title: Uncertainty and psychological adjustment in patients with lung cancer.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Findings suggest that interventions to address avoidance and intolerance of uncertainty in individuals with lung cancer may help improve psychological adjustment.
authors.affiliation: Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
authors.forename: Keiko
authors.initials: K
authors.lastname: Kurita
authors.forename: Edward B
authors.initials: EB
authors.lastname: Garon
authors.forename: Annette L
authors.initials: AL
authors.lastname: Stanton
authors.forename: Beth E
authors.initials: BE
authors.lastname: Meyerowitz
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D018450:Disease Progression; D004644:Emotions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D035501:Uncertainty