Trait Hopelessness Research Articles

Comorbidities are associated with state hopelessness in adults with ischemic heart disease

BackgroundIn adults with ischemic heart disease (IHD), comorbidities and hopelessness are independently associated with increased risk of mortality. ObjectivesTo determine if comorbidities were associated with state and trait hopelessness and explore the influence of specific conditions and hopelessness in individuals hospitalized for IHD. MethodsParticipants completed the State-Trait Hopelessness Scale. Charlson Comorbidity Index (CCI) scores were generated from the medical record. A chi-squared test was used to examine differences in 14 diagnoses included in the CCI by CCI severity. Unadjusted and adjusted linear models were used to explore the relationship between hopelessness levels and the CCI. ResultsParticipants (n=132) were predominantly male (68.9%), with a mean age of 62.6 years, and majority white (97%). The mean CCI was 3.5 (range 0-14), with 36.4% having a score of 1-2 (mild), 41.2% with a score of 3-4 (moderate) and 22.7% with a score of ≥5 (severe). The CCI was positively associated with both state (β=0.03; 95% CI 0.01, 0.05; p=0.002) and trait (β=0.04; 95% CI 0.01, 0.06; p=0.007) hopelessness in unadjusted models. The relationship for state hopelessness remained significant after adjusting for multiple demographic characteristics (β=0.03; 95% CI 0.01, 0.05; p=0.02), while trait hopelessness did not. Interaction terms were evaluated, and findings did not differ by age, sex, education level, or diagnosis/type of intervention. ConclusionHospitalized individuals with IHD with a higher number of comorbidities may benefit from targeted assessment and brief cognitive intervention to identify and ameliorate state hopelessness which has been associated with worse long-term outcomes.

Abstract 11275: Comorbidity Score is Positively Associated With Hopelessness in Adults With Ischemic Heart Disease

Introduction: Comorbidities are associated with increased risk of mortality in adults with ischemic heart disease (IHD). Hopelessness, a negative outlook and sense of helplessness towards the future, is identified in 27–52% of patients with IHD and associated with a 3.4 times increased risk of mortality or nonfatal myocardial infarction. The relationship between comorbidities and hopelessness in adults with IHD is unknown. Hypothesis: A higher comorbidity score is positively associated with state and trait hopelessness levels in adults hospitalized with an IHD event. Methods: Participants completed the State-Trait Hopelessness Scale and reported basic demographics. Continuous (range 0-14) and categorical scores for the Charlson Comorbidity Index (CCI) were generated based on patient medical records. Results: Participants (n=132) were typical of the U.S. IHD population except for race/ethnicity. Ninety-one were male (68.4%), mean age was 62.6 years (SD= 9.6), and 97% were non-Latinx White (3.0%). The mean CCI was 3.5 (SD=2.2), with 36.4% having a score of 1-2 (mild), 41.2% with a score of 3-4 (moderate) and 22.7% with a score of ≥5 (severe). The CCI was positively associated with both state and trait hopelessness in unadjusted and adjusted (demographics, medical history, and exercise history) analyses (unadjusted: r=0.26, p=0.002 (state); r=0.23, p=0.009 (trait) and adjusted: r=0.22, p=0.008 (state); r=0.18, p=0.052 (trait)). Components of the CCI showing the strongest relationships with higher levels of hopelessness were cerebrovascular accident (n=8), organ damage from diabetes (n=17), COPD (n=24), and renal failure (n=9). Interaction terms were evaluated and there was no evidence that the relationship between the CCI and hopelessness differed by age, gender, education level, or cardiac intervention type. Conclusions: Our hypothesis of a positive association between comorbidity score and state and trait hopelessness was confirmed. Knowledge of hopelessness in IHD patients with comorbidities is important for health care professionals in acute care and outpatient settings so at-risk patients can be identified and appropirate interventions employed. Future work should be conducted in larger, more heterogeneous samples.

Reliability and Validity of the State-Trait Hopelessness Scale in a Primarily Rural Population of Adults With Ischemic Heart Disease in the US Great Plains.

Hopelessness and rurality are each independently associated with increased mortality in adults with ischemic heart disease (IHD), yet there is no known research examining hopelessness in rural patients with IHD. The authors of this study evaluated the reliability and validity of the State-Trait Hopelessness Scale (STHS) in a primarily rural population of adults with IHD living in West North Central United States (US Great Plains). Reliability, concurrent validity, and convergent validity were evaluated for 115 adults hospitalized for IHD. Rural-Urban Commuting Area codes were used to stratify participants by rurality level, with 66% categorized as rural. Principal component analysis was used to examine potential factor structure of the STHS. Cronbach α for the State and Trait Hopelessness subscales were 0.884 and 0.903, respectively. Concurrent validity was supported for the State and Trait subscales using the Patient Health Questionnaire-8 (State: r = 0.50, P < .001; Trait: r = 0.35, P < .001). Convergent validity was supported for the State subscale using the Duke Activity Status Index ( r = -0.23, P = .013). Principal component analysis showed 2 factors (hopelessness present and hopelessness absent) for the State and Trait subscales, accounting for 63% and 58% of variance, respectively. Findings support the reliability and validity of the STHS for evaluation of hopelessness in rural adults with IHD in clinical and research settings. Results replicated the same factor structure found in testing of the STHS in a primarily urban sample. Because of the prevalence of hopelessness in rural adults with IHD and association with increased mortality, hopelessness should be assessed during hospitalization and in the recovery period.

High depression symptomatology and mental pain characterize suicidal psychiatric patients.

Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered. 2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk. More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments. Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.

Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease.

BackgroundRurality and hopelessness are each associated with increased mortality in adults with ischemic heart disease (IHD), yet there is no known research examining rurality as a risk factor for hopelessness in patients with IHD. This study evaluated rurality as a risk factor for state and trait hopelessness in adults hospitalized with IHD in samples drawn from the Great Lakes and Great Plains regions of the United States.Methods and ResultsA descriptive cross‐sectional design was used. Data were collected from 628 patients hospitalized for IHD in the Great Lakes (n=516) and Great Plains (n=112). Rural–Urban Commuting Area codes were used to stratify study participants by level of rurality. Levels of state hopelessness (measured by the State‐Trait Hopelessness Scale) were higher in rural patients (58.8% versus 48.8%; odds ratio [OR], 1.50; 95% CI, 1.03–2.18), a difference that remained statistically significant after adjusting for demographics, depression severity (measured by the Patient Health Questionnaire–8), and physical functioning (measured by the Duke Activity Status Index; OR, 1.59; 95% CI, 1.06–2.40; P=0.026). There was evidence of an interaction between marital status and rurality on state hopelessness after accounting for covariates (P=0.02). Nonmarried individuals had an increased prevalence of state hopelessness (nonmarried 72.0% versus married 52.0%) in rural areas (P=0.03).ConclusionsRural patients with IHD, particularly those who are nonmarried, may be at higher risk for state hopelessness compared with patients with IHD living in urban settings. Understanding rurality differences is important in identifying subgroups most at risk for hopelessness.RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT04498975.

Materialism and Drinking Motives: Examining the Longitudinal Associations in an Undergraduate Sample

Alcohol use is common among individuals attending university and frequent use is associated with several negative effects. It is therefore important to assess individual difference factors preceding alcohol use. Materialism, a value one holds that prioritizes status through the acquisition of money and possessions, has received minimal research focus in relation to alcohol use and has predominantly been examined using cross-sectional designs (i.e., data collected at one time point). The present study was the first to test the association between materialism, risky drinking motives (i.e., motives preceding alcohol use associated with increased consumption and related problems), and risky personality traits (i.e., stable characteristics associated with frequent substance use and related problems) using a short-term longitudinal design. Undergraduate student drinkers (N = 317) completed self-report questionnaires at baseline and follow-up (2 weeks later). Hierarchical regression analyses found that greater levels of materialism significantly predicted each drinking motive while controlling for risky personality traits. Materialism significantly predicted drinking to cope with depression when controlling for trait hopelessness (β = .16, p = .014), drinking to cope with anxiety while controlling for anxiety sensitivity (β = .11, p = .024), and drinking for enhancement while controlling for sensation seeking (β = .24, p &lt; .001). Results provide evidence that materialism is associated with risky drinking motives, which may inform prevention and treatment efforts for problematic use among undergraduate students.

Reliability and Validity of the State-Trait Hopelessness Scale in Patients With Heart Disease and Moderate to Severe Hopelessness.

The aim of this study was to evaluate the reliability and validity of the State-Trait Hopelessness Scale (STHS) in patients with heart disease who report moderate to severe state hopelessness. Reliability, concurrent validity, and convergent validity were evaluated for 20 patients. Cronbach's α for the State and Trait subscales were .81 and .79, respectively. Strong correlations between the State Hopelessness Subscale and Patient Health Questionnaire-9 (r = 0.77, P < .001), State Hope Scale (r = -0.75, P < .001), EQ-5D-5L (r = 0.59, P < .005), and PROMIS-29 domains of depression (P = .72, P < .001), fatigue (P = .61, P < .001), and social roles (P = .45, P = .047) were found. There were strong correlations between the Trait Hopelessness Subscale and Trait Hope Scale (r = -0.58, P < .005), State Hope Scale (r = -0.49, P = .03), and PROMIS-29 fatigue domain (r = 0.54, P = .015). Findings support the reliability and validity of the STHS for evaluation of hopelessness in patients with heart disease.

Ethnic minority members may be at risk for state hopelessness following hospitalization for ischemic heart disease

ObjectiveTo examine differences in state and trait hopelessness between ethnic minority and White patients hospitalized with ischemic heart disease (IHD). MethodsA descriptive cross-sectional design was used to enroll 517 patients at one Midwestern U.S. hospital. The State-Trait Hopelessness Scale measured hopelessness. ResultsState hopelessness was higher in ethnic minority patients compared to Whites. Ethnic minority patients who had never been married had higher state hopelessness than those who were married or separated/divorced. There were no differences in trait hopelessness. ConclusionsEthnic minority patients with IHD, who have never been married, may be at higher risk for state hopelessness.

State and trait hopelessness in a prospective five-year study of patients with depressive disorders

BackgroundHopelessness is a common experience of patients with depressive disorders (DD) and an important predictor of suicidal behaviour. However, stability and factors explaining state and trait variation of hopelessness in patients with DD over time are poorly known. MethodsPatients with DD (n = 406) from the Vantaa Depression Study and the Vantaa Primary Care Depression Study filled in the Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Perceived Social Support Scale–Revised (PSSS-R), and Eysenck Personality Inventory–Q (EPI-Q) at baseline, at six and eighteen months, and at five years. We conducted a multilevel linear regression analyses predicting BHS with these covariates. ResultsDuring the five-year follow-up half of the variance in BHS was attributable to between-patient variance (50.6%, CI = 41.2–61.5%), and the rest arose from within-patient variance and measurement errors. BDI and BAI explained 5.6% of within-patient and 28.4% of between-patient variance of BHS. High Neuroticism and low Extraversion explained 2.6% of the between-patient variance of BHS. PSSS-R explained 5% of between-patient variance and 1.7% of within-patient variance of BHS. LimitationsNo treatment effects were controlled. ConclusionsHopelessness varies markedly over time both within and between patients with depression; it is both state- and trait-related. Concurrent depressive and anxiety symptoms and low social support explain both state and trait variance, whereas high Neuroticism and low Extraversion explain only trait variance of hopelessness. These variations influence the utility of hopelessness as an indicator of suicide risk.

The Differentiating Role of State and Trait Hopelessness in Suicidal Ideation and Suicide Attempt

With suicide being a leading cause of death in the United States, research must aim to increase efficacious prevention methods. The purpose of the present study was to gain greater understanding of the difference between suicidal ideation and suicide attempt. Previous research emphasizes the role of hopelessness in attempts and ideation (Bagge, Lamis, Nadorff, & Osman, 2014). Yet while hopelessness offers predictive value to suicide attempt, it fails in discriminating between suicide attempters and suicide ideators. Thus the goal was to examine the possible influence of different types of hopelessness on suicidal ideation and attempt. The experience of hopelessness as a temporary feeling, or state, versus as an enduring emotion, or trait, was examined in this study. The State-Trait Hopelessness Scale and 4 suicidal thought and suicidal behavior questions were assessed. Results of logistic regression analysis supported the hypothesis that state and trait hopelessness were differentially associated with ideation and attempt. While trait hopelessness was significantly positively associated with responses to all 4 suicidality questions (p’s < 0.001), state hopelessness was only positively related to responses to 1 ideation question (p < 0.01). In all, these results point to the importance of understanding the role of different types of hopelessness in differentiating suicidal ideation and attempt.

Abstract P312: High State and Trait Hopelessness Levels Predict Lower Home-based Exercise Participation in Patients With Coronary Heart Disease

Introduction: Hopelessness is associated with increased adverse events and decreased survival in patients with coronary heart disease (CHD). Hopelessness can persist in these patients and reduce their participation in hospital-based cardiac rehabilitation (CR) exercise following an acute event. Because the majority of CHD patients do not attend a hospital-based CR exercise program, examination of factors affecting home exercise is needed. The purpose of this study was to describe the impact of hopelessness levels on both home- and hospital based CR exercise participation in patients with CHD. Hypothesis: It was hypothesized that higher state and trait hopelessness levels would adversely affect both home- and hospital-based CR exercise participation. Methods: The Theory of Hopelessness Depression was used as a foundation for study aims. Using a descriptive, longitudinal design, 282 patients who had been hospitalized with a CHD event were asked to complete the State-Trait Hopelessness Scale (STHS) during their hospitalization and the STHS and the Cardiac Rehabilitation Exercise Participation Questionnaire at 3, 8, and 12 months after hospital discharge. Patients who provided data at any two concurrent time points over the year were included in the analyses. Regular exercise was defined as walking or biking ≥3 days/week in a home- or hospital-based Phase II CR exercise program. Logistic regression was used to evaluate the relationship between STHS scores on the likelihood that patients would participate in regular exercise in home- or hospital-based Phase II CR settings. Results: Patients were predominantly male (64.9%) with a mean age of 65.4±9.7 years. Patients had persistent, modest levels of state and trait hopelessness across all time points. High levels of state and trait hopelessness were predictive of lower home-based exercise participation (state: OR 0.4, 95% CI [0.1, 0.7], p=0.002; trait: OR 0.4, 95% CI [0.2, 0.8], p=0.01) but not hospital-based Phase II CR exercise, after adjusting for age and sex. Conclusions: These findings demonstrate the importance of assessing hopelessness in patients with CHD and provide critical evidence of the need for clinicians to encourage CHD patients who are feeling hopeless to participate in CR exercise, particularly in the home setting.

Impact of Home- and Hospital-Based Exercise in Cardiac Rehabilitation on Hopelessness in Patients With Coronary Heart Disease.

Hopelessness is associated with increased adverse events and decreased survival in patients with coronary heart disease (CHD). The purpose of this research was to examine the effect of regular home- and hospital-based cardiac rehabilitation (CR) exercise on hopelessness levels in patients with CHD, hypothesizing that increased exercise in either setting would lead to decreased state hopelessness. A descriptive longitudinal design was used at a large teaching hospital in Michigan. A total of 324 patients provided data during hospitalization and at least 1 followup time point (3, 8, and 12 months). The patients had persistent, modest levels of state and trait hopelessness across all time points. Among home exercisers with moderate to severe state hopelessness at baseline, both mean state (P = .002) and trait (P = .02) hopelessness were reduced at later time points compared with those who quit or did not start exercise. Multivariable models showed that when individuals had moderate to severe baseline state hopelessness, home exercise remained associated with decreases in state hopelessness compared with no exercise, even after adjusting for hospital exercise, depression, and demographic variables. Exercise may be effective in reducing moderate to severe hopelessness in patients with CHD. Moderate to severe baseline state hopelessness was a predictor of attrition in this cohort, especially for home exercisers, but this was mediated in hospital-based programs. Further research is needed to determine how hopeless individuals can be encouraged to exercise and whether home- or a hospital-based CR exercise is superior in impacting hopelessness.

Patterns of cannabis use, psychotic-like experiences and personality styles in young cannabis users

ObjectiveTo examine the influence of personality traits on the relationship between cannabis use and psychotic like experiences (PLEs) in young adults. Method499 lifetime cannabis users aged 18 to 25years completed an online survey assessing PLEs using the positive scale of the Community Assessment of Psychic Experiences (CAPE) and personality styles using the Brief Schizotypal Personality Questionnaire (SPQ-B) and the Substance Use Risk Profile Scale (SURPS), a measure of trait hopelessness, anxiety-sensitivity, impulsivity and sensation seeking. Cannabis use was assessed using items from the Youth Risk Behaviour Survey (YRBS) and a self-report measure of the lifetime level of cumulative cannabis use. ResultsCannabis use as well as schizotypy and the four SURPS personality risk profiles were significantly associated with the frequency of PLEs in young cannabis users. The cumulative levels of lifetime cannabis exposure, trait schizotypy and hopelessness were the strongest predictors of PLEs in the multivariate analysis. Little evidence of a moderating effect of the personality risk profiles on the relationship between cannabis use and PLEs was found. Trait hopelessness was found to have a moderating effect on the relationship between the recency of cannabis use and the frequency of PLEs. ConclusionsThe cumulative levels of lifetime cannabis exposure, trait schizotypy and hopelessness were associated with PLEs in young cannabis users. Individuals with high levels of trait hopelessness who use cannabis may be at higher risk of PLEs. Future research is required to increase understanding of the relationship between cannabis use and PLEs, using more complex moderation models containing personality traits along with other risk factors for PLEs.

The State–Trait Hopelessness Scale

Hopelessness is predictive in the development of coronary heart disease (CHD) and can persist in patients after a CHD event, adversely affecting recovery. Hopelessness may represent a temporary response (state) or a chronic outlook (trait). Common hopelessness measures fail to differentiate state from trait hopelessness, a potentially important differentiation for treatment. The State-Trait Hopelessness Scale (STHS) was developed and pilot tested with two groups of college students (n = 39 and 190) and patients with CHD (n = 44). The instrument was then used with 520 patients, confirming reliability (Cronbach's α) for the State (.88) and Trait (.91) subscales and concurrent and predictive validity. Separate exploratory factor analyses showed two factors (hopelessness present or hopelessness absent) for the State and Trait subscales, accounting for 58.9% and 57.3% of variance, respectively. These findings support future use of the tool in clinical settings and in intervention studies focused on hopelessness.

Hopelessness as a Response to Physical Illness

To analyze hopelessness as a psychological response to physical illness, differentiate hopelessness from depression, and discuss measures of hopelessness. Walker and Avant's (1995) concept analysis strategy. A review of the literature from 1983 to 2004 was completed, with a focus on hopelessness theory and measurement. Although hopelessness is closely related to depression, distinct characteristics of hopelessness were identified. A continuum of attributes of hopelessness and depression was derived. Hopelessness has been examined in a variety of populations with several different instruments. One established measure was selected for discussion. Continued study of hopelessness as a psychological response to physical illness is needed, including the continued differentiation of hopelessness from depression, further analysis of the continuum of hopelessness and depression, and the differentiation of state from trait hopelessness. Research to validate this conceptualization will enhance accuracy of the diagnosis of hopelessness and testing of nursing inteventions.