title: Anger Proneness and Prognostic Pessimism in Men With Prostate Cancer.
abstract: OBJECTIVE
  Anger is a common reaction to cancer diagnosis which may impact patients' perceptions of their prognosis and goals of care. This study tested the hypothesis that men with prostate cancer who are anger prone are pessimistic regarding their cancer prognosis.
  
  
  METHODS
  Two hundred and twelve men with a history of prostate cancer completed measures of personality traits, their prostate cancer prognosis, and their perception of their doctor's assessment of their prognosis. Anger proneness was operationally defined by the presence of high levels (ie, above the medians) of neuroticism and disagreeableness.
  
  
  RESULTS
  One in 4 men with prostate cancer disagreed with their doctor about prognosis. Anger-prone participants endorsed more pessimistic perceptions of prognosis ( P = .041). This significant association was maintained after accounting for potential confounders.
  
  
  CONCLUSIONS
  Greater attention paid to patient anger regulation style and pessimistic perceptions will improve discussions about prognosis and goals of care among men with prostate cancer. Given recent calls for wider distress screening and earlier palliative care intervention in cancer settings, providers have an unprecedented opportunity to assess and respond to anger in the clinical setting. Communication could be improved through empathic statements that convey realistic optimism when appropriate, a commitment to the patient-provider relationship and a willingness to explore and address patient needs.
authors.affiliation: 1 Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
authors.forename: James
authors.initials: J
authors.lastname: Gerhart
authors.affiliation: 1 Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.|2 Center for Innovation to Implementation (Ci2i), HSR&D, Palo Alto VA Health Care System, Menlo Park, CA, USA.|3 Stanford Health Policy, Stanford University, Stanford, CA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Schmidt
authors.affiliation: 1 Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Lillis
authors.affiliation: 4 Hospice and Palliative Medicine, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: O'Mahony
authors.affiliation: 5 Department of Psychiatry, University of Rochester, Rochester, NY, USA.|6 Department of Family Medicine, University of Rochester, Rochester, NY, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Duberstein
authors.affiliation: 7 Department of Psychology, Tulane Cancer Center, New Orleans, LA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hoerger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D006801:Humans; D008297:Male; D008875:Middle Aged; D000075384:Neuroticism; D000067657:Pessimism; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000150:complications* / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*
keywords: agreeableness; anger; neuroticism; personality; prognosis; prostate cancer