Optimism, Coping, and Physical Health
Many studies have examined the role of optimism and coping with a variety of situations. The following two sections examine the role of optimism in an individual’s ability to cope with acute and chronic physical health problems, problems related to daily living, and sudden crises.
Peterson and Bossio (1991) examine the role of optimism in health matters. They present evidence that optimism is a factor influencing well being. The authors indicate that “the optimist is healthy because she acts in ways to promote health and combat illness. She eats sensibly, exercises regularly, and knows when to say when.” (Peterson & Bossio, 1991, p.9). This view is consistent with Scheier and Carver’s hypothesis that optimism may influence coping styles (2000). Additionally, Peterson and Bossio present a study exploring the relationship between health and optimism. Peterson, Seligman, and Vaillant examined essays produced by men in the Harvard Study of Adult Development and rated the causal explanations for negative events according to whether the explanation related to internal factors, stability, and globality to determine each essay writer’s optimism score. They then compared these optimism scores with individuals’ health scores and found that “men who used optimistic explanations for bad events at age 25 were healthier later in life than men who offered pessimistic explanations” (p. 29).
The exploration of optimism’s effects on individual health and health-related behaviors has been continually developed as a research question. For example, Johnson and Endler (2002) found that optimism was negatively correlated with emotional preoccupation, state anxiety, and distress among men who tested positively for HIV. In the same study, optimism was positively correlated with distraction and lower levels of distress. Additionally, the authors found that palliative coping was positively correlated with depression and anxiety, particularly among participants who appeared low on optimism. Distinguishing individuals who are low in optimism may allow for more appropriate means of guiding individuals’ health-related behaviors in ways that do not increase psychological distress. Additionally, these research findings may imply that supporting individuals’ development of optimism may ultimately support medical compliance as well as psychological health.
Similarly, Pence, Valrie, Gil, Redding-Lallinger, and Daeschener (2007) found that optimism predicted pain medication usage among adolescents with sickle cell disease. They found that individuals with high and medium optimism levels reported a positive relationship between opioid usage and pain severity, while individuals with low optimism levels did not report a relationship between opioid usage and pain severity. Because adolescents in this study self-medicated, the appropriate usage of pain medication is an important indicator of the ability to comply with medical instructions. This study may also hold implications for developing strategies that support individuals’ medical compliance and health-related behaviors in that optimism seemed to mitigate individuals’ choices about pain medication.
Many studies relating optimism to physical health examine individuals with cardiac problems. Brink and Grankvist (2006) explored the relationships between optimism, fatigue, and depression on individuals who had experienced a heart attack for the first time. The investigators asked people to complete a depression measure, an optimism scale, and a fatigue scale a year after they had been admitted to the hospital for heart attacks. The authors found a curvilinear relationship between fatigue and optimism, in that higher optimism scores correlated with lower fatigue scores. They did not find a relationship between depression and optimism. The authors propose that “a pessimistic view of life may have more negative consequences, such as leading to the manifestation of fatigue, than an optimistic view of life has positive consequences” (p. 409).
In another study that looked at the psychological health of cardiac patients, Ai, Peterson, Tice, Huang, Rodgers and Bolling (2007) investigated the contradictive findings related to using prayer as a coping technique. They argue that prayer may indicate an active, optimistic, coping strategy, but that it may also indicate a high level of distress and anxiety. These arguments lead to a hypothetical model where a positive pathway, leading through pre-operative optimism yields better mental health postoperatively. While a negative pathway, leading through acute stress symptoms yields more anxiety and depression postoperatively. Ai, et al. (2007) conducted a study testing this model. They interviewed men and women two-weeks before surgery, two days after surgery, and approximately a month following surgery. Participants were assessed for depression, anxiety, optimism, acute posttraumatic stress disorder symptoms, and the use of prayer as a means for coping. They found that postoperative depression and anxiety had strong negative correlations to optimism and strong positive correlations to acute distress symptoms.
Additional statistics found that optimism negatively correlated to acute distress symptoms. The authors conclude that optimism mediates the beneficial effect of prayer coping on mental health.
Several studies that examine the relationship between optimism and physical health look at individuals experiencing gynecological cancers. In one study, De Moor, De Moor, Basen-Engquist, Kudelka, Bevers, & Cohen (2006) investigated optimism, distress, quality of life, and cancer antigen levels in women undergoing chemotherapy for ovarian cancer. The authors reviewed research that indicates that women with ovarian cancer who experience social support may have lower tumor-related markers. DeMoor, et al. (2006), measured distress, quality of life, and optimism at the beginning of treatment and before the last cycle of chemotherapy. The investigators found that optimism was negatively related to anxiety, perceived stress and depression at baseline and follow up. In other words, women with higher levels of optimism had lower levels of distress before and after chemotherapy treatment. Optimism was positively associated with social and functional well-being at follow up, though it did not relate to the quality of life. Additionally, DeMoor, et al. (2006) found optimism predicted lower cancer antigen levels at follow up. A reduction in cancer antigen levels is known to predict the likelihood of remission and survival in patients with ovarian cancer.
Friedman, Kalidas, Elledge, Chang, Romero, Husain, Dulay, and Liscum (2006) examined the roles of optimism and social support in the psychosocial functioning, adjustment and health-related quality of life in women with breast cancer. They indicate that behavioral self-regulation theory assumes that “people’s behaviors are affected by their beliefs or expectations about the likely outcomes of their behaviors” (p. 596). To discern influences on health-related quality of life, Friedman et al. (2006), extended research by looking at ethnically diverse women as well as individual characteristics, such as optimism, and medical characters, such as time since diagnosis. The investigators found that women who reported higher levels of optimism also reported higher levels of emotional, functional, and subjective well-being, lower cancer-related distress, and lower mood disturbances. They also found that pessimism and a family history of breast cancer accounted for 41% of the variance in mood disturbance. The authors concluded that optimism plays a similar role in psychological functioning among Hispanic, African-American, and Caucasian women with breast cancer.
Schou, Ekeberg, Sandvik, and Ruland, (2005) also looked at optimism and mental health among women with breast cancer. They specifically investigated the tendency for women to report stable levels of optimism over time in relation to receiving bad news, such as a breast cancer diagnosis, and potentially developing depression and anxiety. The authors report evidence from literature that the LOT-R offers both test-retest stability and lability over short time periods (Shifren & Hooker, 1995; Scheier & Carver, 1987). The researchers asked women to complete questionnaires following the hospital visit in which they received the diagnosis of breast cancer. At this stage, the women did not have definite treatment plans or much knowledge about their actual disease. The investigators divided the participants into two groups: one in which the women received further bad news following surgery, and one in which they did not.
They found that the LOT-R scores were stable over time for both groups. They also found that anxiety and depression decreased over the course of a year for both groups. The authors found that “one’s optimism-pessimism remains stable regardless if one experiences more or less anxiety or depression” (p. 152). Interestingly, the authors find that the women in the study actually had higher scores on the LOT-R than comparison groups of American, Australian, and Chinese students and American Animal rights demonstrators (Creed, Patton, & Bartum, 2002; Gavin & Herzog, 1998; Lai & Yue, 2000; Puskar, Sereika, Lamb, Tusaie-Mumford, & McGuiness, 1999, as cited by Schou, et al, 2005), although the authors concede that the age, gender, education, and cultural differences may explain this pattern.
McGregor, Bowen, Ankerst, Andersen, Yasui, & McTiernan (2004) also looked at the relationship between optimism, perceived risk of breast cancer, and worry about developing cancer as a means for exploring the relationship between optimism and distress. They hypothesized that optimism would be negatively related to worrying about cancer and to the perceived risk of breast cancer. In a methodology similar to Dillard, et al. (2006), the authors asked participants to rate their perceived risk for breast cancer while also calculating the participants’ objective risk of breast cancer. Participants completed measures of optimism and of cancer worry. Through statistical analyses, the researchers found that overall, the participants grossly overestimated their chances of developing breast cancer. They also found support for their hypotheses in that optimism was negatively correlated with cancer worry and that optimism and perceived risk had a significant relationship between each other. They found that “low levels of optimism would lead to a greater tendency for a negative preoccupation like cancer worry” (p. 342).
References
Ai, A. L., Peterson, C., Tice, T. N., Huang, B., Rodgers, W., & Bolling, S. F. (2007). The influence of prayer coping on mental health among cardiac surgery patients: The role of optimism and acute distress. Journal of Health Psychology, 12, 580-596.
Brink, E., & Grankvist, G. (2006). Associations between depression, fatigue, and life orientation in myocardial infarction patients. Journal of Cardiovascular Nursing, 21, 407-411.
De Moor, J. S, De Moor, C. A., Basen-Engquist, K., Kudelka, A., Bevers, M. W., & Cohen, L. (2006). Optimism, distress, health-related quality of life, and change in cancer antigen 125 among patients with ovarian cancer undergoing chemotherapy. Psychosomatic Medicine, 68, 555-562.
Friedman, L. C., Kalidas, M., Elledge, R., Chang, J., Romero, C., Husain, I., et al. (2006). Optimism, social support and psychosocial functioning among women with breast cancer. Psycho-oncology, 15, 595-603.
Johnson, J. M., & Endler, N. S. (2002). Coping with human immunodeficiency virus: Do optimists fare better? Current Psychology: Developmental, Learning, Personality, Social, 21, 3-16.
McGregor, B. A., Bowen, D. J., Ankerst, D. P., Andersen, M. R., Yasui, Y., & McTiernan, A. (2004). Optimism, perceived risk of breast cancer, and cancer worry among a community-based sample of women. Health Psychology, 23, 339-344.
Pence, L., Valrie, C. R., Gil, K. M., Redding-Lallinger, R., & Daeschner, C. (2007). Optimism predicting daily pain medication use in adolescents with sickle cell disease. Journal of Pain and Symptom Management, 33, 302-309.
Peterson, C. & Bossio, L. (1991). Health and optimism. New York, NY, US: Free Press.
Peterson, C., Seligman, M. E., Vaillant, G. (1988) Pessimistic explanatory style is a risk factor for physical illness: A thirty-five-year longitudinal study. Journal of Personality and Social Psychology, 55, 23-27.
Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology. 4, 219-247.
Schou, I., Ekeberg, O., Sandvik, L., & Ruland, C. M. (2005). Stability in optimism-pessimism in relation to bad news: A study of women with breast cancer. Journal of Personality Assessment, 84, 148-154.
Shifren, K. & Hooker, K. (1995). Stability and change in optimism: A study among spouse caregivers. Experimental aging research, 21, 59-76.
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