Skip to main content
SpringerLink
Log in

Hopelessness depression in depressed inpatients: Symptomatology, patient characteristics, and outcome

  • Published:
Cognitive Therapy and Research Aims and scope Submit manuscript

Abstract

This exploratory study examined the association between level of hopelessness and specific depression symptomatology, patient characteristics, and treatment outcome. Results from 80 unipolar depressed inpatients suggested that high-hopelessness patients could be discriminated from low-hopelessness patients on hypothesized symptoms of depression, characterized by retarded initiation of voluntary responses (a motivational symptom) and sad affect (an emotional symptom). Moreover, high-hopelessness patients could be discriminated from patients low in hopelessness on the patient characteristics of greater suicidal ideation, social dysfunction, and cognitive dysfunction. Finally, compared to low-hopelessness patients, depressed inpatients high in hopelessness exhibited a poorer outcome to pharmacological and cognitive-behavioral treatment interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abramson, L. Y., Alloy, L. B., & Metalsky, G. I. (1988). The cognitive diathesis-stress theories of depression: Toward an adequate evaluation of the theories' validities. In L. B. Alloy (Ed.),Cognitive processes in depression (pp. 3–30). New York: Guilford Press.

    Google Scholar 

  • Abramson, L. Y., Garber, J., Edwards, N. B., & Seligman, M. E. P. (1978). Expectancy changes in depression and schizophrenia.Journal of Abnormal Psychology, 87, 102–109.

    Article  PubMed  Google Scholar 

  • Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression.Psychological Review, 96, 358–372.

    Article  Google Scholar 

  • Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. (1978). Learned helplessness in humans: Critique and reformulation.Journal of Abnormal Psychology, 87, 49–74.

    Article  PubMed  Google Scholar 

  • Alloy, L. B., Hartlage, S., & Abramson, L. Y. (1988). Testing the cognitive diathesis-stress theories of depression: Issues of research design, conceptualization, and assessment. In L. B. Alloy (Ed.),Cognitive processes in depression (pp. 31–73). New York: Guilford Press.

    Google Scholar 

  • American Psychiatric Association (1980).Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • Barnett, P. A., & Gotlib, I. H. (1988). Psychosocial functioning and depression: Distinguishing among antecedents, concomitants, and consequences.Psychological Bulletin, 104, 97–126.

    Article  PubMed  Google Scholar 

  • Beach, S. R. H., Sandeen, E. E., & O'Leary, K. D. (1990).Depression in marriage: A model for etiology and treatment. New York: Guilford Press.

    Google Scholar 

  • Beach, S. R. H., Whisman, M. A., & O'Leary, K. D. (1994). Marital therapy for depression: Theoretical foundations, current status, and future directions.Behavior Therapy, 25, 345–371.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intent: The Scale for Suicidal Ideation.Journal of Consulting and Clinical Psychology, 47, 343–352.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Riskind, J. H., Brown, G., & Steer, R. A. (1988). Levels of hopelessness in DSM-III disorders: A partial test of content specificity in depression.Cognitive Therapy and Research, 12, 459–469.

    Article  Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979).Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  • Beck, A. T., & Steer, R. A. (1988).Beck Hopelessness Scale manual. San Antonio: The Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., Beck, J. S., & Newman, C. F. (1993). Hopelessness, depression, suicidal ideation, and clinical diagnosis of depression.Suicide & Life Threatening Behavior, 23, 139–145.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.Clinical Psychology Review, 8, 77–100.

    Article  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Blackburn, I. M., Jones, S., & Lewin, R. J. P. (1986). Cognitive style in depression.British Journal of Clinical Psychology, 25, 241–251.

    PubMed  Google Scholar 

  • Brown, G., & Beck, A. T. (1989). The role of imperatives in psychopathology: A reply to Ellis.Cognitive Therapy and Research, 13, 315–321.

    Article  Google Scholar 

  • Clark, D. A., Beck, A. T., & Brown, G. (1989). Cognitive mediation in general psychiatric outpatients: A test of the content-specificity hypothesis.Journal of Personality and Social Psychology, 56, 958–964.

    Article  PubMed  Google Scholar 

  • Clark, D. A., Beck, A. T., & Stewart, B. (1990). Cognitive specificity and positive-negative affectivity: Complementary or contradictory views on anxiety and depression?Journal of Abnormal Psychology, 99, 148–155.

    Article  PubMed  Google Scholar 

  • Coyne, J. C. (1976). Toward an interactional description of depression.Psychiatry, 39, 28–40.

    PubMed  Google Scholar 

  • Coyne, J. C. (1989). Thinking post-cognitively about depression. In A. Freeman, K. M. Simon, L. E. Beutler, & H. Arkowitz (Eds.),Comprehensive handbook of cognitive therapy (pp. 227–244). New York: Plenum Press.

    Google Scholar 

  • Coyne, J. C., Burchill, S. A. L., & Stiles, W. B. (1991). An interactional perspective on depression. In C. R. Snyder & D. R. Forsyth (Eds.),Handbook of social and clinical psychology: The health perspective (pp. 327–349). New York: Pergamon Press.

    Google Scholar 

  • Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collins, J. F., Glass, D. R., Pilkonis, P. A., Leber, W. R., Docherty, J. P., Fiester, S. J., & Parloff, M. B. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: General effectiveness of treatments.Archives of General Psychiatry, 46, 971–982.

    PubMed  Google Scholar 

  • Greene, S. M. (1981). Levels of measured hopelessness in the general population.British Journal of Clinical Psychology, 20, 11–14.

    Google Scholar 

  • Greene, S. M. (1989). The relationship between depression and hopelessness: Implications for current theories of depression.British Journal of Psychiatry, 154, 650–659.

    PubMed  Google Scholar 

  • Greene, S. M., O'Mahoney, P. D., & Rungawamy, P. (1982). Levels of measured hopelessness in physically ill patients.Journal of Psychosomatic Research, 20, 591–593.

    Article  Google Scholar 

  • Haaga, D. A. F., Dyck, M. J., & Ernst, D. (1991). Empirical status of cognitive theory of depression.Psychological Bulletin, 110, 215–236.

    Article  PubMed  Google Scholar 

  • Habif, V. L., & Lahey, B. B. (1980). Assessment of the life stress-depression relationship: The use of social support as a moderator variable.Behavioral Assessment, 2, 167–173.

    Article  Google Scholar 

  • Hamilton, E. W., & Abramson, L. Y. (1983). Cognitive patterns and major depressive disorder: A longitudinal study in a hospital setting.Journal of Abnormal Psychology, 92, 173–184.

    Article  PubMed  Google Scholar 

  • Hamilton, M. (1960). A rating scale for depression.Journal of Neurology, Neurosurgery and Psychiatry, 12, 56–62.

    Google Scholar 

  • Hammen, C., & Krantz, S. E. (1985). Measures of psychological process in depression. In E. E. Beckham & W. R. Leber (Eds.),Handbook of depression: Treatment, assessment, and research (pp. 408–444). Homewood, IL: Dorsey Press.

    Google Scholar 

  • Hayes, S. C., Nelson, R. O., & Jarrett, R. B. (1987). The treatment utility of assessment: A functional approach to evaluating assessment quality.American Psychologist, 42, 963–974.

    Article  PubMed  Google Scholar 

  • Hollon, S. D., & Kendall, P. C. (1980). Cognitive self-statements in depression: Development of an automatic thoughts questionnaire.Cognitive Therapy and Research, 4, 383–395.

    Article  Google Scholar 

  • Keitner, G. I., & Miller, I. W. (1990). Family functioning and major depression: An overview.American Journal of Psychiatry, 147, 1128–1137.

    PubMed  Google Scholar 

  • Keller, M. B. (1988). Diagnostic issues and clinical course of unipolar illness. In A. J. Frances & R. E. Hales (Eds.),Review of psychiatry (pp. 188–212). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Keller, M. B., & Shapiro, R. W. (1982). “Double depression”: Superimposition of acute depressive episodes on chronic depressive disorders.American Journal of Psychiatry, 139, 438–442.

    PubMed  Google Scholar 

  • Klerman, G. L., & Weissman, M. M. (1986). The interpersonal approach to understanding depression. In T. Millon & G. L. Klerman (Eds.),Contemporary directions in psychopathology: Toward the DSM-IV (pp. 429–456). New York: Guilford Press.

    Google Scholar 

  • Krantz, S., & Hammen, C. L. (1979). Assessment of cognitive bias in depression.Journal of Abnormal Psychology, 88, 611–619.

    Article  PubMed  Google Scholar 

  • Leber, W. R., Beckham, E. E., & Danker-Brown, P. (1985). Diagnostic criteria for depression. In E. E. Beckham & W. R. Leber (Eds.),Handbook of depression: Treatment, assessment, and research (pp. 343–371). Homewood, IL: Dorsey Press.

    Google Scholar 

  • McCranie, E. W., & Riley, W. T. (1992). Hopelessness and persistence of depression in an inpatient sample.Cognitive Therapy and Research, 16, 699–708.

    Article  Google Scholar 

  • Merluzzi, T. V., & Boltwood, M. D. (1989). Cognitive assessment. In A. Freeman, K. M. Simon, L. E. Beutler, & H. Arkowitz (Eds.),Comprehensive handbook of cognitive therapy (pp. 249–266). New York: Plenum Press.

    Google Scholar 

  • Miller, I. W., Bishop, S., Norman, W. H., & Maddever, H. (1985). The Modified Hamilton Rating Scale for Depression: Reliability and validity.Psychiatry Research, 14, 131–142.

    Article  PubMed  Google Scholar 

  • Miller, I. W., Norman, W. H., Bishop, S. B., & Dow, M. G. (1986). The Modified Scale for Suicidal Ideation: Reliability and validity.Journal of Consulting and Clinical Psychology, 54, 724–725.

    Article  PubMed  Google Scholar 

  • Miller, I. W., Norman, W. H., Keitner, G. I., Bishop, S. B., & Dow, M. G. (1989). Cognitive-behavioral treatment of depressed inpatients.Behavior Therapy, 20, 25–47.

    Google Scholar 

  • Needles, D. J., & Abramson, L. Y. (1990). Positive life events, attributional style, and hopefulness: Testing a model of recovery from depression.Journal of Abnormal Psychology, 99, 156–165.

    Article  PubMed  Google Scholar 

  • Nekanda-Trepka, C. J. S., Bishop, S., & Blackburn, I. M. (1983). Hopelessness and depression.British Journal of Clinical Psychology, 22, 49–60.

    PubMed  Google Scholar 

  • Norman, W. H., Miller, I. W., & Klee, S. (1983). Assessment of cognitive distortion in a clinically depressed population.Cognitive Therapy and Research, 7, 133–140.

    Article  Google Scholar 

  • Robins, L. N., Helzer, J. E., Croughan, J., & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule.Archives of General Psychiatry, 38, 381–389.

    Google Scholar 

  • Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978). Assessing the impact of life changes: Development of the Life Experiences Survey.Journal of Consulting and Clinical Psychology, 46, 932–946.

    Article  PubMed  Google Scholar 

  • Spangler, D. L., Simons, A. D., Monroe, S. M., & Thase, M. E. (1993). Evaluating the hopelessness model of depression: Diathesis-stress and symptom components.Journal of Abnormal Psychology, 102, 592–600.

    Article  PubMed  Google Scholar 

  • Sweeney, P. D., Anderson, K., & Bailey, S. (1986). Attributional style in depression: A meta-analytic review.Journal of Personality and Social Psychology, 50, 974–991.

    Article  PubMed  Google Scholar 

  • Weissman, A. N., & Beck, A. T. (1978, March).Development and validation of the Dysfunctional Attitude Scale: A preliminary investigation. Paper presented at the meeting of the American Educational Research Association, Toronto, Canada.

  • Weissman, M. M., & Bothwell, S. (1976). The assessment of social adjustment by patient self-report.Archives of General Psychiatry, 33, 1111–1115.

    Google Scholar 

  • Weissman, M. M., Prusoff, B. A., DiMascio, A., Neu, C., Goklaney, M., & Klerman, G. L. (1979). The efficacy of drugs and psychotherapy in the treatment of acute depressive episodes.American Journal of Psychiatry, 136, 555–558.

    PubMed  Google Scholar 

  • Whisman, M. A. (1993). Mediators and moderators of change in cognitive therapy of depression.Psychological Bulletin, 114, 248–265.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Yale University, P.O. Box 208205, 06520-8205, New Haven, Connecticut

    Mark A. Whisman

  2. Brown University and Butler Hospital, USA

    Ivan W. Miller, William H. Norman & Gabor I. Keitner

Authors
  1. Mark A. Whisman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ivan W. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William H. Norman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gabor I. Keitner
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This research was supported by National Institute of Mental Health grants MH-35945 and MH 44778. Preparation of this article was supported by a grant from the National Alliance for Research on Schizophrenia and Depression. Portions of this article were presented at the 26th annual convention of the Association for Advancement of Behavior Therapy, Boston, November 1992.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Whisman, M.A., Miller, I.W., Norman, W.H. et al. Hopelessness depression in depressed inpatients: Symptomatology, patient characteristics, and outcome. Cogn Ther Res 19, 377–398 (1995). https://doi.org/10.1007/BF02230407

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02230407

Key words

Search

Navigation