Hopelessness in a community population: factorial structure and psychosocial correlates

A Longitudinal Study of the Impact of COVID-19 on Optimism Prediction

The purpose of this longitudinal study was to investigate how optimistic predictions, hopelessness, and depressive symptoms changed as a result of the COVID-19 pandemic, and the causal relationships between these variables. To achieve this purpose, we used data from online surveys conducted in 2019 and 2021 among men and women aged 20-79. Based on item response theory, we developed a future prediction task for the assessment of optimistic predictions. Our comparison of online survey responses found a decline in optimistic predictions before and after the pandemic. More specifically, there were no change in predictions of negative future events, but there was the decrease in predictions of positive future events. Furthermore, we found that those who were more stressed by COVID-19 were less likely to have an optimistic view of the near future. We also found a relationship between optimistic predictions and hopelessness and depressive symptoms with lower optimism predicting more hopelessness and more depression predicting lower optimism. To prevent feelings of hopelessness, it is important to help people develop positive expectations about the future.

The Beck Hopelessness Scale's psychometric features: A new short form based on item response theory

BACKGROUND

The assessment of hopelessness plays a significant role in preventing various psychological disorders and major life events within the general population. However, the psychometric properties of the Beck Hopelessness Scale (BHS) have been a subject of controversy, primarily studied in clinical groups. The aim of the present study was to gain new psychometric insights and propose a new short version of the BHS for the general population using the Item Response Theory (IRT) approach.

METHODS

A total of 2164 Argentinean individuals completed the BHS alongside the Inventory of Suicide Orientation-30. We compared IRT models with two and three parameters for the original BHS version, exploring the removal of redundant and less informative items. Convergent and discriminant validity was also examined.

RESULTS

Our results support the 2PL model for the BHS-19. In addition, the BHS-10 short version adequately depicted the same range of the measured trait as the original version, showing reasonable measurement accuracy in the middle-high levels of the trait (marginal reliability = 0.70, Cronbach's α = 0.86). Notably, a positive correlation was found between the factorial score of BHS-10, BHS-19, and suicide orientation.

CONCLUSIONS

In conclusion, our findings support the use of a simplified version as a practical and valuable tool for both research and clinical practice in the future.

Depression Accompanied by Hopelessness Is Associated with More Negative Future Thinking

BACKGROUND

This study aimed to delineate the interplay between depression, hopelessness, and episodic future thinking (EFT), focusing on cognitive biases towards negative future thinking that are central to depressive symptomatically.

METHODS

A Japanese university student was utilized to scrutinize divergences in EFT across groups stratified by varying degrees of depression and hopelessness. The research leveraged a modified future thinking task (FTT), the Beck Hopelessness Scale, and the Beck Depression Inventory-II to gauge participants' levels of hopelessness and depressive symptoms.

RESULTS

Consistent with prior research, the non-depressed group showed a reduction in positive EFT, reinforcing the idea that diminished positive future thinking is a hallmark of depressive conditions, even in the absence of a clinical diagnosis. Moreover, individuals with comorbid depression and elevated hopelessness demonstrated a significant decrease in positive EFT and an increase in negative EFT, substantiating a distinctive cognitive profile for this subgroup. This finding suggests that the presence of hopelessness exacerbates the negative cognitive biases associated with depression.

CONCLUSIONS

The study emphasizes the importance of considering hopelessness as an independent construct when assessing EFT in clinical contexts. The pronounced impact of hopelessness on future thinking in those with depression suggests that targeted interventions, such as future-directed therapy (FDT), may be particularly effective for individuals with hopelessness depression by focusing on modifying negative future thinking patterns and enhancing life quality.

Beck Hopelessness Scale-20: Dimensionality and Nomological Validity Among Colombian School-Age Adolescents

To establish the validity of the BHS-20, a sample of 2064 adolescent students aged 14 and 17 years (M = 15.61, SD = 1.05) were invited to participate in the research. Cronbach's alpha (α) and McDonald's omega (ω) were computed to evaluate the internal consistency. Confirmatory factor analysis was used to test the dimensionality of the BHS-20. The Spearman correlation (rs) with depressive symptoms and risk of suicide scores of the Plutchik Suicide Risk Scale were computed to explore the nomological validity. The BHS-20 showed a high internal consistency (α = .81, ω = .93), an adequate one-dimensional structure with an excellent adjustment [χ2 S-B = 341, df = 170, p < .01, Comparative Fit Index = .99, RMSEA = .03] and acceptable nomological validity with depressive symptoms (rs = .47, p < .01) and scores for suicide risk (rs = .33, p < .01). In conclusion, current results suggest that the BHS-20 demonstrates validity and reliability among Colombian adolescent students.

Reverse-Coded Items Do Not Work in Spanish: Data From Four Samples Using Established Measures

The potential for suboptimal psychometric performance of reverse-coded items may be particularly pronounced when scales are translated and administered in Spanish with these problems exacerbated in youth respondents. This is a significant concern, given the rapid rise in Hispanic-American and Spanish-speaking individuals in the US and their rightful, growing representation in psychological research and clinical care. The aim of this study was to examine the psychometric performance of reverse-coded items across four Spanish-speaking samples spanning developmental stages including youth, college students, and parents (N = 1,084; Adolescents n = 107; M = 19.79; SD = 2.09; 41.1% female; Caregivers n = 58; M = 40.79; SD = 7.94; 60.3% female; Spanish-speaking adults in the US n = 157; M = 33.4; SD = 9.5; 68.8% female; and College students living in Latin America n = 783; M = 21.04; SD = 3.13; 69.2% female) and four scales (Big Five Inventory; Strengths and Difficulties Questionnaire; Difficulties in Emotion Regulation Scale; Beck Hopelessness Scale); we expected reverse-coded items would demonstrate inadequate item–total correlations and their inclusion would compromise scale internal consistency. Hypotheses were supported with evidence of poor psychometric performance for at least two reverse-coded items on each instrument, such that un-reversing the items improved their item–total correlations. Across every instrument, alpha was either improved by excluding reverse-coded items or by including them in an un-reversed fashion and, overall, there was a moderate, negative effect of reverse-coded items on scale alphas. In growing consensus with previous authors, we recommend that reverse-coded items not be included in Spanish scales.

Hopelessness and shame in relation to suicide attempts by Cuban adolescents

Youth suicide rates in Cuba are very high compared with most other countries, despite considerable improvement in recent years. The purpose of our study was to determine whether hopelessness and shame distinguish adolescent suicide attempters from non-attempters, over and above the effects of depression and suicidal ideation. Participants were 844 Cuban adolescents from the province of Holguin in Eastern Cuba. The attempter groups included 38 participants being treated for suicide attempts in a day hospital and 82 participants in the community who self-reported a previous suicide attempt. The other participants were non-attempter controls. All participants were asked to complete measures of depression, hopelessness, shame and suicidal ideation. As expected, attempters scored higher than non-attempters on the control variables of depression and suicidal ideation. In addition, attempters self-reported greater shame, especially behavioral and characterological shame, than non-attempters. Contrary to our hypothesis, there was no significant difference in hopelessness between attempters and non-attempters. The results are inconsistent with the considerable narrative lore about hopelessness as a reason for suicide in Cuba and other socialist countries. However, some collective socialization practices may lead to shame.

Analysing the Impacts of Financial Support for Regional Suicide Prevention Programmes on Suicide Mortality Caused by Major Suicide Motives in Japan Using Statistical Government Data

To improve and plan regional suicide prevention programmes that utilise more cost-effective governmental financial support compared with previous programmes, the present study determined the effects of the amount of financial support provided for regional suicide prevention programmes, such as the Emergency Fund to Enhance Community-Based Suicide Countermeasures (EFECBSC), on the trends of suicide mortalities caused by six major suicide motives between 2009 and 2018, using forward multiple regression analysis. The ranking order of motives for male suicide was health, economy, family, employment, romance and school (in that order), whereas the ranking order for females was health, family, economy, romance, employment and school. Male suicide mortality caused by economy-related motives was significantly/inversely related to prefectural intervention programmes, whereas mortality caused by health-related motives was also significantly/inversely related to prefectural intervention programmes, but significantly/positively related to prefectural personal consultation support programmes. Contrary to males, female suicide mortality caused by health-related motives was significantly/inversely related to the municipal development programmes of leaders/listeners, whereas mortality caused by family- and school-related motives was significantly/positively related to prefectural and municipal telephone consultation support programmes, respectively. Contrary to our expectations, school-aged female suicide mortality caused by school-related motives was significantly/positively related to prefectural personal consultation support, enlightenment and municipal telephone consultation support programmes. These results indicate that Japanese regional suicide prevention programmes probably affect the suppression of male suicide mortality. However, these programmes are possibly ineffective, or at least partially, have an adverse effect, in regard to the suicide mortalities of female and school-aged populations. Therefore, we should work to improve regional suicide prevention programmes, making them more cost-effective and targeted towards female and school-aged populations in the future.

Escala de Desesperanza de Beck (BHS): ventajas de una administración adaptativa

La escala de Desesperanza de Beck (BHS) es usada con frecuencia como screening para la detección de riesgo suicida y/o depresión aun cuando, por su extensión de 20 ítems, resulta poco eficiente. En este trabajo se analiza si una estrategia de administración adaptativa podría abreviar el tiempo de aplicación de la BHS. Participaron 783 individuos de población general (50.9% mujeres). Se seleccionó aleatoriamente un 70% de los casos para calibrar los ítems con el Modelo Logístico de 2 parámetros de la Teoría de Respuesta al Ítem. Se eliminaron dos elementos que presentaron funcionamiento inadecuado. El 30% restante de la muestra se utilizó para simular una administración adaptativa de los 18 ítems calibrados. Se compararon dos modalidades de interrupción: a) al administrar 9 ítems y b) al alcanzar un error de estimación ≤ 0.35 o administrar 9 ítems (criterio mixto). Bajo ambas condiciones se registraron correlaciones de .95 con el nivel de Desesperanza estimado a partir de los 18 ítems. No obstante, la interrupción basada en el criterio mixto no mostró un impacto adicional en la eficiencia de la medida. Al igual que la versión de 18 ítems, las aplicaciones adaptativas estimaron con más precisión los niveles elevados del rasgo. La medición adaptativa no afectó las evidencias de validez al estudiar la asociación del rasgo con facetas del Neuroticismo y dimensiones sintomatológicas. Se concluye que una administración adaptativa de 9 ítems puede abreviar considerablemente la BHS sin perjudicar la validez y confiabilidad de la medida.

Relationship between Beck Hopelessness Scale and suicidal ideation: A short-term longitudinal study

We aimed to clarify if the Beck Hopelessness Scale (BHS) predicted change in suicidal ideation in the general population. This study used a prospective cohort design (4-week survey interval) (N = 3,295). The online survey covered the BHS, suicidal ideation, depression/anxiety tendencies, and demographic details. Hierarchical multiple regression analysis showed hopelessness was a significant predictor of change in suicidal ideation from T1 to T2 (B = 0.07, 95% confidence interval: 0.05-0.09). Although high hopelessness was related to a short-term rise in suicidal ideation, the risk for suicide cannot be judged adequately by hopelessness from a clinical perspective.

Further Insights Into the Beck Hopelessness Scale (BHS): Unidimensionality Among Psychiatric Inpatients

Short versions of the Beck Hopelessness Scale have all been created according the Classical Test Theory, but the use and the application of this theory has been repeatedly criticized. In the current study, the Item Response Theory approach was employed to refine and shorten the BHS in order to build a reasonably coherent unidimensional scale whose items/symptoms can be treated as ordinal indicators of the theoretical concept of hopelessness, scaled along a single continuum. In a sample of 492 psychiatrically hospitalized, adult patients (51.2% females), predominantly with a diagnosis of Bipolar Disorder type II, the BHS was submitted to Mokken Scale Analysis. A final set of the nine best-fitting items satisfied the assumptions of local independency, monotonicity, and invariance of the item ordering. Using the ROC curve method, the IRT-based 9-item BHS showed good discriminant validity in categorizing psychiatric inpatients with high/medium suicidal risk and patients with and without suicide attempts. With high sensitivity (>.90), this newly developed scale could be used as a valid screening tool for suicidal risk assessment in psychiatric inpatients.

Measuring elderly people's quality of life through the Beck Hopelessness Scale: a study with a Spanish sample

OBJECTIVES

Hopelessness is a key element of suicidal intent. It can instill a pessimistic outlook on the future, leading an individual to believe that suicide is the only answer to their problems. Hopelessness operates as a modulating variable between depression and suicidal behavior. The aim of this study was to confirm the factor structure of the Beck Hopelessness Scale (BHS) in a non-clinical sample.

METHOD

Three hundred and sixty-two Spanish individuals, aged over 60, free of cognitive impairment and depressive symptoms, completed the BHS scale. Participants were tested using confirmatory factor analysis (CFA), using one-, two- and three-factor models.

RESULTS

The one- and two-factor models presented adequate fit indices. Specifically, the indices of the two-factor models were better than those of the one-factor model. The two-factor model, without items 4, 9 and 14, provided the best fit, given that the indices obtained in the CFA and their internal consistency were better than those of the other models.

CONCLUSION

The validation of the BHS for a population of Spanish older adults provides a reliable and valid measure of hopelessness and could be useful in clinical practice and research as an effective tool for the early detection of suicidal behaviors.

Risk and Resilience Factors Related to Parental Bereavement Following the Death of a Child with a Life-Limiting Condition

This paper reviews the theoretical and empirical literature on risk and resilience factors impacting on parental bereavement outcomes following the death of a child with a life-limiting condition. Over the past few decades, bereavement research has focussed primarily on a risk-based approach. In light of advances in the literature on resilience, the authors propose a Risk and Resilience Model of Parental Bereavement, thus endeavouring to give more holistic consideration to a range of potential influences on parental bereavement outcomes. The literature will be reviewed with regard to the role of: (i) loss-oriented stressors (e.g., circumstances surrounding the death and multiple losses); (ii) inter-personal factors (e.g., marital factors, social support, and religious practices); (iii) intra-personal factors (e.g., neuroticism, trait optimism, psychological flexibility, attachment style, and gender); and (iv) coping and appraisal, on parental bereavement outcomes. Challenges facing this area of research are discussed, and research and clinical implications considered.

Psychometric Properties and Correlates of the Beck Hopelessness Scale in Family Caregivers of Nigerian Patients with Psychiatric Disorders in Southwestern Nigeria

Objectives:

To examine the construct and correlates of hopelessness among family caregivers of Nigerian psychiatric patients.

Materials and Methods:

This is a cross-sectional, descriptive study involving 264 family caregiver-patients’ dyads recruited from two university teaching hospitals psychiatric clinics in Southwestern Nigeria.

Results:

Exploratory factor analysis revealed a two-factor 9-item model of the Beck Hopelessness Scale (BHS) among the family caregivers. Confirmatory factor analysis of the model revealed satisfactory indices of fitness (goodness of fit index = 0.97, comparative fit index = 0.96, Chi-square/degree of freedom (CMIN/DF) = 1.60, root mean square error of approximation = 0.048, expected cross-validation index = 0.307, and standardized root mean residual = 0.005). Reliability of the scale was modestly satisfactory (Cronbach's alpha 0.72). Construct validity of scale was supported by significant correlations with the family caregivers’ scores on the Zarit Burden Interview, mini international neuropsychiatric interview suicidality module, General Health Questionnaire-12 (GHQ-12), and Patient Health Questionnaire-9. The greatest variance in the family caregivers’ scores on the BHS was contributed by their scores on the psychological distress scale (GHQ-12).

Conclusions:

The BHS has adequate psychometric properties among Nigerian psychiatric patients’ family caregivers. There is the need to pay attention to the psychological well-being of the family caregivers of Nigerian psychiatric patients.

Clinical and biological correlates of resilience in patients with schizophrenia and bipolar disorder: A cross-sectional study

OBJECTIVE

The concept of resilience is relevant in understanding the heterogeneous outcomes noted in schizophrenia and bipolar disorder. However, clinical and biological correlates of resilience in these populations have rarely been investigated. We aimed to identify key correlates of subjective resilience in such patients using comprehensive assessments and to explore associations between resilience levels and peripheral biomarkers.

METHOD

180 subjects with DSM-IV schizophrenia, bipolar disorder, and healthy controls (60 per group) were included. Demographic and clinical variables were assessed by means of interview and various psychometric scales. Furthermore, blood and saliva samples were obtained for the assessment of brain-derived neurotrophic factor, adrenocorticotropic hormone, cortisol, high sensitivity C-reactive protein, and alpha-amylase levels. Cross-sectional associations with resilience, as assessed by the 25-item Resilience Scale were sought.

RESULTS

Resilience Scale total scores were significantly higher in healthy individuals (130.1, 95% confidence intervals (CI): 124.8-135.4) compared to subjects with schizophrenia (109.9, 95% CI: 104.6-115.2, p<0.001) and bipolar disorder (119.0, 95% CI: 113.8-124.3, p=0.012), while the difference between patient groups was non-significant (p=0.055). Self-esteem, spirituality, quality of life, and hopelessness were correlated with resilience in all three groups. In addition, internalized stigma and depression were relevant factors in the schizophrenia and bipolar disorder group, respectively. Correlations between resilience levels and peripheral biomarkers did not reach significance.

CONCLUSION

Although causal relationships must be confirmed in prospective studies, our results have implications in developing psychological interventions to enhance resilience in patients with schizophrenia and bipolar disorder. The biological correlates of resilience in these populations warrant further investigations.

Depressive Symptoms Are Associated with More Hopelessness among White than Black Older Adults

BACKGROUND

Hopelessness is a core component of depression. Our information is, however, very limited on ethnic variations in the magnitude of the link between depression and hopelessness. Using a national sample of older adults in United States, we compared Blacks and Whites for the magnitude of the association between depressive symptoms and hopelessness.

METHODS

With a cross-sectional design, we used baseline data of the Religion, Aging, and Health Survey, 2001. Linear regression models were used for data analysis. Depressive symptoms (CES-D) and hopelessness were conceptualized as independent and dependent variables in different models, respectively. Demographic factors (age and gender), socioeconomic status (education and marital status), and health (self-rated health) were covariates. Ethnicity was the moderator.

RESULTS

In the pooled sample, higher depressive symptoms were predictive of hopelessness, above and beyond all covariates. We also found significant interactions suggesting that the association between depressive symptoms and hopelessness is weaker among Blacks compared to Whites. In ethnic-specific models, there were significant associations between depressive symptoms and hopelessness among Whites but not Blacks.

CONCLUSION

Depressive symptoms accompany more hopelessness among Whites than Blacks. This finding may explain why Blacks with depression have a lower tendency to commit suicide. Future research should test whether or not Whites with depression better respond to psychotherapies and cognitive behavioral therapies that focus on hope enhancement. This finding may explain differential correlates of depression based on race and ethnicity.

The Beck Hopelessness Scale

Abstract. The aim of the present study was to examine the construct and cross-cultural validity of the Beck Hopelessness Scale (BHS; Beck, Weissman, Lester, & Trexler, 1974 ). Beck et al. applied exploratory Principal Components Analysis and argued that the scale measured three specific components (affective, motivational, and cognitive). Subsequent studies identified one, two, three, or more factors, highlighting a lack of clarity regarding the scale’s construct validity. In a large clinical sample, we tested the original three-factor model and explored alternative models using both confirmatory and exploratory factor analytical techniques appropriate for analyzing binary data. In doing so, we investigated whether method variance needs to be taken into account in understanding the structure of the BHS. Our findings supported a bifactor model that explicitly included method effects. We concluded that the BHS measures a single underlying construct of hopelessness, and that an incorporation of method effects consolidates previous findings where positively and negatively worded items loaded on separate factors. Our study further contributes to establishing the cross-cultural validity of this instrument by showing that BHS scores differentiate between depressed, anxious, and nonclinical groups in a Hungarian population.

Beck Hopelessness Scale (BHS)

The Beck Hopelessness Scale (BHS) is an instrument for assessing cognitive thoughts among suicidal persons. Previous studies have identified different factor structures of the BHS. However, results were not conclusive. The aim of this study was to test the factor structure of the BHS in a sample of Italian individuals (N = 509) from the community, and secondarily to investigate correlations between the BHS, depression (Beck Depression Inventory Second Edition), and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire). Following recommendations of previous investigations, we utilized a 5-point response format. We applied a second-order Confirmatory Factor Analyses and tested for the model invariance. The results suggest that besides a single second-order factor, a second-order three-factor solution is also reasonable, in line with Beck’s theorization.

Beck Hopelessness Scale: Psychometric Properties Among Rural Chinese Suicide Attempters and Non-Attempters

The authors recruited 401 suicide attempters from general hospitals and 409 matched non-attempters to evaluate the psychometric properties of the Beck Hopelessness Scale (BHS) in rural China. All participants completed the BHS, Center for Epidemiologic Studies Depression Scale (CES-D), and Trait Anxiety Inventory (TAI). Suicide attempters had higher BHS scores than non-attempters. Cronbach's alpha coefficients were satisfactory and BHS scores significantly correlated to CES-D and TAI scores. Confirmatory factor analysis supported a four-factor model for suicide attempters and a five-factor model for non-attempters. The BHS is satisfactory in assessing hopelessness among suicide attempters in rural China.

Factors that influence suicidal ideation among elderly Korean immigrants: focus on diatheses and stressors

OBJECTIVES

The study examined major diatheses and stressors directly related to suicidal ideation among elderly Korean immigrants. The study also explored the significant interactions among these factors.

METHOD

Data were collected from a cross-sectional survey of 220 elderly Korean immigrants (age ≥ 65) in Los Angeles County.

RESULTS

Using a robust hierarchical regression, the study found that neuroticism and hopelessness were significantly associated with suicidal ideation. In addition, two interaction terms - neuroticism by hopelessness and neuroticism by acculturation - were both significant predictor variables with strong explanatory power.

CONCLUSION

The theoretical implications as well as the practical implications for developing and implementing late-life suicide prevention strategies are discussed.

Network analysis for motives in suicide cases: a cross-sectional study

AIM

Suicide victims have various distresses or motives. There are few studies on how these motives toward suicide relate with each other. We used network analyses to extract the structures of correlations among the motives for suicide.

METHODS

We obtained datasets of suicide victims from 2007-2009 in Japan in cooperation with Ibaraki Prefectural Police Headquarters. The data were analyzed by network centrality measures and a structural analysis by block modeling.

RESULTS

Among the motives, depression and physical illness showed relatively high scores of 'degree centrality', whereas depression and unemployment showed relatively high scores of 'betweenness centrality'. Structural analysis by block modeling resulted in eight blocks. The most important block comprised eight motives, including conflict between parent and child, marital conflict, economic hardship, and overloaded with debt.

CONCLUSION

Depression and physical illness were important and priority areas for completed suicides, although these two motives had different influences on suicide behaviors. Furthermore, structural analysis revealed the important role of a block, including some familial and financial motives, which induced hopelessness. Our results suggest that it might be useful to consider the common ways in which motivations for suicide are tied together when suicide intervention is launched from a social model point of view.

Proposal for a short version of the Beck Hopelessness Scale based on a national representative survey in Hungary

In our study we assessed the frequency of reported hopelessness and suicide attempts in the national representative survey Hungarostudy 2002. The randomly selected sample consisted of 14,000 individuals over the age of 18. We created a short version of the widely used Beck Hopelessness Scale for screening purposes in suicide prevention. The short version of the BHS consists of four items and has high internal consistency (Cronbach's alpha = 0.85). Moreover, we conducted an investigation into psychological, somatic, sociological and socio-economic as well as cultural variables that show a positive or negative correlation with hopelessness and important predictors of suicide. The following psychological variables showing a positive correlation with hopelessness were identified: dysfunctional attitudes, exhaustion, psychological distress, hostility, lack of life goals and inability to cope emotionally. Sense of coherence, social support, perceived self-efficiency, subjective well-being and problem-solving coping showed a negative correlation with hopelessness. Concerning the relationship between hopelessness and suicide attempts, we found that participants who attempted suicide in the last year scored higher (mean = 4.86) than participants who attempted suicide more than 3 years ago (mean = 3.57). These results indicate that applying the short version of the BHS could be very useful in general practice and in psychiatric care.

Affective temperaments and hopelessness as predictors of health and social functioning in mood disorder patients: a prospective follow-up study

BACKGROUND

Affective disorders are highly disabling illnesses constituting a significant burden for the patients, their family and the society. Therefore, it would be very useful to find tools which carefully subtype these conditions and have a strong and reliable predictive power concerning the course of illness and health and social functioning. To date, the role of hopelessness and affective temperaments in the prediction of health and social functioning and the course of affective disorders has not been studied. Thus, the aim of the present study was to assess whether affective temperaments and hopelessness, measured during hospitalization, can be useful in the prediction of global functioning (the severity of the illness and the presence and severity of psychosocial problems) at follow-up in inpatients with major depressive disorder and bipolar disorder (BD).

METHODS

The patients were 96 consecutive patients admitted to the inpatient psychiatric clinic of Sant'Andrea Hospital between January 2009 and December 2010. All patients completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A) and the Beck Hopelessness Scale on admission. They were contacted on average 14 months after discharge and were asked to complete a telephone interview based on the Health of the Nation Outcome Scales (HoNOS).

RESULTS

Two patients committed suicide before the follow-up assessment. Around 77% of the patients who completed the follow-up assessment were diagnosed as BD, and around 47% reported severe hopelessness. In the multivariate analyses, a factor derived from hopelessness and hyperthymia scores and unemployment, independently predicted severity of the illness and psychosocial functioning at the follow-up.

CONCLUSIONS

Screening for the affective temperament profile and for hopelessness has importance for designing the treatment and rehabilitation plans of affective disorder patients, as these variables are involved in the course and outcome of affective disorder patients and influence their health and social functioning.

Adolescents at risk of psychosis have higher level of hopelessness than adolescents not at risk of psychosis

BACKGROUND

Hopelessness has been a widely studied phenomenon in psychotic disorders. However, previous evidence of hopelessness in at-risk state of psychosis is lacking. The primary aim of the present study was to investigate associations between at-risk state of psychosis and the level of hopelessness, the secondary aim being to investigate, at item-level, hopelessness differences in hopelessness profile of adolescents at risk of psychosis.

METHODS

Hopelessness was assessed with the Beck Hopelessness Scale (BHS) and risk of psychosis with the PROD screen by an early detection team at the Helsinki University Central Hospital in a sample of 200 help-seeking adolescents between 11 and 22 years of age. Of them, 66 were classified as belonging to the at-risk of psychosis group and 134 to the not-at-risk of psychosis group.

RESULTS

The at-risk group scored higher in total sum scores of hopelessness than the not-at-risk group (9.15 vs. 6.63, P = 0.002). In an additional analysis of the BHS, the sub-item "I have great faith in the future" (P < 0.001) differed by risk status of psychosis after correction for multiple analysis. In a logistic regression analysis, BHS subfactor III (sum scores of items "I can't imagine what my life would be like in 10 years" and "I don't expect to get what I really want") explained (P = 0.047) the at-risk status of psychosis after age, gender and other BHS subfactors had been adjusted for.

CONCLUSIONS

Adolescents at risk of psychosis have higher hopelessness than other help-seekers. In light of a heightened possibility of suicidal behaviour, psychiatric care should pay attention to these findings.

Beck Hopelessness Scale: exploring its dimensionality in patients with schizophrenia

Hopelessness is a pre-eminent risk factor for suicide and non-fatal self-harm. Although the Beck Hopelessness Scale is often used for schizophrenia, its factor structure has been given relatively little consideration in this context. This study aimed to examine the reliability and validity of the Taiwanese version of the Beck Hopelessness Scale (BHS-T) in a chronic schizophrenia out-patient sample. One hundred and two (102) outpatients were evaluated using the translated Taiwanese version of the BHS (BHS-T), as well as several Beck-related symptom rating scales and the Positive and Negative Syndrome Scale (PANSS) for psycho-pathology. The patients were also evaluated for suicidal intent using the critical items of the Scale for Suicide Ideation (SSI) and suicide attempts. The psychometric properties of the BHS-T were also evaluated, including construct validity, internal consistency, test-retest reliability, convergence, and discriminative validity. The BHS-T showed good overall reliability and stability over time. This translated scale comprised a two-factor solution corresponding negative expectation and loss of motivation dimensions. Differences in mean hopelessness scores between participants with and without suicidal intent were significant. The results also indicated that, among individuals with schizophrenia, "negative expectation in the future" is more closely linked to suicide intent than "loss of motivation for the future". The BHS-T is a reliable and valid instrument for measuring the multi-dimensionality of hopelessness and may complement clinical suicidal risk assessments in individuals with schizophrenia.

Evaluation of an Anxiety-prevention and Positive-coping Program (FRIENDS) for Children and Adolescents of Non-English-speaking Background

This study aimed to (a) appraise the efficacy of a well validated Anglo-Australian anxiety-prevention and stress-resiliency program (FRIENDS) for use with culturally diverse migrant groups residing in Australia, (b) examine the social validity of FRIENDS, and (c) obtain information from both participants and facilitators regarding how the program can best be modified for specific use with non-English-speaking background (NESB) clients. To test the efficacy of the intervention, pre- and post-intervention evaluation of internalising symptoms and coping ability were compared with waiting-list control groups (matched according to ethnic group, gender, and school level). One hundred and six primary and ninety-eight high school students differentiated by cultural origin (former-Yugoslavian, Chinese, and mixed-ethnic) and school level (primary and high school), completed standardised measures of internalising symptoms and were allocated to either an intervention (n = 121) or a waiting-list (n = 83) condition. Both groups were readministered the assessment package for comparison following a 10-week treatment or waiting period. Consistent with a recent pilot study, pre/post-assessment indicated that participants in the intervention condition exhibited lower anxiety and a more positive future outlook than waiting-list participants. Participating students reported to be highly satisfied with the intervention. Despite the overall success of FRIENDS, the program may be enhanced by culturally sensitive supplements so that the program is more applicable for use with NESB participants. Suggestions for treatment program modifications of FRIENDS are discussed.

The prevalence of hopelessness among adults: disability and other related factors

BACKGROUND

Hopelessness has become an important issue in the fields of health and social care.

OBJECTIVE

This study aims to determine the prevalence of hopelessness and its association with the current health condition, disability, and other socio-demographic characteristics.

METHOD

The cross-sectional study sampled a population of 501 adults in Bolu, Turkey. Questionnaires included the Household Questionnaire, the Health Condition Questionnaire, Beck Hopelessness Scale, and Brief Disability Questionnaire. Data were collected through face-to-face home interviews between September 29 and October 11, 2003.

RESULTS

The prevalence of hopelessness was 30.9%. It was higher among the literate (60.0%) (p < 0.05), males (35.0%) (p > 0.05), and agricultural workers and peasants (50.0%, 41.9%) (p < 0.05). Almost half of the participants were disabled, and 44.6% of the subjects with disabilities were hopeless (p < 0.05). Being without hope was statistically significant with gender, social class, perceived health, and disability (p < 0.05). The risk of hopelessness increased in subjects with perceived bad health, lowered social class, and disability, compared with the reference groups.

CONCLUSIONS

In this study, hopelessness prevalence was high and it was also associated with the current state of health, perceived health, disability, and some socio-demographic variables. It will be important to increase the number of studies related to hopelessness and associated factors for improved mental health services planning at population level.

Factor structure of the Beck Hopelessness Scale in individuals with advanced cancer

OBJECTIVE

Although the Beck Hopelessness Scale is often used with the seriously ill, its factor structure has been given relatively little consideration in this context.

METHODS

The factor structure of this scale was examined in a sample of 406 ambulatory patients with advanced lung or gastrointestinal cancer, using a sequential exploratory-confirmatory factor analysis procedure.

RESULTS

A two-factor model was consistent with the data: The first factor reflected a negative outlook and was labeled 'negative expectations'; the second factor identified a sense of resignation and was labeled 'loss of motivation.'

CONCLUSIONS

Implications regarding scoring of the scale in this population are discussed, as are implications of the two-factor structure for our understanding of hopelessness in individuals with advanced cancer.

Development and initial psychometric properties of the University of Texas at San Antonio Future Disposition Inventory

We describe the development and initial psychometric properties of a 24-item self-report measure, the University of Texas at San Antonio Future Disposition Inventory (UTSA FDI). This instrument is designed to evaluate future related thoughts and feelings that are associated with suicide-related risk behaviors: positive focus, suicide orientation, and negative focus. The items were generated by clinical and nonclinical samples. The structure of the instrument was defined in a sample of 350 university undergraduate students (Study 1). Using CFA, we confirmed the fit of the 3-factor solution in an independent sample of college age students (n=452; Study 2). Scale reliability estimates were good (all rho's>or=.80) in both studies. Known-groups validation analyses showed that scores on each scale were useful in differentiating the responses of the study groups. Correlates for the scales were identified when scores on measures of suicide-related risk and general psychological symptoms were included as validation self-report instruments.

The Hopelessness Scale: a factor analysis

A confirmatory factor analysis of the Beck Hopelessness Scale in a sample of 340 Italian students did not support the 3-factor model reported for previous samples of psychiatric patients. A follow-up principal axis factor analysis yielded two interpretable correlated factors, suggesting that the structure of the scale may differ across clinical and nonclinical groups and as a function of nationality.

Hope theory: a framework for understanding suicidal action

This article examines C. R. Snyder's (1994, 2000a) theory of hope and its application for understanding suicide. Strengths, weaknesses, and gaps in the suicide literature are outlined, and A. T. Beck's theory of hopelessness is compared with Snyder's hope theory. Hope theory constructs are used to examine the relationship of suicide to hope/hopelessness, goals, pathways thinking, and agency thinking. This critical review is intended to broaden our theoretical understanding of suicide and is meant to form the basis for future empirical investigation of suicide-related behavior using the framework of hope theory. Implications for suicide prevention programs and approaches to treating suicidal individuals are outlined.

Relation between rates of suicide in 15-24-year-olds and per capita consumption of alcohol beverages in European countries

Suicide in adolescents and young adults is a serious medical and social problem. One factor that has been consistently implicated in suicide is alcohol use. This study examined the relation between rates of suicide in 15-24-year-olds and per capita consumption of alcohol beverages in European countries. Data on suicide rates in 15-24-year-olds and per capita consumption of alcohol beverages were obtained from the World Health Organization databases. Correlations were computed to examine relationships between suicide rates in 15-24-year-old males and females and per capita consumption of beer, wine, and spirits in the general population in 34 European countries. Suicide rates in males and females were compared using t-test. There was a negative correlation between suicide rates in 15-24-year-old males and per capita consumption of wine. There was also a trend towards a negative correlation between suicide rates in 15-24-year-old females and per capita consumption of wine. No correlations between suicide rates in 15-24-year-olds and per capita consumption of beer or spirits were found. As expected, suicide rates in males were significantly higher than in females. Lower suicide rates in 15-24-year-olds are associated with higher per capita consumption of wine in the general population. It is possible that the observed relationship is a result of a third factor affecting both suicide rates in 15-24-year-olds and consumption of wine. Further studies are necessary to clarify the relation between suicide rates in different age groups and consumption of alcohol beverages.

Future outlook and financial strain: testing the personal agency and latent deprivation models of unemployment and well-being

A sample (N=239) of unemployed adults completed scales measuring well-being, financial strain, future outlook, and the latent benefits of employment. The study tested (a) the relative contributions of the latent deprivation and agency restriction models in predicting well-being and (b) whether financial strain interacted with future outlook to predict well-being or whether financial strain was mediated by future outlook. The authors found support for agency restriction over the latent deprivation model and concluded that examining internal personal agency processes is required to explain the decline in well-being. No interaction effects were identified for financial strain and future outlook, but future outlook did mediate the influence of financial strain. Age and length of unemployment were also associated with well-being.

Despair and hopelessness in the context of HIV - a meta-synthesis on qualitative research findings

AIM

The aim of the study was to explore the concepts of despair and hopelessness in the context of human immunodeficiency virus based on previous studies.

BACKGROUND

Some of the consequences of living with human immunodeficiency virus or as a significant other to a person with human immunodeficiency virus include despair and hopelessness.

METHODS

The study is based on five earlier studies describing the dynamics of hope (including despair and hopelessness) in adult persons living with human immunodeficiency virus.

RESULTS

Despair consists of two sub-processes. The downward sub-process of despair refers to stopping and being stuck in a situation, losing grip and sinking into a narrowing existence, focusing on impossibility and losing perspective of the future. Furthermore, the downward orientation means questioning the possibility of hope. The upward sub-process of despair implies fighting against sinking and fighting to rise back up with a glimmer of hope. Hopelessness is the polar opposite of hope and includes sub-processes of helplessly giving up everything (including hope) and living in emptiness in the face of an assumed non-existing future, collapsing mentally, and becoming paralyzed without reason to live.

CONCLUSIONS

The results of this study support the findings of previous studies revealing that despair and hopelessness are possible elements in the life situation of persons living with human immunodeficiency virus and significant others to persons living with human immunodeficiency virus. The results of this study help to define the contents of despair and hopelessness, and help us to distinguish one from the other. The dual-dimensionality of despair has not been pointed out in previous studies and in this way the present study offers new information about the phenomenon of despair.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study offer clinical guidelines on a conceptual level about how to detect these phenomena in persons living with human immunodeficiency virus and their significant others. Furthermore, the findings offer a starting point for interventions used to alleviate despair and hopelessness. Suggestions for suitable interventions are offered. The results of this study underline the clinical relevance of these phenomena in adding new information to the previously documented consequences of despair and hopelessness.

Hope in the general Norwegian population, measured using the Herth Hope Index

Objective:The aims of this study were to describe hope in a large sample that was drawn from the general Norwegian population and to examine how sociodemographic and health-related variables were related to hope.

Methods:Of 4,000 adult citizens, randomly drawn from the National Register, 1,912 (49%) returned the Norwegian version of the Herth Hope Index (HHI).

Results:When demographic and health-related variables were controlled for, age, gender, marital status, and employment status were significantly related to hope. The most important health-related variable was self-assessed health status, with participants who were satisfied with their health reporting significantly higher levels of hope. Participants who indicated that they had a chronic disease reported significantly higher hope scores compared to those without a chronic disease. Older men, individuals who were receiving a pension or were unemployed, and individuals who were widowed or unmarried reported the lowest levels of hope. In this study, an individual's subjective evaluation of his/her health was the most important health-related predictor of hope.

Significance of the research: The most important health-related variable that predicted hope was self-assessed health in that participants who were satisfied with their health reported higher levels of hope. This finding suggests that an individual's subjective assessment of health is a better predictor of hope than the presence a chronic disease. Knowledge about levels of hope in the general population can be used as reference values against which an individual score or a group mean may be compared.