Breaking the Vise of Hopelessness: Targeting its Components, Antecedents, and Context

Abstract

Hopelessness is a painful cognitive state that is related to depression and suicide. Despite its importance, only unsystematic efforts have been made to specifically target hopelessness in interventions, and no comprehensive review is currently available to guide future clinical studies. In this narrative review, we first analyze the phenomenon of hopelessness, by highlighting its components (e.g., dismal expectations, blocked goal-directed processing, and helplessness), antecedents (e.g., inferential styles), and contextual factors (e.g., loneliness and reduced social support). Then, we review the currently available interventions and manipulations that target these mechanisms, either directly or indirectly, and we highlight both their strengths and lacunae. Finally, we propose possible avenues to improve our clinical toolbox for breaking the vise of hopelessness.

Hope for brain health: impacting the life course and society

“…Irrespective of the presence or absence of brain-related disease, achieving an optimal level of brain health enables success across the life course (Brain Health, 2022). For example, a recent review highlights how specific components of hopelessness could be considered a clinical target for intervention as it improves psychological flexibility and adaptability (Marchetti et al, 2023).…”

“…While psychological interventions like cognitive behavior therapy and supportive counseling are effective interventions for depression where hopelessness is a common clinical feature, unpacking the mechanisms of hope and neurobiological basis offer potential to develop interventions specifically targeting the use of hope in a clinical setting (Cuijpers et al, 2013;Hernandez and James, 2021;Marchetti et al, 2023). Recent years have seen an abundance of mental health apps for "therapy on-the-go, " and while the evidence around their clinical efficacy is limited (Torous et al, 2018;Marshall et al, 2020), they have become incredibly popular among consumers and are increasingly being used as an adjunct.…”