Negative Effect of Pessimism Seen Only in Younger Patients

WASHINGTON -- Past research on the relationship between a broad range of psychosocial factors such as personality style, depressed mood, hopelessness, social support and anger, and the occurrence and course of cancer has produced a decidedly mixed bag of results: some studies have found significant associations; others have not. Now a new study that takes a more focused approach to the possible links between psychological factors and cancer survival, looking specifically at the influence of optimism and pessimism, has identified pessimism as an important risk factor for morality in cancer patients under the age of 60.

The study, "Pessimism, Age, and Cancer Mortality, " which appears in the June issue of the journal Psychology and Aging, published by the American Psychological Association (APA), followed 238 patients with metastasized or recurrent cancer who were receiving radiation treatment for palliation of symptoms. Half of the participants were male and half were female; the vast majority were white. The most prevalent form of cancer among them was cancer of the lung or breast; the least common were colorectal and gastrointestinal cancers. Assessments of the patients' optimism, pessimism and level of depression were taken when they entered the study and again four months and eight months later. Seventy patients had died by the eight-month follow-up.

The researchers found that while there was no significant association between optimism or depression and survival or mortality -- regardless of patient age -- there was a definite association between pessimism and mortality, but only for those patients under 60. (The authors note that optimism and pessimism are not the opposite sides of the same coin -- a person can lack optimism but not be pessimistic and vice-versa.) "Our findings," the authors write, "indicate that the endorsement of a pessimistic life orientation may function as an important risk factor for mortality among younger (ages 30-59) cancer patients."

The data from this study did not explain the precise mechanism by which pessimism affects mortality in cancer patients, but the authors note that "it is possible...that pessimism affects behaviors such as adherence to a medical regimen, or that it directly affects the endocrine and immune systems, or both."

As for the age differences, once again the authors could only speculate. For example, they note that for older persons, pessimism may be used as a coping strategy to adapt to declines in their ability to control important life outcomes such as health, but that in younger people it may reflect "genuine hopelessness and despair about the future." A second possibility is that the psychological threat of an illness like cancer is not as great among older people when compared with the young. "Cancer is more normative among older adults; that is, they are far more likely to know someone in their peer group who has experienced (and perhaps coped successfully with) cancer," they note.

5/30/98

Reference: "Pessimism, Age, and Cancer Survival" by Richard Schulz, Ph.D., and Jamila Bookwala, Ph.D., Judith E. Knapp, Ph.D., Michael Scheier, Ph.D., Gail M. Williamson, Ph.D.; Psychology and Aging, Vol. 11, No. 2, pp 304-309.

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 159,000 researchers, educators, clinicians, consultants and students. Through its divisions in 50 subfields of psychology and affiliations with 58 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.