Timothy J Williamson1, Alyssa K Choi1, Julie C Kim1, Edward B Garon2, Jenessa R Shapiro3, Michael R Irwin4, Jonathan W Goldman2, Krikor Bornyazan5, James M Carroll5, Annette L Stanton6. 1. Department of Psychology, University of California-Los Angeles, Los Angeles, California. 2. Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California; Jonsson Comprehensive Cancer Center, University of California-Los Angeles, Los Angeles, California. 3. Department of Psychology, University of California-Los Angeles, Los Angeles, California; Anderson School of Management, University of California-Los Angeles, Los Angeles, California. 4. Department of Psychology, University of California-Los Angeles, Los Angeles, California; Department of Psychiatry/Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California; Cousins Center for Psychoneuroimmunology, University of California-Los Angeles, Los Angeles, California. 5. Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California. 6. Department of Psychology, University of California-Los Angeles, Los Angeles, California; Jonsson Comprehensive Cancer Center, University of California-Los Angeles, Los Angeles, California; Department of Psychiatry/Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California; Cousins Center for Psychoneuroimmunology, University of California-Los Angeles, Los Angeles, California. Electronic address: astanton@ucla.edu.
Abstract
INTRODUCTION: Internalized lung cancer stigma (i.e., feelings of regret, shame, and self-blame about one's lung cancer) is related to poorer psychological outcomes. Less is known about how internalized stigma relates to physical and functional outcomes or how constrained disclosure (i.e., avoidance of or discomfort about disclosing one's lung cancer status to others) relates to well-being. Furthermore, no study has examined whether internalized stigma and constrained disclosure predict changes in well-being for lung cancer patients. This longitudinal study characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional outcomes. METHODS: Participants (N = 101, 52.4% male, 63.4% currently/formerly smoked) were lung cancer patients on active medical treatment who completed questionnaires on stigma and well-being at study entry and at 6- and 12-week follow-up. Multivariable linear regressions characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional well-being at study entry and across time. RESULTS: Participants who currently or formerly smoked reported higher levels of internalized stigma (but not constrained disclosure), compared to never smokers (p < 0.001). Higher internalized stigma and constrained disclosure were uniquely associated with poorer emotional and physical/functional well-being at study entry (all p < 0.05), beyond sociodemographic characteristics, time elapsed since diagnosis, and smoking status. Higher internalized stigma predicted significant declines in emotional well-being across 6 and 12 weeks (all p < 0.01) and declines in physical/functional well-being across 6 weeks (p < 0.05). CONCLUSIONS: Internalized lung cancer stigma and constrained disclosure relate to emotional and physical/functional maladjustment. Findings carry implications for provider- and patient-focused interventions to reduce internalized stigma and promote well-being.
INTRODUCTION: Internalized lung cancer stigma (i.e., feelings of regret, shame, and self-blame about one's lung cancer) is related to poorer psychological outcomes. Less is known about how internalized stigma relates to physical and functional outcomes or how constrained disclosure (i.e., avoidance of or discomfort about disclosing one's lung cancer status to others) relates to well-being. Furthermore, no study has examined whether internalized stigma and constrained disclosure predict changes in well-being for lung cancerpatients. This longitudinal study characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional outcomes. METHODS:Participants (N = 101, 52.4% male, 63.4% currently/formerly smoked) were lung cancerpatients on active medical treatment who completed questionnaires on stigma and well-being at study entry and at 6- and 12-week follow-up. Multivariable linear regressions characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional well-being at study entry and across time. RESULTS:Participants who currently or formerly smoked reported higher levels of internalized stigma (but not constrained disclosure), compared to never smokers (p < 0.001). Higher internalized stigma and constrained disclosure were uniquely associated with poorer emotional and physical/functional well-being at study entry (all p < 0.05), beyond sociodemographic characteristics, time elapsed since diagnosis, and smoking status. Higher internalized stigma predicted significant declines in emotional well-being across 6 and 12 weeks (all p < 0.01) and declines in physical/functional well-being across 6 weeks (p < 0.05). CONCLUSIONS: Internalized lung cancer stigma and constrained disclosure relate to emotional and physical/functional maladjustment. Findings carry implications for provider- and patient-focused interventions to reduce internalized stigma and promote well-being.
Authors: Jamie S Ostroff; Kristen E Riley; Megan J Shen; Thomas M Atkinson; Timothy J Williamson; Heidi A Hamann Journal: Psychooncology Date: 2019-04-16 Impact factor: 3.894
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Authors: Timothy J Williamson; Edward B Garon; Jenessa R Shapiro; Denise A Chavira; Jonathan W Goldman; Annette L Stanton Journal: Health Psychol Date: 2022-04 Impact factor: 5.556
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