Beck Hopelessness Inventory
KeywordsSuicide Attempt Suicidal Behavior Concurrent Validity Negative Life Event Childhood Trauma
Hopelessness is conceptualized as negative beliefs and expectations about the future. Hopelessness is comprised of two core elements: (1) negative expectations about outcomes, and (2) expectations of helplessness in relation to changing such outcomes (Zhou et al. 2013), and can be measured with the Beck Hopelessness Scale (BHS). The BHS is a 20-item, paper and pencil format, self-report inventory for adults. Respondents answer questions in a true or false fashion, and it takes approximately 5–10 min to complete in its entirety.
Prior to the development of the BHS, many clinical investigators believed hopelessness was a diffuse feeling state that was too vague and fluid to define; however, Stotland (1969) disagreed with this conviction and proposed that hopelessness involved negative expectancies concerning the self and the future. Therefore, in the development of the BHS, a 20-item scale, nine items were chosen from a test of attitudes about the future and revised to reflect the present tense, and the other eleven items were drawn from a pool of pessimistic statements made by psychiatric patients who were assessed by clinicians as hopeless (Beck et al. 1974). The BHS items are in true-false answer choice format and measure negative attitudes about the future. Of note, the BHS was originally developed to predict eventual death by suicide. Nine items are reverse scored and summed with the other items, and higher ratings reflect greater levels of hopelessness. Sample items include: “I might as well give up because I can’t make things better for myself,” “My future seems dark to me,” and “Things just won’t work out the way I want them to.”
Initial evidence reported by Beck et al. (1974) indicated that the BHS was a reliable and valid measure of hopelessness and resulted in three factors. The first factor assessed affectively toned associations with hopelessness (e.g., enthusiasm, happiness), the second factor measured motivational associations (e.g., giving up, deciding not to want anything), and the third factor assessed cognitive aspects of the future, including future anticipation. Hopelessness has been identified as one of the core characteristics of depression (Beck 1963) and research indicates its predictive ability in suicide ideation and attempts, and death by suicide in clinical and community samples (Beck et al. 1985; Liu et al. 2015).
The BHS was normed on a sample of 294 psychiatric inpatients who had made a recent suicide attempt (Beck 1963). Item-total correlations ranged from .39 to .76. Internal consistency of the scale was assessed via KR-20 coefficients and was found to be excellent (0.93). To measure concurrent validity, Beck and colleagues examined the relationship between clinical ratings of hopelessness and the BHS in a sample of outpatients (N = 23) and a sample of inpatients recently hospitalized for a suicide attempt (N = 62). Concurrent validity was .74 (p < .001) and .62 (p < .001), respectively. Since the original study, the BHS has been utilized in numerous studies across a variety of populations. Among other studies, the BHS exhibited internal consistency ranging from .83 to .86 for psychiatric samples (Durham 1982), .92 for clinical populations (Dyce 1996; Young et al. 1992), and .88 to .91 for college populations (Chang et al. 2010; Steed 2001). Additionally, the BHS is indicated as a valid measure for detecting hopelessness in clinical and community adult and adolescent populations (Durham 1982; Lester 2015; Rosellini and Bagge 2014).
Hopelessness research indicates that hopelessness is associated with a wide range of constructs, including being an important component in a variety of psychological conditions. When developing the BHS, Beck et al. (1974) summarized that hopelessness is a core characteristic of depression, but also related to suicidal behavior, schizophrenia, sociopathy, and physical illness. In addition to psychopathology, hopelessness is related to cognitive-emotional constructs; for instance, hopelessness is positively related to negative affect and perceived stress, and inversely related to optimism and hope (Steed 2001). Hopelessness is also related to many psychosocial stressors including older age, being divorced or widowed, lower education levels, being unemployed or retired, and financial difficulties (Soares et al. 2008). Further, certain personality traits, such as neuroticism, are positively related to hopelessness, whereas traits such as extraversion, openness, and agreeableness are inversely related to hopelessness (Bayrami et al. 2012; Chioqueta and Stiles 2005).
Working Model and Hypothesis Testing
Stotland (1969) proposed that hopelessness is defined in terms of a system of negative expectancies concerning the self and the future. Hopelessness is a significant component in many psychological conditions; however, it has particular salience with regard to depression. In 1988, Abramson and colleagues presented a working model for a particular subtype of depression, hopelessness depression. This model posits that attributional style and negative life events contribute to feelings of hopelessness (e.g., those who attribute negative events to stable, global, and internal factors are more prone to hopelessness) which, in turn, leads to the development of depressive symptoms. The hopelessness theory of depression provides a framework for hypothesis formulation and testing when using the BHS and has been applied to other related constructs such as suicide and childhood trauma (Liu et al. 2015).
The BHS has been examined in many populations (e.g., inpatient, clinical and nonclinical adults, college students, adolescents, rural, medical conditions, older adults), highlighting its utility across multiple populations. The scale has also been adapted for use across persons speaking different languages. For example, there is a Yoruba version of the BHS used for Nigerian individuals (Aloba et al. 2015), as well as Italian (Innamorati et al. 2014) and Turkish (Erol and Ergun 2013) versions of the scale, among other translations. There are also short versions of the BHS, which utilize either three or four of the original 20 questions, and which have been validated in Chinese, French, Japanese, and Hungarian samples (Forintos et al. 2013). All adaptations and translations of the scale are reported to retain high internal consistency, correlate highly with the original version, and the BHS, overall, appears to generalize well across cultures.
The concept of hopelessness, as measured by the Beck Hopelessness Scale, contributes to the understanding of the role of negative expectancies about the self and the future for psychological, cognitive-emotional, physical, and social well-being. Researchers, as well as clinicians, have examined this construct and have utilized the BHS across a wide range of populations, disorders, and research areas, including clinical interventions, to further understand the impact of hopelessness on multiple aspects of health functioning and the human experience.
- Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1988). The hopelessness theory of depression: Does the research test the theory? In L. Y. Abramson (Ed.), Social cognition and clinical psychology: A synthesis (pp. 33–65). New York: Guilford Press.Google Scholar
- Aloba, O., Akinsulore, A., Mapayi, B., Oloniniyi, I., Moasku, K., Alimi, T., & Esan, O. (2015). The Yoruba version of the Beck hopelessness scale: Psychometric characteristics and correlates of hopelessness in a sample of Nigerian psychiatric outpatients. omprehensive. Psychiatry, 56, 258–271. doi:10.1016/j.comppsych.2014.09.024.Google Scholar
- Chang, E. C., Sanna, L. J., Hirsch, J. K., & Jeglic, E. L. (2010). Loneliness and negative life events as predictors of hopelessness and suicidal behaviors in Hispanics: Evidence for a diathesis-stress model. Journal of Clinical Psychology, 66(12), 1242–1253. doi:10.1002/jclp.20721.CrossRefPubMedGoogle Scholar
- Innamorati, M., Lester, D., Balsamo, M., Erbuto, D., Ricci, F., Amore, M., Girardi, P., & Pompili, M. (2014). Factor validity of the Beck hopelessness scale in Italian medical patients. Journal of Psychopathology and Behavioral Assessment, 36, 300–307. doi:10.1007/s10862-013-9380-3.CrossRefGoogle Scholar
- Stotland, E. (1969). The psychology of hope. San Fransisco: Jossey-Bass.Google Scholar
- Young, M. A., Halper, I. S., Clark, D. C., Scheftner, W., & Fawcett, J. (1992). An item-response theory evaluation of the Beck Hopelessness Scale. Cognitive Therapy and Research, 16, 579–587. doi:10.1007BF01175143.Google Scholar