what is beck hopeless scale?

 Back hopelessness Scale

INTRODUCTION
Background and development
The back hopelessness scale(BHS; Beck’ weissman, lester, &trexler, 1974) IS A 20 item scale for measuring the extent of negative attitude about the future (pessimism)as perceived by adolescents and adult.

The BHS was originally developed by Aron T. Beck and his associates the center for cognitive theropy (CCT), University of Pennsylvania Medical School, Department of psychiatry, to measure pessimism in psychiatric patients consider tobe suicidal risks, but it has been used subsequently with adolescent and adult normal population.

Hopelessness is a psychological construct that has been observed to underlie a variety of mental health disorder. After reviewing the literature on the hopelessness construct. 

Stotland (1969) concluded that although many cliniciansbelievedthat hopelessness wastoodifuse to be measured systematically, there was sufficient consensus to construct an instrument to evaluate negative attitudes concerning oneself and one’s future Drawing upon nine items from a test of attitudes about the future 

( Heimberg, 1961), Beck and his associate added 11 more items from a pool of pessimistic statements about the future which were collected from psychiatric patients who had described hopeless cognitions. The statements were selected to reflect a board spectrum of negative attitudes about future which were frequently mentioned by patients.

(1973) the 20 statements were then administer to a random sample of depressed and no depressedpatients. The patients had been told about the purpose of the test, and were asked to evaluate the relevance and clarity of each statement. The statements were then reviewed by several clinicians for face validity and comprehensibility before being pilot test as ashcake called the generalized expectancy scale. 

For several years the gas was employed to measure hopelessness in suicide attempts and patients describing suicidal ideation.

In (Beck et al., 1974) the wording of some of the statements was changed slightly and the present form of the BHS was established.
Stotland’s (1969) The BHS 

Stotland’s (1969)The BHS adheres closely to conception of hopelessness as a system of cognitive schemas in which the common denominator is negative expectancy about the shot and long term future.

Hopelessness individual believes
1. That nothing will turn out right from them 
2. That they will never succeed at what they attempt to do 
3. That their important goal can never be obtained 
4. That their worst problem can never be solved

This definition of hopelessness corresponds to the third component of the negative tried in Beck’s (1967) cognitive model of depression: consisting of: 
1. A negative view of the self 
2. A negative view of present functioning 
3. A negative view of the future.

Psychometric Characteristics
Although studies have addressed the psychometric characteristics of BHS across diverse samples of both psychometrically diagnosed and normal population much of the data has been based on samples not diagnosed according to the diagnostic and statistical manual of mental disorder,3rd ed. Therefore, this manual describes not only published studies, but it also provides additional data on seven normative samples used by CCT in studying the BHS.

Most studies of BHS have been directed at suicidal behaviors, and some have been derived for a long –term prospective study of suicidal behavior which was begun by Beck and his associates at CCT in 1970 and completed in 1982 .Several of the studies describing the psychometric characteristics of the BHS drew uponconsecutive cohorts of patients at suicidal risk who are admitted to the longitudinal study. The psychometric characteristics of BHS for the final samples of 499 suicide attempters and 207 suicide ideatorswho were eventually included in the study are provided.

The psychometrics characteristics of the BHS for the BHS for 211 heroin addicts and 105 alchohlistics drawn from a large community mental health center also are provided. Naddition to these samples ,134 patients with recurrent episode major depression disorders, 72 patients with single episode major depression disorders, and 177 patients with dysthymic disorders wereincluded.Several studies were conducted into the analysis of psychometric properties of BHS (Bouvard, Charles, Guerin, &Aimard 1992; Durak, 1994; Durham, 1982; Hughes &Neimeyer, 1993; Shek, 1993). The psychometric analysis indicated high internal consistency, high reliability and good concurrent validity of the scale (Beck et al., 1974). The internal reliability coefficients were shown to be reasonably high (Pearson r = .82 to .93 in seven norm groups), but the BHS test-retest reliability coefficients are modest (.69 after one week and .66 after six weeks; Aiken, 2002). 

Reliability & Validity
The reliability and validity of BHS was also examined by a Turkish research team in 1994 (Durak, 1994). Durak assessed 373 psychiatric patients and controls between age of 15 and 65. The BHS proved to be a reliable and valid measure in the Turkish sample according to their results. Predictive validity of the BHS was also examined using a longitudinal study design (13-year follow-up) with a community sample of more than 3000 participants (Tanaka, Sakamoto, Ono, Fujihara, & Kitamura, 1998). According to their results hopelessness was an independent risk factor for completed and attempted suicide and suicide ideation. Another follow-up study has also found a high predictive power of BHS (Beevers& Miller, 2004). A recent follow-up research focused on predictors of attempted suicide such as dysfunctional attitudes, hopelessness, rumination and negative cognitive styles (Smith, Alloy, & Abramson, 2006). It was found that the presence and duration of suicidal ideation was predicted prospectively by hopelessness and rumination. Aanalyzing the relationship between hopelessness and suicide attempts, individuals with suicide attempt within one year scored the highest versus those with an earlier attempt. Thus, hopelessness, depression and suicide risk are closely related and assessing hopelessness is an important and essential part of suicide prevention. According to extensive literature data (Kuyken, 2004; Williams, Crane, Barnhofer, & Duggan 2005) hopelessness is a modifiable risk factor that can be diminished by proper psychotherapeutic interventions. BHS is the most well-known scale on hopelessness; several studies support its validity and reliability. It has also been validated in previous studies as a measure of suicidality. In addition, BHS can be filled in and evaluated in a very short time making rapid assessment of suicide risk.

Description and content of the scale
The BHS consist of 20 true- false that assess the extent of negative expectancies about the immediate and long range future. Each o the 20 statements is scored 1 to 0. Of the 20 true false statements, 9 are keyed False, and 11 are keyed True indicate endorsement of pessimism about the future. theitems scores are summed to yield a total sore that can range from 0 to 20 with higher scores indicating greater hopelessness. The 20 statements of the BHS and the corresponding response which indicate hopeless cognition are:

Statementsresponse key for Hopelessness

1. I look forward to the future with hope and enthusiasm. F
2. I mihgt as well as give up because there is nothing I can do T
about making things better for myself.

3. When things are going badly, I mheleped by knowing F 
that they can not stay that way forever.
4. I can’t imagine that my life would be like in 10 years. T
5. I have enough time to accomplish the things I want to do F
6. In the future, I expect to succeed in what concern me most. F
7. My future seems dark to me. T
8. I happen to be particularly lucky, and I expect to get more
of the good things in life than the average person. F
9. I juast can’t get the breaks, and there’s no reason I will in future. T 
10. My past experiences have prepared me well for the future. F
11. All I can see ahead of me is unpleasantness rather than pleasantness. T
12. I don’t expect to get what I really want. T
13. When I look ahead to the future, I expect that I will be 
happier than I am now. F
14. Things just don’t work out the way I want them to. T
15. I have greate future in the future. F
16. I never get what I want, so it’s foolish to want anything. T
17. It’s very unlucky that I will get any real satisfaction in the
Future. T
18. The future seems vague and uncertain to me. T
19. I can look forward to more good than bad times.F
20. There’s no use in really trying to get anything I want 
because I probably won’t get it.T

Administration and scoring
Testing conditions

The testing environment in which the BHS administered must provide sufficient illumination for the reading and be quite enough to allow the patient to concentrate.

Administrating time 

The BHS requires between 5 and 10 minutes to complete when self administered.
Oral administration takes 10 minutes, and extremely obsessive examinee may require 15 minutes.

Self – Administration

The require consist of 20 statements, read the statements very carefully one by one. If state describes your attitude for the past week including today, darken the circle with T indicating TRUE in the column. If the statements does not describes attitude than darken the circle with F indicting FALSE in the column.
Oral administration 
The BHS also may be administered orally, in such cases some instructions are suggested to the examinee.

Response set

Bhs has been roughly balanced between 11 positively and 9 negatively statements with respect to hopelessness, the examiner must be carefully that examinee does not use one type of response for all answers.

Scoring guideline

0 to 3 is minimal range
4 to 8 is mild
9 to 14 is moderate
15 above is severe



Clinical use of the Beck Hopelessness Scale
It was designed to measure three major aspects of hopelessness about the future, loss of motivation, and expectations.
It is designed for adult, age 17 to 80. 
It measures the extent of the respondent’s negative attitudes, or pessimism, about the future. It may be used as an indicator of suicidal risk in depressed people who have made suicide attempts.
It may be administered and scored by paraprofessionals; but must be used and interpreted only by clinically trained professionals, who can employ psychotherapeutic interventions.

Beck Hopelessness Scale As a Lead to Assessing Suicidal Ideation

The beck Hopelessness Scale is a brief, self-report measure that predicts suicide in both inpatient and outpatient psychiatric clients and is one of the most widely used scales for hopelessness.
The BHS has 20 true-false questions assessing positive and negative thought about future over the course of the past week.

As a clue Source and Resolution of a Clinical Impasse

The BHS is available tool which indicates the patient’s condition even though significant improvement in symptoms. By discussing the items on the BHS with the patient, the therapist can then pinpoint some of the particular situational and psychological factors contributing to a therapeutic impasse.