Optimism and the Experience of Pain: A Systematic Review

Abstract

A growing body of literature provides evidence of the health-promoting effects of optimism, including its protective role in acute and chronic pain. Optimists are characterized by positive expectations concerning the future. These positive outcome expectancies lead to more and longer goal-directed efforts and the use of approach coping strategies. No systematic review on the effects of optimism on the experience of pain has so far been conducted. A search in the databases PubMed, Web of Science and PsycInfo, and the scanning of reference lists identified 69 eligible studies. These were categorized according to sample size, participants’ age and sex, design, optimism-pain relation as primary vs. secondary study objective, and level of study/publication quality. Overall percentages of positive, zero, and negative associations between optimism and pain as well as relative frequencies of these associations in the different categories were analyzed. About 70% of the studies showed a positive, i.e., beneficial association between optimism and at least one pain outcome. A larger percentage of beneficial associations was found in studies with experimental designs, in studies with the optimism-pain relation as primary objective, in high-quality studies/publications, and in studies including participants with a higher average age. The review suggests that optimism is associated with less acute and chronic pain, especially since a higher percentage of beneficial associations was found with high study/publication quality and with the primary focus on this relationship. For the moderating role of age, different explanations are proposed. Further research on causal relationships and on optimism-fostering clinical interventions is needed.

Keywords:

• chronic pain
• optimism; pain
• positive psychology
• resilience

Notes

Disclosure statement

The authors declare that they have no conflict of interest.

Notes

1 In order to avoid confusions of the term “positive result” which could be interpreted as either a positive correlation between optimism and pain or as a protective association (i.e., a negative correlation) between optimism and pain, the term “beneficial association of optimism with pain” (referring to a negative statistical correlation) will be used throughout the text.

2 In the following, numbers of studies are referred to by the k common in meta-analyses while numbers of persons are designated by n.

Additional information

Funding

This study was funded by Evangelisches Studienwerk Villigst.