An MMPI-2 hopelessness scale: Construction, initial validation and implication for suicide risk

Abstract

• Some suicidal patients may deny suicidal ideation/intent on psychodiagnostic questionnaires. • Such patients may show a lower threshold for acknowledging hopelessness. • Acknowledged feelings related to hopelessness predicts suicide risk. • A new 11 or 12 item scale is a valid measure of potential suicide risk. • Replicates findings with a different psychometric instrument. This study documents the development of a new MMPI-2 scale, Hopelessness (Hp), designed to identify suicide risk in examinees who, for whatever reason, may be reluctant to endorse items reflecting explicit suicide content. The psychometric and empirical validity characteristics were examined in a sample of 153 Italian psychiatric inpatients, all of whom were administered the MMPI-2, the Beck Hopelessness Scale (BHS), and the Mini International Neuropsychiatric Interview (MINI) shortly following admission. Item analysis suggested that the removal of one of the twelve original Hp items enhanced homogeneity of the scale and Bayesian confirmatory factor analysis (BCFA) indicated the fit of a unidimensional model (PPPs = 0.50 [PPC = -36.42/37.07]) for the 11-item version, with adequate reliability (ordinal alpha = 0.86). A regression analysis, with the MINI scores as criterion, and Hp and BHS scores as independent variables, indicated that only Hp scores (beta = 0.25, t = 2.32, p < 0.05) were independently associated with the MINI suicide risk. These findings indicate that the MMPI-2 Hp scale may be considered a valid and potentially useful measure of pessimistic attitudes toward the future and of potential suicide risk.