6  Health Attributions & Morality

This chapter explores your moral foundations, beliefs about the causes of mental illness, and essentialist beliefs about addiction. These constructs shape how you make moral judgments, how you attribute the causes of health and disease, and how you view people with addiction — all of which directly influence health communication strategies around tailoring, audience segmentation, and framing.

ImportantPH 322 — Week 6: Audience Profile Based on Attributions

This week explores how moral foundations, health attributions (biological, social, lifestyle, personal), and categorical vs. continuum conceptions of health influence the design of tailored health interventions.


6.1 Moral Foundations Questionnaire

Constructs

The Moral Foundations Questionnaire (MFQ; Graham et al., 2011) measures five moral foundations that underlie moral judgments across cultures:

  • Harm/Care: Sensitivity to suffering and cruelty; concern for the well-being of others
  • Fairness/Reciprocity: Concern for justice, equal treatment, and proportional outcomes
  • Ingroup/Loyalty: Valuing group membership, patriotism, and loyalty to one’s community
  • Authority/Respect: Respect for tradition, hierarchy, and social order
  • Purity/Sanctity: Concern about physical and spiritual purity, contamination, and disgust

Measures

The MFQ contains 22 items across two blocks: Block 1 measures moral relevance (11 items; 1 = Not at All Relevant to 5 = Extremely Relevant) and Block 2 measures moral agreement (11 items; 1 = Strongly Disagree to 6 = Strongly Agree). Each foundation is scored from 2 relevance items and 2 agreement items (after rescaling). Item 6 in each block is a catch/attention-check item and is excluded from scoring.

Example items:

  • Harm/Care (Relevance): “Whether or not someone suffered emotionally”
  • Harm/Care (Agreement): “Compassion for those who are suffering is the most crucial virtue.”

Your Scores

Moral Foundations: Harm/Care & Fairness/Reciprocity
Password Harm/Care Harm/Care (%) Fairness Fairness (%)
$iorrZZ2425! 5.75 95% (high) 5.75 92% (high)
'@Auliebear224757328el 4.50 39% (mid) 5.12 63% (mid)
5121lyster 4.62 45% (mid) 4.31 18% (low)
78fArO50r 3.75 11% (low) 4.88 50% (mid)
Arlingtonfootball(333) 4.12 29% (low) 4.94 55% (mid)
Benny2013 4.69 50% (mid) 4.12 13% (low)
Binghamton1234 5.38 82% (high) 5.12 63% (mid)
Birth2005 3.50 5% (low) 4.75 45% (mid)
Biscuit1227 3.94 16% (low) 3.50 8% (low)
Bxqc3216 4.69 50% (mid) 5.12 63% (mid)
Damilola1976 5.25 79% (high) 6.00 100% (high)
December1912 3.69 8% (low) 3.19 3% (low)
Eski3754 5.69 89% (high) 5.25 82% (high)
Funkita732 4.50 39% (mid) 4.62 34% (mid)
Goodwin7292()! 4.12 29% (low) 4.94 55% (mid)
Health$402 4.69 50% (mid) 4.44 26% (low)
Health1203 4.94 63% (mid) 4.62 34% (mid)
Littlekitty1019 5.19 71% (high) 4.62 34% (mid)
LongSurvey1234 4.00 18% (low) 5.75 92% (high)
Power2 4.00 18% (low) 4.62 34% (mid)
Rcool1229 5.00 68% (high) 3.19 3% (low)
Strawberryhamburger3 5.38 82% (high) 5.12 63% (mid)
Tinawatsonqwe1 4.25 37% (mid) 4.75 45% (mid)
VT1107lyn!Bing 4.62 45% (mid) 4.56 32% (low)
biotinISneeded2313! 6.00 97% (high) 5.75 92% (high)
brita6767 3.25 3% (low) 3.06 0% (low)
earth5567 5.69 89% (high) 5.19 76% (high)
ha1rcut 4.81 58% (mid) 5.12 63% (mid)
health0925 4.00 18% (low) 4.31 18% (low)
health1244 4.88 61% (mid) 4.88 50% (mid)
health1248 3.12 0% (low) 4.50 29% (low)
health4103 4.00 18% (low) 5.25 82% (high)
jelly1909 3.92 13% (low) 3.50 8% (low)
kyunkyun3890 5.38 82% (high) 5.38 87% (high)
schre0000 4.94 63% (mid) 4.38 24% (low)
surv1901 4.17 34% (mid) 4.25 16% (low)
vidyaravi1 NaN NA% (high) NaN NA% (high)
water6331 5.19 71% (high) 4.94 55% (mid)
water9813 6.00 97% (high) 5.69 89% (high)
witch2026 5.19 71% (high) 5.19 76% (high)
Moral Foundations: Ingroup/Loyalty & Authority/Respect
Password Ingroup/Loyalty Ingroup/Loyalty (%) Authority/Respect Authority/Respect (%)
$iorrZZ2425! 4.19 82% (high) 3.56 47% (mid)
'@Auliebear224757328el 3.25 47% (mid) 4.06 71% (high)
5121lyster 3.25 47% (mid) 3.50 37% (mid)
78fArO50r 2.62 26% (low) 4.25 79% (high)
Arlingtonfootball(333) 2.94 34% (mid) 3.50 37% (mid)
Benny2013 4.25 84% (high) 4.31 82% (high)
Binghamton1234 2.50 16% (low) 4.88 95% (high)
Birth2005 3.00 37% (mid) 4.75 92% (high)
Biscuit1227 3.50 66% (mid) 5.12 97% (high)
Bxqc3216 3.25 47% (mid) 4.00 63% (mid)
Damilola1976 4.50 95% (high) 4.44 87% (high)
December1912 1.81 3% (low) 1.50 0% (low)
Eski3754 3.31 58% (mid) 3.31 32% (low)
Funkita732 2.19 11% (low) 3.50 37% (mid)
Goodwin7292()! 4.56 100% (high) 4.06 71% (high)
Health$402 4.25 84% (high) 4.06 71% (high)
Health1203 2.06 8% (low) 2.94 13% (low)
Littlekitty1019 2.50 16% (low) 3.88 58% (mid)
LongSurvey1234 2.69 32% (low) 3.00 16% (low)
Power2 3.19 42% (mid) 2.88 11% (low)
Rcool1229 2.25 13% (low) 1.94 5% (low)
Strawberryhamburger3 3.00 37% (mid) 2.75 8% (low)
Tinawatsonqwe1 2.50 16% (low) 4.00 63% (mid)
VT1107lyn!Bing 3.25 47% (mid) 3.44 34% (mid)
biotinISneeded2313! 2.56 24% (low) 3.06 18% (low)
brita6767 3.44 63% (mid) 3.06 18% (low)
earth5567 3.31 58% (mid) 4.00 63% (mid)
ha1rcut 4.38 89% (high) 3.88 58% (mid)
health0925 3.19 42% (mid) 3.12 29% (low)
health1244 3.81 76% (high) 3.56 47% (mid)
health1248 4.12 79% (high) 4.38 84% (high)
health4103 3.75 74% (high) 4.69 89% (high)
jelly1909 3.50 66% (mid) 3.81 55% (mid)
kyunkyun3890 1.88 5% (low) 3.06 18% (low)
schre0000 4.50 95% (high) 3.06 18% (low)
surv1901 2.62 26% (low) 3.50 37% (mid)
vidyaravi1 NaN NA% (high) NaN NA% (high)
water6331 3.50 66% (mid) 3.75 53% (mid)
water9813 4.38 89% (high) 5.19 100% (high)
witch2026 1.56 0% (low) 1.81 3% (low)
Moral Foundations: Purity/Sanctity
Password Purity/Sanctity Purity/Sanctity (%)
$iorrZZ2425! 4.69 79% (high)
'@Auliebear224757328el 3.50 29% (low)
5121lyster 3.00 13% (low)
78fArO50r 5.12 89% (high)
Arlingtonfootball(333) 4.94 87% (high)
Benny2013 5.38 97% (high)
Binghamton1234 5.12 89% (high)
Birth2005 3.75 34% (mid)
Biscuit1227 5.19 95% (high)
Bxqc3216 4.38 68% (high)
Damilola1976 3.94 50% (mid)
December1912 1.81 0% (low)
Eski3754 2.25 3% (low)
Funkita732 3.25 16% (low)
Goodwin7292()! 4.38 68% (high)
Health$402 3.75 34% (mid)
Health1203 3.88 47% (mid)
Littlekitty1019 4.00 55% (mid)
LongSurvey1234 3.56 32% (low)
Power2 4.06 58% (mid)
Rcool1229 3.25 16% (low)
Strawberryhamburger3 3.94 50% (mid)
Tinawatsonqwe1 3.75 34% (mid)
VT1107lyn!Bing 2.94 11% (low)
biotinISneeded2313! 4.62 76% (high)
brita6767 4.31 66% (mid)
earth5567 4.69 79% (high)
ha1rcut 4.12 63% (mid)
health0925 3.44 26% (low)
health1244 3.25 16% (low)
health1248 4.06 58% (mid)
health4103 4.56 74% (high)
jelly1909 2.50 5% (low)
kyunkyun3890 4.88 84% (high)
schre0000 3.25 16% (low)
surv1901 3.75 34% (mid)
vidyaravi1 NaN NA% (high)
water6331 3.81 45% (mid)
water9813 5.75 100% (high)
witch2026 2.75 8% (low)

Class Distribution

Moral Foundations: Harm/Care & Fairness/Reciprocity across all participants. Dashed lines indicate 33rd and 67th percentiles.

Moral Foundations: Ingroup/Loyalty & Authority/Respect across all participants. Dashed lines indicate 33rd and 67th percentiles.

Moral Foundations: Purity/Sanctity across all participants. Dashed lines indicate 33rd and 67th percentiles.

6.2 Beliefs about the Causes of Mental Illness

Constructs

The Beliefs about the Causes of Mental Illness Scale (Knettel, 2019) measures how people attribute the causes of mental illness across four categories. The scale presents a vignette about Cameron, a 30-year-old man with depression, and asks you to rate the importance of potential causes:

  • Social Attributions: Social injustice, lack of support, poverty, stressful circumstances, traumatic experiences
  • Biological Attributions: Genes, biological/medical disorder, chemical imbalance
  • Personal Attributions: Lack of will or self-control, personal choice, negative attitude
  • Lifestyle Attributions: Improper diet, exposure to germs, lack of physical activity

Measures

The scale contains 14 items rated on a 7-point scale: 1 = Not at All Important, 2 = Not Very Important, 3 = Somewhat Important, 4 = Moderately Important, 5 = Important, 6 = Significantly Important, 7 = This Cause Is Very Important. Higher scores indicate stronger attribution to that category.

Example items:

  • Social: “Social injustice or discrimination”
  • Biological: “Genes or heredity”
  • Personal: “Lack of will or self-control”
  • Lifestyle: “Improper diet”

Your Scores

Beliefs about Causes of Mental Illness: Social & Biological Attributions
Password Social Social (%) Biological Biological (%)
$iorrZZ2425! 6.2 74% (high) 4.67 36% (mid)
'@Auliebear224757328el 5.8 54% (mid) 2.33 3% (low)
5121lyster 3.6 0% (low) 3.33 8% (low)
78fArO50r 4.0 3% (low) 1.67 0% (low)
Arlingtonfootball(333) 5.4 33% (low) 4.67 36% (mid)
Benny2013 5.6 46% (mid) 5.67 74% (high)
Binghamton1234 6.2 74% (high) 4.67 36% (mid)
Birth2005 7.0 97% (high) 7.00 95% (high)
Biscuit1227 5.8 54% (mid) 5.33 62% (mid)
Bxqc3216 6.0 67% (high) 5.33 62% (mid)
Damilola1976 6.4 79% (high) 6.00 82% (high)
December1912 5.6 46% (mid) 6.33 90% (high)
Eski3754 6.8 92% (high) 5.33 62% (mid)
Funkita732 5.0 18% (low) 4.67 36% (mid)
Goodwin7292()! 5.8 54% (mid) 4.67 36% (mid)
Health$402 5.4 33% (low) 3.67 13% (low)
Health1203 5.8 54% (mid) 5.33 62% (mid)
Littlekitty1019 5.0 18% (low) 4.00 23% (low)
LongSurvey1234 6.0 67% (high) 6.33 90% (high)
Power2 4.4 10% (low) 4.67 36% (mid)
Rcool1229 5.4 33% (low) 7.00 95% (high)
Strawberryhamburger3 5.2 28% (low) 4.33 28% (low)
Tinawatsonqwe1 4.0 3% (low) 4.00 23% (low)
VT1107lyn!Bing 5.6 46% (mid) 6.00 82% (high)
biotinISneeded2313! 6.4 79% (high) 5.33 62% (mid)
brita6767 4.2 8% (low) 3.00 5% (low)
earth5567 6.0 67% (high) 6.00 82% (high)
ha1rcut 5.8 54% (mid) 4.33 28% (low)
health0925 5.0 18% (low) 4.67 36% (mid)
health1244 4.8 13% (low) 4.67 36% (mid)
health1248 5.4 33% (low) 3.67 13% (low)
health4103 6.6 85% (high) 3.67 13% (low)
jelly1909 4.8 13% (low) 4.33 28% (low)
kyunkyun3890 6.8 92% (high) 5.67 74% (high)
schre0000 5.2 28% (low) 3.33 8% (low)
surv1901 5.0 18% (low) 5.00 59% (mid)
vidyaravi1 5.4 33% (low) 3.67 13% (low)
water6331 6.6 85% (high) 7.00 95% (high)
water9813 6.6 85% (high) 4.67 36% (mid)
witch2026 7.0 97% (high) 5.67 74% (high)
Beliefs about Causes of Mental Illness: Personal & Lifestyle Attributions
Password Personal Personal (%) Lifestyle Lifestyle (%)
$iorrZZ2425! 5.33 79% (high) 5.00 69% (high)
'@Auliebear224757328el 3.00 15% (low) 4.00 38% (mid)
5121lyster 3.00 15% (low) 2.67 10% (low)
78fArO50r 4.33 49% (mid) 2.33 3% (low)
Arlingtonfootball(333) 2.33 8% (low) 3.67 28% (low)
Benny2013 5.67 87% (high) 5.50 92% (high)
Binghamton1234 5.00 69% (high) 4.00 38% (mid)
Birth2005 7.00 97% (high) 7.00 97% (high)
Biscuit1227 6.33 90% (high) 5.00 69% (high)
Bxqc3216 3.33 28% (low) 4.00 38% (mid)
Damilola1976 7.00 97% (high) 7.00 97% (high)
December1912 2.33 8% (low) 5.00 69% (high)
Eski3754 3.00 15% (low) 2.67 10% (low)
Funkita732 4.67 56% (mid) 4.67 62% (mid)
Goodwin7292()! 5.00 69% (high) 5.00 69% (high)
Health$402 3.33 28% (low) 4.33 56% (mid)
Health1203 6.33 90% (high) 2.67 10% (low)
Littlekitty1019 5.33 79% (high) 3.67 28% (low)
LongSurvey1234 4.67 56% (mid) 3.00 18% (low)
Power2 3.00 15% (low) 4.33 56% (mid)
Rcool1229 4.33 49% (mid) 2.33 3% (low)
Strawberryhamburger3 2.00 5% (low) 1.67 0% (low)
Tinawatsonqwe1 4.00 41% (mid) 4.00 38% (mid)
VT1107lyn!Bing 3.33 28% (low) 4.00 38% (mid)
biotinISneeded2313! 4.33 49% (mid) 4.67 62% (mid)
brita6767 4.00 41% (mid) 4.00 38% (mid)
earth5567 5.00 69% (high) 6.00 95% (high)
ha1rcut 4.00 41% (mid) 4.67 62% (mid)
health0925 3.67 36% (mid) 4.00 38% (mid)
health1244 1.67 0% (low) 3.33 21% (low)
health1248 4.67 56% (mid) 5.33 85% (high)
health4103 6.67 95% (high) 3.33 21% (low)
jelly1909 3.67 36% (mid) 3.67 28% (low)
kyunkyun3890 4.67 56% (mid) 5.33 85% (high)
schre0000 4.67 56% (mid) 3.33 21% (low)
surv1901 5.00 69% (high) 5.00 69% (high)
vidyaravi1 3.00 15% (low) 2.33 3% (low)
water6331 1.67 0% (low) 5.00 69% (high)
water9813 5.33 79% (high) 5.33 85% (high)
witch2026 2.67 13% (low) 3.67 28% (low)

Class Distribution

Beliefs about the Causes of Mental Illness: Social & Biological attributions. Dashed lines indicate 33rd and 67th percentiles.

Beliefs about the Causes of Mental Illness: Personal & Lifestyle attributions. Dashed lines indicate 33rd and 67th percentiles.

6.3 Essentialist Beliefs about Addiction

Constructs

The Essentialist Beliefs about Addiction Scale (GENBELIEFS3; 15 items) measures the extent to which you view addiction through an essentialist lens:

  • Categorical Thinking: Belief that people fall into discrete categories of “addict” or “non-addict,” with clear-cut boundaries and predictable traits
  • Biological Essentialism: Belief that addiction is genetically or biologically determined

Measures

The scale contains 15 items (11 categorical thinking, 4 biological essentialism) rated on a 5-point scale: 1 = Strongly Disagree, 5 = Strongly Agree. Higher scores indicate stronger essentialist beliefs.

Example items:

  • Categorical Thinking: “The boundaries that define the differences between addicts and non-addicts are clear-cut.”
  • Biological Essentialism: “With enough scientific knowledge, addiction can be traced back to genetic causes.”

Your Scores

Essentialist Beliefs about Addiction: Your Composite Scores
Password Categorical Thinking Categorical (%) Biological Essentialism Biological (%)
$iorrZZ2425! 2.45 44% (mid) 2.50 41% (mid)
'@Auliebear224757328el 2.55 51% (mid) 2.50 41% (mid)
5121lyster 2.00 21% (low) 3.25 72% (high)
78fArO50r 2.00 21% (low) 1.50 0% (low)
Arlingtonfootball(333) 2.18 36% (mid) 3.25 72% (high)
Benny2013 1.91 13% (low) 2.00 15% (low)
Binghamton1234 3.45 97% (high) 1.50 0% (low)
Birth2005 3.36 95% (high) 3.25 72% (high)
Biscuit1227 3.00 79% (high) 3.00 64% (mid)
Bxqc3216 2.09 28% (low) 2.00 15% (low)
Damilola1976 3.18 85% (high) 2.75 54% (mid)
December1912 1.82 8% (low) 3.50 87% (high)
Eski3754 2.09 28% (low) 1.75 10% (low)
Funkita732 2.73 74% (high) 3.50 87% (high)
Goodwin7292()! 2.64 69% (high) 3.00 64% (mid)
Health$402 2.45 44% (mid) 3.75 95% (high)
Health1203 2.45 44% (mid) 2.50 41% (mid)
Littlekitty1019 2.55 51% (mid) 2.25 38% (mid)
LongSurvey1234 2.55 51% (mid) 3.25 72% (high)
Power2 2.55 51% (mid) 2.00 15% (low)
Rcool1229 1.91 13% (low) 4.00 100% (high)
Strawberryhamburger3 1.91 13% (low) 1.50 0% (low)
Tinawatsonqwe1 3.00 79% (high) 3.00 64% (mid)
VT1107lyn!Bing 2.64 69% (high) 3.50 87% (high)
biotinISneeded2313! 1.64 3% (low) 2.00 15% (low)
brita6767 3.27 92% (high) 3.25 72% (high)
earth5567 2.18 36% (mid) 2.00 15% (low)
ha1rcut 2.55 51% (mid) 2.00 15% (low)
health0925 2.36 41% (mid) 2.50 41% (mid)
health1244 2.55 51% (mid) 2.50 41% (mid)
health1248 2.91 77% (high) 2.75 54% (mid)
health4103 3.18 85% (high) 3.25 72% (high)
jelly1909 3.18 85% (high) 2.00 15% (low)
kyunkyun3890 2.00 21% (low) 1.50 0% (low)
schre0000 1.55 0% (low) 2.00 15% (low)
surv1901 2.09 28% (low) 2.00 15% (low)
vidyaravi1 2.55 51% (mid) 2.75 54% (mid)
water6331 1.82 8% (low) 3.75 95% (high)
water9813 3.55 100% (high) 2.75 54% (mid)
witch2026 1.64 3% (low) 1.75 10% (low)

Class Distribution

Essentialist Beliefs about Addiction: Categorical Thinking and Biological Essentialism. Dashed lines indicate 33rd and 67th percentiles.

References

Graham, J., Nosek, B. A., Haidt, J., Iyer, R., Koleva, S., & Ditto, P. H. (2011). Mapping the moral domain. Journal of Personality and Social Psychology, 101(2), 366–385. https://doi.org/10.1037/a0021847

Knettel, B. A. (2019). Exploring diverse conceptions of mental health and mental illness. In Developing, Delivering, and Sustaining School Counseling Practices through a Culturally Affirming Lens. Information Age Publishing.