Positive Psychology in Cancer Care: A Story Line Resistant to Evidence

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. PURPOSE: 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. CONCLUSION: Positive psychology’s interpretations of the literature regarding positive psychological states and cancer outcomes represent a self-perpetuating story line without empirical support.