Optimism, Pessimism and Negative Mood Regulation Expectancies in Cancer Patients
Sucala, Madalina L., Tatar, Aurora Szentágotai, Journal of Evidence-Based Psychotherapies
The purpose of this study was to investigate the interrelations among optimism, pessimism and negative mood regulation expectancies in predicting distress levels in a sample of women (N=64) diagnosed with breast or cervical cancer. The study offers empirical data that could clarify the relation between these variables impacting emotional distress. Our results indicate that negative mood regulation expectancies completely mediated the effects of pessimism on symptoms of depression and anxiety. The direct relation between negative mood regulation expectancies and emotional distress can be explained by conceptualizing these expectancies as specific beliefs within a response expectancy model.
Keywords: anxiety, depression, cancer, negative mood regulation expectancies, optimism, pessimism
Optimism and pessimism
A large body of evidence supports the idea that the expectancies about the future have a significant impact on the present well-being (Andersson, 1996). Studies show that optimistic people have lower levels of distress in various stressful situations (Andersson, 1996), they adjust better to stressors (Aspinwall & Taylor, 1992; Carver et al., 2005; Scheier, Carver, & Bridges 2001; Scheier & Carver, 1987) and they report a higher quality of life (Gustavsson-Lilius, Julkunen & Hietanen, 2007). Optimism and pessimism, defined as generalized positive and negative outcome expectancies, respectively, are considered to represent important predictors of adjustment (Scheier & Carver, 1985).
The hypothesis that optimism and pessimism influence health and coping with illness has been investigated in numerous studies (Scheier & Carver, 1992). Several of these studies are focused on the benefits of optimism for cancer patients, showing that a higher level of optimism is associated with a less negative mood both at the time of diagnosis and during treatment (Carver et al., 1993; Carver, Giunta et al., 2005; David, Montgomery, & Bovjerg, 2006; Epping- Jordan et al., 1999; Stanton & Snider, 1993). These studies indicate that patients with higher levels of optimism have fewer symptoms of emotional distress while patients with higher levels of pessimism experience greater emotional distress. Pessimism has also been related to a higher rate of mortality in cancer patients (Schultz, Bookwala, Knapp, Scheier, & Williamson, 1996).
Despite the growing body of literature on the effects of optimism and pessimism, the mechanism by which these variables have an impact on emotional distress is not entirely understood. There are researchers who suggest that the effect of optimism on distress is mediated by more specific expectancies. For example, in a study by McGregor, Bowen, Ankerst, Andersen, Yasui and McTiernan (2004), the authors examined the relation between dispositional optimism and specific illness expectancies, showing that these expectancies partially mediated the effects of optimism on distress.
Negative Mood Regulation Expectancies (NMR Expectancies)
Beside optimism and pessimism, numerous studies support the impact of response expectancies on emotional distress. Kirsch (1985) developed the response expectancy theory, focusing on the relations between expectancies and automatic responses. Response expectancies are defined as anticipations of nonvolitional reactions to stimuli and behaviors. Kirsch (1985) hypothesized that response expectancies are self-confirming, sufficient to cause automatic responses and directly related to non-volitional outcomes (i.e., are not mediated by other psychological variables) (Kirsch, 1985). Elaborating on this idea in the Rational- Emotive Behavior theory framework, David (2003) suggests that, once negative dysfunctional emotions are generated by irrational beliefs (Ellis, 1994), these emotions can than be maintained by response expectancies. In the study of Montgomery, David, DiLorenzo and Schnur (2007) results indicated that response expectancies, at least in part, accounted for the effects of irrational beliefs on distress. …