Attribution Through the Layperson's Lens: Development and Preliminary Validation of an Inclusive, International Measure of Beliefs About the Causes of Mental Illness

ABSTRACT

Attributions, or beliefs about the causes of mental illness, have traditionally been dichotomized based on their locus, controllability, specificity, and stability. However, scholars have introduced an alternative lay beliefs model identifying attributions related to specific biological, social, and spiritual attributions. This research describes the potential benefits of this alternative model and outlines the validation of a comprehensive, international measure of lay beliefs, the Mental Illness Attribution Questionnaire (MIAQ). Validation included piloting, qualitative rating, confirmatory factor analysis, and evaluation of internal consistency, convergent validity, and test–retest reliability with a sample of 680 U.S.-based international students representing 94 nations. Scales measured attributions related to supernatural forces, social stress, lifestyle, health, substance use, heredity, and personal weakness. This structure was tested across 3 conditions—schizophrenia, depression, and alcoholism—demonstrating strong psychometric properties. The lay beliefs model appears to closely reflect the manner in which laypersons attribute cause for mental health problems, making it a natural fit for community-based research. Further, its validation with 2 international samples supports its utility in diverse populations. Together, the results support the MIAQ as a valid and reliable measure of mental illness attribution with potential for examining help-seeking and stigmatizing behavior across cultures.

Acknowledgments

The author would like to acknowledge Dr. Valeriya Spektor, Asmita Pendse, Ge Song, David Zelaya, and Khadijah Enoh for their invaluable assistance in the rating task and qualitative analysis for this study.