***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This article examines the influence of three pre-morbidly assessed psychological attributes ( i.e. neuroticism , mastery and self-efficacy expectancies ) on  functional decline after congestive heart failure ( CHF ; n = 134 ) and acute myocardial infa rct ion ( AMI ; n = 79 ) in late middle-aged and older persons . Due to the prospect i ve design of the study initial baseline levels of functional disability and number of chronic medical conditions could be adjusted , next to age , gender and the severity of either CHF or AMI . Functional disability was re-assessed 8 weeks after the diagnosis of either CHF or AMI . Significant unique contributions of self-efficacy expectancies were found for functional decline after CHF , while mastery significantly contributes to functional decline after AMI : those patients with higher levels of mastery or self-efficacy expectancies showed less decline . In conclusion , pre-morbidly assessed psychological attributes substantially influence functional decline after cardiac disease in late middle-aged and older persons , but the impact of specific attributes is somewhat different for CHF and AMI BACKGROUND Improvement in treatment of patients with coronary heart disease ( CHD ) has caused longer survival but also an increase in the number of patients at risk for subsequent cardiac events and impaired quality of life ( QOL ) . We hypothesized that chronic emotional distress confers an increased risk of poor outcome despite appropriate treatment . METHODS AND RESULTS This prospect i ve study examined the 5-year prognosis of 319 patients with CHD . Baseline assessment included symptoms of depression/anxiety and distressed personality type ( type D-ie , high negative affectivity and social inhibition ) . The main end points were cardiac death or nonfatal myocardial infa rct ion and impaired QOL . There were 22 cardiac events ( 16 nonfatal ) ; they were related to left ventricular ejection fraction ( LVEF ) < /=50 % , poor exercise tolerance , age < /=55 years , symptoms of depression , and type D personality . Multivariate analysis yielded LVEF < /=50 % ( OR , 3.9 ; P=0.009 ) , type D personality ( OR , 8.9 ; P=0.0001 ) , and age < /=55 years ( OR , 2.6 ; P=0.05 ) as independent predictors of cardiac events . Convergence of these risk factors predicted the absence of the expected therapeutic response that was observed in 10 % of the patients . When 2 or 3 risk factors occurred together , the rate of poor outcome was 4-fold higher ( P=0 . 0001 ) . Estimates of medical costs increased progressively with an increasing number of risk factors . Smoking , symptoms of depression , and type D personality were independent predictors of impaired QOL . CONCLUSIONS Decreased LVEF , type D personality , and younger age increase the risk of cardiac events ; convergence of these factors predicts nonresponse to treatment . Emotionally stressed and younger patients with CHD represent high-risk groups deserving of special study OBJECTIVE Self-esteem is widely used as an outcome variable in studies of psychiatric rehabilitation , based on the assumption that improved functional status leads to higher self-esteem . Little is known , however , about the determinants of self-esteem among adults with severe mental illness . The utility of a popular measure of global self-esteem-the Rosenberg Self-Esteem Scale-as  an outcome measure was examined in this population . METHODS A total of 143 participants enrolled in a study of vocational rehabilitation were assessed at baseline and six , 12 , and 18 months later using measures of  self-esteem , symptoms , life satisfaction , work status , housing status , and total income . RESULTS Scores on the Rosenberg Self-Esteem Scale did not vary with work status or other functional outcomes but instead were strongly related to measures of life satisfaction and affective symptoms . CONCLUSIONS The hypothesis that working leads to improved self-esteem for people with severe mental illness was not supported . For this population , self-esteem , as measured by the Rosenberg Self-Esteem Scale , appears to be a relatively stable trait that reflects general life satisfaction and affective symptoms rather than objective functional status The ability of personality traits to predict important life outcomes has traditionally been question ed because of the putative small effects of personality . In this article , we compare the predictive validity of personality traits with that of socioeconomic status ( SES ) and cognitive ability to test the relative contribution of personality traits to predictions of three critical outcomes : mortality , divorce , and occupational attainment . Only evidence from prospect i ve longitudinal studies was considered . In addition , an attempt was made to limit the review to studies that controlled for important background factors . Results showed that the magnitude of the effects of personality traits on mortality , divorce , and occupational attainment was indistinguishable from the effects of SES and cognitive ability on these outcomes . These results demonstrate the influence of personality traits on important life outcomes , highlight the need to more routinely incorporate measures of personality into quality of life surveys , and encourage further research about the developmental origins of personality traits and the processes by which these traits influence diverse life outcomes The aim of the study was to determine the prevalence of alexithymia in an elderly Finnish population sample . Associations between alexithymia and sociodemographic factors were investigated , together with the relationship between alexithymia and perceived somatic health and self-reported psychic health . The study forms a part of the Turun Vanhustutkimus ( TUR-VA ) project , which is a longitudinal , prospect i ve follow-up study dealing with psychosocial adaptation to retirement and to old age . The study group consisted of a population sample of 72-year-old people ( N = 190 ) .  Alexithymia was measured with the  26-item version of the Toronto Alexithymia Scale ( TAS-26 ) . The prevalence of alexithymia was 34 % . Alexithymia was associated with poor perceived somatic health . Alexithymia was associated with having a psychiatric disturbance ( measured by the 36-item General Health Question naire [ GHQ-36 ] ) , but this relationship disappeared when the influence of perceived somatic health was controlled for . Alexithymia was not associated with gender , marital status , social status , or residential area One must consider both trait and state affect to predict  individual differences in emotional processing .  The present results document a novel trait-state interaction that is consistent with proposals concerning the epistemic functions of affect ( A. R. Damasio , 1994 ) . Four studies tested the effects of extraversion and mood  on motivation-relevant processing . Study 1 measured naturally occurring mood , whereas Studies 2 - 4 manipulated mood .  Extraverts were faster to link events to their personal motivations when in a positive mood state , whereas introverts were faster to do so in a neutral or negative mood state . Further findings indicate that this interaction affects attitude accessibility rather than event elaboration . Overall , the authors suggest that there are pragmatic benefits to trait-consistent moods , particularly for processing motivation-relevant stimuli Background While research on school children 's health has mainly focused on risk factors and illness , few studies have examined aspects of health promotion . Thus , this study focuses on health promotional factors including general self-efficacy ( GSE ) and  health-related quality of life ( HRQOL ) . GSE refers to a global confidence in coping ability across a wide range of dem and ing situations , and is related to health . The purpose of this study was to examine associations between GSE and HRQOL , and associations between HRQOL and socio-demographic characteristics . Knowledge of these associations in healthy school children is currently lacking . Methods During 2006 and 2007 , 279 school children in the seventh grade across eastern Norway completed a survey assessing their GSE and HRQOL .  The children were from schools that had been r and omly selected using cluster sampling .  T-tests were computed to compare mean subscale values between HRQOL and socio-demographic variables . Single and multiple regression analyses were performed to explore associations among GSE , HRQOL and socio-demographic variables . Results Regression analyses showed a significant relationship between increasing degrees of GSE and increasing degrees of HRQOL . In analyses adjusted for socio-demographic variables , boys scored higher than girls on self-esteem .  School children from single-parent families had lower scores on HRQOL than those from two-parent families , and children who had relocated within the last five years had lower scores on HRQOL than those who had not relocated . Conclusion The strong relationship between GSE and HRQOL indicates that GSE might be a re source for increasing the HRQOL for school children This article examines the main and moderating effects of 3  personality characteristics on the association between  chronic medical morbidity and health-related quality of life ( HRQL ) in a large ( N = 5,279 ) community-based older sample . Reasonably high unique contributions of neuroticism , mastery , and self-efficacy to HRQL were found . The additional amounts of variance explained beyond and above medical morbidity and age vary from about 4 % ( bodily pain ) to above 30 % ( mental health ) . Little empirical evidence was found for the moderating effects of personality . In conclusion , personality characteristics such as neuroticism , mastery , and self-efficacy influence the reported levels of HRQL . The extent to which this is due to an influence of personality on true versus perceived levels of HRQL is unclear Type D personality has been shown to increase the risk for cardiovascular events in patients with coronary artery disease ( CAD ) . We investigated the effects of exp and ed cardiac rehabilitation on type D score and psychosocial characteristics in 224 CAD patients r and omised to either exp and ed cardiac rehabilitation ( stress management , increased physical training , stay at a “ Patient Hotel ” after discharge and cooking sessions ) , or routine rehabilitation . Follow-up was 1 year . At baseline patients with a high type D score [ patients in the upper quartile of type D score ( Q4 ) i.e. , type D patients ] had a lower sense of coherence ( p < 0.001 ) , a lower quality of life ( p < 0.001 ) , more depressive symptoms ( p < 0.001 ) and increased anxiety ( p < 0.001 ) as compared to patients with a low type D score ( Q1 ) . During follow-up , type D patients ( Q4 ) r and omised to intervention had significant decrements in type D-score ( p < 0.01 ) , depression and anxiety ( p < 0.05 ) and an increment in quality of life scores ( p < 0.001 ) . Quality of life was also improved in control type D patients ( Q4 ; p < 0.01 ) but no significant changes were seen in type D score , depression or anxiety .  Exp and ed cardiac rehabilitation reduces type D score , anxiety and depressive symptoms , and improves the quality of life in type D patients PURPOSE Clinical trials with the  implantable cardioverter defibrillator ( ICD )  have demonstrated desirable outcomes in terms of mortality and morbidity among patients with potentially lethal arrhythmias . This study examined the " resilience factors " of positive health expectations and global optimism prospect ively using the general quality -of-life ( QOL ) scores of newly implanted ICD patients . METHODS The study enrolled 88 newly implanted ICD patients ( mean age , 65.3 + /- 13.2 years ; 83 % male ; 92 % white ) assessed 8 and 14 months after ICD implantation . A series of 2 x 2 factorial multivariate analyses of covariance were performed to examine the differences between baseline low versus high positive health expectations and baseline low versus high optimism in short- and long-term general QOL scores . RESULTS After control was used for ejection fraction ( mean , 31 % ) , the patients with baseline high positive health expectations reported better general health at a long-term follow-up assessment ( P = .002 ) . The patients with high optimism reported better mental health and social functioning at a short-term follow-up assessment ( P = . 056 ) , and this finding approached significance at a long-term follow-up assessment ( P = .061 ) . CONCLUSIONS Positive health expectations and optimism are differentially related to various components of QOL . Collectively , these two resilience factors may be targeted in future studies of interventions to improve QOL for ICD patients OBJECTIVE To determine whether optimism predicts lower rates of rehospitalization after  coronary artery bypass graft surgery for the 6 months after surgery . METHODS A prospect i ve , inception cohort design was used . The sample consisted of all consenting patients ( N=309 ) from a consecutive series of patients scheduled for elective coronary artery bypass graft surgery at a large , metropolitan hospital in Pittsburgh , Pa. To be eligible , patients could not be scheduled for any other coincidental surgery ( eg , valve replacement ) and could not be in the cardiac intensive care unit or experiencing angina at the time of the referral . Participants were predominantly men ( 69.9 % ) and married ( 80.3 % ) , and averaged 62.8 years of age . Recruitment occurred between January 1992 and January 1994 . RESULTS Compared with pessimistic persons , optimistic persons were significantly less likely to be rehospitalized for a broad range of aggregated problems ( including postsurgical sternal wound infection , angina , myocardial infa rct ion , and the need for another bypass surgery or percutaneous transluminal coronary angioplasty )  generally indicative of a poor response to the initial surgery ( odds ratio=0.50 , 95 % confidence interval=0.33- 0.76 ; P=.001 ) . The effect of optimism was independent of traditional sociodemographic and medical control variables , as well as independent of the effects of self-esteem , depression , and neuro 
    Output:
    
Results Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL .
Personality characteristics , especially neuroticism , mastery , optimism , and sense of coherence were most likely to be associated with psychosocial HRQOL .
Personality explained varying proportions of variance in different domains of HRQOL .
Conclusions Personality characteristics are related to HRQOL .