Factor Validity of the Beck Hopelessness Scale in Italian Medical Patients

The aim of the present study was to assess the factor structure of the Italian version of the Beck Hopelessness Scale (BHS) in a large sample of patients with medical conditions, comparing four different models proposed previously in the literature. Participants were 514 Italian adult patients with diagnoses of chronic daily headache, type 1 (insulin-dependent) or type 2 diabetes mellitus, epilepsy, open-angle glaucoma, human immunodeficiency virus infection, and women admitted for childbirth to a Department of Fetal–Maternal Medicine. All the patients were administered the BHS during routine visits. Confirmatory factor analyses were used to compare four models using several fit indices. The one-construct two-method model (i.e., the BHS measures one substantive hopelessness construct plus artifacts due to negative–positive item polarity) had the best fit indices and was more parsimonious than other models. The BHS seems to be a unidimensional measure of hopelessness, although there may be artifacts due to item polarity (i.e., positively and negatively worded items). Hopelessness scores differed in patients with particular medical diseases, with higher scores in conditions such as chronic daily headache and diabetes, and lower scores in patients positive for the human immunodeficiency virus (HIV), and with open-angle glaucoma or epilepsy.