Discussion
The primary goal of the current study was to develop a
more nuanced understanding of the association between
the social environment and uncertainty among a sample
of patients with AATD-associated COPD. Perceived criticism from family members was associated with more
ambiguity (i.e., uncertainty about physical cues and
symptoms) and complexity (i.e., uncertainty about treatment and the medical system). This finding is consistent with a prior study that found an association between dissatisfaction with social interactions and greater uncertainty among individuals with systemic sclerosis [17]. Unsupportive interactions (such as criticism) may lead patients to feel that members of their social system are not available to provide support or, worse, may indicate that members of their social system are more a source of stress than support. This may make it difficult for patients to interpret and manage fluctuations in their symptoms and navigate the medical system. Future research should attempt to elucidate how unsupportive social interactions contribute to high illness uncertainty.