Behavioral and characterological self-blame in chronic obstructive pulmonary disease.

OBJECTIVE To assess behavioral and characterological self-blame, identify demographic and relational correlates of self-blame, and determine the association of self-blame with psychological and clinical outcomes of chronic obstructive pulmonary disease (COPD). METHODS Data were collected via self-report questionnaires completed by 398 individuals with COPD who had at least a 10 pack-year history of smoking. Behavioral and characterological self-blame were measured, and multiple regression was used to identify correlates of both types of self-blame. Multiple regression was also used to determine the association of self-blame with outcomes of COPD. RESULTS More than one-third of participants endorsed the maximum possible score on the measure of behavioral self-blame. The perception that family members blamed the individual for having COPD (p=.001), tobacco exposure (p=.005), and general family functioning (p=.002) were associated with behavioral self-blame. Current smoking status (p=.001) and perception of blame from family (p<.001) were associated with characterological self-blame. While behavioral self-blame was associated with fewer symptoms of depression (p=.02), characterological self-blame was associated with more symptoms of depression (p=.02). CONCLUSIONS Individuals with COPD tend to blame themselves for smoking and other behaviors that may have led to their COPD. Smoking-related variables and the perception that family members blamed the individual for having COPD were associated with self-blame. Findings support the importance of distinguishing between behavioral and characterological self-blame in COPD, as behavioral self-blame had a negative association with depression and characterological self-blame had a positive association with depression.