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Uncertainty and psychological adjustment in patients with lung cancer


Correspondence to: Department of Psychology, University of Southern California, 3620 McClintock Ave., SGM-501, Los Angeles, CA 90089-1061. E-mail:



For many patients with lung cancer, disease progression occurs without notice or with vague symptoms, and unfortunately, most treatments are not curative. Given this unpredictability, we hypothesized the following: (1) poorer psychological adjustment (specifically, more depressive symptoms, higher perceptions of stress, and poorer emotional well-being) would be associated with higher intolerance for uncertainty, higher perceived illness-related ambiguity, and their interaction; and (2) greater avoidance would mediate associations between higher intolerance of uncertainty and poorer psychological adjustment.


Participants (N = 49) diagnosed with lung cancer at least 6 months prior to enrollment completed the Center for Epidemiologic Studies – Depression Scale, the Functional Assessment of Cancer Therapy – Lung Emotional Well-being subscale, the Perceived Stress scale, the Intolerance of Uncertainty scale, the Mishel Uncertainty in Illness Scale Ambiguity subscale, the Impact of Event – Revised Avoidance subscale, and the Short-scale Eysenck Personality Questionnaire – Revised Neuroticism subscale. Mean age was 64.2 years (standard deviation [SD] = 11.0), mean years of education was 15.6 (SD = 3.1), and 71.4% were female. Hypotheses were tested with regression analyses, adjusted for neuroticism.


Higher perceptions of stress and poorer emotional well-being were associated with higher levels of intolerance of uncertainty and higher perceived illness-related ambiguity. Non-somatic depressive symptoms were associated with higher levels of intolerance of uncertainty. Avoidance was found to mediate relations of intolerance of uncertainty with non-somatic depressive symptoms and emotional well-being only.


Findings suggest that interventions to address avoidance and intolerance of uncertainty in individuals with lung cancer may help improve psychological adjustment. Copyright © 2012 John Wiley & Sons, Ltd.

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