included the same basic information but individually framed according to the participants' symptom profiles, treatment preferences, causal symptom attributions, health insurance, and local residence. Research staff were masked to group allocation and outcome assessment as these were done using online questionnaires. The primary outcome was change in depression severity, defined as change in PHQ-9 score 6 months after random assignment. Analyses were conducted following the intention-to-treat principle for participants with at least one follow-up visit. This trial was registered at ClinicalTrials.gov, NCT04633096. Between Jan 12, 2021, and Jan 31, 2022, 4878 individuals completed the internet-based screening. Of these, 1178 (24%) screened positive for depression (mean age 37·1 [SD 14·2] years; 824 [70%] woman, 344 [29%] men, and 10 [1%] other gender identity). 6 months after random assignment, depression severity decreased by 3·4 PHQ-9 points in the no feedback group (95% CI 2·9-4·0; within-group d 0·67; 325 participants), by 3·5 points in the non-tailored feedback group (3·0-4·0; within-group d 0·74; 319 participants), and by 3·7 points in the tailored feedback group (3·2-4·3; within-group d 0·71; 321 participants), with no significant differences among the three groups (p=0·72). The number of participants seeking help for depression or initiating psychotherapy or antidepressant treatment did not differ among study groups. The results remained consistent when adjusted for fulfilling the DSM-5-based criteria for major depressive disorder or subjective belief of having a depressive disorder. Negative effects were reported by less than 1% of the total sample 6 months after random assignment. Automated feedback following internet-based depression screening did not reduce depression severity or prompt sufficient depression care in individuals previously undiagnosed with but affected by depression. German Research Foundation.

Predictors of alignment between aid donors’ and recipients’ interests in evaluating the effectiveness of the Shelter.Ukraine initiative: Contribution analysis

This article evaluates the effectiveness of the Shelter.Ukraine Initiative, a civic response to the humanitarian crisis resulting from Russia’s full-scale invasion of Ukraine. The Initiative aims to address pressing needs through a local umbrella funding approach. Utilizing an evaluative framework that combines multiple approaches, including causal attribution techniques, contribution analysis, and regression analysis, we assess the effectiveness of the Shelter.Ukraine Initiative. We uncover influencing factors that contribute to the Initiative success. These include organizational ambidexterity, learning-by-doing, inter-organizational structure, and advanced technology for financial resource distribution. Our findings underscore the importance of reconfiguring the humanitarian aid architecture to enhance effectiveness. In addition, we suggest that the insights gained from our study can inform future evaluations of humanitarian aid initiatives. By incorporating similar evaluative frameworks and methodologies, researchers can assess the effectiveness of other initiatives and identify key factors contributing to success.

An Empirical Investigation of the Relationships Among Self-Esteem, Depression and Self-Serving Bias in People with Internet Gaming Disorder.

People are generally characterized by a self-serving bias which describes the tendency to ascribe positive outcomes or success to internal or personal causes (self-enhancement motivation) and ascribe negative outcomes or failure to external or situational causes (self-protection motivation). It has been found that the individuals with internet gaming disorder (IGD) who have low self-esteem and high depression exhibit an attenuated self-serving bias. However, the relationships among self-esteem, depression and self-serving bias are not clearly identified. A sample of 138 IGD participants completed self-esteem and depression scales and a causal attribution task (Study 1) to examine the relationships among self-esteem, depression and self-serving bias (both self-enhancement and self-protection). In follow-up Study 2, 28 IGD participants were recruited to undertake self-affirmation intervention which can affirm one's sense of global self-view and bolster self-esteem to explore whether self-affirmation would trigger a reduction of depression and a raise of self-serving bias. The results of path analysis in Study 1 showed that the self-serving bias was predicted by self-esteem and depression, and the depression played a mediating role between self-esteem and self-serving bias. The results of Study 2 showed that the IGD participants reported higher self-esteem, lower depression and engaged in more self-protection motivation after affirming-self manipulation as compared with affirming-other manipulation. These findings suggest that self-esteem predicts self-serving bias through depression and self-affirmation could trigger an increase of self-esteem, further decrease depression and improve self-serving bias for the individuals with IGD. The present article clearly identified the relationships among these factors and provided a new approach to promote positive self-concept in individuals with IGD. Future research is warranted to explore the lasting benefits of self-affirmation on domains of education, relationships and gaming withdrawal for the individuals with IGD among different populations.

IF-City: Intelligible Fair City Planning to Measure, Explain and Mitigate Inequality.

With the increasing pervasiveness of Artificial Intelligence (AI), many visual analytics tools have been proposed to examine fairness, but they mostly focus on data scientist users. Instead, tackling fairness must be inclusive and involve domain experts with specialized tools and workflows. Thus, domain-specific visualizations are needed for algorithmic fairness. Furthermore, while much work on AI fairness has focused on predictive decisions, less has been done for fair allocation and planning, which require human expertise and iterative design to integrate myriad constraints. We propose the Intelligible Fair Allocation (IF-Alloc) Framework that leverages explanations of causal attribution (Why), contrastive (Why Not) and counterfactual reasoning (What If, How To) to aid domain experts to assess and alleviate unfairness in allocation problems. We apply the framework to fair urban planning for designing cities that provide equal access to amenities and benefits for diverse resident types. Specifically, we propose an interactive visual tool, Intelligible Fair City Planner (IF-City), to help urban planners to perceive inequality across groups, identify and attribute sources of inequality, and mitigate inequality with automatic allocation simulations and constraint-satisfying recommendations (IF-Plan). We demonstrate and evaluate the usage and usefulness of IF-City on a real neighborhood in New York City, US, with practicing urban planners from multiple countries, and discuss generalizing our findings, application, and framework to other use cases and applications of fair allocation.

Rethinking child behavior: Attribution retraining improves child educators' understanding and response

Adults' explanations for child behavior influence their response and, in turn, how child behavior and development progress. Various social-psychological factors (e.g., cognitive belief structures, developmental expectations) help determine the formation of attributions, which are characterized as largely stable. Nonetheless, research demonstrates that attributions can be restructured via attribution retraining (AR). The following study was the first to examine the impact of an AR intervention embedded within training in child development and traumatic stress response. Of particular interest was the malleability and stability of attributions of child behavior, and their contribution to discipline responses among 114 child educators (e.g., teachers, administrators). Post-training, there was a significant decrease in participants' causal attributions and unsupportive intervention preference and a significant increase in trauma-informed attitudes, largely maintained at one-year follow-up, suggesting that this training intervention offers a feasible and scalable method to integrate child development and trauma-informed care to improve perceptions of child behavior.

Is air pollution the original sin of firms? The impact of air pollution on firms' ESG scores

This is the first article to demonstrate the negative impact of air pollution as an informal institution on firms' ESG scores with listed manufacturing firms in China from 2010 to 2020. It is based on causal attribution theory and risk perception theory. We argue that, under the current ESG rating system, air pollution issues may be overly attributed to firms, resulting in decreased ESG scores. We find that when PM2.5 pollution concentration increases by 1 μg/m3, firms' ESG scores decrease by roughly 0.3 points. These results remained significant after a series of robustness tests and instrumental variable regressions. We find that firms in heavily polluting industries are almost twice as affected as those in non-heavily polluting industries. The negative impact on labor-intensive firms is also significantly higher than the impact on capital-intensive firms. State-owned firms and large-scale firms are less affected than private firms or small firms. The results show that information asymmetry is an important influencing mechanism. Firms can reduce the negative influence of air pollution through active information disclosure and external media reports. We note that air pollution can also decrease firms' ESG scores by increasing firm survival risks. Our results enrich the ESG literature and contribute to the understanding of the impact of informal institutions on firms' ESG scores.

Empathy helps, dehumanization harms: Beliefs about the causes of homelessness are (in)directly related to intentions to help and harm those who are unhoused

AbstractHomelessness is a complex social issue that can be attributed to a constellation of dispositional, situational, and health‐related causes. The extent to which these causal attributions are associated with the treatment of individuals experiencing homelessness, however, is not well understood. The current study addressed this gap by exploring the extent to which individual beliefs about the causes of homelessness were associated with intentions to help as well as endorsements of restrictions and legalistic harm aimed at those who are unhoused. Results demonstrated that structural and dispositional, but not health, attributions were associated with helpful and hurtful behaviors. Further, a structural equation model revealed that these effects were explained, in part, by empathy for and the dehumanization of individuals experiencing homelessness. Attributions were most clearly associated with intentions to help via empathy and endorsements of harm via distinct forms (animalistic and mechanistic) of dehumanization. Theoretical implications pertaining to Attribution Theory of Emotion and Motivation and the practical implications for improving the treatment of and support for individuals experiencing homelessness are also discussed.

Causal Attributions (Framing)

Causal Attributions (Framing)

Varieties of gratitude: Identifying patterns of emotional responses to positive experiences attributed to God, karma, and human benefactors.

Good fortune can be attributed to many sources, including other people, personal efforts, and various theistic and nontheistic supernatural forces (e.g., God, karma). Four studies (total N = 4,579) of religiously diverse samples from the United States and the United Kingdom investigated the distinct emotional reactions to recalled positive experiences attributed to natural and supernatural benefactors. We found that the hallmarks of interpersonal gratitude (e.g., thankfulness, admiration, indebtedness) were reported when believers attributed their good fortune to a personal, benevolent God. However, a distinct emotional profile arose when participants attributed good fortune to the process of karmic payback, which was associated with relatively less gratitude but with higher scores for feelings of pride and deservingness. These results were partially explained by participants' attributions of positive experiences to an external agent (e.g., God) versus a universal law or internal factors as in the case of karma. We conclude that diverse spiritual beliefs influence causal attributions for good fortune, which, in turn, predict distinct emotional responses. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Illness perceptions, experiences of stigma and engagement in functional neurological disorder (FND): exploring the role of multidisciplinary group education sessions

BackgroundA critical first step in managing functional neurological disorder (FND) is a positive diagnosis and clear explanation using an understandable illness model. Multidisciplinary group education sessions are one way to...

Examining Malaysian mothers' causal attributions of maladaptive externalizing and internalizing behaviors in young children

AbstractObjectiveThis study provides insight into how cultural beliefs influence parents' causal attributions of maladaptive externalizing and internalizing behaviors in young children.BackgroundUnderstanding how parents from different cultures explain difficult behavior in young children may inform culturally sensitive approaches for early intervention and prevention. To date, work on Malaysian parents' causal attributions of maladaptive behaviors in young children has received little empirical attention.MethodWe employed a semistructured interview method to assess Malaysian mothers' (N = 16) open‐ended explanations for maladaptive externalizing and internalizing behavior in their young children, as depicted in hypothetical scenarios. Mothers' responses were coded according to a coding system of parental attributions.ResultsWe identified cultural specificity in Malaysian parents' attributions of children's behaviors, with mothers endorsing reasons for children's maladaptive externalizing and internalizing behaviors that were not previously captured by the existing coding system. Mothers' attributions were informed by religious and spiritual beliefs.ConclusionsParents' causal attributions for children's maladaptive behaviors are culturally specific and are best captured by open‐ended approaches.ImplicationsCultural frames of reference shape parental beliefs, which are crucial to the effective formulation of early intervention and prevention approaches. Caution should be taken in general against universally operationalizing parents' attributions of children's behaviors.

Somatized or stigma? Causal attributions and emotional responses in shaping social distance towards people with mental illness, China

BackgroundMental illness in China has traditionally been attributed to physical factors and somatization tendencies, which seldom result in stigma. How has this perception changed after decades of social change? MethodsBased on the Chinese General Social Survey database in 2011, this study constructed a structural equation model to analyze the effects of causal attribution and emotional responses on social distance. The causal attributions include dangerousness, controllability, and responsibility. And the emotional responses encompass negative affect, traditional prejudice, treatment carryover, and exclusionary sentiments. In addition, higher scores indicating greater social distance, whereas a low score reflected stronger emotional responses or a greater degree of internal attribution. ResultsThe results reported a high level of social distance towards people with mental illness. These findings indicated that emotional responses have a direct impact on social distance. Specifically, when negative affect, traditional prejudice, and exclusionary sentiments increase by one standard deviation, the social distance decreases by 0.497, 0.178, and 0.073 standard deviation, respectively. Conversely, as the level of treatment carryover rises, social distance increases by 0.087. Meanwhile, the causal attribution only exerts a significant indirect effect on social distance by the function of emotional causal responses. ConclusionThe results indicated that the public attributes mental illnesses like depression primarily to psychological issues rather than somatic ones. It suggested widespread stereotypes and public stigma towards people with mental illness in China, as well as an arduous task in anti-stigma. In addition, a targeted way to address public stigma lies in changing the stereotype of people with mental illness.

Polarized Perspectives on Health Equity: Results from a Nationally Representative Survey on US Public Perceptions of COVID-19 Disparities in 2023

Republicans and Democrats responded to the COVID-19 pandemic in starkly different ways, from their attitudes in 2020 about whether the virus posed a threat to whether the pandemic ended in 2023. The consequences of COVID-19 for health equity have been a central concern in public health, and the concept of health equity has also been beset by partisan polarization. In this article, the authors present and discuss nationally representative survey data from 2023 on US public perceptions of disparities in COVID-19 mortality (building on a previous multiwave survey effort) as well as causal attributions for racial disparities, the contribution of structural racism, and broader attitudes about public health authority. The authors find anticipated gulfs in perspectives between Democrats on the one hand and independents and Republicans on the other. The results offer a somewhat pessimistic view of the likelihood of finding common ground in how the general public understands health inequities or the role of structural racism in perpetuating them. However, the authors show that those who acknowledge racial disparities in COVID-19 are more likely to support state public health authority to act in response to other infectious disease threats. The authors explore the implications of these public opinion data for advocacy, communication, and future needed research.

Enhancing care: evaluating the impact of True North Sexual Health and Rehabilitation eTraining for healthcare providers working with prostate cancer patients and partners.

Educational programs that enhance healthcare providers' competence in managing the care of patients with sexual dysfunction following prostate cancer treatments are needed to facilitate comprehensive sexual health treatments for patients and their partners. In this study we evaluated the impact of a real-world online sexual health educational intervention called the True North Sexual Health and Rehabilitation eTraining Program. This program is designed to increase healthcare providers' knowledge and self-efficacy in providing sexual healthcare to prostate cancer patients and their partners. Healthcare providers were invited to join a 12-week virtual training program. Participants completed precourse surveys (n = 89), retrospective prepost surveys (n = 58), and a 3-month follow-up survey (subset n = 18) to assess retention of relevant outcomes. Additionally, a course satisfaction survey was administered to participants (n = 57) at the end of the course. The main outcomes focused on participants' perceived knowledge and self-efficacy in conducting assessments and providing interventions for various relevant physical, functional, psychological, and relational domains of sexual dysfunction in prostate cancer patients and their partners. According to the retrospective analysis of post-then-pre-survey results, graduates perceived that their knowledge of and self-efficacy in providing sexual health counseling improved after completing the course. The 3-month follow-up survey indicated that the course graduate self-efficacy remained high 3 months after the course. Furthermore, the satisfaction survey indicated that a vast majority (98.2%) of participants were satisfied with the educational intervention. This real-world sexual health educational intervention can increase self-efficacy and knowledge in healthcare providers who are supporting prostate cancer patients dealing with sexual dysfunction. The use of a retrospective post-then-pre-survey helped to mitigate response shift bias while minimizing data gaps. However, it is important to note that this investigation was not a traditional research study and lacked a control group, thus limiting causal attributions. The True North Sexual Health and Rehabilitation eTraining program acts as an accessible and effective resource for healthcare providers seeking specialized training in providing sexual healthcare for prostate cancer patients and their partners.

Brokering knowledge from laboratory experiments in evidence‐based education: The case of interleaving

AbstractThe turn to ‘evidence‐based education’ in the past three decades favours one type of evidence: experiment. Knowledge brokers ground recommendations for classroom practice on reports of experimental research. This paper distinguishes field and laboratory experiments, on the basis of control and precision of causal ascription. Briefly noting problems with knowledge brokers’ extrapolating from field experiments, the paper's main focus is on extrapolating from laboratory experiments, using the case of ‘interleaving’. It argues that knowledge brokers often extrapolate from laboratory experiments as if they are field experiments. By considering both laboratory and ‘extra‐lab’ interleaving studies, it suggests that an alternative extrapolation—creating laboratory effects in the classroom—has little pedagogical value. The conclusion suggests focussing on mechanisms, contexts and outcomes as a more useful basis for brokering pedagogical knowledge from laboratory experiments.

Reciprocal Mechanism of Real-Name Reporting and Causal Attribution of Specified Juveniles:The Individualization Perspective

Reciprocal Mechanism of Real-Name Reporting and Causal Attribution of Specified Juveniles:The Individualization Perspective