4.5 Article

Facets of Stigma, Self-Compassion, and Health-Related Adjustment to Lung Cancer: A Longitudinal Study

Journal

HEALTH PSYCHOLOGY
Volume 41, Issue 4, Pages 301-310

Publisher

AMER PSYCHOLOGICAL ASSOC
DOI: 10.1037/hea0001156

Keywords

lung cancer; stigma; disclosure; discrimination; self-compassion

Funding

  1. American Lung Association [LH-51232]
  2. National Cancer Institute [T32CA009461, P30CA008748, R01CA208403, K99CA256351]
  3. National Institute of Mental Health [T32MH15750]
  4. Jonsson Comprehensive Cancer Center

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This study aimed to investigate the unique contributions of different facets of lung cancer stigma on psychological and physical health outcomes, and to examine self-compassion as a potential moderator of the stigma-health relationship. The results indicated significant associations between various aspects of stigma and health-related adjustment to lung cancer. Self-compassion was found to moderate the impact of stigma on psychological health outcomes.
Objective: The aim of this study was to investigate whether three facets of lung cancer stigma (internalized stigma, constrained disclosure, and perceived subtle discrimination) uniquely predicted psychological and physical health-related adjustment to lung cancer across 12 weeks. Additionally, self-compassion was tested as a moderator of the stigma-health relationship. Method: Adults receiving oncologic treatment for lung cancer (N = 108) completed measures of lung cancer stigma, self-compassion, depressive symptoms, cancer-related stress, and physical symptom bother. Multivariable linear regression models were used to investigate cross-sectional and longitudinal relationships (at 6- and 12-week follow-up) between indicators of stigma and health-related outcomes, controlling for covariates. Self-compassion was tested as a moderator of these relationships. Results: At study entry, higher internalized stigma, constrained disclosure, and perceived subtle discrimination were associated significantly and uniquely with higher depressive symptoms (all p < .05). Constrained disclosure and perceived subtle discrimination were also associated significantly with higher cancer-related stress and higher physical symptom bother at study entry (all p < .05). Furthermore, higher internalized stigma predicted significant increases in depressive symptoms across 12 weeks and in cancer-related stress across 6 and 12 weeks (all p < .05). Higher self-compassion significantly moderated relationships between perceived discrimination and psychological health outcomes at study entry as well as between internalized stigma and increasing depressive symptoms across 12 weeks (all p < .05). Conclusions: Results indicated robust relationships between distinct facets of stigma and health-related adjustment to lung cancer. Supportive care programs that bolster self-compassion may be useful for reducing lung cancer stigma.

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