Explanatory style and health among polio survivors.

Abstract

Explanatory style (ES), the way individuals make attributions about the causes of events, has emerged as a construct of optimism and has been found to be associated with physical well-being. Individuals who interpret the causes of negative events as temporary, specific to the current circumstances and externally are thought to have an optimistic ES. There is no formalized line of research on the links between ES and the physical well-being of individuals with disabilities such as those related to polio, or post-polio syndrome (PPS). PPS is a poorly understood condition that affects up to 80% of polio survivors. Symptoms include fatigue, muscle weakness and pain. This study explores the relationship between ES and health outcomes in a sample of 114 women with polio who participated in the Wellness for Women with Polio Study at the University of Michigan Medical Center. Three-year follow-up data examining the health status and ES of these individuals was gathered. The Physical Health Component score (PHC) of the SF-36, and questions regarding PPS symptomatology were utilized to assess physical health status. ES was measured through the Attributional Style Questionnaire (ASQ). These measures were administered at baseline (T1) and at the three-year follow-up (T3). It was hypothesized that more optimistic ASQ scores would be related to positive health outcomes. Hierarchical regression analyses showed that an optimistic ES at T1 can predict report of less extensive symptoms of pain and fatigue at T3. The relationship between ES at T1 and PHC at T3 was found to be mediated by ES's impact on baseline levels of PHC. Results also suggest that health status can have an effect on ES, in what can be described as a reciprocal relationship. Pathways between ES and health are also examined as the health behavior correlates of dispositional optimism and ES are compared. The relationship between physical health and John Henryism, a high-effort coping style associated with unrealistic optimism, was also assessed. Results suggest that ES and John Henryism can be important psychological factors in the long-term course of progressive disabilities such as those related to PPS. Implications for future research and interventions are discussed.