title: Optimism, social support, and mental health outcomes in patients with advanced cancer.
abstract: OBJECTIVE
  Optimism and social support serve as protective factors against distress in medically ill patients. Very few studies have specifically explored the ways in which these variables interact to impact quality of life (QOL), particularly among patients with advanced cancer. The present study examined the role of optimism as a moderator of the relationship between social support and anxiety, depression, hopelessness, and QOL among patients with advanced cancer.
  
  
  METHODS
  Participants (N = 168) completed self-report assessments of psychosocial, spiritual, and physical well-being, including social support, optimism, hopelessness, depressive and anxious symptoms, and QOL. Hierarchical multiple regression analyses were conducted to determine the extent to which social support and optimism were associated with depressive and anxious symptomatology, hopelessness and QOL, and the potential role of optimism as a moderator of the relationship between social support and these variables.
  
  
  RESULTS
  Higher levels of optimism were significantly associated with fewer anxious and depressive symptoms, less hopelessness, and better QOL. Higher levels of perceived social support were also significantly associated with better QOL. Additionally, optimism moderated the relationship between social support and anxiety, such that there was a strong negative association between social support and anxiety for participants with low optimism.
  
  
  CONCLUSIONS
  This study highlights the importance of optimism and social support in the QOL of patients with advanced cancer. As such, interventions that attend to patients' expectations for positive experiences and the expansion of social support should be the focus of future clinical and research endeavors.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Allison J
authors.initials: AJ
authors.lastname: Applebaum
authors.forename: Emma M
authors.initials: EM
authors.lastname: Stein
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lord-Bessen
authors.forename: Hayley
authors.initials: H
authors.lastname: Pessin
authors.forename: Barry
authors.initials: B
authors.lastname: Rosenfeld
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000523:psychology*; D009519:New York City; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: advanced cancer; optimism; psychological distress; quality of life; social support