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Abstract Optimism is a key variable for adjustment in aversive conditions. The purpose of this study was to examine whether optimism is predicted by two stress‐related variables which represent information about self and the environment (i.e. illness‐related stress and self‐efficacy), in a sample of breast cancer survivors. Ninety‐two women who had undergone a mastectomy participated in the study (minimum time elapsed since diagnosis = 3 years). Most participants (51 per cent) reported that at least one of four illness‐related concerns had been quite or very stressful in the past 6 months. Analyses showed that illness‐related stress exerted influence on optimism through coping, whereas self‐efficacy exerted influence both directly and through coping. Stress was predicted by two medical variables (time since diagnosis and time since mastectomy). These findings confirmed our hypothesis that knowledge about personal abilities, as well as about environment difficulties can predict the way a person evaluates future outcomes. This study has significant implications for clinical practice with patients. Copyright © 2007 John Wiley & Sons, Ltd.
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