A Pessimistic Explanatory Style Is Prognostic for Poor Lung Cancer Survival

Background: Several studies have demonstrated the importance of personality constructs on health behaviors and health status. Having a pessimistic outlook has been related to negative health behaviors and higher mortality. However, the construct has not been well explored in cancer populations. Methods: Survival time of 534 adults who were diagnosed with lung cancer was examined. The patients had completed the Minnesota Multiphasic Personality Inventory approximately 18.2 years before receiving their lung cancer diagnosis. Minnesota Multiphasic Personality Inventory Optimism-Pessimism scores were divided into high (60 or more) and low scores (<60), and log-rank tests and Kaplan-Meier curves were used to determine survival differences. Multivariate Cox models were used for assessing prognostic values of pessimism along with other known predictors for lung cancer survival outcome. Bootstrapping of the survival models was used as a sensitivity analysis. Results: At the time of lung cancer diagnosis, patients were at an average age of 67 years old; 48% of them were women, 85% had non-small cell lung cancer, 15% had small cell lung cancer, 30% were stage I, 4% were stage II, 31% were stage III/limited, and 35% were stage IV/extensive. Patients who exhibited a nonpessimistic explanatory style survived approximately 6 months longer than patients classified as having a pessimistic explanatory style. Conclusion: Among lung cancer patients, those having a pessimistic explanatory style experienced a less favorable survival outcome, which may be related to cancer treatment decisions. Further research in this area is warranted.