Prediction of psychological adjustment to multiple sclerosis

2003

Psychology & Health

The aim of the present study was to investigate longitudinally the sensitivity of optimistic beliefs (positive outcome expectancies, efficacy expectancies, and optimistic bias) to disease-related stress (measured by disease duration, depressive symptoms, physical symptoms, physical impairment, and life-events) in Type 1 diabetes (n ¼ 90) and multiple sclerosis (n ¼ 90). First, we examined whether chronically ill patients were less optimistic than a healthy control group (n ¼ 60), which showed that patients reported lower levels of optimistic bias but similar levels of the two other optimistic beliefs. Next, we analyzed the stability of the three types of optimistic beliefs across time (one year) for both disease groups, which demonstrated that optimistic bias in MS patients decreased. Finally, the impact of disease-related stressors on optimistic beliefs during a one-year period was determined, showing that all three optimistic beliefs decreased when patients reported depressive symptoms. Together, these findings show that positive outcome expectancies and efficacy expectancies were unaffected by being ill and fairly stable unless patients reported depressive symptoms while optimistic bias appeared to decrease as a result of being ill. Results are discussed in terms of the role of control and depression in optimistic bias.

mentioning

confidence: 63%

Section: Participantsmentioning

confidence: 99%

Is Optimism Sensitive to the Stressors of Chronic Disease? The Impact of Type 1 Diabetes Mellitus and Multiple Sclerosis on Optimistic Beliefs

2003

Psychology & Health

“…However, prospective studies of optimism have suggested that RA patients (Brenner et al, 1994) and cancer patients (Carver et al, 1993) may bene t from positive outcome expectancies over a longer period of time. Also, ef cacy expectancies have proved helpful over a longer period of time in diabetic patients (Kavanagh, Gooley, & Wilson, 1993), RA patients (Lorig, Mazonson, & Holman, 1993), and MS patients (Barnwell & Kavanagh, 1997). The long-term effect of positive unrealistic thinking is still unknown, however.…”

Section: Discussionmentioning

confidence: 99%

Optimism and adaptation to chronic disease: The role of optimism in relation to self‐care options of type 1 diabetes mellitus, rheumatoid arthritis and multiple sclerosis

British J Health Psychol

2002

122

102

Objectives: To determine the role of optimistic beliefs in adaptation processes of three chronic diseases different in controllability by self‐care. It was expected that optimism towards the future would relate to adaptation independently of the controllability of disease. Optimism regarding one's coping ability should be beneficial in controllable diseases. Unrealistic optimism was expected to be beneficial in uncontrollable disease. Design: The cross‐sectional design involved 104 patients with type 1 diabetes, 95 patients with rheumatoid arthritis and 98 patients with multiple sclerosis, recruited via their physician at the out‐patient department of five hospitals. Method: Confirmatory Factor Analysis (LISREL) was employed to confirm a three‐dimensional approach of optimism: outcome expectancies, efficacy expectancies and unrealistic thinking. Multi‐sample analysis by path modelling was used to examine whether the relationship of the three optimistic beliefs with coping (CISS‐21), depression and anxiety (HADS), and physical functioning (SF‐36) differs with the controllability based on the self‐care options of chronic disease. Results: These show that when chronic disease must be controlled by self‐care, physical health depends more strongly on positive efficacy expectancies. In contrast, when self‐care options for controlling chronic disease are limited, physical health depends more strongly on positive unrealistic thinking and relates negatively to positive efficacy expectancies. The impact of the three optimistic beliefs on mental health is independent of the controllability by self‐care. Conclusion: Optimistic beliefs are differently beneficial for physical health dependent on the controllability of chronic disease. Unrealistic beliefs are helpful when patients are confronted with moderately to largely uncontrollable disease where self‐care options are limited, in contrast to positive efficacy expectancies that are helpful when patients deal with largely controllable disease where self‐care is required.

“…Rudick, Miller, Clough, & Farmer, 1992), there is a need to evaluate the impact of psychological characteristics including optimism. A growing number of studies demonstrate that optimism is a relevant predictor of psychological and physical functioning in patients suffering from rheumatoid arthritis (Brenner, Melamed, & Panush, 1994), multiple sclerosis (Barnwell & Kavanagh, 1997), breast cancer (Carver et al, 1993), diabetes mellitus (Kavanagh, Gooley & Wilson, 1993), and HIV infection (Taylor, Kemeny, Aspinwall, Schneider, Rodriguez, & Herbert, 1992). It has been shown that optimistic patients employ more problem-focused coping strategies and more effective ways of emotional regulation, both of which are factors that contribute to better functioning (Carver et al, 1993;Taylor & Armor, 1996).…”

Section: Introductionmentioning

confidence: 99%

How optimism contributes to the adaptation of chronic illness. A prospective study into the enduring effects of optimism on adaptation moderated by the controllability of chronic illness

Personality and Individual Differences

2002

The aim of this study was to investigate the impact of optimistic beliefs on coping and adaptation over 6 and 12 months of chronic illness, and whether the adaptiveness of optimistic beliefs was moderated by the controllability of disease. In addition, we examined whether coping strategies contribute to the stability of optimistic beliefs, and thus indirectly to their adaptiveness. Three chronic diseases differing in controllability were included: type 1 diabetes (n=90), rheumatoid arthritis (n=89) and multiple sclerosis (n=90). Path models were used to examine the relationship of three optimistic beliefs (outcome expectancies, efficacy expectancies, unrealistic thinking) with coping, anxiety, depression and physical functioning. Results show that coping contributes to the stability of outcome and efficacy expectancies which, in turn, contribute to mental health by using more task oriented and less emotion oriented coping. The controllability of disease moderated the effectiveness of efficacy expectancies and unrealistic thinking, as both optimistic beliefs are specifically beneficial when patients suffer from a chronic disease that is to a considerable extent controllable. #