Carver C S, Pozo-Kaderman C, Harris S D, Noriega V, Scheier M F, Robinson D S, Ketcham A S, Moffat F L, Clark K C
Department of Psychology, University of Miami, Coral Gables, FL 33124-2070.
Cancer. 1994 Feb 15;73(4):1213-20. doi: 10.1002/1097-0142(19940215)73:4<1213::aid-cncr2820730415>3.0.co;2-q.
Recent studies indicate that breast cancer patients do not usually experience the devastating psychological consequences once viewed as inevitable. However, some adjust to the disease more poorly than others. This study examined the personality trait of optimism versus pessimism as a predictor of adjustment over the first year, postsurgery.
Seventy women with early stage breast cancer reported on their general optimism-pessimism at diagnosis. One day before surgery, and at 3-month, 6-month, and 12-month follow-ups, they reported their subjective well-being (mood scales and a measure of satisfaction with life). At follow-ups, they also rated their sex lives, indicated how much physical discomfort was interfering with their daily activities, and reported on thought intrusion.
Pessimism displayed poorer adjustment at each time point by all measures except interference from pain. Even controlling for previous well-being, pessimism predicted poorer subsequent well-being, suggesting that pessimism represents a vulnerability to a negative change in adjustment. In contrast, effects of pessimism on quality of sex life and thought intrusion were not incremental over time. Additional analyses indicated that effects of the optimism-pessimism measure were captured relatively well by a single item from the scale.
A sense of pessimism about one's life enhances a woman's risk for adverse psychological reactions to the diagnosis of, and treatment for, breast cancer. This finding suggests the potential desirability of assessing this quality informally in patients, to serve as a warning sign regarding the patient's well-being during the period surrounding and following surgery.
近期研究表明，乳腺癌患者通常不会经历曾经被视为不可避免的毁灭性心理后果。然而，一些患者对疾病的适应情况比其他患者更差。本研究考察了乐观与悲观的人格特质，将其作为术后第一年适应情况的预测指标。
70名早期乳腺癌女性在确诊时报告了她们总体的乐观-悲观程度。在手术前一天以及术后3个月、6个月和12个月的随访中，她们报告了自己的主观幸福感（情绪量表和生活满意度测量）。在随访时，她们还对自己的性生活进行了评分，指出身体不适对日常活动的干扰程度，并报告了侵入性思维情况。
除了疼痛干扰这一指标外，在各个时间点，悲观者在所有指标上的适应情况都较差。即使对先前的幸福感进行控制，悲观情绪仍预示着随后较差的幸福感，这表明悲观代表了适应出现负面变化的一种易感性。相比之下，随着时间推移，悲观情绪对性生活质量和侵入性思维的影响并未增加。进一步分析表明，乐观-悲观量表的效应通过量表中的一个单项能较好地体现出来。
对生活持悲观态度会增加女性对乳腺癌诊断和治疗产生不良心理反应的风险。这一发现表明，在患者中非正式地评估这种特质具有潜在的可取性，可作为手术前后期间患者幸福感的一个警示信号。
