Most cases of lung cancer have a commonly-understood behavioral etiology. Thus, individuals with lung cancer are often blamed for their illness by others and may therefore seek to avoid this blame by concealing their diagnosis from others. This study sought to determine the prevalence of diagnosis concealment, examine potential predictors of concealment, and test parts of a cognitive-affective-behavioral model of the effects of concealing a concealable stigma among individuals receiving treatment for lung cancer. With regard to predictors of concealment, it was hypothesized that concealment would be positively associated with male gender, introversion, and trait social anxiety and would be negatively associated with social support and the use of seeking guidance and support as a coping strategy. Hypothesized correlates of concealment included poorer self-esteem as well as greater anxiety, cancer-specific distress, and social avoidance. A sample of 117 participants receiving chemotherapy or radiation for stage I-IV non-small cell lung cancer and limited to extensive stage small cell lung cancer was recruited during routine outpatient visits. A medical chart review was conducted to assess clinical factors and participants completed a standard demographic questionnaire as well as measures of coping strategies, introversion, trait social anxiety, social avoidance, social support, anxiety, depression, cancer-specific distress, self-esteem, perceived stigma, public self-consciousness, and private self-consciousness. Results indicated that 31% of participants concealed their diagnosis from others since their diagnosis and 26% concealed their diagnosis in the month preceding their participation in the study. Hypotheses regarding predictors and correlates of concealment were not supported. However, exploratory analyses identified use of alcohol, recency of a recurrence of lung cancer, use of positive reappraisal as a coping strategy, and social support as predictors of concealment as well as internalized shame as a correlate of concealment. These findings serve to extend existing literature on concealing a concealable stigma and support parts of an existing model on the effects of concealment. Future research should aim to test the impacts of concealment in the context of certain social situations to examine longitudinal relationships between predictors and consequences of concealment.

Previous research suggests that lung cancer patients are at an increased risk for depressive symptomatology; however, little is known about the possible etiology or correlates of depression among these patients. This study examined the relationship between perceived stigma and depressive symptomatology among lung cancer patients, and sought to find potential mediators of this relationship. It was hypothesized that more perceived stigma would be related to greater depressive symptomatology and that perceived stigma would contribute unique variance to depressive symptomatology above and beyond that contributed by clinical, demographic, and psychosocial variables. A sample of 95 participants receiving chemotherapy for stage II-IV non-small cell lung cancer was recruited during routine outpatient chemotherapy visits. A medical chart review was conducted to assess clinical factors and participants completed a standard demographic questionnaire as well as measures of perceived stigma, depressive symptomatology, and other psychosocial variables. As hypothesized, there was a positive association of perceived stigma to depressive symptomatology. Perceived stigma contributed significant unique variance to depressive symptomatology. In addition dyadic adjustment and dysfunctional attitudes mediated this relationship. Future research should aim to replicate and extend these findings in longitudinal analyses and attempt to ameliorate lung cancer patients' depressive symptomatology by targeting perceived stigma.