Causal attributions and their impact on psychosocial functioning in head and neck cancer patient–caregiver dyads: a preliminary, longitudinal study

  • Jessica L. BurrisEmail author
  • Jessica N. Rivera-Rivera
  • Kent Armeson
  • Jane Zapka
  • Anthony J. Alberg
  • Terry A. Day
  • Katherine R. Sterba
Brief Communication



This longitudinal study explores causal attributions in newly diagnosed head/neck cancer (HNC) patients and their caregivers.


Perceptions of causal attributions and associated level of responsibility regarding each patient’s HNC diagnosis at baseline (n = 72 dyads) were described and then tested as predictors of depressive symptoms, cancer worry, and perceived support 6 months later.


When causes were reported, tobacco and alcohol use topped the list of both patients and caregivers. Three-quarters of dyads agreed about perceptions of the patients’ responsibility in causing their HNC. Some dyad-level patterns of causal attribution were associated with patients’ and caregivers’ cancer worry (p < 0.05) and caregivers’ perceived support (p < 0.05) in unadjusted models.


This preliminary study indicates that causal attributions warrant further exploration in HNC patient–caregiver dyads specifically, as well as studies of quality of life in patient–caregiver dyads more broadly considered.


Cancer Causal attributions Distress Dyads Social support 



The authors acknowledge data collection and recruitment support from Rebecca Patten, OT, Lee Anne Tetrick, BS and Amy Buchanan, MPH, RD. This work was supported by the American Cancer Society [MRSG-12-221-01-CPPB]; the National Center for Advancing Translational Sciences [UL1TR000062]; and the National Cancer Institute [P30 CA138313, K07 CA181351]. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the American Cancer Society or National Institutes of Health.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This research was supported by the American Cancer Society [MRSG-12-221-01-CPPB]; the National Center for Advancing Translational Sciences [UL1TR000062]; and the National Cancer Institute [P30 CA138313, K07 CA181351]. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the American Cancer Society or National Institutes of Health.


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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Psychology and Markey Cancer CenterUniversity of KentuckyLexingtonUSA
  2. 2.Department of Public Health Sciences and Hollings Cancer CenterMedical University of South CarolinaCharlestonUSA
  3. 3.Department of Epidemiology and BiostatisticsUniversity of South CarolinaColumbiaUSA
  4. 4.Department of Otolaryngology and Hollings Cancer CenterMedical University of South CarolinaCharlestonUSA

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