Beck Hopelessness Scale: Exploring its Dimensionality in Patients with Schizophrenia

Hopelessness is a pre-eminent risk factor for suicide and non-fatal self-harm. Although the Beck Hopelessness Scale is often
used for schizophrenia, its factor structure has been given relatively little consideration in this context. This study aimed
to examine the reliability and validity of the Taiwanese version of the Beck Hopelessness Scale (BHS-T) in a chronic schizophrenia
out-patient sample. One hundred and two (102) outpatients were evaluated using the translated Taiwanese version of the BHS
(BHS-T), as well as several Beck-related symptom rating scales and the Positive and Negative Syndrome Scale (PANSS) for psycho-pathology.
The patients were also evaluated for suicidal intent using the critical items of the Scale for Suicide Ideation (SSI) and
suicide attempts. The psychometric properties of the BHS-T were also evaluated, including construct validity, internal consistency,
test–retest reliability, convergence, and discriminative validity. The BHS-T showed good overall reliability and stability
over time. This translated scale comprised a two-factor solution corresponding negative expectation and loss of motivation
dimensions. Differences in mean hopelessness scores between participants with and without suicidal intent were significant.
The results also indicated that, among individuals with schizophrenia, “negative expectation in the future” is more closely
linked to suicide intent than “loss of motivation for the future”. The BHS-T is a reliable and valid instrument for measuring
the multi-dimensionality of hopelessness and may complement clinical suicidal risk assessments in individuals with schizophrenia.