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ORIGINAL ARTICLE
An Examination of Optimism/Pessimism and Suicide Risk
in Primary Care Patients: Does Belief in a Changeable Future
Make a Difference?
Edward C. Chang •Elizabeth A. Yu •
Jenny Y. Lee •Jameson K. Hirsch •
Yvonne Kupfermann •Emma R. Kahle
Published online: 16 December 2012
ÓSpringer Science+Business Media New York 2012
Abstract An integrative model involving optimism/pes-
simism and future orientation as predictors of suicide risk
(viz., depressive symptoms and suicidal behavior) was
tested in a sample of adult, primary care patients. Beyond
the additive influence of the two predictors of suicide risk,
optimism/pessimism and future orientation were also
hypothesized to interact together to exacerbate suicide risk.
Results indicated that optimism/pessimism was a robust
predictor of suicide risk in adults. Future orientation was
found to add significant incremental validity to the pre-
diction of depressive symptoms, but not of suicidal
behavior. Noteworthy, the optimism/pessimism 9future
orientation interaction was found to significantly augment
the prediction of both depressive symptoms and suicidal
behavior. Implications for therapeutic enhancement of
future-oriented constructs in the treatment of suicidal
individuals are discussed.
Keywords Optimism/pessimism Future orientation
Adults Primary care Suicide risk
Introduction
Over the past 30 years, findings from hundreds of studies
on optimism based on Scheier and Carver’s (1985) popular
model of generalized positive outcome expectancies, as
measured by their Life Orientation Test (LOT) or the
revised Life Orientation Test (LOT-R; Scheier et al. 1994),
have pointed to a reliable link between dispositional opti-
mism and health (see Carver et al. 2010, for a recent
review), especially a link with psychological adjustment
(Carver and Scheier 2002; Scheier et al. 2001). According
to Scheier and Carver’s (1985) model, generalized positive
and negative outcome expectancies, or optimism/pessi-
mism, represent robust proximal determinants of adjust-
ment in adults. Consistent with this view, findings from
numerous studies have indicated that higher LOT or LOT-R
scores are associated with higher scores on measures of
life satisfaction (e.g., Bailey et al. 2007; Chang 1998;
Daukantaite
´and Zukauskiene 2012), positive affect (e.g.,
Hart et al. 2008; Marshall et al. 1992), self-esteem (e.g.,
Ma
¨kikangas et al. 2004; Vacek et al. 2010), and various
dimensions of psychological well-being, including self-
acceptance, positive relations with others, autonomy,
environmental mastery, purpose in life, and personal
growth (Chang 2009). Likewise, lower LOT or LOT-R
scores, reflecting greater dispositional pessimism or gen-
eralized negative outcome expectancies, have been found
to be associated with higher scores on measures of symp-
toms of anxiety (e.g., Chang and Bridewell 1998; Lancastle
and Boivin 2005; Siddique et al. 2006), stress (Chang
1998,2002b; Endrighi et al. 2011), and negative affect
(Daukantaite
´and Zukauskiene 2012; Marshall et al. 1992;
Vacek et al. 2010). Given these findings and the presumed
importance of generalized outcome expectancies in
adjustment, some researchers have recently voiced a need
to examine if optimism/pessimism is involved in other
important outcomes and conditions, including adult suicide
risk (Wingate et al. 2006). Indeed, although a number of
studies have looked at the link between optimism/pessimism
E. C. Chang (&)E. A. Yu J. Y. Lee Y. Kupfermann
E. R. Kahle
Department of Psychology, University of Michigan,
530 Church Street, Ann Arbor, MI 48109, USA
e-mail: changec@umich.edu
J. K. Hirsch
Department of Psychology, East Tennessee State University,
Johnson City, TN 37614, USA
123
Cogn Ther Res (2013) 37:796–804
DOI 10.1007/s10608-012-9505-0
and general conditions typically indicative of increased
suicide risk in adults such as depressive symptoms (e.g.,
Chang 2002a; Hart et al. 2008; Scheier et al. 1994), it is
remarkable that over the last three decades, only a handful
of studies have actually looked at the link between opti-
mism/pessimism and more direct indices of adult suicide
risk (e.g., suicide ideation). And of these studies, most have
been limited to studies of college student samples (e.g.,
Chang 2002a; Hirsch et al. 2007a,c). Accordingly, to
expand on past work and to provide a more compelling
examination of optimism/pessimism, it would be critical to
determine if optimism/pessimism is associated with both
general and specific measures of suicide risk (e.g.,
depressive symptoms, suicide ideation) in a more selective,
community-based adult population (i.e., primary care
patients).
Optimism as Always Good and Pessimism as Always
Bad: Is It Useful to Consider Changeability
of the Future in Predicting Adult Suicide Risk?
Given the reliable pattern of associations found between
optimism/pessimism and psychological adjustment in the
extant literature, it is not surprising that researchers have
often come to the general conclusion that optimism is
good, and pessimism is bad (Carver et al. 2010; Scheier
et al. 2001; cf. Chang 2001; Norem and Chang 2002). Yet,
some researchers have long pointed to the importance of
considering alternative patterns, including the potential
costs of optimism (Tennen and Affleck 1987) and, con-
versely, the potential benefits of pessimism (Norem and
Chang 2002). Indeed, findings from a range of studies
looking at optimism/pessimism, and other related self-
enhancing versus self-critical processes (Chang 2008),
have shown that the associations between these types of
cognitions and important outcomes (e.g., psychological
symptoms, life satisfaction, coping) can often be signifi-
cantly dependent on a number of contextual factors,
including race, ethnicity, and culture (e.g., Chang 1996;
Chang and Asakawa 2003; Chang and Banks 2007; Hirsch
et al. 2012) and source, type, or chronicity of stress expe-
riences (Chang 2002b; Harris et al. 2008; Terrill et al.
2010). Other researchers have begun to examine how
individual-differences factors may not only add to, but also
interact with optimism/pessimism in predicting adjustment
(Lopes and Cunha 2008). For example, Davidson and
Prkachin (1997) examined the extent to which unrealistic
optimism interacted with optimism/pessimism in predict-
ing health-related behaviors and outcomes. Interestingly,
these investigators found that the association between
unrealistic optimism and gains in health knowledge
decreased for optimists, but increased for pessimists
(Study 2). Accordingly, there may be situations in which
being pessimistic may not always be as harmful or as
maladaptive as is typically believed. Likewise, situations
may also exist in which being optimistic may not always
involve helpful or adaptive conditions and outcomes
(Hirsch et al. 2007a,b,c). Given these possibilities, we
believe that in addition to optimism/pessimism, one vari-
able that may be useful for understanding adult suicide risk
is a belief in the changeability of the future or future ori-
entation (Hirsch et al. 2006).
Based on works by Hirsch and colleagues (Hirsch et al.
2006,2007b), future orientation represents a specific belief
(compared to more generalized beliefs involved in opti-
mism/pessimism) that one’s future can change for the
better (e.g., one will feel better in the future, one will be
able to engage in useful plans in the future, one will be able
to reach desired goals in the future). Not surprisingly,
findings from their studies based on adult clinical samples
have shown that higher future orientation is significantly
associated with less suicide risk. Moreover, Hirsch et al.
(2007b) also found that although greater functional
impairment was a significant predictor of suicide ideation
in a sample of depressed adults, future orientation signifi-
cantly interacted with functional impairment to predict
suicide ideation. Specifically, these investigators found that
for patients with high future orientation (i.e., those who
believed that their future was changeable), the association
between functional impairment and suicide ideation was
weakest compared to what was found for those with low
future orientation (i.e., believed that their future was
unchangeable). Thus, it may be that future orientation not
only adds beyond optimism/pessimism to the prediction of
adult suicide risk, but it may also interact with optimism/
pessimism in predicting suicide risk in adults. That is,
being pessimistic may be associated with greater suicide
risk in adults, but this may be less true for pessimists
holding a high future orientation. Alternatively, being
optimistic may be associated with less suicide risk in
adults, but this may be truer for optimists holding a high
future orientation. To date, no study has examined the role
of optimism/pessimism and future orientation as additive
and/or interactive predictors of suicide risk in a select adult
population. Noteworthy, in a study of college students,
O’Connor and Cassidy (2007) showed that optimism/pes-
simism interacted with the number of positive future
events, ranging from those that were trivial to important,
that students were able to quickly list within a 3 min
timeframe. However, their performance-based measure of
‘‘future thinking’’ does not in any way assess for future
orientation, the belief that one’s future is changeable,
which is a distinct focus of our study.
Cogn Ther Res (2013) 37:796–804 797
123
Purpose of the Present Study
Given these concerns and possibilities, we conducted the
present study to (a) examine the relations between optimism/
pessimism, future orientation, and indices of suicide risk
including depressive symptoms and suicidal ideation and
attempts; (b) determine if future orientation would add any
incremental validity to the prediction of suicide risk beyond
optimism/pessimism; and (c) determine if the optimism/pes-
simism 9future orientation interaction would add further
incremental validity to these predictions beyond main effects
of optimism/pessimism and future orientation. Given con-
ceptual similarities in optimism/pessimism and future orien-
tation, we predicted that these variables would be positively
related to each other. Also, consistent with our expectation for
additive effects, we predicted that future orientation would
add significant incremental validity beyond what is accounted
for by optimism/pessimism in the prediction of suicide risk.
Given our earlier discussion of possible interaction effects,
we also expected to find evidence for a significant optimism/
pessimism 9future orientation interaction. That is, we
expected to find that future orientation will interact with opti-
mism/pessimism in predicting suicide risk, such that the risk for
suicidal behavior will be lowest for pessimists at higher than at
lower levels of future orientation, and will be highest for
optimists at lower than at higher levels of future orientation.
Consistent with this view, for example, studies have shown that
pessimists who act as if the future is changeable do not nec-
essarily incur the same outcomes and conditions as those who
act as if the future is unchangeable (e.g., Norem 2008;Norem
and Cantor 1986; Showers and Ruben 1990).
Method
Participants
A total of 101 adults (29 male and 72 female) were recruited
from a primary care clinic serving working, uninsured
patients, in the Southeast US; importantly, primary care
settings are a vital catchment site for the detection and pre-
vention of suicidal behaviors, as over 50 % of individuals
who die by suicide have seen a primary care physician in the
month prior to their death (Unu
¨tzer 2002). Ages ranged from
18 to 64 years, with a mean age of 42.18 (SD =12.83). Most
of the participants were Caucasian (93 %).
Measures
Optimism/Pessimism
To assess for optimism/pessimism, we used the LOT-R
(Scheier et al. 1994). The LOT-R is a 10-item measure of
individual differences in generalized positive and negative
outcome expectancies. Three items are positively worded
(e.g., ‘‘In uncertain times, I usually expect the best’’), and
three items (reverse scored) are negatively worded (e.g.,
‘‘I hardly ever expect things to go my way’’). The remaining
four items are filler items. Respondents are asked to indicate
the extent to which each they agree with each item using a
5-point Likert-type scale, ranging from 0 (strongly dis-
agree)to4(strongly agree). Evidence for the construct
validity of the LOT-R has been reported in Scheier et al.
(1994). In the present sample, internal reliability for the
LOT-R was .92. In general, higher scores on the LOT-R are
indicative of greater dispositional optimism, whereas lower
scores are indicative of greater dispositional pessimism.
Future Orientation
Future orientation was measured with the Future Orienta-
tion Scale (FOS; Hirsch et al. 2006). The FOS is a 6-item
self-report measure that was developed to assess for an
individual’s belief and appreciation that the future could be
changed even when experiencing stressful circumstances or
negative events (e.g., ‘‘No matter how badly I feel, I know
it will not last’’). Respondents are asked to indicate ‘‘how
important each reason is to you for dealing with stressors’’
using a 6-point Likert-type scale, ranging from 1 (extre-
mely unimportant)to5(extremely important). Evidence for
the construct validity of the FOS has been reported in
Hirsch et al. (2006,2007b). In the present sample, internal
reliability for the FOS was .87. In general, higher scores on
the FOS indicate a greater appreciation for the belief that
one’s future can be changed for the better.
Suicide Risk
We used two measures to assess for suicide risk in adults.
First, given the robust involvement of depressive experi-
ences in adult suicide (e.g., Cheung et al. 2007; Cukrowicz
et al. 2011; Thomson 2012), and studies pointing to the
importance of measuring for depressive symptoms in pri-
mary care patients as part of a general assessment for
suicide risk in adults (Hooper et al. 2012), we used the
Center for Epidemiologic Studies Depression Scale (CES-D;
Radloff 1977) as a broad measure of adult suicide risk. The
CES-D is a commonly used 20-item scale that assesses
for severity of depressive symptoms in the past week.
Respondents are asked to rate the extent to which they have
experienced specific depressive symptoms (e.g., ‘‘I felt
depressed’’) across a 4-point Likert-type scale, ranging
from 0 (rarely or none of the time)to3(most or all of the
time). Evidence for the construct validity of the CES-D has
been reported in Radloff (1977) and for the utility of the
CES-D as a broad screening device for identifying adult
798 Cogn Ther Res (2013) 37:796–804
123
suicide risk has been reported in Cheung et al. (2007). In
the present sample, internal reliability for the CES-D was
.93. In general, higher scores on the CES-D indicate more
severe levels of depressive symptoms (i.e., increased gen-
eral risk for suicide).
Second, we used four items from the Suicide Behaviors
Questionnaire-Revised (SBQ-R; Osman et al. 2001)asa
more direct measure of adult suicide risk. The SBQ-R is a
self-report measure developed to directly tap key aspects of
suicidality, namely, lifetime ideation and/or suicide attempt
(‘‘Have you ever thought about or attempted to kill your-
self?’’), frequency of suicidal ideation over the past
12 months (‘‘How often have you thought about killing
yourself in the past year?’’), threat of suicide attempt
(‘‘Have you ever told someone that you were going to
commit suicide or that you might do it?’’), and likelihood
of suicidal behavior in the future (‘‘How likely is it that you
will attempt suicide someday?’’). The responses for each
item are given total points, and are measured across a 5- or
6-point Likert-type scale. Evidence for the construct
validity of the SBQ-R has been reported in Osman et al.
(2001). In the present sample, internal reliability for these
four SBQ-R items was .77. In general, higher scores on the
SBQ-R indicate greater likelihood of suicidal behavior.
Procedure
Approval for the study was obtained from the Institutional
Review Board prior to data collection. Participants were
recruited at a primary care clinic using advertisements
displayed throughout the clinic and were compensated $15
for completion of the study. All participants provided
written, informed consent that indicated that all test data
would be kept strictly confidential.
Results
Of the original sample of 101 adults, some participants
failed to complete all items on the measures (e.g., CES-D).
As a result, some minor variations are present in our sub-
sequent analyses due to the number of complete responses
that were available for use.
Relations Between Optimism/Pessimism, Future
Orientation, and Suicide Risk in Adults
Correlations, means, and standard deviations for all study
measures are presented in Table 1. As the table shows,
LOT-R scores were found to have moderate to large
associations (Cohen 1988) with scores on the two measures
of suicide risk used in the present study. Specifically, LOT-R
scores were found to be significantly and negatively
correlated with scores on the CES-D (r=-.67) and the
SBQ-R (r=-.40). Similarly, FOS scores were also found
to have moderate to large associations with scores on the
two suicide risk measures. Specifically, FOS scores were
found to be significantly and negatively correlated with
scores on the CES-D (r=-.48) and the SBQ-R (r=
-.34). Although LOT-R scores and FOS scores were found
to have a large and positive association with each other
(r=.52, p\.001), it is important to note that scores on
these measures only had less than 28 % of the variance in
common.
Optimism/Pessimism and Future Orientation
as Predictors of Suicide Risk in Adults
To examine the predictive utility of optimism/pessimism
(as measured by the LOT-R) and future orientation (as
measured by the FOS) in accounting for variance in each of
the two measures of suicide risk (viz., depressive symp-
toms, suicidal behavior), we conducted a pair of hierar-
chical regression analyses. For each of the equations,
LOT-R scores were entered in the First Step, followed by
FOS scores in the Second Step. Finally, to test for an
optimism/pessimism 9future orientation interaction, the
multiplicative term was entered in the Final Step of the
equation. To reduce the possibility of multicollinearity, we
centered our predictors prior to running our regression
analyses. Results of these analyses for predicting unique
variance in depressive symptoms and suicidal behavior are
presented in Table 2. To determine if scores reflecting
optimism/pessimism and future orientation accounted for a
small, medium, or large amount of the variance in func-
tioning, we used Cohen’s (1977) convention for small
(f
2
=.02), medium (f
2
=.15), and large effects (f
2
=.35).
As the table shows, optimism/pessimism was found to
account for a large (f
2
=.82) 45 % of significant vari-
ance in depressive symptoms, F(1, 93) =76.16, pB.001.
Table 1 Correlations between measures of optimism/pessimism,
future orientation, and suicide risk in community adults
Measures 1234
1. LOT-R –
2. FOS .52*** –
3. CES-D -.67*** -.48*** –
4. SBQ-R -.40*** -.34*** .53*** –
M19.82 28.88 15.40 4.90
SD 5.41 6.03 11.79 2.48
ns =94–101
LOT-Rrevised life orientation test, FOS future orientation scale; CES-D
center for epidemiological studies-depression scale, SBQ-Rsuicide
behavior questionnaire-revised
*** p \.001
Cogn Ther Res (2013) 37:796–804 799
123
Optimism/pessimism was found to be a significant and
unique predictor of depressive symptoms (b=-.67). When
future orientation was entered in the next step, it was found
to account for a small (f
2
=.02), but significant 2 % of
additional variance in depressive symptoms, F(1, 92) =
3.94, pB.05. Future orientation was found to be a signifi-
cant additive predictor (b=-18) of depressive symptoms.
Furthermore, it is worth noting that the interaction term
involving optimism/pessimism 9future orientation was
found to account for a small (f
2
=.04), but significant
4 % of additional variance above and beyond optimism/
pessimism and future orientation, F(1, 91) =7.80, p\.01.
As the table also shows, optimism/pessimism was found
to account for a medium (f
2
=.19) 16 % of significant
variance in suicidal behavior, F(1, 99) =18.90, pB.001.
Optimism/pessimism was found to be a significant pre-
dictor of suicidal behavior (b=-.40). When future ori-
entation was entered in the next step, it was found to
account for a small (f
2
=.03) 3 % of additional variance
in suicidal behavior, which approached significance,
F(1, 98) =2.98, p=.09. Future orientation was found to
be a marginally significant additive predictor (b=-.18,
p\.10) of suicidal behavior. Moreover, it is worth noting
that the interaction term involving optimism/pessi-
mism 9future orientation was again found to account for
a small (f
2
=.09), but significant 8 % of additional vari-
ance above and beyond optimism/pessimism and future
orientation, F(1, 97) =10.73, pB.001. Furthermore, to
explore the possible impact of controlling for depressive
symptoms in predicting suicide behavior (Hirsch et al.
2006), we conducted an additional regression analysis in
which we included depressive symptoms as a covariate in
our prediction model. Importantly, from this analysis, the
optimism/pessimism 9future orientation term was found
to account for a small (f
2
=.04), but significant 4 %
of additional variance above and beyond depressive
symptoms, optimism/pessimism, and future orientation,
F(1, 96) =5.37, p\.05.
Lastly, to visually inspect the manner in which opti-
mism/pessimism and future orientation interacted with
each other in predicting suicide risk, we plotted the
regression of depressive symptoms (Fig. 1) and suicidal
behavior (Fig. 2) on future orientation at low and high
levels (split below and above the mean, respectively) of
optimism/pessimism based on our initial regression results.
Results of plotting these interactions were consistent with
our hypothesis for pessimists, but not for optimists. Spe-
cifically, pessimists reported less depressive symptoms and
less suicidal behavior when they believed that their future
was changeable versus unchangeable. In contrast, optimists
showed little difference in depressive symptoms and in
suicidal behavior regardless of whether they believed that
their future was changeable or not.
Table 2 Results of hierarchical regression analyses showing amount
of variance in suicide risk accounted for by optimism/pessimism and
future orientation in community adults
Suicide risk bR
2
DR
2
Fp
Depressive symptoms
Step 1: Optimism/
pessimism
-.67*** .45 – 76.16 \.001
Step 2: Future orientation -.18* .47 .02 3.94 B.05
Step 3: Optimism/
pessimism 9future
orientation
.22** .51 .04 7.80 \.01
Suicidal behavior
Step 1: Optimism/
pessimism
-.40*** .16 – 18.90 \.001
Step 2: Future orientation -.18
.19 .03 2.98 \.10
Step 3: Optimism/
pessimism 9future
orientation
.31*** .27 .08 10.73 B.001
ns=94–100
p\.10, * pB.05, ** p\.01, *** pB.001
Fig. 1 Depressive symptoms at low versus high future orientation for
optimists and pessimists
Fig. 2 Suicidal behavior at low versus high future orientation for
optimists and pessimists
800 Cogn Ther Res (2013) 37:796–804
123
Discussion
Given the dearth of research examining positive cognitions
that may be involved in adult suicide risk (Wingate et al.
2006), the purpose of the present study was to examine the
value of an integrative model that included optimism/pes-
simism and future orientation as predictors of two impor-
tant indices of adult suicide risk, namely, depressive
symptoms and suicidal behavior, in a community sample of
adults. Consistent with past findings for optimism/pessi-
mism based on college student samples (e.g., Hart et al.
2008; Scheier et al. 1994), our correlational results indi-
cated that greater pessimism (lower optimism) was also
associated with greater depressive symptoms and greater
suicidal behavior in community adults. Likewise, consis-
tent with past findings for future orientation based on
depressed patients (e.g., Hirsch et al. 2007b), we also found
greater future orientation was associated with fewer
depressive symptoms and less suicidal behavior in the
present sample. Noteworthy, given that optimism and
future orientation both represent positive cognitions that
are future oriented, it is not surprising that we found these
two constructs to be significantly and positively intercor-
related. However, despite their conceptual similarities, they
were not found to be wholly redundant with each other
based on the amount of variance they shared in common.
Accordingly, this latter finding may be taken to offer
additional support for the construct validity of future ori-
entation in adults (Hirsch et al. 2006).
With regard to additive effects, we found support for the
role of optimism/pessimism in predicting variance in sui-
cide risk in community adults. Specifically, optimism/
pessimism was found to predict a significant amount of
variance in both depressive symptoms and suicidal
behavior in the present sample. Interestingly, optimism/
pessimism was found to account for more than twice the
amount of variance in depressive symptoms (R
2
=.45),
than in suicidal behavior (R
2
=.16). Future orientation
was found to significantly augment the prediction model
for depressive symptoms (DR
2
=.02), but only approa-
ched significance in augmenting the prediction model for
suicidal behavior.
Importantly, we found evidence for interaction effects.
Specifically, after controlling for the variance accounted
for by both optimism/pessimism and future orientation, the
optimism/pessimism 9future orientation term was found
to account for a significant 4 % of additional variance in
depressive symptoms, and for a significant 8 % of addi-
tional variance in suicidal behavior. Consistent with our
notion that belief in the changeability of the future may
weaken the positive link between pessimism and suicide
risk, we found that pessimistic adults with higher, com-
pared to lower, future orientation reported both less
depressive symptoms and less suicidal behavior. As noted
earlier, researchers have found that some pessimists,
despite their expectation for negative outcomes, actually
engage in goal-driven efforts to change the course of their
negative future, which in turn often leads to achieving
goals and successful outcomes (e.g., Norem 2008; Showers
and Ruben 1990). Accordingly, it may be the presence (vs.
absence) of a belief that one’s future can be changed and
the motivation to seek a positive outcome, that work in
confluence to help some pessimists act proactively to attain
positive goals and outcomes (Chang 1996,2001; Norem
and Chang 2002). Given this possibility and our findings, it
may be useful to look at interventions that may help gen-
erate a belief in one’s perception that the future is
changeable as an important means for reducing suicide risk
in pessimistic adults. For example, mindfulness training is
believed to foster metacognitive awareness, including the
ability to decenter one’s thoughts from one’s immediate
situation (Keng et al. 2011). Such training may be suffi-
cient to help some pessimists detach themselves from
maintaining a fatalistic stance, and to begin accepting the
possibility of alternative experiences and possibilities.
In contrast to expectations, however, we did not find
evidence to support the notion that belief in the change-
ability of the future would further strengthen the negative
link between optimism and suicide risk. Specifically, we
found that optimistic adults reported comparable levels of
depressive symptoms and suicidal behavior regardless of
their belief that the future was changeable or not.
According to Scheier and Carver (1985; see also, Carver
et al. 2010), optimists expect the best for a wide range of
reasons, from those due to internal factors (e.g., self-
esteem, self-efficacy) to those due to external factors (e.g.,
luck, chance). Thus, it may be that for most optimists, a
belief that one’s future can be changed (or not) is not as
important a factor as other beliefs in predicting outcome.
Indeed, in contrast to findings from some studies that
have pointed to the potential pitfalls associated with the
co-presence of optimism and other positive cognitions
(e.g., Davidson and Prkachin 1997), our findings for pre-
dicting suicide risk in the present study indicate that there
may not be any particular advantages or disadvantages in
‘‘doubling up’’ on positive future cognitions in adults.
Nonetheless, it would be important to examine other
positive future cognitions (e.g., hope; Snyder et al. 2001).
Some Limitations of the Present Study
Although the present findings provide promising empirical
support for our integrative model involving optimism/
pessimism and future orientation as additive and interactive
factors involved in suicide risk in a community sample of
Cogn Ther Res (2013) 37:796–804 801
123
adults, some important limitations to the present study
should also be noted. First, given the cross-sectional nature
of the present study, cause and effect cannot be determined.
In that regard, it would be important in future studies to
determine if and how optimism/pessimism and future ori-
entation may predict changes in adult suicide risk across
time. Second, although an important strength of the present
study was the use of a clinical sample of primary care
patients (rather than the use of a convenience sample; e.g.,
college students), our sample did not include many older
adults. Given that suicide rates have historically been
highest among the elderly (De Leo 2001), it may be useful
to replicate the present study in an elderly population.
Third, because racial/ethnic differences in adults have been
found in studies of optimism/pessimism (e.g., Chang
2002a), it would be important to determine the extent to
which the present findings may be generalized to more
diverse racial and ethnic groups. Lastly, we focused in the
present study on factors that may predict suicide risk in
adults. It would be useful to determine if an integrative
model involving optimism/pessimism and future orienta-
tion is also useful in predicting other important outcomes
(e.g., happiness, life satisfaction, coping behaviors).
Concluding Thoughts
In summary, we examined the utility of an integrative
model involving optimism/pessimism and future orienta-
tion as additive and interactive predictors of suicide risk
(viz., depressive symptoms and suicidal behavior) in an
adult community sample. We found robust support for the
role of optimism/pessimism as a predictor of both suicide
measures examined in the present study. In contrast, we
found more limited support for the additive role of future
orientation in predicting suicide risk. Importantly, how-
ever, we found support for a significant optimism/pessi-
mism 9future orientation interaction in predicting both
depressive symptoms and suicidal behavior. Overall, our
findings are the first to provide evidence for the potential
value of considering the interactive function of optimism/
pessimism and future orientation in understanding adult
suicide risk.
Acknowledgments The first author would like to acknowledge
Chang Suk-Choon and Tae Myung-Sook for their encouragement and
support throughout this project.
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