Cogn Ther Res (2013) 37:796–804 DOI 10.1007/s10608-012-9505-0
ORIGINAL ARTICLE
An Examination of Optimism/Pessimism and Suicide Risk in Primary Care Patients: Does Belief in a Changeable Future Make a Difference? Edward C. Chang • Elizabeth A. Yu • Jenny Y. Lee • Jameson K. Hirsch • Yvonne Kupfermann • Emma R. Kahle
Published online: 16 December 2012 Ó Springer Science+Business Media New York 2012
Abstract An integrative model involving optimism/pessimism and future orientation as predictors of suicide risk (viz., depressive symptoms and suicidal behavior) was tested in a sample of adult, primary care patients. Beyond the additive influence of the two predictors of suicide risk, optimism/pessimism and future orientation were also hypothesized to interact together to exacerbate suicide risk. Results indicated that optimism/pessimism was a robust predictor of suicide risk in adults. Future orientation was found to add significant incremental validity to the prediction of depressive symptoms, but not of suicidal behavior. Noteworthy, the optimism/pessimism 9 future orientation interaction was found to significantly augment the prediction of both depressive symptoms and suicidal behavior. Implications for therapeutic enhancement of future-oriented constructs in the treatment of suicidal individuals are discussed. Keywords Optimism/pessimism Future orientation Adults Primary care Suicide risk
Introduction Over the past 30 years, findings from hundreds of studies on optimism based on Scheier and Carver’s (1985) popular E. C. Chang (&) E. A. Yu J. Y. Lee Y. Kupfermann E. R. Kahle Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, USA e-mail:
[email protected] J. K. Hirsch Department of Psychology, East Tennessee State University, Johnson City, TN 37614, USA
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model of generalized positive outcome expectancies, as measured by their Life Orientation Test (LOT) or the revised Life Orientation Test (LOT-R; Scheier et al. 1994), have pointed to a reliable link between dispositional optimism and health (see Carver et al. 2010, for a recent review), especially a link with psychological adjustment (Carver and Scheier 2002; Scheier et al. 2001). According to Scheier and Carver’s (1985) model, generalized positive and negative outcome expectancies, or optimism/pessimism, represent robust proximal determinants of adjustment in adults. Consistent with this view, findings from numerous studies have indicated that higher LOT or LOT-R scores are associated with higher scores on measures of life satisfaction (e.g., Bailey et al. 2007; Chang 1998; Daukantaite´ and Zukauskiene 2012), positive affect (e.g., Hart et al. 2008; Marshall et al. 1992), self-esteem (e.g., Ma¨kikangas et al. 2004; Vacek et al. 2010), and various dimensions of psychological well-being, including selfacceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth (Chang 2009). Likewise, lower LOT or LOT-R scores, reflecting greater dispositional pessimism or generalized negative outcome expectancies, have been found to be associated with higher scores on measures of symptoms of anxiety (e.g., Chang and Bridewell 1998; Lancastle and Boivin 2005; Siddique et al. 2006), stress (Chang 1998, 2002b; Endrighi et al. 2011), and negative affect (Daukantaite´ and Zukauskiene 2012; Marshall et al. 1992; Vacek et al. 2010). Given these findings and the presumed importance of generalized outcome expectancies in adjustment, some researchers have recently voiced a need to examine if optimism/pessimism is involved in other important outcomes and conditions, including adult suicide risk (Wingate et al. 2006). Indeed, although a number of studies have looked at the link between optimism/pessimism
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and general conditions typically indicative of increased suicide risk in adults such as depressive symptoms (e.g., Chang 2002a; Hart et al. 2008; Scheier et al. 1994), it is remarkable that over the last three decades, only a handful of studies have actually looked at the link between optimism/pessimism and more direct indices of adult suicide risk (e.g., suicide ideation). And of these studies, most have been limited to studies of college student samples (e.g., Chang 2002a; Hirsch et al. 2007a, c). Accordingly, to expand on past work and to provide a more compelling examination of optimism/pessimism, it would be critical to determine if optimism/pessimism is associated with both general and specific measures of suicide risk (e.g., depressive symptoms, suicide ideation) in a more selective, community-based adult population (i.e., primary care patients).
Optimism as Always Good and Pessimism as Always Bad: Is It Useful to Consider Changeability of the Future in Predicting Adult Suicide Risk? Given the reliable pattern of associations found between optimism/pessimism and psychological adjustment in the extant literature, it is not surprising that researchers have often come to the general conclusion that optimism is good, and pessimism is bad (Carver et al. 2010; Scheier et al. 2001; cf. Chang 2001; Norem and Chang 2002). Yet, some researchers have long pointed to the importance of considering alternative patterns, including the potential costs of optimism (Tennen and Affleck 1987) and, conversely, the potential benefits of pessimism (Norem and Chang 2002). Indeed, findings from a range of studies looking at optimism/pessimism, and other related selfenhancing versus self-critical processes (Chang 2008), have shown that the associations between these types of cognitions and important outcomes (e.g., psychological symptoms, life satisfaction, coping) can often be significantly dependent on a number of contextual factors, including race, ethnicity, and culture (e.g., Chang 1996; Chang and Asakawa 2003; Chang and Banks 2007; Hirsch et al. 2012) and source, type, or chronicity of stress experiences (Chang 2002b; Harris et al. 2008; Terrill et al. 2010). Other researchers have begun to examine how individual-differences factors may not only add to, but also interact with optimism/pessimism in predicting adjustment (Lopes and Cunha 2008). For example, Davidson and Prkachin (1997) examined the extent to which unrealistic optimism interacted with optimism/pessimism in predicting health-related behaviors and outcomes. Interestingly, these investigators found that the association between unrealistic optimism and gains in health knowledge
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decreased for optimists, but increased for pessimists (Study 2). Accordingly, there may be situations in which being pessimistic may not always be as harmful or as maladaptive as is typically believed. Likewise, situations may also exist in which being optimistic may not always involve helpful or adaptive conditions and outcomes (Hirsch et al. 2007a, b, c). Given these possibilities, we believe that in addition to optimism/pessimism, one variable that may be useful for understanding adult suicide risk is a belief in the changeability of the future or future orientation (Hirsch et al. 2006). Based on works by Hirsch and colleagues (Hirsch et al. 2006, 2007b), future orientation represents a specific belief (compared to more generalized beliefs involved in optimism/pessimism) that one’s future can change for the better (e.g., one will feel better in the future, one will be able to engage in useful plans in the future, one will be able to reach desired goals in the future). Not surprisingly, findings from their studies based on adult clinical samples have shown that higher future orientation is significantly associated with less suicide risk. Moreover, Hirsch et al. (2007b) also found that although greater functional impairment was a significant predictor of suicide ideation in a sample of depressed adults, future orientation significantly interacted with functional impairment to predict suicide ideation. Specifically, these investigators found that for patients with high future orientation (i.e., those who believed that their future was changeable), the association between functional impairment and suicide ideation was weakest compared to what was found for those with low future orientation (i.e., believed that their future was unchangeable). Thus, it may be that future orientation not only adds beyond optimism/pessimism to the prediction of adult suicide risk, but it may also interact with optimism/ pessimism in predicting suicide risk in adults. That is, being pessimistic may be associated with greater suicide risk in adults, but this may be less true for pessimists holding a high future orientation. Alternatively, being optimistic may be associated with less suicide risk in adults, but this may be truer for optimists holding a high future orientation. To date, no study has examined the role of optimism/pessimism and future orientation as additive and/or interactive predictors of suicide risk in a select adult population. Noteworthy, in a study of college students, O’Connor and Cassidy (2007) showed that optimism/pessimism interacted with the number of positive future events, ranging from those that were trivial to important, that students were able to quickly list within a 3 min timeframe. However, their performance-based measure of ‘‘future thinking’’ does not in any way assess for future orientation, the belief that one’s future is changeable, which is a distinct focus of our study.
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Purpose of the Present Study Given these concerns and possibilities, we conducted the present study to (a) examine the relations between optimism/ pessimism, future orientation, and indices of suicide risk including depressive symptoms and suicidal ideation and attempts; (b) determine if future orientation would add any incremental validity to the prediction of suicide risk beyond optimism/pessimism; and (c) determine if the optimism/pessimism 9 future orientation interaction would add further incremental validity to these predictions beyond main effects of optimism/pessimism and future orientation. Given conceptual similarities in optimism/pessimism and future orientation, we predicted that these variables would be positively related to each other. Also, consistent with our expectation for additive effects, we predicted that future orientation would add significant incremental validity beyond what is accounted for by optimism/pessimism in the prediction of suicide risk. Given our earlier discussion of possible interaction effects, we also expected to find evidence for a significant optimism/ pessimism 9 future orientation interaction. That is, we expected to find that future orientation will interact with optimism/pessimism in predicting suicide risk, such that the risk for suicidal behavior will be lowest for pessimists at higher than at lower levels of future orientation, and will be highest for optimists at lower than at higher levels of future orientation. Consistent with this view, for example, studies have shown that pessimists who act as if the future is changeable do not necessarily incur the same outcomes and conditions as those who act as if the future is unchangeable (e.g., Norem 2008; Norem and Cantor 1986; Showers and Ruben 1990).
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individual differences in generalized positive and negative outcome expectancies. Three items are positively worded (e.g., ‘‘In uncertain times, I usually expect the best’’), and three items (reverse scored) are negatively worded (e.g., ‘‘I hardly ever expect things to go my way’’). The remaining four items are filler items. Respondents are asked to indicate the extent to which each they agree with each item using a 5-point Likert-type scale, ranging from 0 (strongly disagree) to 4 (strongly agree). Evidence for the construct validity of the LOT-R has been reported in Scheier et al. (1994). In the present sample, internal reliability for the LOT-R was .92. In general, higher scores on the LOT-R are indicative of greater dispositional optimism, whereas lower scores are indicative of greater dispositional pessimism. Future Orientation Future orientation was measured with the Future Orientation Scale (FOS; Hirsch et al. 2006). The FOS is a 6-item self-report measure that was developed to assess for an individual’s belief and appreciation that the future could be changed even when experiencing stressful circumstances or negative events (e.g., ‘‘No matter how badly I feel, I know it will not last’’). Respondents are asked to indicate ‘‘how important each reason is to you for dealing with stressors’’ using a 6-point Likert-type scale, ranging from 1 (extremely unimportant) to 5 (extremely important). Evidence for the construct validity of the FOS has been reported in Hirsch et al. (2006, 2007b). In the present sample, internal reliability for the FOS was .87. In general, higher scores on the FOS indicate a greater appreciation for the belief that one’s future can be changed for the better.
Method
Suicide Risk
Participants
We used two measures to assess for suicide risk in adults. First, given the robust involvement of depressive experiences in adult suicide (e.g., Cheung et al. 2007; Cukrowicz et al. 2011; Thomson 2012), and studies pointing to the importance of measuring for depressive symptoms in primary care patients as part of a general assessment for suicide risk in adults (Hooper et al. 2012), we used the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff 1977) as a broad measure of adult suicide risk. The CES-D is a commonly used 20-item scale that assesses for severity of depressive symptoms in the past week. Respondents are asked to rate the extent to which they have experienced specific depressive symptoms (e.g., ‘‘I felt depressed’’) across a 4-point Likert-type scale, ranging from 0 (rarely or none of the time) to 3 (most or all of the time). Evidence for the construct validity of the CES-D has been reported in Radloff (1977) and for the utility of the CES-D as a broad screening device for identifying adult
A total of 101 adults (29 male and 72 female) were recruited from a primary care clinic serving working, uninsured patients, in the Southeast US; importantly, primary care settings are a vital catchment site for the detection and prevention of suicidal behaviors, as over 50 % of individuals who die by suicide have seen a primary care physician in the month prior to their death (Unu¨tzer 2002). Ages ranged from 18 to 64 years, with a mean age of 42.18 (SD = 12.83). Most of the participants were Caucasian (93 %). Measures Optimism/Pessimism To assess for optimism/pessimism, we used the LOT-R (Scheier et al. 1994). The LOT-R is a 10-item measure of
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suicide risk has been reported in Cheung et al. (2007). In the present sample, internal reliability for the CES-D was .93. In general, higher scores on the CES-D indicate more severe levels of depressive symptoms (i.e., increased general risk for suicide). Second, we used four items from the Suicide Behaviors Questionnaire-Revised (SBQ-R; Osman et al. 2001) as a more direct measure of adult suicide risk. The SBQ-R is a self-report measure developed to directly tap key aspects of suicidality, namely, lifetime ideation and/or suicide attempt (‘‘Have you ever thought about or attempted to kill yourself?’’), frequency of suicidal ideation over the past 12 months (‘‘How often have you thought about killing yourself in the past year?’’), threat of suicide attempt (‘‘Have you ever told someone that you were going to commit suicide or that you might do it?’’), and likelihood of suicidal behavior in the future (‘‘How likely is it that you will attempt suicide someday?’’). The responses for each item are given total points, and are measured across a 5- or 6-point Likert-type scale. Evidence for the construct validity of the SBQ-R has been reported in Osman et al. (2001). In the present sample, internal reliability for these four SBQ-R items was .77. In general, higher scores on the SBQ-R indicate greater likelihood of suicidal behavior. Procedure Approval for the study was obtained from the Institutional Review Board prior to data collection. Participants were recruited at a primary care clinic using advertisements displayed throughout the clinic and were compensated $15 for completion of the study. All participants provided written, informed consent that indicated that all test data would be kept strictly confidential.
Results Of the original sample of 101 adults, some participants failed to complete all items on the measures (e.g., CES-D). As a result, some minor variations are present in our subsequent analyses due to the number of complete responses that were available for use.
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correlated with scores on the CES-D (r = -.67) and the SBQ-R (r = -.40). Similarly, FOS scores were also found to have moderate to large associations with scores on the two suicide risk measures. Specifically, FOS scores were found to be significantly and negatively correlated with scores on the CES-D (r = -.48) and the SBQ-R (r = -.34). Although LOT-R scores and FOS scores were found to have a large and positive association with each other (r = .52, p \ .001), it is important to note that scores on these measures only had less than 28 % of the variance in common. Optimism/Pessimism and Future Orientation as Predictors of Suicide Risk in Adults To examine the predictive utility of optimism/pessimism (as measured by the LOT-R) and future orientation (as measured by the FOS) in accounting for variance in each of the two measures of suicide risk (viz., depressive symptoms, suicidal behavior), we conducted a pair of hierarchical regression analyses. For each of the equations, LOT-R scores were entered in the First Step, followed by FOS scores in the Second Step. Finally, to test for an optimism/pessimism 9 future orientation interaction, the multiplicative term was entered in the Final Step of the equation. To reduce the possibility of multicollinearity, we centered our predictors prior to running our regression analyses. Results of these analyses for predicting unique variance in depressive symptoms and suicidal behavior are presented in Table 2. To determine if scores reflecting optimism/pessimism and future orientation accounted for a small, medium, or large amount of the variance in functioning, we used Cohen’s (1977) convention for small (f2 = .02), medium (f2 = .15), and large effects (f2 = .35). As the table shows, optimism/pessimism was found to account for a large (f2 = .82) 45 % of significant variance in depressive symptoms, F(1, 93) = 76.16, p B .001. Table 1 Correlations between measures of optimism/pessimism, future orientation, and suicide risk in community adults Measures 1. LOT-R 2. FOS
Relations Between Optimism/Pessimism, Future Orientation, and Suicide Risk in Adults Correlations, means, and standard deviations for all study measures are presented in Table 1. As the table shows, LOT-R scores were found to have moderate to large associations (Cohen 1988) with scores on the two measures of suicide risk used in the present study. Specifically, LOT-R scores were found to be significantly and negatively
1
2
3
4
– .52***
–
3. CES-D
-.67***
-.48***
4. SBQ-R
-.40***
-.34***
–
M
19.82
28.88
15.40
4.90
SD
5.41
6.03
11.79
2.48
.53***
–
ns = 94–101 LOT-R revised life orientation test, FOS future orientation scale; CES-D center for epidemiological studies-depression scale, SBQ-R suicide behavior questionnaire-revised *** p \ .001
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Table 2 Results of hierarchical regression analyses showing amount of variance in suicide risk accounted for by optimism/pessimism and future orientation in community adults b
R2
DR2
F
p
Step 1: Optimism/ pessimism
-.67***
.45
–
76.16
\.001
Step 2: Future orientation
-.18*
Suicide risk Depressive symptoms
.47
.02
3.94
B.05
.22**
.51
.04
7.80
\.01
Step 1: Optimism/ pessimism
-.40***
.16
18.90
\.001
Step 2: Future orientation
-.18
Step 3: Optimism/ pessimism 9 future orientation Suicidal behavior
Step 3: Optimism/ pessimism 9 future orientation
.31***
–
.19
.03
2.98
\.10
.27
.08
10.73
B.001
Fig. 1 Depressive symptoms at low versus high future orientation for optimists and pessimists
ns = 94–100
p \ .10, * p B .05, ** p \ .01, *** p B .001
Optimism/pessimism was found to be a significant and unique predictor of depressive symptoms (b = -.67). When future orientation was entered in the next step, it was found to account for a small (f2 = .02), but significant 2 % of additional variance in depressive symptoms, F(1, 92) = 3.94, p B .05. Future orientation was found to be a significant additive predictor (b = -18) of depressive symptoms. Furthermore, it is worth noting that the interaction term involving optimism/pessimism 9 future orientation was found to account for a small (f2 = .04), but significant 4 % of additional variance above and beyond optimism/ pessimism and future orientation, F(1, 91) = 7.80, p \ .01. As the table also shows, optimism/pessimism was found to account for a medium (f2 = .19) 16 % of significant variance in suicidal behavior, F(1, 99) = 18.90, p B .001. Optimism/pessimism was found to be a significant predictor of suicidal behavior (b = -.40). When future orientation was entered in the next step, it was found to account for a small (f2 = .03) 3 % of additional variance in suicidal behavior, which approached significance, F(1, 98) = 2.98, p = .09. Future orientation was found to be a marginally significant additive predictor (b = -.18, p \ .10) of suicidal behavior. Moreover, it is worth noting that the interaction term involving optimism/pessimism 9 future orientation was again found to account for a small (f2 = .09), but significant 8 % of additional variance above and beyond optimism/pessimism and future orientation, F(1, 97) = 10.73, p B .001. Furthermore, to explore the possible impact of controlling for depressive symptoms in predicting suicide behavior (Hirsch et al. 2006), we conducted an additional regression analysis in which we included depressive symptoms as a covariate in
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Fig. 2 Suicidal behavior at low versus high future orientation for optimists and pessimists
our prediction model. Importantly, from this analysis, the optimism/pessimism 9 future orientation term was found to account for a small (f2 = .04), but significant 4 % of additional variance above and beyond depressive symptoms, optimism/pessimism, and future orientation, F(1, 96) = 5.37, p \ .05. Lastly, to visually inspect the manner in which optimism/pessimism and future orientation interacted with each other in predicting suicide risk, we plotted the regression of depressive symptoms (Fig. 1) and suicidal behavior (Fig. 2) on future orientation at low and high levels (split below and above the mean, respectively) of optimism/pessimism based on our initial regression results. Results of plotting these interactions were consistent with our hypothesis for pessimists, but not for optimists. Specifically, pessimists reported less depressive symptoms and less suicidal behavior when they believed that their future was changeable versus unchangeable. In contrast, optimists showed little difference in depressive symptoms and in suicidal behavior regardless of whether they believed that their future was changeable or not.
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Discussion Given the dearth of research examining positive cognitions that may be involved in adult suicide risk (Wingate et al. 2006), the purpose of the present study was to examine the value of an integrative model that included optimism/pessimism and future orientation as predictors of two important indices of adult suicide risk, namely, depressive symptoms and suicidal behavior, in a community sample of adults. Consistent with past findings for optimism/pessimism based on college student samples (e.g., Hart et al. 2008; Scheier et al. 1994), our correlational results indicated that greater pessimism (lower optimism) was also associated with greater depressive symptoms and greater suicidal behavior in community adults. Likewise, consistent with past findings for future orientation based on depressed patients (e.g., Hirsch et al. 2007b), we also found greater future orientation was associated with fewer depressive symptoms and less suicidal behavior in the present sample. Noteworthy, given that optimism and future orientation both represent positive cognitions that are future oriented, it is not surprising that we found these two constructs to be significantly and positively intercorrelated. However, despite their conceptual similarities, they were not found to be wholly redundant with each other based on the amount of variance they shared in common. Accordingly, this latter finding may be taken to offer additional support for the construct validity of future orientation in adults (Hirsch et al. 2006). With regard to additive effects, we found support for the role of optimism/pessimism in predicting variance in suicide risk in community adults. Specifically, optimism/ pessimism was found to predict a significant amount of variance in both depressive symptoms and suicidal behavior in the present sample. Interestingly, optimism/ pessimism was found to account for more than twice the amount of variance in depressive symptoms (R2 = .45), than in suicidal behavior (R2 = .16). Future orientation was found to significantly augment the prediction model for depressive symptoms (DR2 = .02), but only approached significance in augmenting the prediction model for suicidal behavior. Importantly, we found evidence for interaction effects. Specifically, after controlling for the variance accounted for by both optimism/pessimism and future orientation, the optimism/pessimism 9 future orientation term was found to account for a significant 4 % of additional variance in depressive symptoms, and for a significant 8 % of additional variance in suicidal behavior. Consistent with our notion that belief in the changeability of the future may weaken the positive link between pessimism and suicide risk, we found that pessimistic adults with higher, compared to lower, future orientation reported both less
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depressive symptoms and less suicidal behavior. As noted earlier, researchers have found that some pessimists, despite their expectation for negative outcomes, actually engage in goal-driven efforts to change the course of their negative future, which in turn often leads to achieving goals and successful outcomes (e.g., Norem 2008; Showers and Ruben 1990). Accordingly, it may be the presence (vs. absence) of a belief that one’s future can be changed and the motivation to seek a positive outcome, that work in confluence to help some pessimists act proactively to attain positive goals and outcomes (Chang 1996, 2001; Norem and Chang 2002). Given this possibility and our findings, it may be useful to look at interventions that may help generate a belief in one’s perception that the future is changeable as an important means for reducing suicide risk in pessimistic adults. For example, mindfulness training is believed to foster metacognitive awareness, including the ability to decenter one’s thoughts from one’s immediate situation (Keng et al. 2011). Such training may be sufficient to help some pessimists detach themselves from maintaining a fatalistic stance, and to begin accepting the possibility of alternative experiences and possibilities. In contrast to expectations, however, we did not find evidence to support the notion that belief in the changeability of the future would further strengthen the negative link between optimism and suicide risk. Specifically, we found that optimistic adults reported comparable levels of depressive symptoms and suicidal behavior regardless of their belief that the future was changeable or not. According to Scheier and Carver (1985; see also, Carver et al. 2010), optimists expect the best for a wide range of reasons, from those due to internal factors (e.g., selfesteem, self-efficacy) to those due to external factors (e.g., luck, chance). Thus, it may be that for most optimists, a belief that one’s future can be changed (or not) is not as important a factor as other beliefs in predicting outcome. Indeed, in contrast to findings from some studies that have pointed to the potential pitfalls associated with the co-presence of optimism and other positive cognitions (e.g., Davidson and Prkachin 1997), our findings for predicting suicide risk in the present study indicate that there may not be any particular advantages or disadvantages in ‘‘doubling up’’ on positive future cognitions in adults. Nonetheless, it would be important to examine other positive future cognitions (e.g., hope; Snyder et al. 2001).
Some Limitations of the Present Study Although the present findings provide promising empirical support for our integrative model involving optimism/ pessimism and future orientation as additive and interactive factors involved in suicide risk in a community sample of
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adults, some important limitations to the present study should also be noted. First, given the cross-sectional nature of the present study, cause and effect cannot be determined. In that regard, it would be important in future studies to determine if and how optimism/pessimism and future orientation may predict changes in adult suicide risk across time. Second, although an important strength of the present study was the use of a clinical sample of primary care patients (rather than the use of a convenience sample; e.g., college students), our sample did not include many older adults. Given that suicide rates have historically been highest among the elderly (De Leo 2001), it may be useful to replicate the present study in an elderly population. Third, because racial/ethnic differences in adults have been found in studies of optimism/pessimism (e.g., Chang 2002a), it would be important to determine the extent to which the present findings may be generalized to more diverse racial and ethnic groups. Lastly, we focused in the present study on factors that may predict suicide risk in adults. It would be useful to determine if an integrative model involving optimism/pessimism and future orientation is also useful in predicting other important outcomes (e.g., happiness, life satisfaction, coping behaviors).
Concluding Thoughts In summary, we examined the utility of an integrative model involving optimism/pessimism and future orientation as additive and interactive predictors of suicide risk (viz., depressive symptoms and suicidal behavior) in an adult community sample. We found robust support for the role of optimism/pessimism as a predictor of both suicide measures examined in the present study. In contrast, we found more limited support for the additive role of future orientation in predicting suicide risk. Importantly, however, we found support for a significant optimism/pessimism 9 future orientation interaction in predicting both depressive symptoms and suicidal behavior. Overall, our findings are the first to provide evidence for the potential value of considering the interactive function of optimism/ pessimism and future orientation in understanding adult suicide risk. Acknowledgments The first author would like to acknowledge Chang Suk-Choon and Tae Myung-Sook for their encouragement and support throughout this project.
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