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ORIGINAL ARTICLE |
From the Department of Health and Social Behavior, Harvard School of Public Health (L.K., I.K.), and Channing Laboratory, Harvard Medical School (I.K., D.S.), Boston; Normative Aging Study, Department of Veterans Affairs Outpatient Clinic, and Department of Medicine, Boston University School of Medicine (D.S., P.V.), Boston, MA.
Address reprint requests to: Dr. L. Kubzansky, Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115. Email: Lkubzans{at}hsph.harvard.edu
OBJECTIVE: A sense of optimism, which derives from the ways individuals explain causes of daily events, has been shown to protect health, whereas pessimism has been linked to poor physical health. We examined prospectively the relationship of an optimistic or pessimistic explanatory style with coronary heart disease incidence in the Veterans Affairs Normative Aging Study, an ongoing cohort of older men.
METHODS AND RESULTS: In 1986, 1306 men completed the revised Minnesota Multiphasic Personality Inventory, from which we derived the bipolar revised Optimism-Pessimism Scale. During an average of 10 years of follow-up, 162 cases of incident coronary heart disease occurred: 71 cases of incident nonfatal myocardial infarction, 31 cases of fatal coronary heart disease, and 60 cases of angina pectoris. Compared with men with high levels of pessimism, those reporting high levels of optimism had multivariate-adjusted relative risks of 0.44 (95% confidence interval = 0.26–0.74) for combined nonfatal myocardial infarction and coronary heart disease death and 0.45 (95% confidence interval = 0.29–0.68) for combined angina pectoris, nonfatal myocardial infarction, and coronary heart disease death. A dose-response relation was found between levels of optimism and each outcome (p value for trend, .002 and .0004, respectively).
CONCLUSIONS: These results suggest that an optimistic explanatory style may protect against risk of coronary heart disease in older men.
Key Words: coronary disease, • optimism, • pessimism, • explanatory style, • stress.
Abbreviations: BMI = body mass index;; CABG = coronary artery bypass graft;; CAVE = content analysis of verbatim explanations;; CHD = coronary heart disease;; CI = confidence interval;; LOT = Life Orientation Test;; MI = myocardial infarction;; MMPI-2 = revised Minnesota Multiphasic Personality Inventory;; NAS = Normative Aging Study;; PSM-R = revised Optimism-Pessimism Scale;; RR = relative risk;; SCL-90 = Symptom Checklist 90;; SD = standard deviation.
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