There is good evidence that building optimism will make you more resilient from depression and more productive at work. There is also mounting evidence that optimism may make you physically healthier, with some of the strongest evidence coming from well-designed studies of cardiac mortality. I believe that your learning the skill of optimism could save your life. (If I am wrong, you have very little to lose except some of your pessimism.) Here’s why I believe this:

The story begins at a poker game in Northern Iowa in the late 1980’s. Bob Colligan, a psychologist from the Mayo Clinic, sat to my right. After singing “two tenors” every time a pair of tens appeared on the table, he made an intriguing suggestion about health. I had presented a talk earlier that evening on the suggestive evidence that optimism improves health in aging men. Bob mentioned that since 1950 every patient admitted to the Mayo Clinic for any physical problem took the Minnesota Multiphasic Inventory, the MMPI. This is a 500 item yes-no test (“I am a secret agent of God”). Could we somehow code each item for optimism or pessimism and form a new optimism-pessimism scale?

Chris Peterson did just that, and Bob soon began to analyze the optimism or pessimism of patients admitted to the Mayo Clinic for all causes, using Chris’s technique. To see if optimism predicted longevity, Bob selected 839 consecutive patients who referred themselves for medical care in 1950. Death from any cause was the focus of the study and two hundred of these patients had died by the year 2000. The optimists had a whopping nineteen percent increase in longevity when their expected life span was compared to that of the pessimists.

Many of these deaths were cardiac, so Greg Buchanan and I undertook a prospective study of optimism and second heart attack. In this study, unlike the Mayo Clinic study, we knew the entire range of risk factors for each patient, so we could better zero in on pessimism as the deadly culprit. One hundred and twenty-six men had their first heart attack in the early 1980s in San Francisco. At that time, they were all interviewed about their lives. Their “attributional style” — pessimism or optimism — was derived from these interviews in just the same content-analytic way that we derived the optimism or pessimism of the MMPI items. The raters of the interviews were, of course, blind, unaware of the health of the men. Over the next eight years, half of these men died, mostly of a second heart attack. What predicted who would survive and who would die? Damage to the heart at the first heart attack, Type A, blood pressure, cholesterol, weight, and the entire panoply of traditional physical risk factors did not predict second heart attack. Pessimism, on the other hand, predicted second heart attack and death. Of the most pessimistic quartile, 86 percent died, whereas only 33 percent of the most optimistic quartile died (Buchanan, 1994).

Laura Kubzansky of the Harvard School of Public Health found similar results. In 1986, 1306 men took the MMPI, from which she derived the optimism-pessimism score. In 10 years of follow-up, 162 cases of coronary heart disease occurred: 71 cases of nonfatal myocardial infarction, 31 cases of fatal coronary heart disease, and 60 cases of angina pectoris. She adjusted for smoking, weight, blood pressure, and a variety of other traditional risk factors. Men with high levels of optimism had less than half the risk for combined fatal and nonfatal myocardial infarction and for angina pectoris. The greater their optimism, the lower the risk for cardiac incidents.

In the largest study, 999 Dutch men and women from the Arnhem Elderly Study, took a variety of psychological tests and were followed for nine years, from 1991 to 2001. 397 died, and a high level of optimism was far and away the best predictor of survival. Taking sex, age, disease, education, smoking, alcohol, prior cardiac disease, cholesterol, and weight into account, strong optimists were at one-quarter the risk for cardiac death. Again the higher the optimism, the more protection against cardiac death. This was true of both men and women.

So the effects of optimism on risk for heart attack are strong, stronger probably than most or even all of the traditional risk factors. But is optimism the cause of the lower risk for heart attack or does it merely correlate with some unknown protective factor, like serotonin level or genes, which in turn is the active ingredient, causing both the optimism and the protection from heart attack?

We do not know, and there is really only one impeccable way to find out: a random-assignment experimental study, in which some people are randomly assigned to become optimists and later heart attacks are measured. Random assignment rules out all such confounding “third variables.” There is one such study in the literature: My research group invites the most pessimistic members of Penn’s entering freshmen to be randomly assigned to a control group or to a workshop which teaches the optimism techniques you will learn over the next three months. The freshmen who learn optimism not only have less depression and anxiety over the next three years but their physical health is significantly better than the controls. While the study is not about heart attack, but about the whole mélange of undergraduate physical ills, it shows optimism to be a cause, not just a correlate of better health.

I urge you (and the people you care about) to do the exercises on happier.com diligently, and as my mother used to say “use them in good health.”

References:

Buchanan, G.M., Gardenswartz, C.A.R., & Seligman, M.E.P. (1999). Physical health following a cognitive-behavioral intervention. Prevention and Treatment, 2.

Giltay, E., Geleljnse, J., Zitman, F., Hoekstra, T., & Schouten, E.(2004). Dispositional optimism and all-cause and cardiovascular mortality in a prospective cohort of elderly Dutch men and women. Archives of General Psychiatry, 61, 1126-1135.

Kubzansky, L. Sparrow, D. Vokonas, P. and Kawachi, I. (2001). Is the Glass Half Empty or Half Full? A Prospective Study of Optimism and Coronary Heart Disease in the Normative Aging Study. Psychosomatic Medicine, 63, 910-916

Maruta, T., Colligan, R. Malinchoc, M. & Offord, K (2000). Optimists vs. pessimists: Survival rate among medical patients over a 30-year period. Mayo Clinic Proceedings, 75, 140-143.

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