Optimism, Pessimism, and Mortality

Abstract

Maruta and colleagues1Maruta T Colligan RC Malinchoc M Offord KP Optimists vs pessimists: survivial rate among medical patients over a 30-year period.Mayo Clin Proc. 2000; 75: 140-143PubMed Scopus (148) Google Scholar report in this issue of Proceedings quite a remarkable finding: that the new Optimism-Pessimism scale of the Minnesota Multiphasic Personality Inventory (MMPI) predicts no less a dependent variable than death itself. The finding is unusually important for 2 reasons: First, the obvious one is predicting a “hard” measure like mortality from a “mere” paper-and-pencil psychological construct. The second is more subtle, and it comes from the long history of this project. More than 2 decades ago, researchers in the field of learned helplessness began to find in animals that encountering uncontrollable bad events resulted in inadequate rejection of implanted tumors and inadequate immune function.2Seligman MEP Helplessness: On Depression, Development, and Death. 2nd ed. WH Freeman, New York, NY1992Google Scholar, 3Peterson C Maier SE Seligman MEP Learned Helplessness: A Theory for the Age of Personal Control. Oxford University Press, New York, NY1993Google Scholar Findings in these well-controlled studies were in line with the more anecdotal evidence on helplessness and mortality that had steadily accumulated since the early writings of Curt Richter4Richter C On the phenomenon of sudden death in animals and man.Psychosom Med. 1957; 19: 191-198PubMed Google Scholar on sudden death and of George Engel5Engel GL Sudden and rapid death during psychological stress folklore or folk wisdom?.Ann Intern.Med. 1971; 74: 771-782Crossref PubMed Scopus (321) Google Scholar on helplessness-hopelessness and physical illness. Researchers of learned helplessness turned to the study of humans in the 1970s and pursued work on a trait that turned out to be a major amplifier of helplessness: pessimism and optimism. It was found that pessimistic individuals (people who interpret bad events as permanent and pervasive) became helpless and depressed more easily than optimists (who see bad events as temporary, controllable, and local). A questionnaire, the Attributional Style Questionnaire, was validated for optimism and pessimism and was widely used to predict depression.6Seligman MEP LearnedOptimism. AA Knopf, New York, NY1991Google Scholar A content-analytic method of measuring optimism and pessimism was then derived to index this trait in people who do not take questionnaires, such as Presidents of the United States, sports heroes, and the dead. Pessimism measured in this way predicted poor health in late middle age as well as mortality.7Peterson C Seligman MK Vaillant GE Pessimistic explanatory style is a risk factor for physical illness: a thirty-five-year longitudinal study.J Pers Soc Psychol. 1988; 55: 23-27Crossref PubMed Scopus (419) Google Scholar, 8Peterson C Seligman ME Yurko KIL Martin LR Friedman HS Catastrophizing and untimely death.Psychol Sei. 1998; 9: 49-52Google Scholar The content-analytic measure of optimism-pessimism has 2 disadvantages, however: it is labor-intensive, and it requires authentic, extensive written or spoken material from an individual's life. Since there was a clear prediction from the work on learned helplessness and on pessimism that pessimistic individuals are at risk for poor health and premature death, a better method allowing wider sampling for measuring pessimism was needed. In stepped Robert Colligan. Large numbers of people have taken the MMPI over the last 50 years, he reasoned. Many of these people are now dead, but their age and health were well documented at the time they took the MMPI. Therefore, by content analyzing every item on the MMPI for pessimism and optimism, a subscale could be created that could then be used to test for the long-term effects of this trait on physical illness and mortality.9Colligan RC Offord KP Malinchoe M Sehulman P Seligman ME CAVEing the MMPI for an Optimism-Pessimism Scale: Seligman's attributional model and the assessment of explanatory style.J Clin Psychol. 1994; 50: 71-95Crossref PubMed Scopus (62) Google Scholar And this is the second important aspect of the study by Maruta et al in this issue: they tested and confirmed the predictive validity of this derived, but easily used, measure of optimism and pessimism. They have opened the field to use this scale to predict much in the way of the specifics of physical illness and its sequelae from optimism and pessimism and the medical records of the many individuals who have taken the MMPI earlier in their lives. So now I believe we have converging and compelling evidence that optimists and pessimists differ markedly in how long they will live. What should the next steps be? There are 3 significant projects that now follow: Which? Mechanism? Intervention? It is not clear from the evidence in the article by Maruta et al or in the converging findings6Seligman MEP LearnedOptimism. AA Knopf, New York, NY1991Google Scholar, 7Peterson C Seligman MK Vaillant GE Pessimistic explanatory style is a risk factor for physical illness: a thirty-five-year longitudinal study.J Pers Soc Psychol. 1988; 55: 23-27Crossref PubMed Scopus (419) Google Scholar, 8Peterson C Seligman ME Yurko KIL Martin LR Friedman HS Catastrophizing and untimely death.Psychol Sei. 1998; 9: 49-52Google Scholar if pessimism shortens life, optimism prolongs life, or both. There are at least 4 mechanisms by which this trait could make a difference to mortality6Seligman MEP LearnedOptimism. AA Knopf, New York, NY1991Google Scholar: (1) Pessimists are passive and have more bad life events than optimists. More bad life events are associated with shorter lives. (2) Pessimists, believing that “nothing I do matters,” comply less well with medical regimens and take fewer preventive actions, like giving up smoking. (3) Pessimists become depressed at a markedly higher rate than optimists do, and depression is associated with mortality. (4) The immune system of pessimists functions less adequately than that of optimists.10Segerstrom SC Taylor SE Kemeny ME Reed GM Visscher DR Causal attributions predict rate of immune decline in HIV-seropositive gay men.Health Psychol. 1996; 15: 485-493Crossref PubMed Scopus (50) Google Scholar, 11Kamen-Siegel L Rodin J Seligman ME Dwyer J Explanatory style and cell-mediated immunity in elderly men and women.Health Psychol. 1991; 10: 229-235Crossref PubMed Scopus (122) Google Scholar Pessimism is identifiable early in life and changeable. So it is possible that individuals at specific physical risk might enter into brief programs that stably change their thinking about bad events and so lower their risk for physical illness and even death.12Buchanan GM Gardensvartz CAR Seligman MEP Physical health following a cognitive-behavioral intervention. Prevention Treatment [serial online].Available at: http://journals.apa.orgpreventionvolume2pre0020010ahtmlDate: December 21, 1999Google Scholar The discovery that Maruta and colleagues have made will aid progress on all 3 of these steps. Optimists vs Pessimists: Survival Rate Among Medical Patients Over a 30-Year PeriodMayo Clinic ProceedingsVol. 75Issue 2PreviewTo examine explanatory style (how people explain life events) as a risk factor for early death, using scores from the Optimism-Pessimism scale of the Minnesota Multiphasic Personality Inventory (MMPI). Full-Text PDF

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