The effects of the perceived accuracy of attributions of self blame and chance blame were examined in the context of health care. Health practitioners (N= 147) rated interviews in which patients made self-or chance-blaming attributions for diseases with high (heart attack, stroke), or low (cancer, arthritis) life-style involvement, or acidental injuries. Three discriminant analyses yielded p < .001. Self-blaming heart and stroke patients were rated as coping better and acting more appropriately and typically than chance blamers. Other self blamers were rated as more depressed, poorly adjusted, coping poorly, not accepting disability, needing counselling and information. Additionally, self-blaming accident victims were judged as more dependent, less likeable, and having poorer prognoses than chance blamers. Realistic self blame for life-style diseases did not lead to victimization, but other self-blaming patients were stigmatized and the adaptiveness of self blame as a coping strategy was unrecognized.