Historical and psychological analysis of the phenomenology of the experience of hopelessness: clinical and prognostic aspects

Abstract

The results of the historical and psychological analysis of the phenomenology of the experience of hopelessness are presented and its clinical and prognostic aspects are specified. It is assumed that hopelessness may have both the nature of a mental state and a personality trait, and may contain both components simultaneously, and the carriers of "hopelessness-trait" are more vulnerable to "hopelessness-state". Hopelessness is seen as a factor that reduces a person's psychological security. Individuals with "hopelessness traits" tend to have negative expectations about many aspects of life, while those who experience hopelessness as a condition have such expectations about a limited number of areas of life. Clarity in the operationalization of these concepts (trait versus state) is lacking today, appropriate tools have not been developed. Close to the phenomenon of hopelessness (but not identical) is the construct of pessimistic attributive style (which to some extent "assimilated" the concept of locus of control), which has traditionally been seen as a cognitive risk factor for depression for both adults and children. An alternative view of hopelessness is to include it in a broader context - the phenomenon of demoralization. This construct describes such experiences as: helplessness, hopelessness, loss of meaning and purpose in life, existential despair; it has common symptoms with distress, but differs from depression in the presence of subjective incompetence and lack of anhedonia. Many, including long-term prospective, epidemiological studies have found that baseline hopelessness is significantly associated with suicidal ideation, attempted suicide, and completed suicide, with variables reflecting the frequency of psychiatric diagnoses. If we accept the hypothesis that the relationship between hopelessness and suicide is influenced by some third variables, it may mean the desirability of a clearer identification of those subgroups of suicides for whom hopelessness is a risk factor as much as possible. This possibility of isolating complex predictors can be a very useful guide in suicidal practice.