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Fairbank EJ, Borenstein-Laurie J, Alberts NM, Wrosch C. Optimism, pessimism, and physical health among youth: a scoping review. J Pediatr Psychol 2024; 49:580-595. [PMID: 38879445 PMCID: PMC11335150 DOI: 10.1093/jpepsy/jsae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/23/2024] [Accepted: 05/25/2024] [Indexed: 08/22/2024] Open
Abstract
OBJECTIVE High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in youth. The present study aimed to review the literature investigating optimism, pessimism, and physical health in children and adolescents from populations with and without health conditions. METHODS We conducted a scoping review up until February 2024. Studies were included if they sampled youth (average age ≤18 years) and treated optimism or pessimism as predictors of health behaviors or outcomes. Data on study and sample characteristics, health outcome, optimism construct, and findings were extracted from eligible papers and results were synthesized. RESULTS Sixty studies were retained. Most studies were conducted in North America, with adolescents, and used cross-sectional designs and self-reported measures of health. Measures of optimism and pessimism differed across studies. Roughly one-third of studies sampled medical populations. Health categories included substance use, diet and physical activity, sexual health practices, medical adherence, other health behaviors, cardiometabolic health, subjective health/health-related quality of life, pain, sleep, and oral health. Generally, we observed adaptive associations between optimism and health. Higher optimism and lower pessimism were most consistently associated with lower rates of substance use and lower cardiometabolic risk. CONCLUSIONS The presence of optimism or the absence of pessimism appears to be associated with various adaptive health outcomes among youth with and without health conditions. Developmental, methodological, and clinical considerations for future research are discussed, such as conducting longitudinal studies with objective measures of health and psychometrically validated instruments.
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Affiliation(s)
- Eloïse J Fairbank
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | | | - Nicole M Alberts
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Carsten Wrosch
- Department of Psychology, Concordia University, Montreal, QC, Canada
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Logan AC, Prescott SL, Haahtela T, Katz DL. The importance of the exposome and allostatic load in the planetary health paradigm. J Physiol Anthropol 2018; 37:15. [PMID: 29866162 PMCID: PMC5987475 DOI: 10.1186/s40101-018-0176-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/25/2018] [Indexed: 02/07/2023] Open
Abstract
In 1980, Jonas Salk (1914-1995) encouraged professionals in anthropology and related disciplines to consider the interconnections between "planetary health," sociocultural changes associated with technological advances, and the biology of human health. The concept of planetary health emphasizes that human health is intricately connected to the health of natural systems within the Earth's biosphere; experts in physiological anthropology have illuminated some of the mechanisms by which experiences in natural environments (or the built environment) can promote or detract from health. For example, shinrin-yoku and related research (which first emerged from Japan in the 1990s) helped set in motion international studies that have since examined physiological responses to time spent in natural and/or urban environments. However, in order to advance such findings into planetary health discourse, it will be necessary to further understand how these biological responses (inflammation and the collective of allostatic load) are connected to psychological constructs such as nature relatedness, and pro-social/environmental attitudes and behaviors. The exposome refers to total environmental exposures-detrimental and beneficial-that can help predict biological responses of the organism to environment over time. Advances in "omics" techniques-metagenomics, proteomics, metabolomics-and systems biology are allowing researchers to gain unprecedented insight into the physiological ramifications of human behavior. Objective markers of stress physiology and microbiome research may help illuminate the personal, public, and planetary health consequences of "extinction of experience." At the same time, planetary health as an emerging multidisciplinary concept will be strengthened by input from the perspectives of physiological anthropology.
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Affiliation(s)
- Alan C. Logan
- In-VIVO Global Initiative, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ 07093 USA
| | - Susan L. Prescott
- School of Medicine, University of Western Australia, Princess Margaret Hospital, PO Box D184, Perth, WA 6001 Australia
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Central Hospital, PO BOX 160, FI-00029 HUS Helsinki, Finland
| | - David L. Katz
- Prevention Research Center, Griffin Hospital, Yale University, 130 Division St, Derby, CT 06418 USA
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Prescott SL, Logan AC. Each meal matters in the exposome: Biological and community considerations in fast-food-socioeconomic associations. ECONOMICS AND HUMAN BIOLOGY 2017; 27:328-335. [PMID: 29107462 DOI: 10.1016/j.ehb.2017.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/23/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Advances in omics and microbiome technology have transformed the ways in which the biological consequences of life in the 'ecological theatre' can be visualized. Exposome science examines the total accumulated environmental exposures (both detrimental and beneficial) as a means to understand the response of the 'total organism to the total environment' over time. The repetitive stimulation of compensatory physiological responses (immune, cardiovascular, neuroendocrine) in response to stress - including sources of stress highly relevant to socioeconomic disadvantage - may lead to metabolic dysregulation and cellular damage, ultimately influencing behavior and disease. The collective toll of physiological wear and tear, known as allostatic load, is not paid equally throughout developed societies. It is paid in excess by the disadvantaged. In the context of fast-food, human and experimental research demonstrates that the biological response to a single fast-food-style meal - especially as mediated by the microbiome- is a product of the person's total lived experience, including the ability to buffer the fast-food meal-induced promotion of inflammation and oxidative stress. Emerging research indicates that each meal and its nutritional context matters. As we discuss, equal weekly visits to major fast-food outlets by the affluent and deprived do not translate into biological equivalency. Hence, debate concerning reducing fast-food outlets through policy - especially in disadvantaged neighborhoods where they are prevalent - requires a biological context. The fast-food establishment and fast-food meal - as they represent matters of food justice and press upon non-communicable disease risk - are far more than physical structures and collections of carbohydrate, fat, sugar and sodium.
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Affiliation(s)
- Susan L Prescott
- School of Medicine, University of Western Australia, PO Box D184, Princess Margaret Hospital, Perth, WA, 6001, Australia; International Inflammation (in-FLAME) Network, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ, 07093, United States.
| | - Alan C Logan
- International Inflammation (in-FLAME) Network, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ, 07093, United States
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Gebremariam MK, Lien N, Nianogo RA, Arah OA. Mediators of socioeconomic differences in adiposity among youth: a systematic review. Obes Rev 2017; 18:880-898. [PMID: 28434193 DOI: 10.1111/obr.12547] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Youth with a low socioeconomic position in developed countries are at a disproportionately higher risk of being overweight or obese than their counterparts. Tackling these inequalities requires that the mechanisms behind them are well understood. OBJECTIVES The aim of this review was to summarize existing evidence regarding the factors that mediate or contribute to the explanation of the relationship between socioeconomic position and adiposity among youth. METHODS AND RESULTS A systematic literature search, conducted using the databases Medline, Embase, Web of Science and PsycINFO, yielded 28 eligible studies. These studies were of low to moderate methodological quality. The most consistent mediators of the association between socioeconomic position and adiposity identified in this review were as follows: consumption of sugar-sweetened beverages, television viewing, computer use, parental body mass index, breastfeeding duration, breakfast consumption, maternal smoking during pregnancy and infant feeding practices. The mediating role of physical activity as well as fruit and vegetable consumption was found to be indeterminate. Other potential mediators were explored in too few studies to make conclusions about their mediating role. CONCLUSION The review found several modifiable factors that could be targeted as feasible in interventions aimed at reducing socioeconomic differences in overweight and obesity among youth.
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Affiliation(s)
- M K Gebremariam
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA.,Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - N Lien
- Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R A Nianogo
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - O A Arah
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California, USA.,UCLA Center for Health Policy Research, Los Angeles, California, USA.,California Center for Population Research, UCLA, Los Angeles, California, USA
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Subjective evaluation of psychosocial well-being in children and youths with overweight or obesity: the impact of multidisciplinary obesity treatment. Qual Life Res 2017; 26:3279-3288. [PMID: 28762099 DOI: 10.1007/s11136-017-1667-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/26/2023]
Abstract
PURPOSE To investigate the effects of a multidisciplinary childhood obesity treatment programme on subjective evaluations of psychosocial well-being and quality of life. METHODS This longitudinal observational study included 1291 children, adolescents and young adults, 6-22 years of age, with overweight or obesity. At entry and after 2-82 months of obesity treatment, the patients evaluated the following domains of psychosocial well-being on a visual analogue scale: quality of life, mood, appetite, bullying, motivation for weight loss and body image satisfaction. The degree of overweight was calculated using a body mass index (BMI) standard deviation score (SDS) at each visit. RESULTS At entry, the mean BMI SDS was 2.81 (range: 1.35-6.65, 95% confidence interval (95% CI): 2.44-3.18). After a median of 14 months of treatment, the median reduction in BMI SDS was 0.29 (95% CI: 0.26-0.31, p < 0.0001). Improvements were observed in the domains of quality of life, mood, appetite, bullying and body image satisfaction (p < 0.0001). Larger reductions in BMI SDS were associated with greater improvements in the domains of quality of life (p = 0.001), mood (p = 0.04) and body image satisfaction (p < 0.0001), independent of BMI SDS at entry. However, improvements in psychosocial well-being were also observed in those increasing their BMI SDS (n = 315). CONCLUSIONS In a large group of children and youths, psychosocial well-being improved during a multidisciplinary childhood obesity treatment programme, irrespective of the degree of obesity at treatment entry. Greater reductions in BMI SDS were associated with greater improvements in psychosocial well-being, but even in the group increasing their BMI SDS improvements were observed.
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Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr 2015; 15:129. [PMID: 26391227 PMCID: PMC4578240 DOI: 10.1186/s12887-015-0443-3] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005. Methods To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses. Results Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship. Conclusion The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Barriuso
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
| | - Estrella Miqueleiz
- Department of Sociology, Universidad Pública de Navarra, Campus de Arrosadía, s/n, 31006, Pamplona, Spain.
| | - Romana Albaladejo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Rosa Villanueva
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juana M Santos
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Enrique Regidor
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Boehm JK, Chen Y, Williams DR, Ryff C, Kubzansky LD. Unequally distributed psychological assets: are there social disparities in optimism, life satisfaction, and positive affect? PLoS One 2015; 10:e0118066. [PMID: 25671665 PMCID: PMC4324648 DOI: 10.1371/journal.pone.0118066] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 01/07/2015] [Indexed: 01/13/2023] Open
Abstract
Socioeconomic status is associated with health disparities, but underlying psychosocial mechanisms have not been fully identified. Dispositional optimism may be a psychosocial process linking socioeconomic status with health. We hypothesized that lower optimism would be associated with greater social disadvantage and poorer social mobility. We also investigated whether life satisfaction and positive affect showed similar patterns. Participants from the Midlife in the United States study self-reported their optimism, satisfaction, positive affect, and socioeconomic status (gender, race/ethnicity, education, occupational class and prestige, income). Social disparities in optimism were evident. Optimistic individuals tended to be white and highly educated, had an educated parent, belonged to higher occupational classes with more prestige, and had higher incomes. Findings were generally similar for satisfaction, but not positive affect. Greater optimism and satisfaction were also associated with educational achievement across generations. Optimism and life satisfaction are consistently linked with socioeconomic advantage and may be one conduit by which social disparities influence health.
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Affiliation(s)
- Julia K. Boehm
- Department of Psychology, Chapman University, Orange, California, United States of America
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of African and African American Studies and Sociology, Harvard University, Cambridge, Massachusetts, United States of America
| | - Carol Ryff
- Department of Psychology, University of Wisconsin Madison, Madison, Wisconsin, United States of America
- Institute on Aging, University of Wisconsin Madison, Madison, Wisconsin, United States of America
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
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Johnson SRL, Blum RW, Cheng TL. Future orientation: a construct with implications for adolescent health and wellbeing. Int J Adolesc Med Health 2015; 26:459-68. [PMID: 24523304 DOI: 10.1515/ijamh-2013-0333] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 01/04/2014] [Indexed: 11/15/2022]
Abstract
Multidisciplinary research has supported a relationship between adolescent future orientation (the ability to set future goals and plans) and positive adolescent health and development outcomes. Many preventive strategies - for example, contracepting, exercising - are based on taking actions in the present to avoid unwanted or negative future consequences. However, research has been hampered by unclear and often divergent conceptualizations of the future orientation construct. The present paper aims to integrate previous conceptual and operational definitions into a conceptual framework that can inform programs and services for youth and efforts to evaluate future orientation as a target for intervention. Recommendations focus on furthering the study of the construct through measurement synthesis as well as studies of the normative development of future orientation. Also suggested is the need to pair environmental intervention strategies with individual level efforts to improve future orientation in order to maximize benefits.
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Sutin AR. Optimism, pessimism and bias in self-reported body weight among older adults. Obesity (Silver Spring) 2013; 21:E508-11. [PMID: 23512794 PMCID: PMC3805958 DOI: 10.1002/oby.20447] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 02/20/2013] [Accepted: 02/21/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Body mass index (BMI) and obesity (BMI ≥ 30) are often derived from self-reported weight and height; psychological dispositions may bias how participants report these physical characteristics. The present research used a large national sample of US adults to examine the correspondence between reported and measured body weight and height and to test whether optimists and pessimists misreport their weight/height in ways that are consistent with their worldviews. METHODS Participants in the Health and Retirement Study (N = 11,207) reported their weight and height and completed a measure of dispositional optimism and pessimism; trained interviewers measured participants' weight and height. RESULTS There was a high correlation between measured and reported weight (r = 0.98) and height (r = 0.92). Consistent with their positive and negative worldviews, respectively, optimists under-reported and pessimists over-reported their weight. There was not a consistent association with misreported height. Optimism and pessimism were also associated with actual BMI and risk of obesity, but the protective/risk effects were amplified when using reported weight to derive BMI. CONCLUSIONS These findings suggested that reported body weight tends to be accurate, but that biases associated with psychological dispositions may inflate the relation between the disposition and obesity. Such biases may extend to associations with other self-reported factors thought to be related to optimism and pessimism.
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Affiliation(s)
- Angelina R Sutin
- Florida State University College of Medicine, Tallahassee, Florida, USA
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Piko BF, Luszczynska A, Fitzpatrick KM. Social inequalities in adolescent depression: the role of parental social support and optimism. Int J Soc Psychiatry 2013; 59:474-81. [PMID: 22491755 DOI: 10.1177/0020764012440788] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Interpersonal theory suggests relationships between socio-economic status (SES) and adolescent psychopathology mediated by negative parenting. This study examines the role of perceived parental social support and optimism in understanding adolescents' depression and self-rated health among a sample of Hungarian youth. METHODS Using a self-administered questionnaire, data (N = 881) were collected from high-school students (14-20 years old) in Szeged, Hungary (a regional centre in the southeastern region, near to the Serbian border, with a population of 170,000 inhabitants). To analyse the overall structure of the relationship between objective/subjective SES, parental support, optimism and health outcomes (depression, self-perceived health), structural equation modelling (SEM) was employed. RESULTS Findings suggest the following: (1) SES variables generate social inequalities in adolescent depression through parental social support, particularly maternal support; and (2) parents provide youths with different levels of social support that in turn may strengthen or weaken optimism during the socialization process. CONCLUSIONS In addressing depression prevention and treatment, we may want to take into account socio-economic differences in social networks and levels of optimism, which may influence youths' psychosocial adjustment and development of psychopathology.
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Affiliation(s)
- Bettina F Piko
- University of Szeged, Department of Behavioural Sciences, University of Szeged, Hungary.
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Oreskovic NM, Goodman E. Association of optimism with cardiometabolic risk in adolescents. J Adolesc Health 2013; 52:407-12. [PMID: 23298981 PMCID: PMC3608806 DOI: 10.1016/j.jadohealth.2012.09.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 09/13/2012] [Accepted: 09/18/2012] [Indexed: 12/22/2022]
Abstract
PURPOSE Dispositional optimism is a psychological trait associated with cardiovascular disease outcomes in adults. However, it is not known whether these associations are present in adolescents. We attempted to determine whether an association exits between optimism and 9 biomarkers of cardiometabolic risk during adolescence. Because cardiometabolic risk differs by race and ethnicity, we also explored whether race and ethnicity moderated the optimism-cardiometabolic risk relationship. METHODS This was a cross-sectional study of 529 non-Hispanic white and 421 non-Hispanic black seventh through 12th graders living in greater Cincinnati in 2001-2002. We measured dispositional optimism with the Life-Orientation Test-Revised as a single continuum and as separate optimism and pessimism dimensions. Multivariable regression analyses tested for associations between optimism and nine biomarkers of risk (interleukin-6, tumor necrosis factor-α, lipids, insulin, glucose, and fibrinogen), adjusting for age, gender, parent education, body mass index, smoking, and pubertal stage. RESULTS Dispositional optimism with the Life-Orientation Test-Revised as a single continuum was inversely associated with two risks (interleukin-6, β = -.03, p = .02; insulin, β = -.02, p = .01), but only among blacks. Optimism and pessimism were inversely related (R = -.27, p < .001) and both were higher in blacks than whites (p < .001). Optimism was directly associated with high-density lipoprotein among all subjects (β = .42, p = .03), and among blacks (β = .74, p = .02) but not whites. Among blacks, optimism was also inversely associated with interleukin-6 (β = -.07, p = .001) and triglycerides (β = -.02, p = .04). Pessimism was inversely associated with glucose, but only in whites (β = -.38, p = .03). CONCLUSIONS Associations between dispositional optimism and cardiometabolic risks are present in adolescence and vary by race and ethnicity. A better understanding of the natural history of these associations over the lifespan may help decrease disparities and prevent cardiometabolic disease.
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Affiliation(s)
- Nicolas M. Oreskovic
- Center for Child & Adolescent Health Research and Policy, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Elizabeth Goodman
- Center for Child & Adolescent Health Research and Policy, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
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