Optimism and Other Sources of Psychological Well-Being
A New Target for Cardiac Disease Prevention
People have characteristic mindsets, habitual ways of thinking that are the product of temperament, upbringing, life experiences, and other factors. One of the best characterized mindsets is that of optimism versus pessimism. According to a simple definition, optimists tend to have a general expectation of positive outcomes, whereas pessimists tend to expect negative outcomes. The value of optimism is clear. Optimism has been repeatedly shown to predict better success in many walks of life, including education, business, politics, and sports performance, and has been associated with more successful aging, higher quality of social relationships, greater resiliency, generally greater get-go, and more happiness.
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Initial medical investigations into the health benefits of optimism began with studies of individuals’ explanatory style about life events, as promulgated by Seligman. For instance, optimists tend to explain negative events as transient in nature, whereas pessimists tend to explain events in more permanent terms. In recent years, investigators have favored measuring dispositional optimism, as commonly assessed according to the Revised Life Orientation Test. This scale includes items such as “in uncertain times, I usually expect the best” and “I hardly ever expect things to go my way”. Notably, both explanatory-style and dispositional optimism have been demonstrated to predict better health outcomes.
In this issue of Circulation: Heart Failure, Kim et al1 report on the 4-year follow-up of 6808 individuals, with a mean age of 70 years, for the development of incident heart failure after an initial psychological and clinical evaluation that included measurement of optimism–pessimism according to the Revised Life Orientation Test. Even after thorough adjustment for clinical, demographic, behavioral, and psychological covariates, including depression, optimism predicted a lower risk for developing heart failure. A dose–response relationship was noted between increasing levels of optimism and decreasing incidence of heart failure. Overall, …