Further Insights Into the Beck Hopelessness Scale (BHS): Unidimensionality Among Psychiatric Inpatients

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.

Factor Structure and Measurement Invariance Across Gender of the Beck Depression Inventory-II in Adolescent Psychiatric Patients

“…In addition, and following a distinction made by Bonifay et al ( 45 ), our bifactor model is not intended to represent a structure of depression psychopathology, but solely for reflecting psychometric properties, i.e., to inform about the degree to which the BDI-II yields an univocal total score and the extent to which the subscales yield reliable scores after accounting for the general factor. Another way to address unidimensionality, and in order to avoid this type of methodological problems along with the difficult interpretability of the specific factors in bifactor models ( 6 ), may be in the application of models from item response theory (IRT) ( 48 , 49 ). Most of these studies, however, usually drop less-fitting items and result in shorter versions of the instrument.…”

Quality of Life and the Experience of Living with Early-Stage Alzheimer’s Disease

“…Negative attitudes about the future or hopelessness is conceived as the experience of anticipating unfavorable situations or consequences that are beyond a person’s control [ 33 ]. Hopelessness is recognized as a risk factor for self-harm and suicide [ 34 ]. In line with these results, 22% of patients in our study had depressive symptoms and 83% had moderate-to-severe hopelessness, implying a potential suicide risk.…”

Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study

“…Beck et al, 1974 ; Bouvard et al, 1992 ; Steed, 2001 ; Kliem et al, 2018 ). In clinical populations, the BHS proved to discriminate between individuals with a high and moderate risk of suicide, as well as individuals with and without a history of suicide attempts (Granö et al, 2017 ; Balsamo et al, 2020 ). The internal consistency of the BHS for baseline scores in the current sample was good (α = 0.82).…”