Happily hopeless: adaptation to a permanent, but not to a temporary, disability.

Journal Article (Journal Article)


The authors tracked patients with either irreversible or reversible colostomies over a 6-month period, beginning a week after the procedure, to examine how they adapted hedonically over time. Based on prior research and theorizing, the authors hypothesized that, paradoxically, those with irreversible colostomies would adapt more fully, and become happier, than would those with colostomies that were potentially reversible.


The authors contacted 107 patients who had recently received either a colostomy or ileostomy. The initial interviews were conducted while patients were still in the hospital recovering from their surgery. Consenting participants were mailed surveys at three time points: 1 week after release from the hospital, 1 month after release, and 6 months after release.

Main outcome measures

The surveys included measures of life satisfaction and perceived quality of life.


As predicted, overall life satisfaction and quality of life increased with time for patients with permanent, but not temporary, ostomies.


These findings suggest that knowing an adverse situation is temporary can interfere with adaptation, leading to a paradoxical situation in which people who are better off objectively are worse off subjectively.

Full Text

Duke Authors

Cited Authors

  • Smith, DM; Loewenstein, G; Jankovic, A; Ubel, PA

Published Date

  • November 2009

Published In

Volume / Issue

  • 28 / 6

Start / End Page

  • 787 - 791

PubMed ID

  • 19916648

Pubmed Central ID

  • PMC2796797

Electronic International Standard Serial Number (EISSN)

  • 1930-7810

International Standard Serial Number (ISSN)

  • 0278-6133

Digital Object Identifier (DOI)

  • 10.1037/a0016624


  • eng