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Researchers ask why optimism is associated with health
Carolyn Butler
Washington Post Staff Writer
Tuesday, January 12, 2010
So, be honest: Is that glass half-full or half-empty?
Personally, I tend toward the latter, though I secretly long to be one of
those Pollyannas who always look on the bright side of things and can remain
hopeful through a family crisis, two hours of downtown gridlock or any other
challenge. In fact, my New Year's resolution for '10 is to be more positive.
(Meanwhile, the pessimist in me is well aware that studies have shown that
roughly 80 percent of those who make such pledges give them up by
Valentine's Day.)
My hope is that positive thinking will make me not only happier but
healthier, in the long run. A recent study published in the journal
Circulation showed that a sunnier outlook on life is associated with a lower
risk of heart disease and mortality. The research, which tracked more than
97,000 women older than 50 for eight years, found that optimists were 9
percent less likely to develop heart disease and 14 percent less likely to
die from any cause than their pessimistic counterparts. Those with a high
degree of "cynical hostility" were 16 percent more likely than all others to
die during that same period.
"This is really consistent with a number of other studies in the past, with
the strongest findings in the realm of coronary heart disease: There is good
evidence to suggest optimism is protective and that pessimism seems to be
detrimental, when it comes to the development of disease and future
outcomes," says Laura Kubzansky, an associate professor at the Harvard
School of Public Health who has focused on these issues. "But what's a
little less clear is what the mechanisms are, or how that protective effect
occurs."
Not surprisingly, environment seems to play some role in the equation. In
this study, for example, socioeconomic status was strongly tied to level of
optimism: The women with the most-positive outlook on life tended to be
wealthier, more educated, in better shape and less likely to smoke or to be
overweight. "It's not shocking that out of all the factors we looked at,
socioeconomic status was the most related to attitude, but even after
controlling for that, attitude was still related to health, so there's
something else going on," says lead author Hilary Tindle, an internist and
assistant professor of medicine at the University of Pittsburgh.
Tindle says several factors are probably at play.
One of the possibilities most interesting to scientists is that your
psychology has a direct effect on physiology, impacting blood pressure,
heart rate, stress hormone levels and immune function, all of which can
contribute to disease and mortality. For example, a study published last
year in the journal Brain, Behavior and Immunity found that higher levels of
pessimism are linked to unfavorable changes in inflammatory markers and
white blood cells.
Tindle and her co-authors found that optimistic types are more likely to
engage in healthy behaviors such as eating well, exercising more and smoking
less; they're also more likely to have better social relationships,
something that has been associated with positive health outcomes.
Finally, there is some evidence that optimistic women tend to adhere more
strictly to medical advice and treatment plans. The study "confirms what a
lot of physicians intrinsically know and experience over and over again, in
that the patients who see the world from a more positive view tend to be
better patients," observes cardiologist Elizabeth Klodas, author of "Slay
the Giant: The Power of Prevention in Defeating Heart Disease." "They are
more adherent to their regimen, actually take your advice and follow it, and
are much more enthusiastic about making the lifestyle changes that are so
critical for cardiovascular disease prevention, whether primary or
secondary, after you've had an event; they are just better partners in
care."
However, Klodas does raise concerns about the link between optimism and
better health: "Is it the chicken or the egg? Are you a better patient
because you have an intrinsic optimistic attitude, or do you become more
optimistic because your outcomes are better because you're following a
regimen that's actually helping you get better?"
The study's authors, too, acknowledge that questions remain. "On the one
hand it seems intuitively obvious, but we're not there yet in terms of the
evidence we need in order to say optimism causes better health outcomes,"
says Tindle. "All we can say now is that optimism is associated with better
health outcomes, but without following people over a lifetime, we can't say
which came first."
Although further research is necessary (and underway), Tindle stands firm in
her belief that a poor outlook on life is detrimental to health. "The
totality of evidence . . . points to the fact that sustained negativity is
toxic to health, and I would absolutely say that it's important for people
to try to reduce the amount of it in their lives."
Coming from a long line of devoted pessimists, I can't help but wonder how
possible it is to revamp your attitude and fill that half-empty glass.
Though genetics do come into play, you're not necessarily destined for a
life of doom and gloom, says James Maddux, a psychology professor at George
Mason University. "It's not a matter of having an optimistic or pessimistic
gene, it's matter of having a brain or nervous system wired more toward the
optimistic or pessimistic end, with a lot of room for learning and exerting
control over your own outlook of life," he explains. "We're really talking
about a continuum with high optimism on one end and low optimism or high
pessimism on the other end, and people fall somewhere in between. And
probably from time to time, depending on the situation, we move back and
forth between some range that's set by our DNA."
Maddux and other experts suggest a variety of techniques for moving toward
the sunnier side of that spectrum, from cognitive behavioral therapy and
lifestyle changes such as sleeping more and making additional time for
friends, to relaxation techniques such as meditation and yoga.
"These things do not directly impact optimism, per se, but may make it
easier to view the world through a happier, more optimistic lens and
increase the general sense of positive feelings," says Harvard's Kubzansky.
"There's a lot of room to maneuver; I'm very optimistic about that. We do
come into the world with an inherent tendency, but then there's room to
shape it."
Yet she acknowledges that it's hard work: "There are lots of ways to achieve
it, but I don't think any are trivial. . . . Different people may get there
differently, but at some level there needs to be a commitment on their part
to figure out 'What are my habitual ways of thinking, and how can I change
them so other things become habitual?' There has to be concerted effort and
thought put into how you're going to make meaningful change. That said, I
think it can definitely be done."
Still, Klodas isn't ready to start prescribing an attitude shift to her
cardiology patients just yet. "There are many positives to being more
positive, but based on this research, we still don't know for sure whether
an attitude change will actually impact health outcomes," she says, although
she remains, well, optimistic that proof is on the way. "I hope somebody
does a study and shows it, because it would be really nice to work on. I
would much rather try to help somebody get a better attitude than prescribe
another pill."
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