Lung cancer is considered the leading cause of cancer death worldwide. An estimated 224,390 new cases of lung cancer are expected to be diagnosed and 158,080 Americans are expected to die from lung cancer in 2016 (National Institutes of Health, 2016; Siegel, Miller, & Jemal, 2016). Lung cancer patients also report the highest levels of psychological distress and symptom burden than any other forms of cancer (Linden, Vodermaier, MacKenzie, & Greig, 2012). Given the prevalence and impact of lung cancer, it is imperative to address the emotional toll this diagnosis can have on those suffering with the disease to develop helpful strategies for those coping with lung cancer. The goal of this study is to determine how much lung cancer patients’ symptom burden affects their level of distress, and how much of this effect is mediated by approach and/or avoidance coping styles. Adults (N = 109, 57% female,) with an average age of 67 (SD = 10.1) diagnosed with lung cancer completed a questionnaire assessing for physical and psychological functioning at two medical centers in Southern California. Results: There was a significant positive relationship between total symptom burden and distress. Avoidance coping was a significant mediator of the relationship between total symptom burden and distress. Approach coping was not a significant mediator of this relationship. Conclusions: Results suggest that a patient experiences more distress as his/her symptom burden increases, and this effect is partially explained by engaging in avoidant coping. Therefore, it is important to find ways to help patients cope more effectively to reduce their levels of stress. The findings of this study show the importance of continued research to find effective coping strategies and as well to inhibit patients from engaging in an avoidant coping style.

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Morrell, Holly E. R.

Second Advisor

Boyd, Kendal C.

Third Advisor

Vermeersch, David A.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Lung Neoplasms - psychology; Stress; Psychological; Adaptation; Psychological

Subject - Local

Lung Cancer; Coping Strategies; Symptom burden; Distress; Avoidant coping



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