OPTIMISM VERSUS PESSIMISM PREDICTS THE QUALITY OF WOMENS ADJUSTMENT TO EARLY-STAGE BREAST-CANCER

Background. Recent studies indicate that breast cancer patients do not usually experience the devastating psychological consequences once vi ewed as inevitable. However, some adjust to the disease more poorly th an others. This study examined the personality trait of optimism versu s pessimism as a predictor of adjustment over the first year, postsurg ery. Methods. Seventy women with early stage breast cancer reported on their general optimism-pessimism at diagnosis. One day before surgery , and at 3-month, 6-month, and 12-month follow-ups, they reported thei r subjective well-being (mood scales and a measure of satisfaction wit h life). At follow-ups, they also rated their sex lives, indicated how much physical discomfort was interfering with their daily activities, and reported on thought intrusion. Results. Pessimism displayed poore r adjustment at each time point by all measures except interference fr om pain. Even controlling for previous well-being, pessimism predicted poorer subsequent well-being, suggesting that pessimism represents a vulnerability to a negative change in adjustment. In contrast, effects of pessimism on quality of sex life and thought intrusion were not in cremental over time. Additional analyses indicated that effects of the optimism-pessimism measure were captured relatively well by a single item from the scale. Conclusions. A sense of pessimism about one's lif e enhances a woman's risk for adverse psychological reactions to the d iagnosis of, and treatment for, breast cancer. This finding suggests t he potential desirability of assessing this quality informally in pati ents, to serve as a warning sign regarding the patient's well-being du ring the period surrounding and following surgery.