FACTORES ASOCIADOS A LA FALTA DE ESPERANZA

International Journal of Social
Psychiatry
http://isp.sagepub.com

Ftors Associated with Hopelessness: A Population Study
Kaisa Haatainen, Antti Tanskanen, Jari Kylmaä, Kirsi Honkalampi, Heli Koivumaa-Honkanen,
Jukka Hintikka and Heimo Viinamaki
International Journal of Social Psychiatry 2004; 50; 142
DOI: 10.1177/0020764004040961

The online version of this article can be found at:
http://isp.sagepub.com/cgi/content/abstract/50/2/142

Published by:

http://www.sagepublications.com

Additional services and information for International Journal of Social Psychiatry can be found at:

Email Alerts: http://isp.sagepub.com/cgi/alerts

Subscriptions: http://isp.sagepub.com/subscriptions

Reprints: http://www.sagepub.com/journalsReprints.nav

Permissions: http://www.sagepub.com/journalsPermissions.nav

Citations (this article cites 32 articles hosted on the
SAGE Journals Online and HighWire Press platforms):
http://isp.sagepub.com/cgi/content/refs/50/2/142

Downloaded from http://isp.sagepub.com at UNIV NACIONAL DE COLOMBIA on July 30, 2008
© 2004 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.

FACTORS ASSOCIATED WITH HOPELESSNESS:
A POPULATION STUDY

¨
KAISA HAATAINEN, ANTTI TANSKANEN, JARI KYLMA,
KIRSI HONKALAMPI, HELI KOIVUMAA-HONKANEN, JUKKA HINTIKKA
¨
& HEIMO VIINAMAKI

ABSTRACT
Background: Hopelessness is associated with depression and suicidality in
clinical as well as in non-clinical populations. However, data on the prevalence
of hopelessness and the associated factors in general population are exiguous.
Aims: To assess the prevalence and the associated factors of hopelessness in a
general population sample.
Methods: The random population sample consisted of 1722 subjects. The study
questionnaires included the Beck Hopelessness Scale (HS), Beck Depression
Inventory (BDI), Toronto Alexithymia Scale (TAS-20) and Life Satisfaction Scale
(LS).
Results: Eleven percent of the subjects reported at least moderate hopeless-
ness. A poor financial situation (OR 3.64), poor subjective health (OR 2.87) and
reduced working ability (OR 2.67) independently associated with hopelessness.
Moreover, the likelihood of moderate or severe hopelessness was significantly
increased in subjects dissatisfied with life (OR 5.99), with depression (OR
4.86), with alexithymia (OR 2.37) and with suicidal ideation (OR 1.85).
Conclusions: This study demonstrated a moderately high prevalence of hope-
lessness at the population level. Hopelessness appears to be an important indi-
cator of low subjective well-being in the general population that health care
personnel should pay attention to.

Key words: hopelessness, population, risk

INTRODUCTION

In earlier studies, hopelessness has been found to be associated with depression (Beck et al.,
1988b; Prezant & Neimeyer, 1988; Whisman et al., 1995; Nimeus et al., 1997), suicidality
(Suominen et al., 1997; Malone et al., 2000; O’Connor et al., 2000) and physical sickness
(Everson et al., 1997; Swindells et al., 1999). Furthermore, in non-clinical samples it has
been shown to be a predictor of depression (Rholes et al., 1985; Alford et al., 1995), and in
clinical populations a predictor of long-term suicidality (Beck et al., 1985, 1990; Fawcett et
al., 1987; Young et al., 1996).
International Journal of Social Psychiatry. Copyright & 2004 Sage Publications (London, Thousand Oaks and
New Delhi) www.sagepublications.com Vol 50(2): 142–152. DOI: 10.1177/0020764004040961


HAATAINEN ET AL.: FACTORS ASSOCIATED WITH HOPELESSNESS 143

In general, baseline hopelessness, even without clinically verified depression, may predict a
future suicide attempt (Young et al., 1996). When persons prone to hopelessness become
depressed, they experience higher levels of suicidal intent than do other depressed patients
(Beck et al., 1985). There is also evidence that hopelessness might even be a more important
risk factor for suicidality than depression (Kovacs et al., 1975; Beck et al., 1985, 1990, 1993;
Salter & Platt, 1990). However, it should be noted that not all depressed patients are hopeless
(Greene, 1989; Cannon et al., 1999), and hopelessness is not always a predictor of suicidal
intent, either (Mendonca & Holden, 1996; Nimeus et al., 1997).
At the population level, data on hopelessness among adult subjects are limited. To our
knowledge, few studies have been carried out in community-based population samples
(Tanaka et al., 1996; Pillay & Sargent, 1999), and only a single study in a general population
(Greene, 1981). According to this, hopelessness was associated with low socio-economic
status and increasing age. However, this study was conducted as long as two decades ago,
and its sample size (N ¼ 400), as well as the number of risk factors studied were relatively
small.
The purpose of our study was to assess the prevalence and the mean level of hopelessness
and to identify associated factors in a random sample of the Finnish population. Sociodemo-
graphic background variables and psychiatric symptom scales were used to study these
relationships.

MATERIAL AND METHODS

Study population
The study was conducted in the district of Kuopio, which is located in the central-eastern
part of Finland. Our population sample included 2945 subjects living in that area, aged
25–64 years, randomly selected from the National Population Register. Study questionnaires
were mailed in May–June 1999. A total of 1767 questionnaires were returned. Due to incom-
plete data, 45 subjects were excluded from the analysis. Thus, the final sample (n ¼ 1722)
included 735 (43%) men and 987 (57%) women, giving a response rate of 58.5%. The mean
age of the responding subjects was 45.9 (SD ¼ 10:5) years; men were older than women
(46.7, SD ¼ 10:1 years vs. 45.3, SD ¼ 10:7 years, p ¼ 0:008). The subjects were mainly
married or cohabiting (73.0%), were living in an urban area (74.4%) and were white-collar
workers (75.4%). The complete study design has been described in detail elsewhere (Honka-
lampi et al., 2001). Approval for the study was obtained from the Ethics Committee of
Kuopio University Hospital and the University of Kuopio.

Hopelessness
The level of hopelessness was assessed by using the Beck Hopelessness Scale (HS), which is a
20-item, self-administered rating scale designed to measure an adult’s negative expectancies
concerning oneself and one’s future life. The Hopelessness Scale is based on three dimensions
of hopelessness: affective (e.g. lack of hope), motivational (giving up) and cognitive (lack of
future expectations) (Beck et al., 1974). The total score of HS ranges from 0 to 20, and the
level of hopelessness increases with increasing scores. If a response was missing for one or


144 INTERNATIONAL JOURNAL OF SOCIAL PSYCHIATRY 50(2)

two items, the missing item was replaced with an arithmetic mean, while in the case of more
missing items the scale was regarded as incomplete data.
Based on the original cut-off points, the subjects were classified into four groups: no hope-
lessness at all (scores 0–3), mild hopelessness (scores 4–8), moderate hopelessness (scores
9–14) and severe hopelessness (scores 15–20) (Beck & Steer, 1988). The alpha reliability coeffi-
cient (Cronbach’s alpha) for the scale was 0.87 in our study.

Depression
Depression was assessed using the 21-item Beck Depression Inventory (BDI) (Beck et al.,
1961). The items of BDI contain four statements each, and reflect the intensity of a particular
depressive symptom. If a response was missing for one or two items, the missing item was
replaced with an arithmetic mean, while in the case of more missing items the scale was
regarded as incomplete data.
BDI was used as a continuous variable or as a class variable with four groups and the fol-
lowing cut-off scores: no depression (scores <10), mild depression (scores 10–18), moderate
depression (scores 19–29) and severe depression (scores 30–63) (Beck et al., 1988a). In the
multiple logistic regression analysis the BDI scores were dichotomised (depressive: scores
5 10 vs. not depressive: scores <10). Cronbach’s alpha was 0.91.

Suicidal ideation
Suicidal ideation refers to cognitions that can vary from transient thoughts about worthless-
ness of life and death wishes to concrete plans for killing oneself and obsessive preoccupation
with self-destruction (Diekstra & Garnefski, 1995). The BDI suicidality item (item 9) can be
used in screening for suicidal ideation (Hintikka et al., 2001).
In this study, the answer alternatives (1) ‘I have thoughts of harming myself but I would
not carry them out’, (2) ‘I feel I would be better off dead’ and (3) ‘I would kill myself if I
could’ indicated the presence of suicidal ideation, and the answer alternative (0) ‘I don’t
have any thoughts of harming myself ’ the absence of it. Item 9 was not included in the
total score of BDI in the multivariate analysis to avoid overlapping of suicidality item in
BDI and suicidal ideation.

Life satisfaction
Life satisfaction was estimated by means of a four-item scale (Koivumaa-Honkanen et al.,
2000). The scale comprised the following questions: (1) ‘Do you feel that your life at present
is very interesting (score 1), fairly interesting (score 2), fairly boring (score 4) or very boring
(score 5)?’ (2) ‘Do you feel that your life at present is very happy (score 1), fairly happy (score
2), fairly unhappy (score 4) or very unhappy (score 5)?’ (3) ‘Do you feel that your life at
present is very easy (score 1), fairly easy (score 2), fairly hard (score 4) or very hard (score
5)?’ (4) ‘Do you feel that at the present moment you are very lonely (score 5), fairly lonely
(score 4) or not at all lonely (score 1)?’ The item responses ‘cannot say’ as well as missing
data were scored as 3 in every question. Thus, the range of the sum score for life satisfaction
was 4–20, with increasing values indicating a decrease in life satisfaction.
Total score was used to classify the subjects into the satisfied (scores 4–6), the slightly dis-
satisfied (scores 7–11) and the dissatisfied (scores 12–20) (Koivumaa-Honkanen et al., 2000).



In the multiple logistic regression analysis life satisfaction was categorised into two classes
(dissatisfied with life: scores 12–20 vs. others: scores 4–11). Cronbach’s alpha was 0.77.

Alexithymia
The prevalence of alexithymia was screened using the Finnish version (Joukamaa et al., 2001)
of the 20-item Toronto Alexithymia Scale (TAS-20) (Bagby et al., 1994a, 1994b). TAS-20
consists of three sub-factors: (1) difficulty in identifying feelings and distinguishing them
from bodily sensations of emotions; (2) difficulty in describing feelings to others; and (3)
an externally oriented style of thinking (Bagby et al., 1994a, 1994b). Each item was rated
on a five-point Likert scale, with total scores ranging from 20 to 100. If a response was miss-
ing for one or two items, the missing item was replaced with an arithmetic mean, while in the
case of more missing items the scale was regarded as incomplete data.
The total scores of the TAS-20 were categorised according to the recommendations of
Bagby and Taylor (1997); thus a score 5 61 indicated alexithymia, and 4 51 no alexithymia.
Subjects with a TAS-20 score between 52 and 60 were categorised into the intermediate group
(Honkalampi et al., 2001). In the multiple logistic regression analysis alexithymia was cate-
gorised into two classes (alexithymic: scores 5 61 vs. others: scores 20–60). Cronbach’s
alpha was 0.86.

Background characteristics
The subjects reported data on the following factors of their sociodemographic back-
ground (classification in parentheses): marital status (married ¼ 1; single, divorced or
widowed ¼ 0); years of education (high i.e. 5 9 ¼ 0; low i.e. <9 years ¼ 1); subjective eva-
luation of working ability (good ¼ 0; reduced or unable to work ¼ 1); place of residence
(urban ¼ 0; rural ¼ 1); subjective evaluation of financial situation (good or fairly good =
0; fairly poor or poor ¼ 1); and subjective evaluation of general health (good or fairly
good ¼ 0; fairly poor or poor ¼ 1).

Statistical analysis
Subjects with moderate or severe hopelessness (HS score of 5 9; n ¼ 193) were compared
with the others (HS score < 9; n ¼ 1529). The statistical methods used included Pearson’s
chi-squared test for categorical variables, the independent-samples t-test, Pearson’s two-
tailed correlation analysis, analysis of variance for continuous variables and multiple logistic
regression analysis (method: enter) to identify factors independently associated with hope-
lessness (HS score 5 9). Data analysis was conducted with SPSS 10.0. All statistical tests
were two-tailed.

RESULTS

A total of 149 subjects (8.7%) reported moderate and 44 subjects (2.6%) severe hopelessness.
The mean score on the Hopelessness Scale was 3.9 (SD ¼ 3:6, ranging from 0 to 20;
n ¼ 1722). The prevalence of hopelessness according to gender and age is shown in Table 1.



Table 1
Prevalence (%) of hopelessness according to gender and age in a general population sample (N ¼ 1722) of
eastern Finland

Level of Mena Womenb
hopelessness Age group (years) Age group (years)
(HS scores)
25–34 35–44 45–54 55–64 Total 25–34 35–44 45–54 55–64 Total

Not at all (0–3) 76 68 60 51 62 73 64 58 41 59
Mild (4–8) 16 21 27 35 26 21 25 33 43 31
Moderate (9–14) 7 8 10 11 9 5 7 7 14 8
Severe (15–20) 1 3 3 3 3 1 5 2 2 2
(N) (106) (190) (260) (179) (735) (195) (263) (307) (222) (987)
a
Linear-by-linear association between levels of hopelessness and age groups, 2 ¼ 13:84, d:f: ¼ 1, p 0:0005
b
Linear-by-linear association between levels of hopelessness and age groups, 2 ¼ 30:97, d:f: ¼ 1, p 0:0005

There was a trend of increasing prevalence of hopelessness with age. Among women, those
who reported moderate or severe hopelessness were significantly older than the others
(48.2, SD ¼ 10:1 years vs. 45.0, SD ¼ 10:7 years, t ¼ 2:947, d:f: ¼ 985, p ¼ 0:003). In men,
the difference did not reach statistical significance (48.5, SD ¼ 9:3 years vs. 46.5, SD ¼
10.2 years, t ¼ 1:785, d:f: ¼ 733, p ¼ 0:075).
Reduced working ability (subjective evaluation), a poor financial situation (subjective
evaluation) and poor subjective health (subjective evaluation) were significantly associated
with hopelessness among all subjects. Hopelessness was significantly associated with being
single, divorced or widowed in men and with low education in women. Place of residence
did not have any association with hopelessness (Table 2).
The prevalence of hopelessness increased with increasing severity of depression. Moderate
or severe hopelessness was found in 88.0% of the subjects with severe depression. Further-
more, subjects with suicidal ideation, with dissatisfaction with life or with alexithymia had
an increased prevalence of moderate to severe hopelessness (Table 3).
All the background factors from Tables 1 and 2 that were found to be significantly asso-
ciated with hopelessness were chosen as covariates in the multiple logistic regression
model. The risk of at least moderate hopelessness was significantly increased in subjects with
a poor financial situation, with poor subjective health and with a reduced working ability
compared with the respective reference groups (Table 4, model A).
Even though intercorrelations between satisfaction with life, depression, alexithymia and
suicidality were rather high (from 0.27 to 0.69), these psychiatric factors were deliberately
forced into the same multiple logistic regression model. In this model all the factors were inde-
pendently associated with hopelessness (dissatisfaction with life OR 5.99, 95% CI 3.78–9.49;
depression OR 4.86, 95% CI 2.95–8.02; alexithymia OR 2.37, 95% CI 1.46–3.84; suicidal
ideation OR 1.85, 95% CI 1.13–3.03) after adjusting for covariates shown in Table 4,
model B. In addition, poor subjective health maintained its association with hopelessness
while the other factors did not.



Table 2
Prevalence (%) of hopelessness (HS-score 5 9) in relation to gender and other sociodemographic factors in a
general population sample of eastern Finland

Men Women Total
(N ¼ 735) (N ¼ 987) (N ¼ 1722)

Marital status
Married or cohabiting 9.8 9.7 9.7
Single, divorced or widowed 19.5 12.9 15.3
( p ¼ 0:001Þ ( p ¼ 0:144Þ ( p ¼ 0:002Þ

Education
5 9 years 10.8 9.2 9.8
9 years 16.7 18.6 17.6
( p ¼ 0:059Þ ( p ¼ 0:003Þ ( p 0:0005Þ

Subjective evaluation of working ability
Good 5.5 5.4 5.4
Reduced or unable to work 22.6 20.8 21.6
( p 0:0005Þ ( p 0:0005Þ ( p 0:0005Þ

Place of residence
Urban 11.2 10.5 10.8
Rural 14.2 11.0 12.4
( p ¼ 0:252Þ ( p ¼ 0:812Þ ( p ¼ 0:337Þ

Subjective evaluation of financial situation
Good or fairly good 6.3 7.5 7.0
Fairly poor or poor 32.5 25.3 28.8
( p 0:0005Þ ( p 0:0005Þ ( p 0:0005Þ

Subjective evaluation of general health
Good or fairly good 7.5 7.4 7.5
Fairly poor or poor 38.7 35.4 37.0
( p 0:0005Þ ( p 0:0005Þ ( p 0:0005Þ

DISCUSSION

Our results give new information about factors associated with hopelessness in a general
population. This information may help health care personnel to recognise hopelessness
more effectively than earlier. Our study demonstrates three notable factors significantly asso-
ciated with hopelessness. We found that the likelihood of moderate to severe hopelessness
was about three-and-a-half-fold higher when the financial situation was poor, nearly three-
fold higher when subjective health was poor and about two-and-a-half-fold higher when
working ability was reduced. In contrast to the previous findings of Greene (1981), the posi-
tive relationship between hopelessness and increasing age was not observed in our study in the
multivariate model.
Further, life dissatisfaction, depressive symptoms, alexithymia and suicidal ideation
proved to be the most potent factors associated with moderate to severe hopelessness. All
these symptom scales measure separate aspects of one’s well-being. Moreover, as all these



Table 3
Prevalence (%) of hopelessness (HS-score 5 9) in relation to depression, suicidal ideation, life satisfaction and
alexithymia in a general population sample of eastern Finland

Men Women Total
(N ¼ 735) (N ¼ 987) (N ¼ 1722)

Depression (BDI scores)
None (0–9) 3.4 2.9 3.1
Mild (10–18) 38.5 24.2 30.4
Moderate (19–29) 70.4 65.1 66.7
Severe (30–63) 92.3 83.3 88.0
( p 0:0005Þ ( p 0:0005Þ ( p 0:0005Þ

Suicidal ideation (BDI-item 9)
No 6.9 7.6 7.3
Yes 40.7 43.5 42.0
( p 0:0005Þ ( p 0:0005Þ ( p 0:0005Þ

Life satisfaction (LS scores)
Satisfied (4–6) 1.1 0.4 0.7
Slightly dissatisfied (7–11) 4.3 6.3 5.5
Very dissatisfied (12–20) 51.9 45.0 48.2
( p 0:0005Þ ( p 0:0005Þ ( p 0:0005Þ

Alexithymia (TAS-20 scores)
Non-alexithymic ( 4 51) 4.4 4.7 4.6
Intermediate group (52–60) 19.3 22.0 20.5
Alexithymic ( 5 61) 43.0 51.9 47.3
( p 0:0005Þ ( p 0:0005Þ ( p 0:0005Þ

psychiatric factors at the same time were significantly associated with hopelessness, hopeless-
ness could be viewed as a cluster of different clinical manifestations, and accordingly a useful
indicator of low subjective well-being. Among sociodemographic factors, poor subjective
general health only remained significantly associated with hopelessness as examining socio-
demographic and psychiatric factors concurrently. To our knowledge, none of the previous
studies has in a general population explored the relationship between hopelessness and
reports of life satisfaction, depressive symptoms, alexithymia and suicidal ideation.
This study shows reliable prevalence rates of hopelessness in a general population. In our
study, the prevalence of moderate to severe hopelessness was close to the figure of 11.5%
reported by Greene (1981). Nevertheless, due to methodological differences, caution is
needed in comparing the results of these studies. In Greene’s study, the cut-off point was
two points higher than the original one reported by Beck and Steer (1988), which was used
in our study. Thus, we can prudently assume that the prevalence of hopelessness in Ireland
in the 1980s was higher than that in Finland at the end of the 1990s. The mean score of hope-
lessness in our sample was also slightly lower than that of Irish people (3.9 vs. 4.5) (Greene,
1981). In addition to the different points in time of the two studies, the results might also
reflect cultural differences between Finland and Ireland. Moreover, the sample size in
Greene’s study was relatively small.


HAATAINEN ET AL.: FACTORS ASSOCIATED WITH HOPELESSNESS

Table 4

Risk factors for hopelessness ( 5 9 scores) in multiple logistic regression models of a general population sample of eastern Finland

Model A Model B
Variables Wald Odds 95% CI a p-value Wald Odds 95% CI a p-value
ratio ratio

Poor ﬁnancial situation (subjective) 51.21 3.64 2.56–5.19 0.0005 2.04 1.39 0.89–2.17 ÀNS
Poor general health (subjective) 23.52 2.87 1.88–4.40 0.0005 4.38 1.76 1.04–2.97 À0.036
Reduced working ability (subjective) 18.81 2.67 1.71–4.17 0.0005 1.57 1.41 0.83–2.40 ÀNS
Single, divorced or widowed 2.87 1.36 0.95–1.93 0.090 0.00 1.00 0.65–1.54 ÀNS
Age (years) 0.34 0.99 0.98–1.01 0.562 0.16 1.00 0.97–1.02 ÀNS
Low education 0.12 1.08 0.69–1.69 0.728 2.36 1.52 0.89–2.58 ÀNS
Male gender 0.00 1.01 0.72–1.40 0.970 0.01 0.98 0.65–1.49 ÀNS

Life dissatisfaction (LS scores 12–20) 58.21 5.99 3.78–9.49 0.0005
Depression (BDI scores 5 10) 38.37 4.86 2.95–8.02 0.0005
Alexithymia (TAS scores 5 61) 12.32 2.37 1.46–3.84 0.0005
Suicidal ideation (BDI item 9) 6.04 1.85 1.13–3.03 À0.014
a
CI ¼ Conﬁdence interval

149


The Beck Hopelessness Scale is occasionally considered to be less reliable for samples in
which the level of hopelessness is expected to be low than it is for psychiatric patients
(Durham, 1982; Young et al., 1992). We have explicit arguments to oppose this view. The
alpha reliability coefficient in our study was high, our sample size was the largest of its
kind and the age range of the random population sample covered the entire period of adult-
hood. The response rate in our study was satisfactory as we are dealing with a postal survey,
and we suggest that our results give a reasonable estimate of the level of hopelessness and the
factors associated with it in an adult population.
We did not conduct any interviews, which can be conceived as a limitation. However, as we
were particularly interested in subjective approximations, we used self-report methods (HS,
BDI, LS and TAS-20) and subjective assessments of health, working ability and financial
situation. On the other hand, as the subjects responded anonymously, we have no reason
to doubt that self-report assessments have been confounded by social desirability that has
widely been debated in several studies (Linehan Nielsen, 1981, 1983; Holden et al., 1989;
Ivanoff Jang, 1991).
The information a cross-sectional study gives may be limited, since hopelessness may be
dynamic, not static (Abramson et al., 1989; Beck et al., 1990; Young et al., 1996). Whether
hopelessness is more temporary than stable when a general population is under examination
should be studied further. In conclusion, the present study broadens the picture of hopeless-
ness and the factors associated with it. Hopelessness can be profiled as an important indicator
of low subjective well-being in the general population that should be recognised in everyday
mental health work. Thus, as we will be facing subjects with a poor financial situation, poor
subjective health or reduced working ability, we are due to be aware of the possibility of
hopelessness.

REFERENCES

ABRAMSON, L.Y., METALSKY, G.I. ALLOY, L.B. (1989) Hopelessness depression: a theory-based sub-
type of depression. Psychological Review, 96, 358–372.
ALFORD, B.A., LESTER, J.M., PATEL, R.J., BUCHANAN, J.P. GIUNTA, L.C. (1995) Hopelessness
predicts future depressive symptoms: a prospective analysis of cognitive vulnerability and cognitive
content specificity. Journal of Clinical Psychology, 51, 331–339.
BAGBY, R.M. TAYLOR, G.J. (1997) Measurement and validation of the alexithymia construct. In
Disorders of Affect Regulation. Alexithymia in Medical and Psychiatric Illness (ed. G.J. Taylor,
R.M. Bagby J.D.A. Parker). Cambridge: Cambridge University Press.
BAGBY, R.M., PARKER, J.D.A. TAYLOR, G.J. (1994a) The twenty-item Toronto Alexithymia Scale – I.
Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32.
BAGBY, R.M., TAYLOR, G.J. PARKER, J.D.A. (1994b) The twenty-item Toronto Alexithymia Scale –
II. Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 33–40.
BECK, A.T. STEER, R.A. (1988) Manual for the Beck Hopelessness Scale. San Antonio, TX: Psychological
Corp.
BECK, A.T., STEER, R.A. GARBIN, M.G. (1988a) Psychometric properties of the Beck Depression Inven-
tory: twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.
BECK, A.T., RISKIND, J.H., BROWN, G. STEER, R.A. (1988b) Levels of hopelessness in DSM-III
disorders: a partial test of content specificity in depression. Cognitive Therapy and Research, 12, 459–469.
BECK, A.T., STEER, R.A., BECK, J.S. NEWMAN, C.F. (1993) Hopelessness, depression, suicidal
ideation, and clinical diagnosis of depression. Suicide and Life-Threatening Behavior, 23, 139–145.



BECK, A.T., STEER, R.A., KOVACS, M. GARRISON, B. (1985) Hopelessness and eventual suicide:
a 10-year prospective study of patients hospitalized with suicidal ideation. American Journal of Psychiatry,
142, 559–563.
BECK, A.T., WEISSMAN, A., LESTER, D. TREXLER, L. (1974) The measurement of pessimism: the
Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42, 861–865.
BECK, A.T., BROWN, G., BERCHICK, R.J., STEWART, B.L. STEER, R.A. (1990) Relationship
between hopelessness and ultimate suicide: a replication with psychiatric outpatients. American Journal
of Psychiatry, 147, 190–195.
BECK, A.T., WARD, C.H., MENDELSON, M., MOCK, J. ERBAUGH, J. (1961) An inventory for
measuring depression. Archives of General Psychiatry, 4, 561–571.
CANNON, B., MULROY, R., OTTO, M.W., ROSENBAUM, J.F., FAVA, M. NIERENBERG, A.A.
(1999) Dysfunctional attitudes and poor problem solving skills predict hopelessness in major depression.
Journal of Affective Disorders, 55, 45–49.
DIEKSTRA, R.F.W. GARNEFSKI, N. (1995) On the nature, magnitude, and causality of suicidal beha-
viors: an international perspective. Suicide and Life-Threatening Behavior, 25, 36–57.
DURHAM, T.W. (1982) Norms, reliability, and item analysis of the hopelessness scale in general psychiatric,
forensic psychiatric, and college populations. Journal of Clinical Psychology, 38, 597–600.
EVERSON, S.A., KAPLAN, G.A., GOLDBERG, D.E., SALONEN, R. SALONEN, J.T. (1997) Hopeless-
ness and 4-year progression of carotid atherosclerosis. The Kuopio Ischemic Heart Disease Risk Factory
Study. Arteriosclerosis, Thrombosis, and Vascular Biology, 17, 1490–1495.
FAWCETT, J., SCHEFTNER, W., CLARK, D., HEDEKER, D., GIBBONS, R. CORYELL, W. (1987)
Clinical predictors of suicide in patients with major affective disorders: a controlled prospective study.
American Journal of Psychiatry, 144, 35–40.
GREENE, S.M. (1981) Levels of measured hopelessness in the general population. British Journal of Clinical
Psychology, 20, 11–14.
GREENE, S.M. (1989) The relationship between depression and hopelessness: implications for current
theories of depression. British Journal of Psychiatry, 154, 650–659.
HINTIKKA, J., PESONEN, T., SAARINEN, P., TANSKANEN, A., LEHTONEN, J. VIINAMAKI, H. ¨
(2001) Suicidal ideation in the Finnish general population: a 12-month follow-up study. Social Psychiatry
and Psychiatric Epidemiology, 36, 590–594.
HOLDEN, R.R., MENDONCA, J.D. SERIN, R.C. (1989) Suicide, hopelessness, and social desirability: a
test of an interactive model. Journal of Consulting and Clinical Psychology, 57, 500–504.
HONKALAMPI, K., KOIVUMAA-HONKANEN, H., TANSKANEN, A., HINTIKKA, J., LEHTONEN, J.
¨
VIINAMAKI, H. (2001) Why do alexithymic features appear to be stable? A 12-month follow-up study
of a general population. Psychotherapy and Psychosomatics, 70, 247–253.
IVANOFF, A. JANG, S.J. (1991) The role of hopelessness and social desirability in predicting suicidal
behavior: a study of prison inmates. Journal of Consulting and Clinical Psychology, 59, 394–399.
JOUKAMAA, M., MIETTUNEN, J., KOKKONEN, P., KOSKINEN, M., JULKUNEN, J.,
¨ ¨
KAUHANEN, J., JOKELAINEN, J., VEIJOLA, J., LAKSY, K. JARVELIN, M.-R. (2001) Psycho-
metric properties of the Finnish 20-item Toronto Alexithymia Scale. Nordic Journal of Psychiatry, 55, 123–
127.
¨
KOIVUMAA-HONKANEN, H., HONKANEN, R., VIINAMAKI, H., HEIKKILA, K., KAPRIO, J. ¨
KOSKENVUO, M. (2000) Self-reported life satisfaction and 20-year mortality in healthy Finnish adults.
American Journal of Epidemiology, 152, 983–991.
KOVACS, M., BECK, A.T. WEISSMAN, A. (1975) Hopelessness: an indicator of suicidal risk. Suicide, 5,
98–103.
LINEHAN, M.M. NIELSEN, S.L. (1981) Assessment of suicide ideation and parasuicide: hopelessness and
social desirability. Journal of Consulting and Clinical Psychology, 49, 773–775.
LINEHAN, M.M. NIELSEN, S.L. (1983) Social desirability: its relevance to the measurement of hopeless-
ness and suicidal behavior. Journal of Consulting and Clinical Psychology, 51, 141–143.
MALONE, K.M., OQUENDO, M.A., HAAS, G.L., ELLIS, S.P., LI, S. MANN, J.J. (2000) Protective
factors against suicidal acts in major depression: reasons for living. American Journal of Psychiatry,
157, 1084–1088.
MENDONCA, J.D. HOLDEN, R.R. (1996) Are all suicidal ideas closely linked to hopelessness? Acta
Psychiatrica Scandinavica, 93, 246–251.
NIMEUS, A., TRASKMAN-BENDZ, L. ALSEN, M. (1997) Hopelessness and suicidal behavior. Journal
of Affective Disorders, 42, 137–144.



O’CONNOR, R.C., CONNERY, H. CHEYNE, W.M. (2000) Hopelessness: the role of depression, future
directed thinking and cognitive vulnerability. Psychology, Health and Medicine, 5, 155–161.
PILLAY, A.L. SARGENT, C.-A. (1999) Relationship of age and education with anxiety, depression, and
hopelessness in a South African community sample. Perceptual and Motor Skills, 89, 881–884.
PREZANT, D.W. NEIMEYER, R.A. (1988) Cognitive predictors of depression and suicide ideation.
Suicide and Life-Threatening Behavior, 18, 259–264.
RHOLES, W.S., RISKIND, J.H. NEVILLE, B. (1985) The relationship of cognitions and hopelessness to
depression and anxiety. Social Cognition, 3, 36–50.
SALTER, D. PLATT, S. (1990) Suicidal intent, hopelessness and depression in a parasuicide population: the
influence of social desirability and elapsed time. British Journal of Psychiatry, 29, 361–371.
¨ ¨
SUOMINEN, K., ISOMETSA, E., HENRIKSSON, M., OSTAMO, A. LONNQVIST, J. (1997) Hopeless-
ness, impulsiveness and intent among suicide attempters with major depression, alcohol dependence, or
both. Acta Psychiatrica Scandinavica, 96, 142–149.
SWINDELLS, S., MOHR, J., JUSTIS, J.C., BERMAN, S., SQUIER, C., WAGENER, M.M. SINGH, N.
(1999) Quality of life in patients with human immunodeficiency virus infection: impact of social support,
coping style and hopelessness. International Journal of STD and AIDS, 10, 383–391.
TANAKA, E., SAKAMOTO, S., ONO, Y., FUJIHARA, S. KITAMURA, T. (1996) Hopelessness in a
community population in Japan. Journal of Clinical Psychology, 52, 609–615.
WHISMAN, M.A., MILLER, I.W., NORMAN, W.H. KEITNER, G.I. (1995) Hopelessness depression in
depressed inpatients: symptomatology, patient characteristics, and outcome. Cognitive Therapy and
Research, 19, 377–398.
YOUNG, M.A., HALPER, I.S., CLARK, D.C., SCHEFTNER, W. FAWCETT, J. (1992) An item-
response theory evaluation of the Beck Hopelessness Scale. Cognitive Therapy and Research, 16, 579–587.
YOUNG, M.A., FOGG, L.F., SCHEFTNER, W., FAWCETT, J., AKISKAL, H. MASER, J. (1996)
Stable trait components of hopelessness: baseline and sensitivity to depression. Journal of Abnormal
Psychology, 105, 155–165.

Kaisa Haatainen, MHSc, researcher, Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
Antti Tanskanen, MD, senior lecturer, Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
Jari Kylma, PhD, senior lecturer, Department of Nursing Science, University of Kuopio, Kuopio, Finland.
¨
Kirsi Honkalampi, PhD, senior researcher, Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
Heli Koivumaa-Honkanen, MD, senior lecturer, Department of Psychiatry, Kuopio University Hospital, Kuopio,
Finland.
Jukka Hintikka, MD, senior lecturer, Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
Heimo Viinamaki, MD, professor, Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
¨
Correspondence to Kaisa Haatainen, MHSc, Research and Development Unit 4977, Department of Psychiatry,
Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland.
Email: kaisa.haatainen@kuh.fi


FACTORES ASOCIADOS A LA FALTA DE ESPERANZA

Recommended

Recommended

More Related Content

What's hot

What's hot (19)

Similar to FACTORES ASOCIADOS A LA FALTA DE ESPERANZA

Similar to FACTORES ASOCIADOS A LA FALTA DE ESPERANZA (20)

More from Kaierleiki

More from Kaierleiki (18)

Recently uploaded

Recently uploaded (20)

FACTORES ASOCIADOS A LA FALTA DE ESPERANZA