Table 2.

Description of Cancer-related Negative Social Expectations Scale Content Domains

	Domain	Rationale	Items from Table 3
1	Expecting others to listen or be available whenever the patient needs them.	Patients have reported feelings of loneliness when visits from family and friends and conversations about their illness did not occur as often as expected [23,12].	1, 5, 7, 11, 13
2	Expecting a lack of understanding of cancer-related concerns.	Patients have reported feeling lonely when they believed others misunderstood their cancer-related experiences and changes [13,12].	2, 8
3	Expecting that others will not understand existential thoughts.	Many cancer patients have reported new existential thoughts, including a newfound awareness of their mortality and unpredictable future, after their diagnosis. Patients have reported feeling lonely when they perceived that others did not share their heightened awareness about mortality [13].	4, 10
4	Expecting sharing cancer-related concerns to burden others	For some patients, a lack of cancer-related disclosure is motivated by a desire to protect others from distress. Some patients with this thought pattern experience distress and disconnection from others when they fail to discuss cancer-related concerns [13,12]. Relatedly, protective buffering (e.g., hiding concerns and worries in an attempt to prevent others from experiencing distress) [25] has been associated with poorer psychological adjustment and lower levels of relationship satisfaction in cancer patients [25,48].	3, 9
5	Expecting disclosure of their diagnosis or cancer-related concerns to worsen their relationships.	Some patients withhold cancer-related information from others due to concerns that disclosing their health status would negatively change the way others interact with them [12]. For example, patients expect others to avoid them or show discomfort during conversations. Thus, whereas domain 4 focuses on cancer-related disclosure burdening others, domain 5 focuses on patients’ anticipated distress as relationships change following disclosure. However, many patients have reported that withholding cancer-related information led to feelings of isolation [12], consistent with social-cognitive processing theory [24,14]. Specifically, processing cancer-related information with others has been found to facilitate psychological adjustment [49,50,16], an opportunity not available to non-disclosing patients.	6, 12, 14