How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer.

Abstract

A good deal of research now indicates that the personality dimension of optimism-pessimism plays an important role in a wide range of behavioral and psychological outcomes when people confront adversity (reviewed in Scheier & Carver, 1992). What is less clear is the mechanism (or mechanisms) by which the beneficial effects of optimism take place. One possibility is that optimists do better than pessimists because they cope more effectively.' There is an abundance of evidence that they at least cope differently. Optimists and pessimists differ from one another in reports of their general coping tendencies (Carver, Scheier, & Weintraub, 1989) and in the coping responses they bring to mind when considering hypothetical situations (Scheier, Weintraub, & Carver, 1986), recalling a stressful situation from the recent past (Scheier et al., 1986), dealing with infertility problems (Litt, Tennen, Affleck, & Klock, 1992), managing a life transition (Aspinwall & Taylor, 1992), coping with a serious disease (Friedman et al., 1992), and dealing with worries about specific health threats (Stanton & Snider, 1993;Taylor et al., 1992).Far less information is available, however, concerning the hypothesis that these differences in coping serve as the vehicle by which optimists experience better eventual outcomes. Three studies in the literature are relevant to the question. One of them (Scheier et al., 1989) examined men undergoing coronary artery bypass surgery. These subjects did not complete a full measure of coping but indicated their use of several cognitive-attentional strategies before and after the surgery. Although optimism was related to several of these strategies, there was scant evidence that the strategies mediated the beneficial effect of optimism on subsequent outcomes. The second study (Aspinwall & Taylor, 1992) assessed optimism and coping in a group of students entering college and assessed well-being 3 months later. In this case, the beneficial effects of optimism appeared to operate at least in part through differences in both active coping and avoidance coping.Both of these studies have an important limitation, however. Neither included an initial measure of the variables that served as the later outcome measure. Thus,

Helping patients with localized prostate carcinoma manage uncertainty and treatment side effects

“…40 Cognitive reframing reportedly is a common coping strategy among cancer patients. 73 Lepore and Helegson 40 identified cognitive processing as an important activity that helps men with prostate carcinoma reinterpret traumatic events into manageable events and integrate uncertain aspects of their experience into a coherent cognitive state during the time of most distress. Consistent with the uncertainty in illness theory 37 and recent work by Pennebaker 74 expressing one's experience to a trusted individual places some structure on the experience, thereby facilitating cognitive restructuring of the event.…”

Optimistic Personality and Psychosocial Well-Being During Treatment Predict Psychosocial Well-Being Among Long-Term Survivors of Breast Cancer.

“…Thus, more is involved than a static translation of a trait into a distress level (cf. Carver et al, 1993). Presumably, women who vary in their dispositions responded differently to new challenges and problems over time (which were not assessed here), resulting in a reordering within the sample that continued to favor the more optimistic women over the less optimistic women.…”

“…The importance of this trait has been shown in several healthrelated contexts (Scheier, Carver, & Bridges, 2001). As a broad sense of confidence, optimism keeps people engaged in efforts toward desired goals, resulting in better behavioral outcomes (Carver, Lehman, & Antoni, 2003) and more adaptive coping (Carver et al, 1993;Stanton & Snider, 1993). Optimism has also predicted lower distress in many populations (Scheier et al, 2001), including breast cancer patients studied during the time surrounding diagnosis and through the next year (Carver et al, 1993Epping-Jordan et al, 1999;Stanton & Snider, 1993).…”

“…Participants were women who had had surgery for early stage breast cancer 5 to 13 years earlier and had participated in studies of psychosocial adjustment at that time. Some had been followed from the point of diagnosis over the next year (Alferi, Carver, Antoni, Weiss, & Durán, 2001;Alferi, Culver, Carver, Arena, & Antoni, 1999;Carver et al, 1993Carver et al, , 1998Culver, Arena, Antoni, & Carver, 2002). Others were assessed once at either 3, 6, or 12 months postsurgery (Spencer et al, 1999).…”

“…One well-studied group of cancer patients is women with breast cancer (e.g., Psychological Aspects of Breast Cancer Study Group, 1987), among whom a number of risk and resilience factors have been identified (Glanz & Lerman, 1992;Irvine, Brown, Crooks, Roberts, & Browne, 1991;Moyer & Salovey, 1996). Factors that have been examined include coping reactions (e.g., Ben-Zur, Gilbar, & Lev, 2001;Carver et al, 1993), social support (Bloom & Spiegel, 1984;Helgeson & Cohen, 1996), sexual self-schemas (Andersen & Cyranowski, 1994;Yurek, Farrar, & Andersen, 2000), personality qualities such as optimism (Carver et al, 1993Epping-Jordan et al, 1999;Stanton & Snider, 1993), and medical factors such as stage of disease and extent of surgery (Glanz & Lerman, 1992;Irvine et al, 1991;Moyer & Salovey, 1996).…”