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Construing Benefits from Adversity: Adaptational Significance and Dispositional Underpinnings

Glenn Affleck and Howard Tennen University of Connecticut School of Medicine


ABSTRACT The discovery of benefits from living with adversity has been implicated in psychological well-being in numerous investigations, is pivotal to several prominent theories of cognitive adaptation to threat, and can be predicted by personality differences. This article summarizes the prevalence and adaptive significance of finding benefits from major medical problems, locates the place of benefit-finding in stress and coping theories, and examines how it may be shaped by specific psychological dispositions such as optimism and hope and by broader personality traits such as Extraversion and Openness to Experience. The distinction between beliefs about benefits from adversity (benefit-^m/ing) and the use of such knowledge as a deliberate strategy of coping with the problem {hene^t-reminding) is underscored and illustrated by daily process research on coping with chronic pain. Right after she was born, I remember having a revelation. Here she was, only a week old, and she was teaching us somethinghow to
Many of the published and unpublished findings reported in this article come from studies funded by National Institute of Arthritis, Musculoskeletal, and Skin Diseases Grant AR-20621 to the University of Connecticut Multipurpose Arthritis Center. We are grateful for the collaboration of Susan Urrows and Micha Abeles and for the assistance of Pamela Higgins and Debra Begin with data collection and management. We are also indebted to Jeff Siegel of National Technology Services for his help in programming the electronic diaries described in this article and to Saul Shiffman for his assistance with protocol development. Finally, we appreciate the assistance of Jerry Suls, Shelley Taylor, and James Coyne in revising an earlier version of the manuscript. Address correspondence to Glenn Affleck, Department of Community Medicine MC-6205, University of Connecticut Health Center, Farmington, CT 06030. E-mail:
AFFLECK@NSOl.UCHC.EDU.

Jourrml of Persormlity 64:4, December 1996. Copyright 1996 by Duke University Press.

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keep things in their proper perspective, how to understand what's important and what's not. I've learned that everything is tentative, that you never learn what life is going to bring. I've come to realize that I shouldn't waste any more time worrying about the little things. Perhaps this is the way it was meant to be. Maybe I wasn't intended to have children. It has made me a stronger person, and has made me appreciate children so much more. Living with this disease has taught me so many precious things that I wouldn't have learned if I were healthy. I guess the most important things it has taught me are to appreciate what life can hold for you every day and to be grateful for the loving relationships in your life. This young father of an acutely ill newborn, this middle-aged woman with impaired fertility, and this older woman with rheumatoid arthritis know that adversity, no less than prosperity, can change us for better as well as for worse. A casual observer can easily appreciate the toll that such adversities can take on someone's physical and psychological wellbeing. But even a close observer may miss their perceived benefits, gains, and advantages. The search for uplifting meaning from threatening experiences is pivotal to a number of prominent theories of psychological reorganization in the aftermath of traumatic events. These include Taylor's thesis of selective evaluation as a response to adversity (Taylor, Wood, & Lichtman, 1983) and her more general theory of cognitive adaptation to threat (Taylor, 1983); Janoflf-Bulman's analysis of assumptive world restoration following victimization (Janoff-Bulman, 1992) and her more general theory of deep-seated personal change (JanoffBulman & Schwartzberg, 1991); Rothbaum's two-factor model of personal control (Rothbaum, Weisz, & Snyder, 1982); and Thompson's taxonomic theory of psychological control appraisals (Thompson, 1981, 1985). These formulations all share the premise that adversity can lose some of its harshness through cognitive adaptationsincluding finding the good in bad eventswhich can restore comforting views of ourselves, other people, and the world. These adaptations can even nourish the conviction that we are in some ways better oflFthan we were before. Accumulating evidence that the ability to detect personal gains from threatening experiences may enhance psychological and physical wellbeing supports these theories' validity and value to stress and coping researchers.

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Our own research program has examined at length the role of finding benefits in adapting to major medical problems. Thus, we will restrict most of our empirical coverage of this phenomenon to medical adversity. We begin by summarizing the prevalence of construing benefits from major medical problems and subsequent documented relations with psychological and physical adjustment. Next, we locate the place of benefit-finding in selected theories of coping with trauma and adversity. We review theory and research concerning the role personality factors may play in finding benefits in adversity and the connection of these factors to successful adjustment. Finally, we draw an unnoticed distinction between benefit-related cognitions that are adaptive beliefs about the consequences of adversity, which we label benefit-finding, and those that serve as coping strategies during difficult times, which we call benefit-reminding. This distinction reflects more than alternative empirical foci: It captures a fundamental difference between the way adaptive beliefs and coping strategies are both conceptualized and measured in the stress and coping literature (Tennen & Affleck, in press-a). To underscore this point, we will accent the utility of a process-oriented approach to studying benefit-finding, benefit-reminding, and their dispositional underpinnings. Prevalence a n d Adaptational Correlates of Benefit-Finding in Major Medical Problems For a variety of reasons, many investigators of the psychological aspects of major medical problems have asked their research participants to describe any gains, benefits, or advantages they have found after weeks to years of contending with these problems. This evidence of benefit-finding derives in large part from answers to direct interview questions about what, if any, positive consequences have ensued from their experience. Less frequently, participants have answered multiitem questionnaires in which they endorse their agreement with certain benefits that could have accrued from their experience (Affleck, Tennen, Rowe, & Higgins, 1990; Tennen, Affleck, Urrows, Higgins, & Mendola, 1992). A review of this literature unearths a wide array of medical problems for which nearly all or more than a majority of informants cited benefits or gains from their adversity. This evidence comes from studies of heart attack survivors (Affleck, Tennen, Croog, & Levine, 1987); women with breast cancer (Taylor, Lichtman, & Wood, 1984); sur-

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vivors of spinal cord injuries (Bulman & Wortman, 1977); individuals who have lost their sense of taste and smell (Tennen, Affleck, & Mendola, 1991a); women with impaired fertility (Abbey & Halman, 1995; Tennen, Affleck, & Mendola, 1991b); patients with chronic rheumatic diseases (Affleck, Pfeiffer, Tennen, & Fifield, 1988; Liang et al., 1984); stroke victims and their caregivers (Thompson, 1991); parents of infants hospitalized on newborn intensive care units (Affleck, Tennen, fe Gershman, 1985; Affleck, Tennen, & Rowe, 1991); and mothers of children with insulin-dependent diabetes (Affleck, Allen, Tennen, McGrade, & Ratzan, 1985), among others. Several categories of perceived benefits cut across these problems and echo what has been found in studies of other types of threatening events (e.g., Janoff-Bulman, 1992; Tedeschi & Calhoun, in press; Thompson, 1985). One common theme is the strengthening of relationships with family and friends. Another is the perception of positive personality change, such as the development of greater patience, tolerance, empathy, and courage. Yet another common benefit appraisal is a valued change in life's priorities and personal goals. Other benefits appear relatively specific to health-related adversity. For example, many men who have had heart attacks believe that this event taught them a lesson about the importance of health behavior practices to live a long life (Affleck et al., 1987), and many mothers claim that their infant's hospitalization on an intensive care unit opened their eyes to the dedication and caring attitudes of health care professionals (Affleck et al., 1991). Is benefit-finding a proxy for denial? Before summarizing evidence of the adaptational consequences of benefit-finding, we must address briefly the possibility that benefit-finding signals denial and thus may prove maladaptive over the long run because it interferes with effective coping strategies for accepting the full severity of the problem (Lazarus, 1983). If benefit-finding stems from or supports psychological denial, then any associations found with reports of psychological well-being might reflect a reluctance to concede the severity of the stressor as well as one's emotional distress (Breznitz, 1983). This issue, framed in broader terms of the relation between "positive illusions" and mental health, was the subject of a fascinating exchange of views between Taylor and Brown (1994) and Colvin and Block (1994). Does finding good things in aversive experiences imply the denial of such experiences' harmful aspects? Tedeschi, Calhoun, and Gross

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(1993) countered this view with findings from a study of college students' appraisals of recent psychological traumas. Scores on a questionnaire measuring the perception of benefits from these events were positively correlated with ratings of both the event's negative and positive impact on their lives. In a study of parents of infants treated on a newborn intensive care unit, a questionnaire assessment of perceived benefits from this crisis was uncorrelated with a companion instrument measuring its harmful aspects (Affleck et al., 1990). Thus, the existing evidence, which clearly deserves more study, refutes the hypothesis that any apparent positive adaptational consequences of finding benefits in traumatic experiences come at the cost of denying their adverse effects. Adaptational outcomes of benefit-finding. Positive adaptational outcomes of benefit-finding are evident in many self-report indicators of psychological well-being. Studies using valid and reliable adaptational outcome measures provide evidence that benefit-finding relates to less negative affect in cancer patients (WoUman & Felton, 1983); less depression and greater meaningfulness in life in stroke victims (Thompson, 1991); less psychological distress in infertile women (Abbey & Halman, 1995; Tennen et al., 1991b) and people who have lost their sense of taste and smell (Tennen et al., 1991a); superior psychological adjustment in women with breast cancer (Taylor et al., 1984); and less mood disturbance and intrusive thoughts in mothers of acutely ill newborns (Affleck et al., 1985). Because it is difflcult to disentangle temporal precedence in these cross-sectional studies, these findings can also mean that those who are better adjusted to their problems find it easier to construe positive aspects of their experience. What's more, both the ability to find benefits and reports of positive adjustment may be influenced by differences in the severity of the problem itself. In a rare longitudinal study of the predictive significance of benefitfinding, Affleck et al. (1991) asked mothers before their child's discharge from a newborn intensive care unit whether they had found any benefits from their child's hazardous delivery and prolonged hospitalization. Seventy-five percent of the mothers cited at least one benefit, including improved relationships with family and friends, the importance of keeping life's problems in perspective, increased empathy, positive changes in their personality, and the conviction that their child was now more precious to them. Mothers who cited no benefits from their child's newborn intensive care reported more mood disturbance and psychological distress 6 and 18 months later, even when their mood at the time they

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were asked to describe any benefits was partialled from these relations. The ability of benefit-finding to predict later emotional well-being was independent of an objective index of the severity of the child's medical problems, echoing what Thompson (1991) found in a study of stroke survivors and Tennen et al. (1991a) documented in a study of victims of taste and smell loss. Thus, preliminary evidence suggests that benefitfinding predicts emotional well-being and is unconfounded by objective measures of the severity of the problem. These mothers' ability to find benefits not only predicted their own well-being but also their child's developmental test scores 18 months later. This relation remained significant even when we controlled for mothers' predischarge mood, age, education, parity, and the severity of the infants' perinatal medical problems. This discovery is critical because it extends the positive outcomes of benefit-finding beyond the realm of self-report. Another demonstration of the predictability of objective outcomes from earlier benefit-finding comes from a cohort of heart attack survivors who participated in an unusually long prospective study (Affleck et al., 1987). After 7 weeks of recovery from their initial heart attack, 58% of these men cited benefits, most prominently anticipated changes in lifestyle to increase enjoyment, valued lessons about the importance of health behavior, and positive changes in their philosophy of life and basic values. Eight years later, those who had construed benefits were in significantly better cardiac health and were less likely to have suffered a subsequent attack. These predictive relations remained significant even after controlling for their age, socioeconomic status, and severity of their initial attack. In summary, research on the adaptational correlates of benefit-finding among individuals facing serious medical problems is beginning to document its unique ability to predict emotional well-being. This, along with initial evidence that benefit-finding may also confer long-term health benefits, is good reason to investigate why positive reappraisals of threatening events are related to positive adaptational outcomes. Tbere is no shortage of positive outcome possibilities in the health arena, ranging from the invigoration of health behavior changes (Affleck et al., 1987) to improvements in health-related social support (WoUman & Felton, 1983). In line with the theme of this special issue, we will examine the possibility that individuals bring life-long characteristics to adverse experiences that shape both their capacity to find benefits and their successful adjustment.

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But first we will review briefly the significance of benefit-finding for several general theories of coping with trauma and adversity. Although these theories have often been ignored as an explicit framework for the empirical studies we have reviewed to this point and have not been well integrated with research on personality and health, they provide a useful scaffolding for the integration of stress and coping theory, personality theory, and research on benefit-finding in adversity.

The Place of Benefit-Finding in Theories of Coping with Adversity


Research on the prevalence and correlates of benefit-finding acquires meaning from a number of theories of psychological reorganization in the wake of adversity. For example, Taylor et al. (1983) list construing benefits from the event as a selective evaluation that helps victims to "devictimize" themselves by mitigating feelings of stigmatization and restoring their self-esteem. In a similar vein, Thompson (1985) includes the discovery of benefits in her taxonomy of methods of psychological control that mitigate the aversiveness of threatening events. To understand the adaptive value of benefit-finding under threat is to appreciate first the ways in which major adversities can threaten our most treasured assumptions about ourselves and the world. JanoffBulman and Frieze (1983) remind us that "from day to day . . . [we] operate on the basis of assumptions and personal theories that allow [us] to set goals, plan activities and order [our] behavior" (p. 3). These basic assumptionsalso referred to as our "higher-order postulates" (Janoff-Bulman & Schwartzberg, 1991) and "assumptive world" (Parkes, 1975)include seeing ourselves as having control over events and being relatively invulnerable to harm; viewing the things that happen to us as orderly, predictable, and meaningful; and regarding ourselves as worthy and other people as benevolent. These "worldviews" are what Watzlawick (1978) calls "second-order realities" as opposed to the first-order reality of the world that exists independent of our appraisals, and as such they belong squarely in the constructivist tradition of psychological functioning and change (e.g., Keeney, 1987; von Glaserfeld, 1984). According to these theories, we are rarely aware of the fundamental elements of our assumptive world; the minor disappointments and failures of everyday life seldom bring them to light. Fundamentally, our assumptive world consists of conservative cognitive schemas that

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resist change and disconfirmation (Janoff-Bulman & Schwartzberg, 1991). This taken-for-granted world is revealed and questioned, however, when a personal catastrophe challenges its validity. As both JanoffBulman and Taylor have so eloquently documented in numerous works, much of the shock and confusion people experience in the immediate aftermath of victimization appear to stem from threats to cherished assumptions of mastery, meaning, and self-worth. This very questioning of basic assumptions is what sets the stage for deep-seated personal change through the task of rebuilding an assumptive world accommodated to new realities (Janoff-Bulman & Schwartzberg, 1991). "By engaging in interpretations and evaluations that focus on the benefits and lessons learned," writes Janoff-Bulman, "survivors emphasize benevolence over malevolence, meaningfulness over randomness, and self-worth over self-abasement" (1992, p. 133). Benefitfinding and other positive appraisals are what Taylor (1983) has made the centerpiece of her theory of cognitive adaptation to threatening events. Rothbaum et al.'s (1982) two-factor model of personal control provides another view of the cognitive reappraisal process that may involve benefit-finding. Rothbaum et al. view the discovery of positive meaning in adversity as a "secondary control" appraisal, one that provides a comforting alternative to feelings of helplessness from the loss of a sense of primary or direct personal control over an uncontrollable event. Their formulation predicts that secondary control appraisals should wax as primary control wanes. We know of only one published study that has tested this "fallback" hypothesis with a required longitudinal design. McLaney, Tennen, Affleck, and Fitzgerald (1995) found that among men and women with impaired fertility, changes in primary control over conception during a 14-month period did not result in changes in benefit-finding. However, benefit-finding did increase when individuals' expectation of conception diminished during this time. The logic of the fallback hypothesis can be applied equally well to charges in outcome expectancies: When individuals encounter repeated failure and become more pessimistic about achieving a desired outcome, they will find more benefits in the situation as a way of enhancing a sense of secondary control. These general theories on coping with adverse events incorporate benefit-finding as an adaptive response, but they do not shed any light on the personological characteristics that may make this response to

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threat more or less likely. We turn next to the part that personality may play in the process of benefit-finding in adversity.

Personality and Dispositional Correlates of Benefit-Finding


The foregoing review of research and overview of theory might foster the impression that benefit-finding in adversity is so prevalent that it spans individual differences in personality traits. Yet many survivors of adversity do not construe positive consequences from their plight, and these individuals could well differ in general or specific personality characteristics. Further, certain dispositional characteristics could predict the number and types of benefits construed from adversity, or that no benefits will likely occur. There are relatively few published empirical studies relating dispositional influences to benefit-finding, and even fewer that address explicit theories. Over the years, authors have variously linked benefit-finding to an internal locus of control (WoUman & Felton, 1983); a persistent belief in a just world (Kiecolt-Glaser & Williams, 1987); dispositional optimism (Tennen et al., 1992; Thompson, 1985); and more recently to Extraversion and Openness to Experience (Tedeschi & Calhoun, in press). In what follows, we focus our attention on those personality dimensions that we believe merit additional or new attention in studies of benefit-finding in adversity. We consider how dispositional optimism/pessimism, cognitive and self-complexity, and dispositional hope, each of which emphasizes the pursuit of personal goals in the face of obstacles, may figure in this process. Then we address the role played by major dimensions of personality captured by the Big Five constellation (McCrae, 1992) of personality organization. Dispositional optimism. Both Thompson (1985) and Tennen et al. (1991) hypothesized that dispositional optimism, or the generalized expectancy for positive outcomes (Scheier & Carver, 1985,1987), may explicate the relation between benefit-finding and adjustment to threatening events. Dispositional optimists do display superior adaptation to medical stressors, including coronary artery bypass surgery (Scheier et al., 1989; Fitzgerald, Tennen, Affleck, & Pransky, 1993), childbirth (Carver & Gaines, 1987), failed in-vitro fertilization (Litt, Tennen, Affleck,

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& Klock, 1992); and HIV-positive status (Taylor et al., 1992). There is also good reason to suspect that optimistic individuals should be more inclined than pessimists to construe benefits from adversity: Their hopeful view of the future may well stem from a positive interpretation of the present. Several studies using the Life Orientation Test (LOT; Scheier & Carver, 1985) of dispositional optimism and pessimism have already shown that perceptions closely related to benefit-finding are related to optimistic expectations. For example, Fontaine, Mastead, and Wagner (1993) found that among college students dispositional optimism was associated with "positive reinterpretation" as a strategy of coping with life stressors. Curbow, Somerfield, Baker, Wingard, and Legro (1993) reported that among individuals undergoing bone marrow transplantation, greater optimism was associated with reports of positive life changes and personal growth; and Carver et al. (1993) found that optimists are more likely to use "positive reframing" as a coping strategy before and after breast cancer surgery. In a study that measured situation-specific optimism (an expected correlate of generalized optimism), Affleck et al. (1991) showed that mothers who maintained more optimistic expectancies for their premature infant's development were more likely to find benefits in the neonatal intensive care crisis. Tennen et al. (1992) also examined how dispositional optimism and benefit-finding relate to one another and figure in the day-to-day symptoms, mood, and functioning of individuals with rheumatoid arthritis, a chronic and incurable disease, whose physical signs and symptoms include severe joint pain and stiffness, fatigue, and, without surgery, irreversible joint damage and immobility. After completing the LOT and measures of perceived control over and benefits from their chronic pain drawn from the Inventory of Perceived Control Beliefs (IPCB; Mendola, 1990), research participants reported each day for 75 consecutive days their pain intensity, mood, and pain-related activity limitations (e.g., missing work, cutting back on planned social activities). As predicted, those scoring higher on the LOT were significantly more likely to endorse benefits from their illness, and they also reported significantly higher levels of average positive daily mood. Perceiving benefits from living with chronic pain also correlated with these participants' positive daily mood. We thus wondered whether the relation between benefit-finding and daily mood might be explained by the tendency of dispositional optimists both to find benefits and to experience more positive mood states. As expected, controlling for

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dispositional optimism did attenuate the significant relation between benefit-finding and mood.' Is the association between benefit-finding and emotional well-being due entirely to differences in dispositional optimism? Enthusiasm for this hypothesis is dampened by refinements in the LOT since Tennen et al.'s (1992) study was published. First, there is compelling evidence that optimism, as measured by total scores on the LOT, is not a unitary construct. Instead, the LOT appears to measure two relatively orthogonal constructs: optimism and pessimism. Moreover, investigators have recently confirmed that optimism and pessimism may not have equivalent relations with other personality and adaptational outcome measures (Marshall, Wortman, Kusulas, Hervig, & Vickers, 1992; Mroczek, Spiro, Aldwin, Ozer, & Bosse, 1993). Thus, the analysis by Tennen et al. (1992) may be flawed because it failed to distinguish between optimism and pessimism as independent correlates of daily mood. A second recent refinement of the LOT recommended by Scheier, Carver, and Bridges (1994) is even more critical to evaluating the specificity of the relation between benefit-finding and emotions. Two of the four items that originally claimed to measure optimism appear instead to measure the ability to extract positive value from negative circumstances: "I always look on the bright side of things" and "I'm a believer in the idea that 'every cloud has a silver lining.' " Thus any apparent relation between optimism and benefit-finding may simply be due to overlapping measures of benefit-finding, one dispositional (as assessed by these two items on the LOT) and the other more specific to the problem itself (as measured by the situation-specific benefits interview or perceived benefits questionnaire). We reanalyzed the data reported by Tennen et al. (1992) to separate the effects of optimism versus pessimism on well-being and of the expectancy versus benefit-finding components of optimism. Benefitfinding remained significantly correlated with the original four-item optimism scale but not with pessimism, and remained significant even when pessimism was partialled from the association. The two-item optimism scale, however, which omits the items on dispositional benefit1. A more complex relation between benefit-finding and daily activity limitations remained independent of dispositional optimism, however. Among patients who reported relatively little daily pain, benefit-finding was unrelated to the number of activity limitation days reported in daily diaries. Among those with relatively severe pain, however, benefit-finding predicted fewer activity limitation days. This interaction is unique in the literature on benefit-finding, which has limited its search for relations to main effects.

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finding, did not correlate significantly with finding benefits from the illness. Most important, benefit-finding remained a significant correlate of daily mood when the restricted optimism score was covaried from this relation. Thus, a more narrowly operationalized measure of optimism did not confound the association between benefit-finding and well-being. In summary, published and unpublished data render equivocal the role of dispositional optimism in benefit-finding and its association with well-being among those facing major medical problems. Because of recent and welcome refinements in the LOT, some of the findings linking optimism and pessimism to benefit-finding should be reconsidered and revisited in future research. Cognitive and self-complexity. The benefits of cognitive complexity share with dispositional optimism/pessimism the ability to achieve personal goals despite barriers imposed by aversive events. More than 30 years ago, Harvey (1965) theorized that the more complex one's conceptual system, the greater one's ability should be to achieve "adequate means of fate control... and a greater mastery over what would otherwise be a capricious, unpredictable, and overwhelming environment" (p. 249). The logic of this argument turns on the contention that in the face of adversity, cognitively complex individuals should be better able to pursue alternative goals and find more flexible ways of achieving them. This is one way of interpreting the redefinition of threatening experiences that occurs when people see the threat as an opportunity to change their life goals, values, or priorities in desirable ways. Linville's more recent elaboration of the concept of self-complexity refines this argument (Linville, 1985, 1987). Linville documented that individuals who display high self-complexityreflecting a greater number of discrete roles or identities used to organize self-schemasadapt better to adversity, presumably because they are less likely to suffer global effects on self-representation. Bringing additional specificity to this hypothesis, Morgan and Janoff-Bulman (1994) suggested that not all forms of complex self-representations should have equivalent efFects on adaptation to threat. Rather, it is the complexity of positively valenced self-representations that should best predict adaptation to events that threaten personal identities and roles. Their test of this hypothesis revealed that psychological adjustment to lifetime traumas (e.g., death of a parent, physical abuse, sexual assault) was superior among those who continued to hold many more independent positive

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self-representations (e.g., "hard working," "focused," "imaginative," "motivated") than among trauma survivors with fewer independent positive self-representations. Whether positive self-schema complexity plays a part in the relationship between well-being and benefit-finding per se remains unknown, however. Dispositional hope. Dispositional hope is yet another personality construct based on the perceived accessibility of desired goals. Dispositional hope differs in one important way from optimism/pessimism in that it encompasses not only one's expectancy that desired goals can be achieved but also one's ability to imagine avenues for goal attainment (Snyder, Irving, & Anderson, 1991). We are uncovering evidence of the key role that dispositional hope plays in finding benefits from living with fibromyalgia, a syndrome of unknown origin that combines widespread pain with unusual tenderness in multiple tender point sites and is often accompanied by sleep disturbance. Our study affords a test of the relative importance of dispositional optimism/pessimism and hope as measured by the LOT and HOPE (Snyder, Harris et al., 1991) scales respectively, in daily coping with fibromyalgia pain. Our preliminary results after studying 35 participants suggest that neither the LOT pessimism scale, nor the revised LOT optimism scale correlate with the extent of perceived benefits from living with fibromyalgia (as measured by IPCB items on benefit-finding). Instead, it is individuals with greater dispositional hope who cite more benefits from living with their chronic pain. In particular, those scoring higher on the HOPE scale endorsed greater agreement with the IPCB items "I have learned a great deal about myself from living with my pain," and "Dealing with my pain has made me a stronger person." The ability of dispositional hope to predict benefit-finding, controlling for differences in the related constructs of optimism and pessimism, is strong evidence of its unique role in shaping positive appraisals of adversity. In a later section, we will summarize additional data concerning dispositional hope's ability to predict how often fibromyalgia patients actually use their conviction of benefits as a daily cognitive coping strategy for contending with their daily pain. The Big Five dimensions of personality. No discussion of the personality underpinnings of coping with adversity would be complete without mentioning the potential contribution of second-order personality

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traits, as captured by the Big Five constellation of Neuroticism, Extraversion, Openness, Conscientiousness, and Agreeableness (McCrae, 1992). McCrae and Costa (1986) found that individuals low in Neuroticism, high in Extraversion, and high in Openness tend to rely to a greater extent on "drawing strength from adversity" as a style of coping with threat. These broad dimensions of personality have considerable appeal as potential correlates of benefit-finding in adversity. They may more efficiently account for the variance in benefit-finding shared by more specific traits that emphasize goal attainment in the face of obstacles. They may also provide a template for predicting the types of benefits people will construe from adversity. Specific benefits attributed to misfortune could match the characteristic approaches to the self, the world, and others associated with major dimensions of personality. For example, the typical negative selfperceptions associated with Neuroticism/negative affectivity would lead to the hypothesis that individuals high on this trait would be less able to find adversity a cause of positive self-appraisals of personal growth. Those scoring higher on measures of Extraversion, who are more gregarious, cheerful, and seekers of social contact, might be especially likely to cite positive consequences of adversity for social relationships. The individual who is more open to experienceimaginative, emotionally responsive, and intellectually curiousmight be particularly likely to meet the challenge of adversity through a philosophical reorientation and a new direction in life plans. To our knowledge, only a single study (Tedeschi & Calhoun, in press) has examined the full range of personality prediction of specific benefits found in adversity. More than 600 college students who reported recent major life stressors, such as the death of a parent, criminal victimization, or accidental injuries, completed the NEO Personality Inventory measure of the five-factor model of personality (Costa & McCrae, 1985) and the Post-Traumatic Growth Inventory (PTGI; Tedeschi & Calhoun, in press), which measures characteristic forms of positive change claimed from adversity, such as the emergence of new possibilities, spiritual growth, and better relationships. Scores for Extraversion, Openness, Agreeableness, and Conscientiousness each correlated significantly with the total posttraumatic growth score. Although a multivariate analysis of personality predictors was not reported, it appears that Extraversion is the most likely candidate to maintain an independent prediction of overall benefit-finding. It correlated the highest with benefit-finding and was the only dimension to be associated

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significantly with each of the subscales of the PTGI. Extraversion, as might be predicted, correlated most strongly with the report of improved relationships. Openness to Experience was also an expectedly strong correlate of the PTGI subscale labeled "new possibilities," which concerns the emergence of new interests and new life paths. The foregoing research and speculation view personality factors as independent variables in the process of benefit-finding from aversive life experiences. However, in view of the promise of personal transformation implied by some of the benefits attributed to misfortune, a case could be made that benefit-finding mediates a change in personality among at least some of those who are contending with acute or chronic adversities. Researchers have yet to address this question in clinical samples, and the prospect of personality change arising from a single experience, no matter how momentous, might be rejected by many personality theorists. Nonetheless, a recent study by Park, Cohen, and Murch (1996) raises the possibility of personality change after encounters with adverse life events. College students who reported more personal growth stemming from their most negative event during a 6-month span displayed significant increases in both dispositional optimism and trait positive affectivity during that time. The findings reported in this section underline the desirability of incorporating specific and general personality measures in future research on individual differences in benefit-finding and their association with psychosocial adjustment to adversity. Future studies would also profit from assessing whether individuals actually use knowledge of any benefits derived from adversity as a way of coping with their misfortune. It is this key distinction between beliefs and coping strategies to which we turn next.

Benefit-Finding versus Benefit-Reminding: From Adaptive Conclusion to Coping Strategy


To this point, we have limited our discussion to the prospect that beliefs about benefits aid adjustment to major medical problems. Such beliefs as they are typically measured in studies of benefit-finding may be conclusions or outcomes of a search for meaning and should not be equated with coping efforts themselves. Coping strategies, as they are currently conceptualized and measured, refer to intentional cognitive or behavioral attempts by the individual to manage a stressor (Carver, Scheier, & Weintraub, 1989; Lazarus & Folkman, 1984; Stone, 1995).

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This consensus definition of coping excludes beliefs, however adaptive they might be. The perception of personal control over a stressful event, though usually an adaptive perception (Folkman, 1984), is not a coping strategy. The expressed belief that one is comparatively better off than someone else, i.e., a downward comparison conclusion (AflSeck, Tennen, Pfeiffer, & Fifield, 1988), does not imply its use as a coping strategy to enhance self-esteem (Tennen & Affleck, in press-a). Neither does benefit-finding itself suggest that a person uses this knowledge as a coping strategy. Some theoretical analyses of selective evaluation processes such as benefit-finding hint at an effortful process of coping (e.g., Taylor et al., 1983), and we are sure that they can be effortful, but under what circumstances? Consider an individual with a chronic pain disorder facing an extended period of intense pain who may be trying to remind herself of some of the benefits she has found from living with this disease as a way of making her pain more bearable. This effort to savor the benefits she has construed from her illness can justifiably be called a coping strategy. It captures the intentional, strategic quality of coping and in this way "behaves" like other cognitive pain coping strategies such as diverting attention or reinterpreting pain sensations (Rosenstiel & Keefe, 1983). Whereas only those who have already discovered benefits from their adversity may be able to use this knowledge to comfort themselves in difficult times, there is nothing about the admission of benefits per se that implies that benefit-related cognitions will be used as eflbrtful coping strategies. In our study-in-progress on fibromyalgia pain, we are exploring this and related questions, which concern the overlapping and unique contributions to psychological adaptation of benefit cognitions that refer to beliefs or that function as daily coping strategies. This investigation is unique in its measurement of benefit cognitions in a daily process design that permits within-person analysis of relations among variables over time and the combination of idiographic and nomothetic methods (see Tennen & Affleck, in press-b, and Larsen & Kasimatis, 1991, for detailed discussions of the benefits of this design).
Daily process findings on benefit-reminding

Our ongoing study of individuals with fibromyalgia uses a prospective daily design that entails time-intensive self-monitoring of daily symptoms, experiences, behaviors, emotions, and cognitions for 30 days. We can summarize preliminary findings from the 35 women we have

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studied to date; describe their effortful daily use of benefit cognitions (benefit-reminding) and its relation with benefit-finding and personality/dispositional variables; and characterize the within-person relations of these comparison processes with fluctuating levels of daily pain and daily mood. The time-intensive self-monitoring methodology used in this study combines a nightly structured diary with a computer-assisted "realtime" assessment of pain intensity and mood several times each day. The hardware for the electronic diary is a PSION palmtop computer programmed to deliver auditory signals to complete an on-screen interview at randomly selected times during the mid-morning, midafternoon, and mid-evening. The interview responses were timestamped and stored in the palmtop computer for subsequent uploading to a desktop system. Shiffman and colleagues (e.g., Penner, Shiffman, Paty, & Fritzche, 1994; Shiffman et al., 1994) have established the feasibility of similar electronic diaries for self-monitoring studies and have discussed their many advantages over traditional paper-and-pencil methods, including superior compliance encouragement and monitoring and mitigation of some systematic biases in experience sampling. One item on the nightly questionnaire measured benefit-reminding: Participants used a 0 (not at all) to 6 (very much) scale to describe how much that day they had "reminded [themselves] of some of the benefits that have come from living with their chronic pain." The average daily mean for this item was .81 {SD = 1.33); the mean percentage of days the average respondent reported any benefit-reminding was 24.8% {SD = 34.6). Eleven participants never reminded themselves of benefits; 15 participants reported benefit-reminding on 1 to 9 days; 4 participants did so on 10 to 20 days; and 5 did so on 21 to 30 days. Clearly, there are considerable individual differences in how frequently these individuals actually reminded themselves of any benefits they had construed from their illness. Some who had cited many benefits never reminded themselves of these benefits during a month's time span, whereas some who had cited only one or a few benefits reported benefit-reminding on many days. Personality correlates of benefit-reminding. As expected, individuals wbo had scored higher on the IPCB subscale on benefit-finding reported more days of benefit-reminding (r = .36, p < .05). Potential confounds such as patients' age, duration of symptoms, education, social class, and level of pain intensity were unrelated to the frequency and intensity of daily benefit-finding. Several personality measures, including

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scores on the NEO Inventory Neuroticism and Extraversion scales and the revised and original optimism scores on the LOT were unrelated to benefit-reminding frequencies. The personality measures that did correlate with benefit-reminding were the LOT pessimism subscale (r = -.38, p < .05), and the HOPE pathways subscale (r = .37, p < .05). Recall that we noted earlier that the HOPE pathways subscale also correlated with benefitfinding in this sample. Because the relation between benefit-finding and benefit-reminding became nonsignificant when HOPE pathway scores were partialled from this association, it appears that this psychological dispositionthe ability to plan alternative avenues for successful goal attainmentmay be a stable individual difference underlying benefitrelated beliefs arui the use of benefit-reminding as a daily pain coping strategy. Within-person analysis of benefit-reminding. The design of our study enables within-person analysis of day-to-day differences in benefitreminding and other daily processes. To examine within-person relations, the data were pooled across persons and days and subjected to a least squares dummy-variable multiple regression analysis (Jaccard & Wan, 1993; Suls, Wan, & Blanchard, 1994), which removes between-persons variance from the data set. In testing the correlates of benefit-reminding, the 11 participants who never reminded themselves of benefits were excluded from these analyses because they contributed no within-person variance to the pooled data set. One such analysis related daily benefit-reminding to daily pain intensity, measured by electronic diary entries of daily ratings of 14 areas of the body, and to daily mood scores, measured by electronic diary data on a 16-item mood adjective checklist capturing all octants of the circumplex model of mood pleasantness and mood arousal (Larsen & Diener, 1992): pleasant mood, unpleasant mood, aroused mood, unaroused mood, pleasant-aroused mood, pleasant-unaroused mood, unpleasant-aroused mood, and unpleasant-unaroused mood. Days characterized by more benefit-reminding did not differ in pain intensity, but were accompanied by significant differences in mood, specifically increased levels of pleasant (i.e., happy, cheerful) mood; increased levels of aroused-pleasant (i.e., peppy, stimulated) mood; and decreased levels of unaroused (passive, quiet) mood. When all eight mood dimension scores were entered as simultaneous correlates of benefit-reminding frequency, only a unique relation remained with

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pleasant mood. Thus, on days when these chronic pain sufferers made greater efforts to remind themselves of the benefits that have come from their illness, they were especially more likely to experience pleasurable mood, regardless of how intense their pain was on these days. This preliminary within-person analysis of efforts to remind oneself of the benefits of living with chronic pain strengthens the hypothesis that benefit-reminding can improve one's emotional well-being on more difficult days. Additional data analyses from an eventually larger data set of more than 100 patients will exploit fully the advantages of the idiographic-nomothetic approach by examining the extent and sources of individual differences in the impact of benefit-reminding and other coping strategies and cognitive appraisals on daily well-being. Interested readers can consult recent articles that provide various multilevel data-analytic strategies for modeling individual differences due to personality in stress-symptom and stress-mood relations across time (Affleck, Tennen, Urrows, & Higgins, 1994; Affleck, Urrows, Tennen, & Higgins, in press; Bolger & Schilling, 1991; Suls et al., 1994).
CONCLUSION

This review of theory and research on the significance of benefit-finding and benefit-reminding for coping with major medical problems leaves little doubt of the need for, and promise of, additional research in this area. A considerable proportion of individuals facing their own or loved ones' severe medical problems cite benefits, gains, or advantages from their adversity, and longitudinal studies reveal that benefit-finding can predict emotional well-being as well as more objective indicators of health. Despite the concern that benefit-finding may be maladaptive because it signals denial of the aversive aspects of threatening experiences, there is no hard evidence to support this view. Most studies measure benefit-finding from structured interviews. New general-purpose questionnaires for measuring benefit-finding in traumatic experiences, i.e., the Post-Traumatic Growth Inventory (Tedeschi & Calhoun, in press) and the Inventory of Perceived Control Behaviors (Tennen et al., 1992), could help improve confidence in the reliable and valid measurement of benefit appraisals in future studies. Future research in this area should also more carefully distinguish between beliefs and coping strategies, as reflected in the difference between benefit-finding and benefit-reminding. As illustrated by our preliminary findings on coping with fibromyalgia pain, research on

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benefit-reminding as a coping strategy can readily exploit the many advantages of daily process designs, including analysis at the withinperson level of change. Interested readers can consult our more thorough case for the adoption of such time-intensive designs to study stresscoping-outcome linkages as manifestations of personality processes (Tennen, Suls, & Affleck, 1991). Benefit-finding occupies a prominent place in major theories of coping with adversity, but its connection with personality traits and psychological dispositions has not been explicitly addressed by theorists and is only beginning to be studied by investigators. We anticipate much success from further research linking benefit-finding and adaptational outcomes with individual differences in specific traits that accent the pursuit of personal goals in the face of obstaclesnotably cognitive and self-complexity, dispositional optimism/pessimism, and dispositional hopeand in the more encompassing personality dimensions of Neuroticism, Extraversion, and Openness to Experience. The best research, however, awaits new theorizing about individual differences in the way victims are able to restore faith in a secure and comforting assumptive world. Not only should we seek further insight into the way personality influences people's attempts to reorganize basic assumptions in the wake of adversity, but we should also investigate the possibility of profound changes in personality emanating from people's efforts to restructure their views of themselves, others, and the future.

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