Explanatory Style And Health Research Paper

1. Measurement Of Explanatory Style

Explanatory style took off as a line of research when measures of this individual difference began to be developed. The first measure of explanatory style to be developed was the Explanatory Style Questionnaire (ASQ; Peterson et al. 1982). The ASQ presents respondents with hypothetical good and bad events involving themselves (e.g., ‘you go out on a date, and it goes badly’). They are asked to imagine the event happening to themselves, and then to write down the event’s ‘one major cause’ if it happened to them. Then they use rating scales to indicate the degree to which the cause falls along dimensions reflecting pessimism versus optimism.

A second way of measuring explanatory style is a flexible content analysis method: the Content Analysis of Verbatim Explanations (CAVE; Peterson et al. 1992). This strategy stemmed from the observation that causal explanations, identical to those given by respondents to the ASQ, were abundant in spontaneous writing or speaking. Was it possible to identify these explanations in verbatim material, extract them, and then to rate them along the dimensions reflecting pessimism versus optimism? Indeed, this could all be done, and explanatory style so assessed proves reliable, consistent, and valid. Potential research subjects neither able nor willing to participate in typical research can be studied with the CAVE technique, as long as they have left behind suitable material containing causal explanations about themselves. To date, the CAVE technique has been used to measure explanatory style from psychotherapy transcripts, interviews, open-ended questionnaires, political speeches, sports stories, religious texts, and even song lyrics. The methodological virtue of this approach to studying explanatory style is that it allows longitudinal research to be conducted retrospectively. If suitable verbal material can be located from early in the lives of individuals whose long-term fate is known, then the CAVE technique allows studies to be done very quickly that nonetheless span decades. For obvious reasons, studies of explanatory style and physical well-being have frequently relied on the CAVE.

2. Explanatory Style And Health

Approximately one dozen studies have established a correlation between explanatory style (measured with the ASQ or the CAVE) and physical health. Taken together, the results of these studies converge with other investigations of positive thinking and wellbeing. Optimism, rendered as explanatory style or in other ways, predicts good health operationalized in a number of ways, from self-reports to physician ratings of general well-being to doctor visits to survival time following a heart attack to immunological efficiency to longevity.

How strong is the association between optimism and good health? Most of the relevant studies report correlation coefficients in the 0.20–0.30 range, which are moderate in size and typical of correlations in psychological research. Research participants have included males and females, some initially healthy and others initially quite ill. Adults across the life span have been included. Many of these studies have been longitudinal, spanning weeks to decades. At least some of these longitudinal studies have statistically controlled for initial levels of health and potential confounds involving tendencies to complain.

Optimistic explanatory style apparently impacts health at a number of junctures. It can make the initial onset of illness less likely; it can minimize the severity of illness; it can speed recovery; it can make relapse less likely. Most of the relevant studies, by virtue of rather stark correlational designs, do not allow conclusions about when health is impacted. Future investigations of a more fine-grained nature are needed.

3. Questions About The Link Between Explanatory Style And Health

Can a lifetime of good health be encouraged by the early cultivation of optimism? Researchers at the University of Pennsylvania have begun an intervention program that involves teaching grade-school children to be more optimistic. Results to date suggest that optimism training makes subsequent episodes of depression less likely. Perhaps studies of physical wellbeing can be included in this ongoing investigation.

We can similarly ask if optimistic ways of thinking acquired once an individual falls ill will boost good health. Again, studies of optimism and depression suggest that this question is worth pursuing. Cognitive therapy that targets negative ways of thinking alleviates depression and prevents its recurrence. By implication, cognitive therapy for the seriously ill might pay health dividends.

Certainly, the most basic question that arises from research into optimism and health involves the mechanisms linking the two. The link appears to be over determined, and there are several plausible routes. For example, there may be an immunological pathway. Researchers have shown that an optimistic explanatory style is positively correlated with the vigor with which the immune system responds to an antigen challenge. Several other similar lines of investigation have looked at how explanatory style is linked to the progression of AIDS. Results here are mixed, but there are hints that optimistic explanatory style predicts survival time and that this effect is mediated in part by immunological factors.

There may also be an emotional pathway between explanatory style and health. As noted earlier, an extensive research literature has shown optimistic explanatory style to be incompatible with depression, and other studies have linked depression to poor health and early death. At least part of this latter path may be immunological.

There are probably several cognitive pathways be- tween optimism and health as well. Optimistic explanatory style is not an isolated belief but rather part of a complex knowledge system that can influence physical well-being in numerous ways. For example, individuals with an optimistic explanatory style see the world as less filled with hassles than do their pessimistic counterparts; this tendency is in turn linked to better health. For another example, optimistic individuals are more likely to see health outcomes as something over which they can exert control; again, this tendency is linked to better health.

Another explanation of why optimistic thinking is related to physical well-being points to a social pathway. People with a pessimistic explanatory style are often socially isolated, and social isolation is a consistent predictor of poor health. In general terms, the individual’s social context can set the stage for the optimism–health link. Epidemiologist Leonard Sagan (1987) put forth the intriguing argument that the dramatic increase in life expectancy in the Western world over the centuries was due not to breakthroughs in medical or public health practices but instead to cultural diffusion of the originally radical notion that an individual is a discrete self-able to have an effect on the world. Once the idea of individual agency was invented, legitimized, and disseminated, the findings discussed here became possible.

Although the link between optimism and health is complexly determined, the most typical and most robust mechanism is a mundane Behavioral pathway. An optimistic explanatory style is associated with a variety of ‘healthy’ practices: exercising, drinking in moderation, avoiding fatty foods, and the like. People with an optimistic explanatory style are more likely than those with a pessimistic explanatory style to respond to colds with appropriate actions: staying home, taking it easy, and increasing the intake of fluids.

A recent study of optimistic explanatory style and physical well-being looked at more than 1,000 individuals over almost 50 years (Peterson et al. 1998). Pessimistic individuals had an increased likelihood of an early death, and the large sample size made it further possible to investigate associations between explanatory style and death due to different causes. The interesting finding was that pessimistic individuals were most likely to die accidental and/or violent deaths. This effect was particularly pronounced for men.

Deaths like these are not random. ‘Being in the wrong place at the wrong time’ may be the result of an incautious and fatalistic life-style entwined not only with pessimism but also with the male gender role. This study did not reveal what the deceased research participants were doing when they died accidentally or violently, there is good reason to suspect that their behavior was somehow implicated, if only by affecting the settings they habitually entered or not.

Follow-up investigations suggest that the link between explanatory style and traumatic accidents involves a preference for potentially risky settings or activities (or at least a tendency not to avoid these) as well as the experience of negative emotions while in these settings. Negative emotions can make accidents more likely by producing passivity, limiting decision making, distracting individuals from dangers, and so on.

A final unresolved issue is whether the health benefits of explanatory style are due to optimism in its own right or simply to the absence of pessimism. Some writers have referred to the latter possibility as ‘the power of non-negative thinking.’ The issue cannot be resolved so long as research juxtaposes optimistic and pessimistic explanatory styles, treating them as mutually exclusive.

Regardless, explanatory style is linked to good health and long life, but it is worth emphasizing that styles of thinking are just one ingredient in physical well-being. Genetic predispositions, lack of health care, traumatic events, and environmental hazards such as toxins and germs take a toll on health regardless of how people might think. Researchers as well as the general public need to think about the determinants of physical health in a sophisticated manner. Psychological factors such as explanatory style are part of the equation but so too are a myriad of other factors.

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