Enhanced measurement sensitivity of hopeless ideation among older adults at risk of self-harm: Reliability and validity of Likert-type responses to the Beck Hopelessness Scale

OBJECTIVE: Responses to the Beck Hopelessness Scale (BHS) have been identified as a significant predictor of suicide-related ideation and self-harm, of note, to a greater degree than severity of depressive symptoms. The BHS is the most widely used instrument to assess this construct, yet concern has been expressed about the traditional true/false response format of this instrument. For this study, we obtained responses from older adults to a revised four-point Likert-type BHS response format. METHOD: A national sample of 117 older Canadians at risk of self-harm was recruited from multiple sources for this study over a one-year period. Most participants were women (65%) with an average age of 68.47 years (SD = 9.02, range 50-92). RESULTS: Exploratory factor analysis suggests the existence of two factors labeled Powerlessness/Disappointment and Negative Future Expectancies. Concurrent validity of this two-factor model of BHS responses is provided vis-a-vis suicide-related ideation subsequent to statistical control for socio-demographic factors, physical health, and depressive symptomatology. Of note, the relative contribution to the measurement of BHS factors is proportionately equal and greater than all other independent variables. CONCLUSION: We contend that this revised BHS response format may be appropriate for use in clinical and research applications though replication with other samples and populations is warranted.