Original Article

Annals of Behavioral Medicine

, Volume 44, Issue 3, pp 331-340

First online:

The Role of Blame in the Psychosocial Adjustment of Couples Coping with Lung Cancer

  • Kathrin MilburyAffiliated withDepartment of Behavioral Science, Unit 1330, The University of Texas MD Anderson Cancer Center Email author 
  • , Hoda BadrAffiliated withDepartment of Oncological Sciences, Mount Sinai School of Medicine
  • , Cindy L. CarmackAffiliated withDepartments of Behavioral Science & Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center

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Lung cancer patients and their spouses may engage in blame attributions regarding the cancer cause, which may adversely affect their psychological adjustment.


The aim of this study was to examine whether dyadic adjustment and network support moderate the association between blame and distress in couples affected by lung cancer.


Patients and their spouses completed questionnaires within 1 month of treatment initiation (baseline) and at 6-month follow-up.


Multilevel modeling of data from 158 couples revealed that, at baseline, dyadic adjustment moderated the association between blame and distress for patients but not spouses (p < 0.05). Controlling for baseline distress, baseline blame predicted later distress (p < 0.05) for both patients and spouses regardless of dyadic adjustment. Network support moderated this association at follow-up.


For patients experiencing low dyadic adjustment, blame was associated with increased distress. Not initially but later, network support may protect against low levels but not high levels of blame in patients and spouses.


Lung cancer Attributions of blame Couples Distress Dyadic adjustment Social support