Causal attributions for raised cholesterol and perceptions of effective risk-reduction: Self-regulation strategies for an increased risk of coronary heart disease

Abstract

Self-regulation strategies are investigated in 317 people with familial hypercholesterolaemia (FH), an inherited predisposition to coronary heart disease (CHD). Measures of illness perceptions and behaviour were assessed 1 week and 6 months after a risk assessment for FH. In cross-sectional analysis, attributions to genetic causes had a small association with perceiving medication as an effective risk-reduction strategy, attributions to behavioural causes were related to perceiving dietary intervention as an effective risk-reduction strategy; and, perceived effectiveness of medication was associated with greater adherence to medication. However, there were few statistically significant prospective associations. These findings give tentative support to the proposition that genetic testing for preventable diseases will reinforce genetic causal models and, therefore, the perceived effectiveness of biologically based methods of reducing risk. There is a need to test the existence of similar effects, and their consequences for adherence to biologically and behaviourally based methods of risk-reduction, in newly diagnosed populations.

∗On behalf of the Genetic Risk Assessment for FH Trial (GRAFT) Study Group.

Keywords:

• Causal attribution
• perceived control
• self regulation
• cholesterol
• genetic testing
• coronary heart disease

Acknowledgments

This research was funded as part of a programme grant from The Wellcome Trust (ref: 037006).

Genetic Risk Assessment for FH Trial (GRAFT) Study Group (alphabetically listed) M. Bobrow (Cambridge), T. Cranston (Great Ormand Street Hospital for Children), M. Crook (Guy's and St Thomas’ Hospitals, Lewisham Hospital), L. Day (Southampton University Hospital), M. Fernandez (King's College London), R. Horne (Brighton), S. Humphries (Royal Free and University College London Medical School), A. Iversen (Royal Sussex County Hospital), Z. Jackson (King's College London), T. M. Marteau (King's College London), J. Lynas (The Conquest Hospital), H. Middleton-Price (Great Ormand Street Hospital for Children), R. Savine (Guy's and St Thomas’ Hospitals), V. Senior (King's College London), J. Sikorski (King's College London), M. Watson (King's College London), J. Weinman (King's College London), A. S. Wierzbicki (Guy's and St Thomas’ Hospitals), R. Wray (The Conquest Hospital).

Notes

∗On behalf of the Genetic Risk Assessment for FH Trial (GRAFT) Study Group.