How optimism contributes to the adaptation of chronic illness. A prospective study into the enduring effects of optimism on adaptation moderated by the controllability of chronic illness

The aim of this study was to investigate the impact of optimistic beliefs on coping and adaptation over 6 and 12 months of chronic illness, and whether the adaptiveness of optimistic beliefs was moderated by the controllability of disease. In addition, we examined whether coping strategies contribute to the stability of optimistic beliefs, and thus indirectly to their adaptiveness. Three chronic diseases differing in controllability were included: type 1 diabetes (n=90), rheumatoid arthritis (n=89) and multiple sclerosis (n=90). Path models were used to examine the relationship of three optimistic beliefs (outcome expectancies, efficacy expectancies, unrealistic thinking) with coping, anxiety, depression and physical functioning. Results show that coping contributes to the stability of outcome and efficacy expectancies which, in turn, contribute to mental health by using more task oriented and less emotion oriented coping. The controllability of disease moderated the effectiveness of efficacy expectancies and unrealistic thinking, as both optimistic beliefs are specifically beneficial when patients suffer from a chronic disease that is to a considerable extent controllable.