A test of the hopelessness theory of depression in youth psychiatric inpatients

Evaluated the hopelessness theory of depression among youth psychiatric inpatients. According to the hopelessness theory of depression, negative attributional style may cross-sectionally relate to an array of psychopathological symptoms. However, in the presence but not the absence of negative life events, negative attributional style relates to the onset and exacerbation of depressive (not other) symptoms. Moreover, negative attributional style relates to depression onset or exacerbation specifically via changes in hopelessness (not other mediators). This study of 60 youth psychiatric inpatients (22 boys and 38 girls; ages 9 to 17, M = 14.33, SD = 1.86), 34 of whom were assessed 2 months after leaving the hospital, tested hopelessness theory. At baseline, participants completed self-report questionnaires on attributional style, hopelessness, self-esteem, depression, and anxiety; at follow-up, questionnaires on negative life events and symptoms were completed. Chart diagnoses were available. Results were consistent with all hypotheses derived from hopelessness theory.     

Evaluation of cognitive diathesis-stress models in predicting major depressive disorder in adolescents

Diathesis-stress predictions regarding the onset of adolescent major depression and nonmood disorders were tested. Adolescents (N = 1,507) were assessed for dysfunctional attitudes and negative attributional style, as well as current depressive symptoms, current depressive and nondepressive diagnoses, and past and family histories of psychopathology. Approximately 1 year later, participants were reassessed on all measures. Analyses supported A. T. Beck's (1976) theory of depression (at the level of a trend) but not the hopelessness theory of depression. Findings were suggestive of a threshold view of vulnerability to depression; for those who experienced negative life events, depressive onset was related to dysfunctional attitudes but only when dysfunctional attitudes exceeded a certain level (low = intermediate < high). For participants who scored either very high or very low on both dysfunctional attitudes and negative attributional style, nonsignificant findings were obtained.     

Psychache and suicide ideation among men who are homeless: a test of Shneidman's model

Suicide ideation among the homeless is 10 times more common than in the general population. Cognitive theories of depression and hopelessness propose to explain suicidality; however, as yet, none of these fully account for the phenomenon. Shneidman has suggested a theory of psychache or unbearable psychological pain to explain suicidality. This theory has found support among low-risk populations but has not been extensively tested within a high-risk population. The current research assessed the utility of psychache among men who are homeless (N = 97). In support of Shneidman's theory, analyses revealed that psychache was a stronger predictor of suicide ideation than was depression, hopelessness, or life meaning.     

Cognitive content-specificity in future expectancies: role of hopelessness and intolerance of uncertainty in depression and GAD symptoms

The present study examined cognitive content-specificity in future-event predictions associated with symptoms of depression and generalized anxiety disorder (GAD). College undergraduates (N=284) completed measures of depression, GAD, and rated their certainty that a given set of positive and negative outcomes were or were not likely to happen in their future. Participants also completed measures of hopelessness and intolerance of uncertainty (IU). Individuals (N=263) completed the same measures again 6 weeks later. Certainty in an absence of positive future outcomes was associated with symptoms of depression but not GAD, and hopelessness mediated this relationship - concurrently and when examining change scores over 6 weeks. Certainty in negative outcomes was concurrently associated with both symptoms of depression and GAD, and hopelessness partially mediated these relationships. IU predicted concurrent increases in depression and GAD symptoms, and negative-outcome certainty partially mediated the IU-depression but not the IU-GAD symptom relationship. Change in certainty did not mediate the relationship between changes in IU and GAD symptoms but partially mediated the relationship between change in IU and depression symptoms over time. Hopelessness appears to play a unique role in the relationship between reduced anticipation of positive future outcomes and depression. Although less clearly suggested by the data, IU may contribute to both depression and GAD symptoms but may do so through different pathways.     

Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression

Do negative cognitive styles provide similar vulnerability to first onsets versus recurrences of depressive disorders, and are these associations specific to depression? The authors followed for 2.5 years prospectively college freshmen (N = 347) with no initial psychiatric disorders at high-risk (HR) versus low-risk (LR) for depression on the basis of their cognitive styles. HR participants had odds of major, minor, and hopelessness depression that were 3.5-6.8 times greater than the odds for LR individuals. Negative cognitive styles were similarly predictive of first onsets and recurrences of major depression and hopelessness depression but predicted first onsets of minor depression more strongly than recurrences. The risk groups did not differ in incidence of anxiety disorders not comorbid with depression or other disorders, but HR participants were more likely to have an onset of anxiety comorbid with depression.     

Factors associated with suicide attempts in female inmates: the hegemony of hopelessness

In this study factors associated with past suicide attempts in female inmates were examined. Female inmate participants (N = 105) were given structured diagnostic assessments of antisocial and borderline personality disorders and substance dependence, as well as measures of depression, hopelessness, problem-focused coping styles, and reasons for living. There was a high lifetime prevalence of past suicide attempts (38.1%). Suicide attempts were positively associated with personality disorders, hopelessness, depression, childhood physical/emotional abuse, and family history of suicide and mood disorders, and negatively associated with income, reasons for living, and problem-focused coping. Controlling for hopelessness, borderline personality disorder and family history of suicide attempts were the only variables that remained uniquely associated with suicide attempts.     

Illness attributions and hopelessness depression: the role of hopelessness expectancy.

According to hopelessness theory, hopelessness expectancy is the proximal, sufficient cause of hopelessness depression. Consequently, hopelessness expectancy is viewed as mediating the influence of all other factors on hopelessness depression. Using a longitudinal research design, we examined hopelessness expectancy as a mediator of the relation between illness attributions and hopelessness depression in a sample of 57 adults with rheumatoid arthritis. Although hopelessness expectancy was a strong predictor of hopelessness depression, it moderated rather than mediated the relation between attributions and depression. Finding support for a moderating rather than a mediating model is inconsistent with theory but is consistent with the findings of Riskind, Rholes, Brannon, and Burdick (1987).     

Does quality of sleep mediate the effect of depression on hopelessness?

The objectives of the study were to evaluate the relationship between sleep quality, depression, and hopelessness in advanced cancer patients and whether sleep quality mediated the effect of depression on hopelessness. The final sample consisted of 102 advanced cancer patients under palliative treatment. Patients completed the Greek Pittsburgh Sleep Quality Index, a sleep quality instrument, the Greek Beck Depression Inventory for measuring depression, and finally the Beck Hopelessness Scale. Patients' performance status was assessed by their overall physical functioning, as defined by the Eastern Cooperative Oncology Group. Depression was highly associated with hopelessness (r = .52, p<.001). Statistically significant associations were found between sleep quality with hopelessness (r = .37, p<.001), as well as with depression (r = .36, p<.001). Mediation analyses indicated that depression influenced hopelessness directly as well as indirectly by its effect on sleep quality. About 14.58% of the variation in hopelessness was explained by depression; 4% of the variance in hopelessness explained by depression was accounted for by the mediation pathway indicating that sleep quality mediated the relationship between depression and hopelessness. Similarly, in the reverse mediation analysis, depression mediated the relationship between sleep quality and hopelessness; 43% of the variation in hopelessness was explained by sleep quality. In conclusion, some of the effect of depression on hopelessness was mediated by sleep quality, but depression had a direct effect on hopelessness as well. Additionally, some of the effect of sleep quality on hopelessness was mediated by depression. The current findings are important because improving sleep quality by treating depression may contribute to decreased hopelessness scores and vice versa: Treating depression by improving sleep quality may also contribute to lower hopelessness scores.     

Negative attributional style, hopelessness depression and endogenous depression

The hopelessness theory of depression [Abramson, L. Y., Metalsky, G. I. & Alloy, L. B. (1989). Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358-372.] postulates that a negative attributional style represents a risk factor for a particular constellation of depressive symptoms, termed 'hopelessness depression'. Four studies tested the relation of negative attributional style to hopelessness depression symptoms versus endogenous depression symptoms. Despite the considerable overlap of hopelessness and endogenous depression symptoms, negative attributional style was more related to the former than the latter, consistent with hopelessness theory.     

Perfectionism, cognitive bias, and hopelessness as prospective predictors of suicidal ideation

Perfectionism, negative cognitive bias, and hopelessness were assessed among people hospitalized for depression (N = 121). Hopelessness and suicidal ideation were assessed 6 months after discharge. Path analyses indicated that higher perfectionism as an inpatient was directly associated with higher suicidal ideation 6 months later. Cognitive bias, in contrast, led to greater hopelessness 6 months later, which in turn led to higher concurrent suicidal ideation. Alternative models examined whether hopelessness partially or fully mediated the effect of perfectionism, whether hopelessness partially mediated the effect of cognitive bias, and whether inpatient depression and suicidal ideation severity explained the observed relationships. These alternative models were not supported. Perfectionism and negative cognitive bias both uniquely contributed to the prospective prediction of suicidal ideation.     

Vulnerability to depressive symptomatology: a prospective test of the diathesis-stress and causal mediation components of the hopelessness theory of depression.

The diathesis-stress and causal mediation components of the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) were tested using a prospective methodology. Measures of the 3 vulnerability factors posited by the theory (cognitive diatheses about cause, consequences, and self) were completed by 152 Ss at Time (T) 1. Ss completed measures of depressive symptoms, anxious symptoms, and hopelessness at T1 and again at T2, 5 weeks later. Naturally occurring stressors were assessed at T2 (covering the T1-T2 interval). Consistent with the diathesis-stress component, each Cognitive Diathesis x Stress (CD x S) interaction predicted onset of depressive symptoms from T1 to T2. In contrast, the CD x S interactions predicted neither state nor trait anxiety. In addition, 2 of the 3 CD x S interactions (those involving cause and self, but not consequences) were partially mediated by hopelessness. Implications for future work on the hopelessness theory of depression are discussed.     

Surviving a failure: Efficacy and a laboratory based test of the hopelessness model of depression

Abramson, Metalsky and Alloy's (1989) revision of the reformulated model of helplessness and depression to hopelessness theory introduced the possibility of additional diatheses for depression. The present paper describes a laboratory-based test of the hopelessness model which provides an opportunity to explore the role of efficacy in relation to the new model and to extend its application to anxiety. Undergraduate students were asked to complete a general ability test and received false feedback which led them to believe that they had performed less well than they had anticipated. Attributional style was found to be predictive of increase in anxiety following failure feedback. The interaction between attributional style and eficacy was found to predict depression. Among subjects who were low in efficacy attributional style was significantly related to depression. While the study provided partial support for hopelessness theory it indicates a role for the assessment of efficacy as a moderator variable within the model.     

When simplifying life is not so bad: the link between rigidity, stressful life events, and mental health in an undergraduate population

Decades of research have generally shown that being more rigid is associated with poorer mental health. We investigated whether all aspects of what has been termed “rigidity” are harmful. In particular, we hypothesized that the desire for simple structure (DSS) will not be associated with poor mental health, and in some cases might be associated with better mental health. In contrast, the intolerance of uncertainty (IU) was hypothesized to be associated with a wide range of indices of poor mental health. We also hypothesized that people high in IU would be less resilient in the face of stressful life events. Results across two cross-sectional surveys (N=240; N=331) supported our hypotheses. DSS was associated with less hopelessness, whereas IU was associated with more depression, anxiety, stress, suicidal ideation, and hopelessness. In addition, moderational analysis supported the hypothesis that IU magnifies the adversive effect of stressful life events on depression, anxiety and hopelessness. IU was more strongly related to the negative indices of well-being than to the positive index of life satisfaction. The implications of these findings for cognitive behavioural therapy practice are discussed.     

Perfectionism,Stress, Daily Hassles,Hopelessness, and Suicide Potential in Depressed Psychiatric Adolescents

The current study examined dimensions of perfectionism, stress, hopelessness, and suicidality in a sample of adolescent psychiatric patients diagnosed with depression. This study evaluated the unique contribution of perfectionism in predicting suicidality after considering other predictors (i.e., hopelessness, depression) and it also examined the diathesis-stress model of perfectionism and suicide. A sample of 55 adolescents (41 females, mean age = 15.53, 25.5 % ethnic/racial minorities) who were psychiatric patients completed measures including the Child-Adolescent Perfectionism Scale, subjective and objective indices of life stress, daily hassles, depression, hopelessness, suicide ideation, prior attempts and suicide potential. In addition, other informants (i.e., adolescents’ parents) completed a diagnostic interview and an interview assessing major stressful experiences. Socially prescribed perfectionism (i.e., the perception that others require perfection of oneself) predicted concurrent levels of suicide potential and this association with suicide potential held even after controlling for the variances accounted for by depression and hopelessness. Hierarchical regression analyses provided partial support for the diathesis-stress model, that is, socially prescribed perfectionism interacted with daily hassles to predict concurrent suicide potential even after controlling for depression, hopelessness, and prior suicide attempt. Together, these findings suggest that socially prescribed perfectionism acts as a vulnerability factor that is predictive of suicide potential or risk among clinically depressed adolescents.     

A cross-cultural investigation of cognitions and depressive symptoms in adolescents

Adolescents (N=2,272) from Hong Kong and the United States provided information regarding their depressive symptoms, cognitions (self-efficacy, negative cognitive errors, and hopelessness), and stressful events between 2 surveys 6 months apart. Depressive symptoms and hopelessness were higher, and self-efficacy and negative cognitive errors were lower in Hong Kong than in the United States. Cognitions were associated with concurrent depressive symptoms and predicted depressive symptoms 6 months later in both cultures. The "reverse" model was also supported with more variance predicted by depressive symptoms to later cognitions than from cognitions to depressive symptoms. There was some support for the hypothesis that self-efficacy is less salient in collective compared with individualistic cultures. These findings extend cognitive theories of depression to a non-Western culture.     

Self‐Esteem and Suicide Ideation in Psychiatric Outpatients

Depression, hopelessness, and low self‐esteem are implicated as vulnerability factors for suicide ideation. The association of self‐esteem with suicide ideation after controlling for depressed mood and hopelessness was examined. Adult psychiatric outpatients (N = 338) completed measures of self‐esteem, suicide ideation, hopelessness, and depression. Self‐esteem was operationalized as beliefs about oneself (self‐based self‐esteem) and beliefs about how other people regard oneself (other‐based self‐esteem). Each dimension of self‐esteem was negatively associated with suicide ideation after controlling for depression and hopelessness. Of the two dimensions of self‐esteem, other‐based self‐esteem was the more robust predictor of suicide ideation. These findings suggest that even in the context of depression and hopelessness, low self‐esteem may add to the risk for suicide ideation.     

Self-discrepancy and suicidal ideation

The purpose of this study was to determine whether certain self-discrepancies predicted the extent to which individuals experienced suicidal ideation. The Selves Questionnaire (an idiographic measure of self-beliefs) was administered to 152 undergraduate participants, who also completed measures of hopelessness, depression, and suicidal ideation. Three kinds of self-discrepancies were associated with suicidal ideation: actual:ideal, actual:ought, and actual:ideal:future. Covariance structure analyses indicated a best-fitting model suggesting that, actual:ideal and actual:ideal:future self-discrepancies contribute to hopelessness, which in turn contributes to depression and suicidal ideation. The findings suggest that self-discrepancy, as a form of negative self-evaluation, may contribute to an individual's risk for suicidal ideation. Moreover, the findings point to an integration of self-discrepancy theory with hopelessness theory.     

Religiosity,attributional style,and social support as psychosocial buffers for African American and white adolescents' perceived risk for suicide

Psychosocial buffers were evaluated for their relative contributions to adolescents' perceived risk for suicide. A community sample of African American and White adolescents (N = 1,098) rated the likelihood that they would die by suicide and completed standardized measures of depression, hopelessness, intrinsic and extrinsic religiosity, orthodoxy, social support, and causal attributional style. Orthodoxy-commitment to core beliefs-emerged as the single strongest correlate after controlling for the effects of other buffers. The effect of depression on perceived suicide risk was moderated by the adolescent's degree of orthodoxy. Commitment to core, life-saving beliefs may help explain the religion-suicide link for adolescents.     

Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: multiple pathways to self-injurious thinking

In order to advance the detection and prevention of suicide, recent research has focused on predictors of suicidal ideation and behavior such as negative cognitive styles, dysfunctional attitudes, hopelessness, and rumination. In this study the relationships among these risk factors in the context of the Attention Mediated Hopelessness (AMH) theory of depression are examined. One hundred and twenty-seven undergraduates in the Cognitive Vulnerability to Depression (CVD) project were followed for 2.5 years. The CVD project followed initially nondepressed freshmen, at either high or low cognitive risk for depression, in order to predict onsets and recurrences of depressive disorders. The presence and duration of suicidal ideation were predicted prospectively by rumination and hopelessness, and hopelessness partially mediated the relationship between rumination and ideation and fully mediated the association between rumination and duration of suicidality. Further, rumination mediated the relationship between cognitive vulnerability and suicidal ideation.     

Naturalistic evaluation of suicidal ideation: variability and relation to attempt status

Suicidal ideation has been thought to have a relatively stable course across weeks and months. However, daily changes in levels of ideation have not been adequately examined despite the importance of potential variability clinically and conceptually. For example, it has been suggested that variability in suicidal ideation may become less closely tied to variability in other mood symptoms (e.g., depression, hopelessness) among individuals with multiple suicide attempts. The present report had two related goals: (1) to prospectively evaluate suicidal ideation and related mood symptoms, and (2) to determine whether suicide attempt status predicted a decreased association between ideation and other mood symptoms. Non-clinical participants (N=108) with varying levels of suicidal ideation and number of previous suicide attempts completed the beck hopelessness scale (BHS), beck depression inventory (BDI), and suicide probability scale (SPS) every day for 4 weeks. Findings suggested considerable variability in suicidal ideation, especially for multiple attempters. Multiple attempt status predicted a decreased association between suicidal ideation and depression, although the results were only marginally significant. These findings have implications for conceptual models of suicide risk as well as assessment and treatment of suicidal individuals.