Lung cancer stigma is a burgeoning area of literature, yet two important questions remain unanswered: a) What are the associations between lung cancer stigma and psychosocial outcomes across lung cancer survivors with different smoking histories and b) how would lung cancer survivors describe their experience of coping strategies they utilize to cope with lung cancer stigma. This dissertation presents two studies that seek to answer the above-mentioned questions: a) a quantitative study that describes the rates of Personal Responsibility, Regret, and Medical Stigma and the associations between the above-mentioned constructs and psychosocial outcomes; and b) a qualitative study of coping strategies that lung cancer survivors reported utilizing in response to lung cancer stigma. Results from the quantitative study suggest that, while current and former smokers report significantly greater rates of Personal Responsibility and Regret when compared to never smokers, smoking status did not significantly affect the level of Medical Stigma reported by lung cancer survivors. The most common themes extracted from the qualitative data were coping strategies involving education, avoidance, support, helping others, acceptance, and assertive communication. Further research is needed to investigate exactly how lung cancer stigma relates to psychosocial outcomes. As future interventions geared towards lung cancer stigma are developed and tested, it will be important to a) measure lung cancer stigma and its associated constructs (e.g., regret, guilt/shame, personal responsibility) with instruments that are firmly rooted in testable theoretical frameworks, b) track psychosocial outcome variables and their changes as a result of the treatment response via the intervention, c) and observe any differences in how stigma variables (e.g., perceived stigma and internalized stigma) might be associated differently with outcome variables and change over time differently depending on smoking history (e.g., comparing outcomes between ever vs. never smokers).

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Owen, Jason E.

Second Advisor

Arechiga, Adam L.

Third Advisor

Thoreson, Laura

Fourth Advisor

Vermeersch, David

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Lung Neoplasms - psychology; Adaptation - psychological; Health Status Indicators; Treatment Outcomes

Subject - Local

Lung Cancer; Stigma; Psychosocial outcomes; Coping strategies; Personal Responsibility and Regret; Guilt/Shame;



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives