Clinical Practice & Epidemiology in Mental Health, 2010, 6, 25-29 25
1745-0179/10 2010 Bentham Open
Optimism and Its Impact on Mental and Physical Well-Being
Ciro Conversano1,†,*, Alessandro Rotondo2,†,*, Elena Lensi1, Olivia Della Vista1, Francesca
Arpone1 and Mario Antonio Reda1
1Istituto di Scienze del Comportamento Università degli Studi di Siena, Policlinico Le Scotte viale Bracci – 53100 Siena,
Italy, 2Azienda Ospedaliero Universitaria Pisana, Pisa, via Roma 67 – 56126 Pisa, Italy
Abstract: Many studies have been carried out about the effectiveness of optimism as a psychological phenomenon, lead-
ing to various theoretical formulations of the same concept, conceptualized as “disposition”, “attributional style”, “cogni-
tive bias”, or “shared illusion”. This overview is an attempt to explore the “optimism” concept and its relations with men-
tal health, physical health, coping, quality of life and adaptation of purpose, health lifestyle and risk perception.
Positive and negative expectations regarding the future are important for understanding the vulnerability to mental disor-
ders, in particular mood and anxiety disorders, as well as to physical illness. A significant positive relation emerges be-
tween optimism and coping strategies focused on social support and emphasis on positive aspects of stressful situations.
Through employment of specific coping strategies, optimism exerts an indirect influence also on the quality of life. There
is evidence that optimistic people present a higher quality of life compared to those with low levels of optimism or even
pessimists. Optimism may significantly influence mental and physical well-being by the promotion of a healthy lifestyle
as well as by adaptive behaviours and cognitive responses, associated with greater flexibility, problem-solving capacity
and a more efficient elaboration of negative information.
Keywords: Optimism, Mental health, Physical health, Coping, Quality of life, Adaptation of purpose, Health lifestyle, Risk percep-
As it is commonly understood, the term ‘optimism’ em-
braces two closely correlated concepts: the first is the incli-
nation to hope, while the second more generally refers to the
tendency to believe that we live in “the best of all possible
worlds”, as coined by the German philosopher Gottfried
Wilhelm Leibniz in his famous theodicy, ridiculed in Vol-
Over the last few years, a significant body of research has
been carried out about the effectiveness of optimism as a
psychological phenomenon, leading to various theoretical
formulations of the same concept, understood as “disposi-
tion”, “attributional style”, “cognitive bias”, or “shared illu-
Scheier and Carver  theorized the “disposition” to-
wards optimism in their studies, called “dispositional opti-
mism”, considering it a trait of an equilibrated personality, in
time and in various situations, that influences the way in
which individuals come to terms with present, past and fu-
ture events in life. Optimistic individuals are positive about
events in daily life. In the research carried out regarding this
perspective, positive correlations have been found between
optimism and physical/mental well-being. Optimistic sub-
jects tend to have more frequently protective attitudes, are
more resilient to stress and are inclined to use more appro-
priate coping strategies.
*Address correspondence to these authors at the Istituto Di Scienze Del
Comportamento, Viale Bracci, 16, 53100 Siena, Italy; Tel: +39 338
2694718; Fax: +39 0577 233215; E-mail: email@example.com
†These authors contributed equally to this work.
In open contrast, studies carried out by Peterson and
Seligman , that were prevalently directed towards the un-
derstanding of the psychological bases of pessimism, lead to
conception of its opposite, optimism, as an “attributional
style”, characterized by the tendency to believe that negative
events are inconstant (the negative event will not repeat it-
self), external (I am not responsible for the event) and spe-
cific (the event is “specific”, self-limiting and will not influ-
ence any other activities of mine and my life). Optimists
believe that positive events are more stable and frequent than
negative ones. They think that they can avoid problems in
daily life and prevent them from happening, and therefore
they cope with stressful situations more successfully than
pessimists [3, 4].
Referring to the viewpoint of Social Cognition, a third
perspective sustains that optimism is the consequence of a
cognitive underestimation of risk, in other words, a “bias”
for the Self. This bias reflects the optimist’s conviction that
positive events are more likely to occur to him/herself while
negative events prevalently affect others. Weinstein [5, 6]
defined this phenomenon “unrealistic optimism”. The opti-
mistic bias is not a personality trait like dispositional opti-
mism  but rather a systematic cognitive distortion of the
consideration of one’s own probability of encountering nega-
tive events. The optimistic bias has been defined as the result
of the joint efforts of two mechanisms. The first of these is
related to cognitive factors such as lack of information and
poor critical insight of one’s own cognitive skills. The sec-
ond mechanism has a motivational nature, closely tied to
defending one’s self-esteem and to defensive negation.
26 Clinical Practice & Epidemiology in Mental Health, 2010, Volume 6 Conversano et al.
This overiew is an attempt to explore optimism concept
and its relations with mental health, physical health, coping,
quality of life and adaptation of purpose, health lifestyle and
OPTIMISM AND MENTAL HEALTH
Positive and negative expectations regarding the future
are important for understanding the vulnerability to mental
disorders, in particular mood disorders. Recent studies have
found an inverse correlation between optimism and depres-
sive symptoms [7, 8], and also between optimism and suici-
dal ideation . As such, optimism seems to have an impor-
tant moderating role in the association between feelings of
loss of hope and suicidal ideation . In relation to this,
Van der Velden et al.  have recently studied the associa-
tion between ‘dispositional optimism’ and depression in vic-
tims of a natural disaster. The results of this research show
that compared to optimists, pessimists nurtured little hope
for the future and were more at risk for depressive and anxi-
ety disorders, with subsequent impairment of social function-
ing and quality of life. The role of optimism in the quality of
life has also been investigated in depressive disorders emerg-
ing in patients suffering from somatic pathologies, (such as
acute coronary syndrome, for instance) in which a significant
inverse correlation was found between dispositional opti-
mism and level of satisfaction in life on one hand and de-
pressive symptoms emerging after the cardiovascular event
on the other hand .
Giltay et al.  raised the question of using psychother-
apy to promote an optimistic disposition in pessimistic sub-
jects, thus developing an efficient strategy to fight depres-
sion. Evidence regarding this subject has emerged also from
studies carried out on victims of catastrophic events such as
natural disasters. In fact, it has been observed that even one
single session of cognitive-behavioural therapy, targeted at
enhancing the sense of control and coping with incapacitat-
ing disturbances that ensue after a natural disaster, may con-
tribute to improving the well-being of the individual . A
brief intervention of this type, focused on recuperating an
active coping strategy and regaining control, may be signifi-
cant for ‘pessimistic’ victims, considering that they are more
inclined to avoid problems and “give up”, instead of trying
to regain control of their lives .
OPTIMISM AND PHYSICAL HEALTH
Despite the small number of studies published on this
matter, the relation between physical health and optimism is
as important as that between optimism and mental health
described above. Many studies have found that optimism is
correlated with better physical well-being compared to pes-
simism. Moreover, in contrast with optimism, pessimism is
correlated with excessive somatic complaints . In a study
on a population of elderly subjects of both sexes, aged be-
tween 65-85 years, Giltay et al.  noted that dispositional
optimism predicted less probability of mortality in general
and of cardiovascular mortality in particular. These data have
been confirmed in a subsequent longitudinal study on a
population of males aged between 64 - 84 years in which an
inverse correlation was reported between dispositional opti-
mism and the risk of cardiovascular death . Matthews et
al.  observed that in the three years following the meno-
pause, carotid atherosclerosis tended to progress more slowly
in optimistic women compared to their pessimistic peers. In
reference to oncological patients, Schulz et al.  noted
that high scores on the pessimism items of the LOT (a meas-
ure of dispositional optimism)  significantly predicted
premature death in young patients with breast cancer.
Among patients with neck or head cancer, optimists mani-
fested significantly greater survival a year after diagnosis
when compared to pessimists . In a recent study, Ironson
et al.  showed how dispositional optimism, less avoidant
coping strategies and lower level of depression positively
influence progression of the illness in patients suffering from
Although optimism is commonly believed to be a protec-
tive factor with regard to well-being and physical and psy-
chical health  some research has suggested that this is not
always the case. Schofield et al.  found that optimism
did not predict lower mortality rates among lung cancer pa-
tients. Also studies concerning the immune system turned
out contrasting results. Tomakowsky et al.  investigated
the correlation between the “dispositional” optimism  and
the “attributional” optimism [2, 4] mentioned earlier, with
the clinical and immune condition of subject affected with
AIDS. The results of their research indicated that both types
of optimism were associated with an improvement of the
symptomatology of AIDS. Nevertheless, in the long term,
high levels of optimism, in particular, of the attributional
type, were associated with a significant impairment of the
immune defence system. Milam et al. , on the other
hand, found that high levels of optimism do not confer any
clinical improvement to AIDS patients, although moderate
levels were found to be associated with more efficacious
immune systems. Segerstrom [24, 25] examined two hy-
potheses that may explain these results: the disappointment
hypothesis, according to which persistent and uncontrollable
stressors reduce the positive expectations that are typical of
optimists and thus consequently control over the stress fac-
tors, leading to decrease in immune defence. The other is the
engagement hypothesis theorizing that more optimistic indi-
viduals are more easily drawn to trying to resolve a problem
while pessimists tend to let the matter drop, thus ending up
more exposed to stress. As such, in cases of severe illnesses
like AIDS, when associated with the elevated levels of corti-
sol and adrenalin that typically present when faced with
stress, optimism may actually determine a decrease in the
defence mechanisms of the immune system.
OPTIMISM AND COPING
Coping refers to those mechanisms and mental processes
enacted by the individual as an adaptive response to reduce
the stress deriving from a threatening situation, as defined by
Lazarus and Opton .
From the early studies of Scheier et al. , a significant
positive relation emerged between optimism and different
aspects of life, such as coping strategies focalized on the
problem, looking for social support and emphasis of the
positive aspects of the stressful situation.
Despite a certain amount of dissent, other researchers
confirmed the first results. Dispositional optimism was found
to be positively correlated with those coping strategies ide-
Optimism and Its Impact on Mental and Physical Well-Being Clinical Practice & Epidemiology in Mental Health, 2010, Volume 6 27
ated to eliminate, reduce or manage the stressors and nega-
tively correlated with those employed to ignore, avoid or
distance oneself from stressors and emotions . Moreover,
the choice of the coping strategy shows to be constant over
the course of time . Low levels of dispositional optimism
were observed in students who were particularly vulnerable
to the normal difficulties encountered in scholastic environ-
ments and who developed intolerance or even hostility to-
wards the school . Also in the work environment a posi-
tive association was observed between optimism and per-
formance, mediated by the positive influence that optimism
has on coping strategies . Many studies have confirmed
that optimists tend to use coping strategies that focalize on
the problem more frequently compared to pessimists. When
these strategies cannot be enacted, optimists resort to adap-
tive strategies that focalize on the emotions, for example,
acceptance, humour and positive re-assessment of the situa-
tion [27, 32-34].
Through employment of specific coping strategies, opti-
mism exerts an indirect influence also on the quality of life.
In a sample of women with breast cancer Schou et al. 
found that optimistic women presented coping strategies
characterized by acceptance of the situation, emphasis of the
positive aspects and attempts to alleviate their condition with
a sense of humour, showing evident positive results on their
quality of life. In contrast, the pessimistic women reacted
with sentiments of impotence and loss of hope which signifi-
cantly worsened their quality of life.
OPTIMISM, QUALITY of LIFE AND ADAPTATION
Quality of life refers to life conditions of an individual
(health, wealth, social conditions) and satisfaction of per-
sonal desires, measured on a scale of personal values .
As such, we are dealing with a multidimensional construct
that integrates objective and subjective indicators, a wide
range of varying contexts of life and individual values.
Wrosch and Scheier  evidenced two variables capa-
ble of influencing quality of life: optimism and adaptation of
purpose. Both in fact exert a fundamental role in adaptive
management of critical circumstances in life and of goals to
reach. There is evidence that optimistic people present a
higher quality of life compared to those with low levels of
optimism or even pessimists [37, 38]. It has been demon-
strated that in the presence of severe pathological conditions,
optimistic patients adapt better to stressful situations com-
pared to pessimists, with positive repercussions on their
quality of life. For example, in a sample of patients who un-
derwent an aortic-coronary bypass, optimism was signifi-
cantly and positively associated with quality of life in the six
months following the operation . The optimistic patients
in fact presented a more rapid clinical improvement during
the period of hospitalization and a quicker return to daily
routine after discharge from hospital. Analogous results are
reported in samples of patients with other pathologies. In
patients affected with epilepsy, Pais-Ribeiro et al.  found
that optimists showed an improved perception of their physi-
cal and mental state of health and reported higher quality of
life compared to pessimists. Kung et al.  examined the
relation between optimism-pessimism and quality of life in
patients with cancer of the neck, head or thyroid. In all the
subjects, optimism was associated with better quality of life
in both the scales of the physical and mental components of
the MMPI (Minnesota Multiphasic Personality Inventory)
, in six of the eight subscales of the SF-12 (12-item Short
Form Health Survey)  and of the SF-36 (36-item Short
Form Health Survey) .
Lastly, in women with breast cancer, optimism was asso-
ciated with better quality of life in terms of emotional, func-
tional and socio-familial well-being .
Many studies have outlined the importance on quality of
life of an individual’s capacity to adapt and modify his/her
own objectives according to different situations [32, 34]. It is
possible to avoid or reduce the negative psychological and
physical repercussions consequent to the non-achievement of
a goal (for example, becoming ill despite constant efforts to
stay healthy) through a process of adaptive self-regulation
targeted at disengaging oneself from an unrealizable goal
and concentrating efforts instead on more attainable objec-
tives. In fact this form of release from a commitment is adap-
tive because it averts the patient from the emotionally nega-
tive consequences of repeated failures, while re-directing the
objectives gives back meaning and a sense of purpose to life.
Individuals who succeed in this present better quality of life
and better physical health compared to those who have
greater difficulty in renouncing their unattainable goals.
Moreover, they are more optimistic towards their future be-
cause they are able to manage difficulties more efficiently as
well as to identify new aims in life.
OPTIMISM, HEALTH LIFESTYLE AND RISK PER-
One way in which optimism may significantly influence
physical well-being is through promotion of a healthy life-
style. In fact, it is thought that optimism facilitates adaptive
behaviours and cognitive responses that consent negative
information to be elaborated more efficiently and that are
associated with greater flexibility and problem-solving ca-
pacity . These coping strategies are in turn predictive of
behaviours targeted at avoiding, and if necessary facing posi-
tively, health problems [46, 47].
Several studies have analysed the correlations between
optimism and healthy behaviours. In particular Steptoe et al.
 in a sample of males and females aged between 65 – 80
years found that optimism was correlated with healthy be-
haviours such as abstaining from smoking, moderate con-
sumption of alcohol, the habit of walking briskly and regular
physical activity, regardless of demographical factors, cur-
rent psycho-physical conditions and body mass.
A recent cohort study which examined 545 males aged
between 64 – 84 for fifteen years revealed a significant in-
verse relation between dispositional optimism and death for
cardio-vascular diseases, with a reduction of 50% of the risk
of cardio-vascular death in the optimistic individuals .
Numerous researches have investigated the relation be-
tween risk perception and unrealistic optimism that leads to
involvement in risky situations. Unrealistically optimistic
subjects tend to perceive themselves as being less at risk
compared to pessimists, as far as questions of health are con-
cerned, and furthermore believe themselves more capable of
28 Clinical Practice & Epidemiology in Mental Health, 2010, Volume 6 Conversano et al.
preventing such problems from happening . For example,
comparing groups of students with a marked disposition to-
wards risky behaviour and students having a low tendency to
get involved in such behaviour, Todesco and Hillman 
found that both groups assessed the possibility of damaging
consequences of a given situation, but the first group was at
variance for the fact that these students perceived themselves
Smokers represent an important field in the study of the
relation between unrealistic optimism and perception of risk
for the health. These subjects consider themselves to be less
at risk than others for developing illnesses associated with
smoking which has been interpreted as a form of irrationality
or rather, as an expression of optimistic bias. McKenna et al.
 illustrated that smokers, while considering themselves
to have a greater risk of contracting pathologies linked to
smoking compared to non-smokers, nonetheless perceived
such a risk as inferior when compared to the average number
of smokers (optimistic bias). More recent studies have indi-
cated that smokers have a significantly lower perception of
risk in comparison with non-smokers . By way of con-
firmation of these data, it was observed that smokers with
unrealistic optimism (that is, those who perceived their own
risk as lower than the effective risk) tended to believe that
smoking only for a few years they would not incur any risk
of lung cancer and that developing lung cancer depends
solely on genetic predisposition .
Furthermore, unrealistic optimists barely considered the
hypothesis of giving up smoking in order to reduce the risk
Optimism is a tendency to expect good things in the fu-
ture. From the literature here reviewed, it is apparent that
optimism is a mental attitude that heavily influences physical
and mental health, as well as coping with everyday social
and working life. Through an adaptive management of per-
sonal goals and development and by using active coping
tactics, optimists are significantly more successful than pes-
simists in aversive events and when important life-goals are
Clinics should develop an application form of optimism
concept in Applied Psychology and in Psychotherapy. As a
matter of fact, application form of optimism concept should
be integrated in treatments and prevention programs respec-
tively in mental and physical health, to improve well-being.
The authors conceived the manuscript and drafted it. All
authors read and approved the final manuscript.
 Scheier MF, Carver CS. Optimism, coping, and health: assessment
and implications of generalized outcome expectancies. Health Psy-
chol 1985; 4(3): 219-47.
 Peterson C, Seligman ME. Explanatory style and illness. J Pers
1987; 55(2): 237-65.
 Aspinwall LG, Richter L, Hoffman RR. Understanding how opti-
mism works: an examination of optimists’ adaptive moderation of
belief and behaviour. In: Optimism and pessimism. Chang EC, Ed.
Washington: American Psychological Association 2001; pp. 217-
 Peterson C, De Avila ME. Optimistic explanatory style and the
perception of health problems. J Clin Psychol 1995; 51(1): 128-32.
 Weinstein ND. Unrealistic optimism about future life events. J Pers
Soc Psychol 1980; 39(5): 806-20.
 Weinstein ND. Why it won’t happen to me: perception of risk
factors and susceptibility. Health Psychol 1984; 3(5): 431-57.
 Chang EC, Sanna LJ. Optimism, pessimism, and positive and nega-
tive affectivity in middle-aged adults: a test of a cognitive-affective
model of psychological adjustment. Psychol Aging 2001; 16(3):
 Hart SL, Vella L, Mohr DC. Relationships among depressive
symptoms, benefit-finding, optimism, and positive affect in multi-
ple sclerosis patients after psychotherapy for depression. Health
Psychol 2008; 27(2): 230-8.
 Hirsch JK, Conner KR, Duberstein PR. Optimism and suicide
ideation among young adult college students. Arch Suicide Res
2007; 11(2): 177-85.
 Hirsch JK, Conner KR. Dispositional and explanatory style opti-
mism as potential moderators of the relationship between hopeless-
ness and suicidal ideation. Suicide Life Threat Behav 2006; 36(6):
 Van der Velden PG, Kleber RJ, Fournier M, Grievink L, Dro-
gendijk A, Gersons BP. The association between dispositional op-
timism and mental health problems among disaster victims and a
comparison group: a prospective study. J Affect Disord 2007;
 Steele A, Wade TD. The contribution of optimism and quality of
life to depression in an acute coronary syndrome population. Eur J
Cardiovasc Nurs 2004; 3(3): 231-7.
 Giltay EJ, Kamphuis MH, Kalmijn S, Zitman FG, Kromhout D.
Dispositional optimism and the risk of cardiovascular death: the
Zutphen Elderly Study. Arch Intern Med 2006; 166(4): 431-6.
 Basoglu M, Salcioglu E, Livanou M, Kalender D, Acar G. Single-
session behavioral treatment of earthquake-related Post-traumatic
Stress Disorder: a randomized waiting list controlled trial. J
Trauma Stress 2005; 8(1): 1-11.
 Martínez-Correa A, Reyes del Paso GA, García-León A, González-
Jareño MI. Relationship between dispositional optimism/pessimism
and stress coping strategies. Psicothema 2006; 18(1): 66-72.
 Giltay EJ, Geleijnse JM, Zitman FG, Hoekstra T, Schouten EG.
Dispositional optimism and all-cause and cardiovascular mortality
in a prospective cohort of elderly dutch men and women. Arch Gen
Psychiatry 2004; 61(11): 1126-35.
 Matthews KA, Räikkönen K, Sutton-Tyrrell K, Kuller LH. Opti-
mistic attitudes protect against progression of carotid atherosclero-
sis in healthy middle-aged women. Psychosom Med 2004; 66(5):
 Schulz R, Bookwala J, Knapp JE, Scheier MF, Williamson GM.
Pessimism, age and cancer mortality. Psychol Aging 1996; 11(2):
 Allison PJ, Guichard C, Fung K, Gilain L. Dispositional optimism
predicts survival status 1 year after diagnosis in head and neck can-
cer patients. J Clin Oncol 2003; 21(3): 543–548.
 Ironson G, Balbin E, Stuetzle R, et al. Dispositional optimism and
the mechanisms by which it predicts slower disease progression in
AIDS: proactive behavior, avoidant coping, and depression. Int J
Behav Med 2005; 12(2): 86-97.
 Schofield P, Ball D, Smith JG, et al. Optimism and survival in lung
cancer patients. Cancer 2004; 100(6): 1276-82.
 Tomakowsky J, Lumley MA, Markowitz N, Frank C. Optimistic
explanatory style and dispositional optimism in HIV-infected men.
J Psychosom Res 2001; 51(4): 577-87.
 Milam JE, Richardson JL, Marks G, Kemper CA, McCutchan AJ.
The roles of dispositional optimism and pessimism in HIV disease
progression. Psychol Health 2004; 19: 167-81.
 Segerstrom SC: Optimism and immunity: do positive thoughts
always lead to positive effects? Brain Behav Immun 2005; 19(3):
 Segerstrom SC. How does optimism suppress immunity? Evalua-
tion of three affective pathways. Health Psychol 2006; 25(5): 653-
 Lazarus RS, Opton EM. A study of psychological stress: a sum-
mary of theoretical formulations and experimental findings. In:
Spielberger CD. Ed. Anxiety and Behavior. New York: Academic
Press 1966; pp. 225-62.
Optimism and Its Impact on Mental and Physical Well-Being Clinical Practice & Epidemiology in Mental Health, 2010, Volume 6 29
 Scheier MF, Weintraub JK, Carver CS. Coping with stress: diver-
gent strategies of optimists and pessimists. J Pers Soc Psychol
1986; 51(6): 1257-64.
 Nes LS, Segerstrom SC. Dispositional optimism and coping: a
meta-analytic review. Pers Soc Psychol Rev 2006; 10(3): 235-51.
 Billingsley KD, Waehler CA, Hardin SI. Stability of optimism and
choice of coping strategy. Percept Mot Skills 1993; 76(1): 91-7.
 Boman P, Yates GC. Optimism, hostility, and adjustment in the
first year of high school. Br J Educ Psychol 2001; 71(3): 401-411.
 Strutton D, Lumpkin J. Relationship between optimism and coping
strategies in the work environment. Psychol Rep 1992; 71(3):
 Rasmussen HN, Wrosch C, Scheier MF, Carver CS. Self-regulation
processes and health: the importance of optimism and goal adjust-
ment. J Personal Disord 2006; 74(6): 1721-48.
 Scheier MF, Carver CS, Bridges MW. Distinguishing optimism
from neuroticism (and trait anxiety, self-mastery, and self-esteem):
a reevaluation of the life orientation test. J Pers Soc Psychol 1994;
 Wrosch C, Scheier MF. Personality and quality of life: the impor-
tance of optimism and goal adjustment. Qual Life Res 2003; 12(1):
 Schou I, Ekeberg Ø, Ruland CM. The mediating role of appraisal
and coping in the relationship between optimism-pessimism and
quality of life. Psychooncology 2005; 14(9): 718-27.
 Cummins RA. Comprehensive quality of life scale: intellectual
disability, 3rd ed, revised. Melbourne: Deakin University, Psychol-
ogy Research Centre 1992.
 Scheier MF, Carver CS. Effects of optimism on psychological and
physical well-being: theoretical overview and empirical update.
Cogn Ther Res 1992; 16: 201-28.
 Scheier MF, Carver CS. Self-regulatory processes and responses to
health threats: effects of optimism on well-being. In: Suls J, Wall-
ston KA, Eds. Social psychological foundations of health and ill-
ness. Oxford: Blackwell 2003; pp. 395-428.
 Scheier MF, Matthews KA, Owens JF, et al. Dispositional opti-
mism and recovery from coronary artery bypass surgery: the bene-
ficial effects on physical and psychological well-being. J Pers Soc
Psychol 1989; 57(6): 1024-40.
 Pais-Ribeiro J, Da Silva AM, Meneses RF, Falco C. Relationship
between optimism, disease variables, and health perception and
quality of life in individuals with epilepsy. Epilepsy Behav 2007;
 Kung S, Rummans TA, Colligan RC, et al. Association of opti-
mism-pessimism with quality of life in patients with head and neck
and thyroid cancers. Mayo Clin Proc 2006; 81(12): 1545-52.
 Hathaway SR, McKinley JC. The MMPI Manual. New York: Psy-
chological Corporation 1940.
 Ware JE Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health
Survey: construction of scales and preliminary tests of reliability
and validity. Med Care 1996; 34(3): 220-33.
 Ware JE Jr. SF-36 Health survey: manual and interpretation guide.
Boston: Nimrod Press 1993.
 Friedman LC, Kalidas M, Elledge R, et al. Optimism, social sup-
port and psychosocial functioning among women with breast can-
cer. Psychooncology 2006; 15(7): 595-603.
 Braverman MT. Research on resilience and its implications for
tobacco prevention. Nicotine Tob Res 1999; 1(1): 67-72.
 Cooper ML, Russell M, Skinner JB, Frone MR, Mudar P. Stress
and alcohol use: moderating effects of gender, coping, and alcohol
expectancies. J Abnorm Psychol 1992; 101(1): 139-52.
 Steptoe A, Wright C, Kunz-Ebrecht SR, Iliffe S: dispositional
optimism and health behavior in community-dwelling people: as-
sociations with healthy ageing. Br J Health Psychol 2006; 11(1):
 Giltay EJ, Geleijnse JM, Zitman FG, Buijsse, Kromhout D. Life-
style and dietary correlates of dispositional optimism in men: the
Zutphen Elderly Study. J Psychosom Res 2007; 63(5): 483-90.
 Todesco P, Hillman SB. Risk perception: unrealistic optimism or
realistic expectancy. Psychol Rep 1999; 84(3): 731-8.
 McKenna FP, Warburton DM, Winwood M. Exploring the limits of
optimism: the case of smokers’ decision making. Br J Psychol
1993; 84(3): 389-94.
 Weinstein ND, Marcus SE, Moser RP. Smokers' unrealistic opti-
mism about their risk. Tob Control 2005; 14(1): 55-9.
 Dillard AJ, McCaul KD, Klein WM. Unrealistic optimism in
smokers: implications for smoking myth endorsement and self-
protective motivation. J Health Commun 2006; 11(1): 93-102.
Received: October 14, 2009 Revised: February 28, 2010 Accepted: February 28, 2010
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