title: Positive psychology in cancer care: a story line resistant to evidence.
abstract: BACKGROUND
  Aspinwall and Tedeschi (Ann Behav Med, 2010) summarize evidence they view as supporting links between positive psychological states, including sense of coherence (SOC) and optimism and health outcomes, and they refer to persistent assumptions that interfere with understanding how positive states predict health.
  
  
  OBJECTIVE
  We critically evaluate Aspinwall and Tedeschi's assertions.
  
  
  METHODS
  We examine evidence related to SOC and optimism in relation to physical health, and revisit proposed processes linking positive psychological states to health outcomes, particularly via the immune system in cancer.
  
  
  RESULTS
  Aspinwall and Tedeschi's assumptions regarding SOC and optimism are at odds with available evidence. Proposed pathways between positive psychological states and cancer outcomes are not supported by existing data. Aspinwall and Tedeschi's portrayal of persistent interfering assumptions echoes a disregard of precedent in the broader positive psychology literature.
  
  
  CONCLUSIONS
  Positive psychology's interpretations of the literature regarding positive psychological states and cancer outcomes represent a self-perpetuating story line without empirical support.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, 3535 Market St., Room 676, Philadelphia, PA, USA, jcoyne@mail.med.upenn.edu.
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Howard
authors.initials: H
authors.lastname: Tennen
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
mesh_terms: D001290:Attitude; D019317:Evidence-Based Medicine; D006262:Health; D006801:Humans; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D011379:Prognosis; D011582:Psychological Theory; D013850:Thinking