Relations of perceived injustice to psycho‐spiritual outcomes in advanced lung and prostate cancer: Examining the role of acceptance and meaning making
Open accessAbstract
Objective: Many advanced cancer patients struggle with anxiety, depressive symptoms, and anger toward God and illness‐related stressors. Patients may perceive their illness as an injustice (i.e., appraise their illness as unfair, severe, and irreparable or blame others for their illness), which may be a risk factor for poor psychological and spiritual outcomes. This study examined relations between cancer‐related perceived injustice and psycho‐spiritual outcomes as well as potential mediators of these relationships. Methods: Advanced lung (n = 102) and prostate (n = 99) cancer patients completed a one‐time survey. Using path analyses, we examined a parallel mediation model including the direct effects of perceived injustice on psycho‐spiritual outcomes (i.e., anxiety, depressive symptoms, anger about cancer, anger towards God) and the indirect effects of perceived injustice on psycho‐spiritual outcomes through two parallel mediators: meaning making and acceptance of cancer. We then explored whether these relations differed by cancer type. Results: Path analyses indicated that perceived injustice was directly and indirectly—through acceptance of cancer but not meaning making—associated with psycho‐spiritual outcomes. Results did not differ between lung and prostate cancer patients. Conclusions: Advanced cancer patients with greater perceived injustice are at higher risk for poor psycho‐spiritual outcomes. Acceptance of cancer, but not meaning making, explained relationships between cancer‐related perceived injustice and psycho‐spiritual outcomes. Findings support testing acceptance‐based interventions to address perceived injustice in advanced cancer patients.
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Among patients with advanced lung or prostate cancer, perceived injustice significantly influenced depression and anxiety symptoms, anger at the cancer, and anger at God.
“In patients with advanced lung and prostate cancer, perceived injustice significantly affected symptoms of depression and anxiety along with anger towards the cancer and anger towards God.11”
From Perceived injustice: a historical and clinical review of a useful concept for psychiatry (2024) · cites this paper as [11]
The Results report significant relationships between perceived injustice and all four outcomes: depressive symptoms, anxiety, anger about cancer, and anger toward God. But the Methods describe a one-time survey, and the Discussion acknowledges that distress might instead contribute to perceived injustice. The claim’s word “affected” implies a causal direction the study does not establish. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAcceptance is the central mediating process in the adjustment process between perceived injustice and psychosocial outcomes.
“In their model, the association between perceived injustice and psychosocial outcomes was mediated by acceptance (not meaning making), suggesting that acceptance is the central mediating process in this adjustment process.”
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- Authors
- Secinti, E., Wu, W., Krueger, E. F., Hirsh, A. T., Torke, A. M., Hanna, N. H., Adra, N., Durm, G. A., Einhorn, L., Pili, R., Jalal, S. I., & Mosher, C. E.
- Affiliations
- Department of Psychology Indiana University–Purdue University Indianapolis Indianapolis Indiana USA
- Indiana University – Purdue University Indianapolis (US)
- Indiana University Health (US)
- Department of Medicine Indiana University School of Medicine Indianapolis Indiana USA
- Department of Medicine Jacobs School of Medicine & Biomedical Sciences University at Buffalo Buffalo New York USA
- ORCID
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2022-11-11
- Volume
- 31
- Issue
- 12
- Pages
- 2177-2184
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- PMC
- PMC9732736
- OpenAlex
- W4308366966
- Cited by
- 11
- References
- 39
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 1
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Cancer Institute
- Walther Cancer Foundation
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- perceived injustice, advanced cancer, lung cancer, prostate cancer, meaning-making, anxiety, depressive symptoms, illness-related stress, acceptance-based interventions
- MeSH terms
- Anger, Anxiety, Humans, Lung, Male, Prostatic Neoplasms, Surveys and Questionnaires, Spirituality
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