Dispositional optimism in adolescents with cancer: Differential associations of optimism and pessimism with positive and negative aspects of well-being

Differential Effects of Optimism and Pessimism on Adolescents' Subjective Well-Being: Mediating Roles of Reappraisal and Acceptance

Prior research has found the differential strength of optimism and pessimism in predicting physical health. However, whether similar findings would be obtained in predicting subjective well-being and the possible underlying mechanisms are still unclear. This study examined the relative strength of optimism and pessimism in predicting adolescent life satisfaction and depression, and further explored the possible mediating mechanisms from the perspective of emotion regulation. A sample of 2672 adolescents (M_age = 13.54 years, SD = 1.04; 55.60% boys) completed a survey assessing optimism and pessimism, the habitual use of reappraisal and acceptance strategies, life satisfaction, and depression. The results from dominance analysis revealed that the presence of optimism was more powerful than the absence of pessimism in predicting adolescent life satisfaction, while the absence of pessimism was more powerful than the presence of optimism in predicting adolescent depression. Moreover, mediation models showed that reappraisal and acceptance mediated both the link between optimism and life satisfaction and the link between pessimism and depression. These findings suggest possible avenues for intervening in different aspects of adolescent subjective well-being.

Health tourism destinations as therapeutic landscapes: Understanding the health perceptions of senior seasonal migrants

Health-driven seasonal tourism has become a new way of providing for the aged, which demonstrates a profound relationship between place and health. Therapeutic landscapes strongly suggest a causal relationship between health tourism destination and individual health. However, the quantitative validation of such relationship remains neglected and possible mechanisms underlying the relationship lack a strong theoretical basis. Based on therapeutic landscape theory and the REPLACE framework, this study quantitatively examines health promotion mechanisms of health tourism destinations by using data collected in Sanya, China, in January 2019. The effect of personal traits of dispositional optimism on health perceptions is also considered. The results show that physical, social, and symbolic landscapes positively influence health perceptions through restorative experiences. Social landscapes, symbolic landscapes and dispositional optimism positively affect health perception, while physical landscapes do not directly have a significant impact on health perception. It is expected that this study will fill the knowledge gap and advance our knowledge of therapeutic landscapes by exploring how they can influence health.

Optimism and Mental Health in Adolescence: a Prospective Validation Study of the Dutch Life-Orientation Test-Revised (LOT-R-A) for Adolescents

The study aimed to examine the psychometric properties of the Dutch Life Orientation Test-Revised for Adolescents (LOT-R-A), a self-report questionnaire assessing dispositional optimism, and to evaluate the two-factor structure (optimism, pessimism). The LOT-R-A and the questionnaires measuring well-being (MHC-SF-A) and psychological problems (SDQ) were completed by 459 Dutch adolescents (178 boys and 281 girls) between the ages of 11 and 18 years at baseline and 281 adolescents at a four-week follow-up. The results confirmed the two-factor structure (optimism, pessimism) of the LOT-R-A. The findings provided evidence of internal consistency of scores ranging from low to good, and evidence of good test-retest reliability of scores. Further, scores of optimism were cross-sectionally positively associated with scores of positive emotions and well-being and negatively with scores of psychological problems and negative emotions, providing evidence of convergent and divergent validity of optimism scores with emotions, well-being, and psychological problems. Lastly, scores of optimism were prospectively positively associated with scores of well-being and negatively with scores of psychological problems, providing evidence of criterion validity of optimism scores with well-being and psychological problems. Based on these findings it can be concluded that the LOT-R-A is a valid instrument to examine optimism among adolescents. Future research can help to elucidate the role of optimism in mental health interventions and can gather knowledge on how these interventions can be refined to optimally cultivate optimism during the developmental period of adolescence.

Profiles and predictors of resilient functioning in youths with pediatric cancer history

OBJECTIVE

To identify and predict resilient functioning over time among youths with pediatric cancer experience (YPCE).

DESIGN

YPCE aged 8-17 years (N = 231) were followed prospectively for 3 years. Their psychosocial adjustment was assessed using self-report and parent-report at 1 year (T2) and 3 years (T3) post-baseline.

METHODS

Latent profile analysis identified subgroups of YPCE with different patterns of adjustment over time. Self-reported factors from baseline and T2 were examined as predictors of subgroup membership.

FINDINGS

Three subgroups of youths were found. Two exhibited average (52.5% of the sample) to better-than-average (41.3%) functioning. One subgroup (6.2%) exhibited subclinical but at-risk range of adjustment. Low optimism and low connectedness to parents and school predicted membership in this group.

CONCLUSIONS

Most YPCE exhibit resilient functioning across time. However, approximately 6% report persistent maladjustment.

IMPLICATIONS

Most YPCE are well-adjusted, but those with low optimism and poor connection to parents or school may require monitoring for psychosocial difficulties.

Identification of Evidence for Key Positive Psychological Constructs in Pediatric and Adolescent/Young Adult Patients with Cancer: A Scoping Review

Introduction: Children and adolescents/young adults (AYAs) with cancer are a vulnerable population susceptible to numerous late effects, such as fatigue and depression, which may diminish their long-term psychological, physical, spiritual, and emotional health. A well-rounded understanding of how positive psychological constructs affect the quality of care and treatment outcomes is therefore warranted.

Methods: We conducted a scoping review of 15 positive psychological constructs in children and AYAs with cancer. The primary research questions were (1) what is known about positive psychological constructs in children and AYAs with cancer; (2) what value is ascribed to these constructs by patients?

Results: Two hundred seventy-six articles were included after database search and screening. These studies were mostly observational or qualitative and conducted in North America. Constructs were often poorly defined, and measurement tools used to gather data were wide ranging. Numerous factors were correlated with increased or decreased expression of certain constructs, but overall themes were difficult to identify. Similarly, patients often spoke of what increased or decreased expression of a construct, with less emphasis on what they implicitly value.

Discussion: This scoping review found ample evidence for what increases or decreases expression of positive psychological constructs, but this evidence was observational and often conflicting. In the future, we recommend the development of a core set of psychological outcomes, with definitions and corresponding measurement tools. We further recommend an emphasis on randomized trials to more rigorously study how expression of constructs can be improved and what effect this has on the quality of life.

Psychological Wellbeing in Adolescents with Leukaemia: A Comparative Study with Typical Development Peers

There is still little research on psychological wellbeing, life satisfaction and reported problems in preadolescents and adolescents under therapy for leukaemia, and also little research comparing them with their healthy peers. The present study aimed to analyse the life satisfaction, hope, psychological wellbeing and reported problems’ intensity in 60 patients aged 8–18 during the first year of therapy, to identify those more at risk and to compare their reports with matched healthy peers. A battery of self-reported questionnaires was administered during hospitalisation or day hospital admissions post 6 months and post 12 months from the diagnosis. Younger patients (aged 8–13 years) were more at risk than older ones in their problems’ intensity and psychological symptoms; females and Acute Myeloid Leukaemia patients reported lower current life satisfaction perceptions; hope was associated with lower depression symptoms and mood problems. Healthy peers have a better perception of current life, but reported a lower hope score, more anxiety symptoms and more cognitive problems than patients. The first 6 months were more critical for patients’ psychological health. Basing on these empirical data, the inclusion of mental health care professionals or supportive psychotherapy into the treatment is recognized as extremely useful.

The glass is not half empty: optimism, pessimism, and health among older adults

OBJECTIVES

Optimism and pessimism are distinct constructs that have demonstrated independent relationships with aspects of health and well-being. The purpose of this study was to investigate whether optimism or pessimism is more closely linked with physical and mental health among older adults.

DESIGN

Cross-sectional survey.

PARTICIPANTS

Community-dwelling older adults (N = 272) ages 59-95 in the southern United States.

MEASUREMENTS

The Life Orientation Test-Revised and the Short Form 8.

RESULTS

At the bivariate level, optimism was associated with higher physical health and mental health, while pessimism was associated with lower physical health and mental health. Multiple-regression analyses as well as comparison of correlation coefficients found that pessimism was more closely associated with physical health and mental health than optimism.

CONCLUSIONS

These results add to the literature suggesting that, in terms of older adults' health and well-being, avoiding pessimism may be more important than being optimistic.

Profiles of Adjustment in Pediatric Cancer Survivors and Their Prediction by Earlier Psychosocial Factors

Objective

To examine individual differences in pediatric cancer survivors' psychosocial adjustment and test the psychosocial predictors, assessed 2-3 years earlier, of those differences.

Method

Pediatric cancer survivors (n = 209, aged 8-17 years at baseline) and their parents were followed for 4 years. They provided reports of survivors' psychosocial adjustment at 3 years post-baseline, and latent profile analysis (LPA) was used to identify subgroups of survivors who differed on those reports. Multinomial logistic regression was used to predict group membership from self- and parent-reported psychosocial factors at baseline (child adjustment, disposition, and parental functioning) and at 1 year post-baseline (child social relations).

Results

The LPA revealed a 3-class model as the best fit: a "Resilient" group (65%), characterized by good psychosocial adjustment; a "Self-Reported At-Risk" group (23%), characterized by subclinical elevations in self-reported internalizing and attention problems; and a "Parent-Reported At-Risk" group (12%), characterized by subclinical elevations in parent-reported internalizing, externalizing, and attention problems and in self-reported attention problems. Several psychosocial predictors, including child posttraumatic stress, affectivity, and connectedness to school, as well as parental distress and overprotection, differentiated the Resilient group from the other groups, in expected directions.

Conclusions

The majority of pediatric cancer survivors exhibit enduring resilience. The protective factors identified for them-including positive affectivity and strong connectedness to school-may inform targeted prevention strategies for the minority of survivors who are at risk for maladjustment.

The Effect of Optimism and Connectedness on Psychological Adjustment of Children with Cancer and Comparison Peers

OBJECTIVE

The present study aimed to examine the relationship of optimism and connectedness with psychological adjustment outcomes in children with cancer and determine whether these relations differ for children with cancer and comparison peers.

METHODS

Participants were 155 children with cancer and 143 comparison youth without a history of cancer, aged 8 to 17 years at study entry, who were followed longitudinally over a 3-year period. Participants completed self-report measures at 3 time points: baseline optimism at study entry (T1), connectedness at 1 year after baseline (T2), and emotional symptoms at 3 years after baseline (T3). A series of regression analyses were conducted using conditional process analysis to examine whether connectedness mediated the relationship between optimism and psychological adjustment and whether this was moderated by health status (i.e., history of childhood cancer vs no history of cancer or other serious or chronic illness).

RESULTS

Connectedness to parents, peers, and friends significantly mediated the relationship between optimism and psychological adjustment (b parents = -0.1387, 95% confidence interval [CI] [-0.2341 to -0.0515]; b peers = -0.2021, 95% CI [-0.3575 to -0.0818]; b friends = -0.0703, 95% CI [-0.1640 to -0.0050]). However, this mediation was not significantly moderated by having a history of cancer. Cancer history did moderate the direct relationship between optimism and psychological adjustment and between connectedness to parents and psychological adjustment.

CONCLUSION

Findings suggest that patients with cancer are doing remarkably well with regard to adjustment. Connectedness with parents and peers mediates the relationship between optimism and psychological adjustment. As such, children with cancer who are identified as experiencing poor adjustment may benefit from interventions to foster connectedness.

Is death anxiety more closely linked with optimism or pessimism among older adults?

The purpose of this study was to investigate whether death anxiety is more closely linked with optimism or pessimism among older adults. Participants consisted of community-dwelling older adults (N = 253; 73.1% female) in the southern U.S. Both optimism and pessimism demonstrated a bivariate association with death anxiety; however, when considering optimism and pessimism together-and after controlling for age, gender, physical health, and mental health-optimism was not associated with death anxiety, while pessimism was associated with higher death anxiety. Post hoc analyses found a unique relationship between pessimism and greater fear of the unknown. Perhaps, given the inevitability of death, limiting negative expectancies is more salient to death anxiety than having positive expectancies, and pessimism may be particularly associated with existential and religious concerns.

Optimism and quality of life in patients with heart failure

OBJECTIVES

Health-related quality of life (HR-QoL) of patients with heart failure (HF) is low despite the aim of HF treatment to improve HR-QoL. To date, most studies have focused on medical and physical factors in relation to HR-QoL, few data are available on the role of emotional factors such as dispositional optimism. This study examines the prevalence of optimism and pessimism in HF patients and investigates how optimism and pessimism are associated with different patient characteristics and HR-QoL.

METHODS

Dispositional optimism was assessed in 86 HF patients (mean age 70 ± 9 years, 28% female, mean left ventricular ejection fraction 33%) with the Revised Life Orientation Test (LOT-R). HR-QoL was assessed with the Minnesota Living with Heart Failure Questionnaire and the EuroQol.

RESULTS

The (mean ± SD) total score on the LOT-R was 14.6 ± 2.9 (theoretical range 0-24) and the scores on the subscales optimism and pessimism were 8.1 ± 1.9 and 5.5 ± 2.5, respectively. Higher age was related to more optimism (r = 0.22, p < 0.05), and optimism was associated with higher generic HR-QoL (B = 0.04, p < 0.05).Significance of resultsThe association found between optimism and generic HR-QoL of HF patients can lead to promising strategies to improve HF patients' HR-QoL, particularly because the literature has indicated that optimism is a modifiable condition.

Reducing discrepancies of personal goals in the context of cancer: A longitudinal study on the relation with well-being, psychological characteristics, and goal progress

OBJECTIVES

To (1) examine whether reducing discrepancies between goal importance and goal attainability is an adaptive predictor of well-being, (2) investigate intrusion, awareness, optimism, and pessimism as determinants of reducing discrepancies between goal importance and goal attainability, and (3) explore how goal progress is involved in reducing discrepancies between goal importance and goal attainability during two major periods after a colorectal cancer diagnosis.

DESIGN

Prospective design.

METHODS

Newly diagnosed colorectal cancer patients (n = 120) were interviewed three times: within a month, 7 months (treatment period), and 18 months (follow-up period) post-diagnosis. Data were analysed using multiple regressions.

RESULTS

Results showed that (1) reducing discrepancies enhances well-being, (2) optimism and pessimism are predictors of reducing discrepancies during the treatment period but not during the follow-up period, while intrusion and awareness do not predict reducing discrepancies in either period, and (3) goal progress is a predictor of reducing discrepancies during the follow-up period, but no evidence for a moderating or mediating role of goal progress in the relation between psychological characteristics and reducing discrepancies was found.

CONCLUSIONS

Reducing discrepancies between goal importance and goal attainability could benefit colorectal cancer patients' well-being. Optimism, pessimism, and goal progress appear to influence cancer patients' ability to reduce discrepancies. Providing assistance in improving goal progress to those who are less optimistic and highly pessimistic may be a suitable training for cancer patients to prevent deterioration in well-being. Statement of contribution What is already known on this subject? More discrepancy between goal importance and goal attainability is associated with lower levels of well-being. People are able to change evaluations of importance and attainability, but it is unknown whether this positively impacts well-being. Underlying causes of differences in the extent to which discrepancies between goal importance and goal attainability are reduced are unknown. What does this study add? This is the first study to show that reducing discrepancies between goal importance and goal attainability is beneficial for well-being. This is the first study to show that optimism and pessimism are determinants of reducing discrepancies between goal importance and goal attainability. Goal progress might be an effective target for interventions that aim to facilitate one's ability to reduce discrepancies between goal importance and goal attainability.

Optimism as a Candidate Health Asset: Exploring Its Links With Adolescent Quality of Life in Sweden

This study aims to understand the role that optimism could play in the context of a health asset approach to promote adolescent health-related quality of life (HRQOL). Adolescents (n = 948), between 11 and 16 years old from a medium-sized rural town in Sweden, answered questionnaires measuring optimism, pessimism, and HRQOL. The findings indicate a significant decrease in optimism and a significant increase in pessimism between early and midadolescence. The study has allowed us to present associational evidence of the links between optimism and HRQOL. This infers the potential of an optimistic orientation about the future to function as a health asset during adolescence and by implication may provide additional intervention tool in the planning of health promotion strategies.

The Influence of Serum Cortisol Level Onto Perceptive Experience of Optimism in Patients with Newly Diagnosed Cancer

THE AIM

The aim of this study is to investigate the correlation between the morning level of serum cortisol and perceptive experience of optimism in a selected group of 60 patients with newly diagnosed cancer who were treated at Mostar University Clinical Hospital during a one-month period.

PATIENTS AND METHODS

The morning level of serum cortisol was measured in all patients following the verification of oncological disease. The patients also filled out a questionnaire of socio-demographic data, as well as the scales for optimism/pessimism assessment.

RESULTS

The average morning serum cortisol level was within the reference values in the majority of patients, independently of their perceptive experience of optimism/pessimism. There was no significant difference in the morning level of serum cortisol among the subgroups of patients high and low on the scale of optimism, as well as the scale of pessimism. No correlation existed between the serum cortisol morning level and expressed optimism/pessimism, as well. The great majority of respondents had secondary and lower education, was retired or unemployed, and suffered lower socio-economic conditions of life. Therefore, their access to medical information and their knowledge of cancer modern treatment options and possibilities were restricted, what may also have an influence onto perceptive experience of optimism/pessimism.

CONCLUSION

The results concerned with the perceptive experience of optimism/pessimism assessment were not a consequence of stress reaction but they were more correlated to general personal characteristics, the level of education, and socio-economic status of patients. The results do not confirm the impact of morning serum cortisol level onto physiological reactions to stressful conditions and situations in selected group of patients with de novo carcinoma.

Different perceptions of stress, coping styles, and general well-being among pregnant Chinese women: a structural equation modeling approach

Few studies have examined different perceptions of stress or explored the positive aspects of well-being among pregnant Chinese women, so there is a need to explore these phenomena in order to fill the research gap. The aim of this study was to examine the relationships among the different perceptions of stress, coping styles, and general well-being using a structural equation modeling approach. We examined a hypothetical model among 755 pregnant Chinese women based on the integration of theoretical models. The Perceived Stress Scale (PSS), the Trait Coping Styles Questionnaire (TCSQ), and the General Well-Being Schedule (GWB) were used to measure perceived stress, coping styles, and general well-being, respectively. A structural equation model showed that positive and negative perceptions of stress significantly influenced positive and negative coping styles, respectively. Different perceptions of stress were significantly associated with general well-being, but different coping styles had no significant effects on general well-being. The model had a good fit to the data (IFI = 0.910, TLI = 0.904, CFI = 0.910, and RMSEA = 0.038). Different perception of stress was able to predict significant differences in coping styles and general well-being.

Profiles of Dispositional Expectancies and Affectivity Predict Later Psychosocial Functioning in Children and Adolescents With Cancer

OBJECTIVE

Examined how individual differences in disposition among pediatric cancer patients predict their later psychosocial functioning.

METHODS

Patients aged 8-17 years (N = 223) reported on their disposition at baseline. One and three years later, self-reports and parent reports of patient psychosocial functioning were obtained. Latent profile analysis was used to identify subgroups that differed on baseline disposition and to compare them on later outcomes.

ESULTS

Three groups were identified: The "Positive" group (59%) had high optimism and positive affectivity and low pessimism and negative affectivity; the "Moderate" group (39%) had a similar profile, with less exaggerated scores; a small, "Negative" group (2%) had the opposite profile (low optimism/positive affectivity; high pessimism/negative affectivity). These groups differed in psychosocial functioning at follow-up, generally in expected directions.

CONCLUSIONS

Most patients have a disposition that may be protective. A small minority at high risk for maladjustment is distinguished by their disposition.

A longitudinal case-control study on goals in adolescents with cancer

OBJECTIVE

This study examined whether: (1) the goals of adolescents with cancer at 3 months post-diagnosis (T1) and healthy peers differed in terms of content, valuation, and abstraction level, (2) the content, valuation and abstraction level of the goals of the adolescents with cancer differed between 3 and 12 months post-diagnosis (T2).

METHODS

Thirty-three adolescents with cancer and 66 matched controls completed the Personal Project Analysis Inventory. After nine months, the adolescents with cancer completed the measure again.

RESULTS

Compared to controls, adolescents with cancer at 3 months post-diagnosis (T1) reported more intrinsic than extrinsic goals, appraised intrinsic goals as more important than extrinsic goals and reported more concrete goals. Within the adolescents with cancer, the content, valuation and abstraction level of the goals did not differ between T1 and T2.

CONCLUSIONS

Adolescents recently diagnosed with cancer set different types of goals than healthy peers and continue to set these types of goals until one year post-diagnosis. Future research can help determine how the personal goals of adolescents with cancer develop in the long term and to what extent personal goal setting during cancer influences the attainment of age-graded developmental tasks and well-being.

Goal adjustment strategies operationalised and empirically examined in adolescents with cancer

Adolescents facing cancer may need to adjust their personal life goals. Theories identified several goal adjustment strategies, but their use has not been tested. Therefore, this study operationalises goal adjustment strategies and examines their use. Adolescent cancer patients listed their goals 3 and 12 months post-diagnosis. Goals received scores on five goal characteristics: life domain, level of abstraction, importance, attainability and effort. Results showed that adolescents with cancer (N = 30, mean age: 14.2 years, 60% female) used four of five strategies described in theory, while one additional strategy was found. These findings suggest that adolescents with cancer use goal adjustment strategies as measured by goal characteristics over time.