Abstract
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.
Highlights
Hopelessness is an important psychological construct, defined as negative expectations regarding oneself and one’s future life and a negative emotional state characterized by the lack of finding a solution for one’s problems [1]
HT was .42 indicating medium accuracy of the item ordering. These results suggested that the refined Hopelessness scale was unidimensional and met the requirements of a MH and Double Monotonicity Model (DM) Mokken scale, the scale’s ability to discriminate between levels of hopelessness severity among psychiatric inpatients was medium
Nine best-fitting items of the Beck Hopelessness Scale satisfied the assumptions of local independency, monotonicity, and invariance of the item ordering when all the items were submitted to Mokken Scale Analysis in a large sample of adult psychiatric inpatients
Summary
Hopelessness is an important psychological construct, defined as negative expectations regarding oneself and one’s future life and a negative emotional state characterized by the lack of finding a solution for one’s problems [1]. In his research focused on depression mood and suicidal behavior, Beck [2,3,4,5] observed that patients diagnosed with depressive disorders shared common cognitive features—a negative view of the self, and of the self in relation to the world and in relation to the future. He paid special attention to one of these cognitive features—a negative view of the self in relation to the future, by introducing the construct of “hopelessness”. They produced empirical evidence for the Unidimensionality of the BHS association between hopelessness and suicidality by arguing that severity of suicidal intent is more strongly related to hopelessness compared to depression [5, 7,8,9,10,11]
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