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Further Insights Into the Beck Hopelessness Scale (BHS): Unidimensionality Among Psychiatric Inpatients.

ABSTRACT: Short versions of the Beck Hopelessness Scale have all been created according the Classical Test Theory, but the use and the application of this theory has been repeatedly criticized. In the current study, the Item Response Theory approach was employed to refine and shorten the BHS in order to build a reasonably coherent unidimensional scale whose items/symptoms can be treated as ordinal indicators of the theoretical concept of hopelessness, scaled along a single continuum. In a sample of 492 psychiatrically hospitalized, adult patients (51.2% females), predominantly with a diagnosis of Bipolar Disorder type II, the BHS was submitted to Mokken Scale Analysis. A final set of the nine best-fitting items satisfied the assumptions of local independency, monotonicity, and invariance of the item ordering. Using the ROC curve method, the IRT-based 9-item BHS showed good discriminant validity in categorizing psychiatric inpatients with high/medium suicidal risk and patients with and without suicide attempts. With high sensitivity (>.90), this newly developed scale could be used as a valid screening tool for suicidal risk assessment in psychiatric inpatients.

SUBMITTER: Balsamo M

PROVIDER: S-EPMC7411257 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Further Insights Into the Beck Hopelessness Scale (BHS): Unidimensionality Among Psychiatric Inpatients.

Balsamo Michela M Carlucci Leonardo L Innamorati Marco M Lester David D Pompili Maurizio M

Frontiers in psychiatry 20200731

Short versions of the Beck Hopelessness Scale have all been created according the Classical Test Theory, but the use and the application of this theory has been repeatedly criticized. In the current study, the Item Response Theory approach was employed to refine and shorten the BHS in order to build a reasonably coherent unidimensional scale whose items/symptoms can be treated as ordinal indicators of the theoretical concept of hopelessness, scaled along a single continuum. In a sample of 492 ps ...[more]

PMID: 32848911

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Project description:BackgroundThe Beck Hopelessness Scale (BHS) has been the most frequently used instrument for the measurement of hopelessness in the past 40 years. Only recently has it officially been translated into German. The psychometric properties and factor structure of the BHS have been cause for intensive debate in the past.MethodsBased on a representative sample of the German population (N = 2450) item analysis including item sensitivity, item-total correlation and item difficulty was performed. Confirmatory factor analyses (CFA) for several factor solutions from the literature were performed. Multiple group factor analysis was performed to assess measurement invariance. Construct validity was assessed via the replication of well-established correlations with concurrently assessed measures.ResultsMost items exhibited adequate properties. Items #4, #8 and #13 exhibited poor item characteristics- each of these items had previously received negative evaluations in international studies. A one-dimensional factor solution, favorable for the calculation and interpretation of a sum score, was regarded as adequate. A bi-factor model with one content factor and two method factors (defined by positive/negative item coding) resulted in an excellent model fit. Cronbach's alpha in the current sample was .87. Hopelessness, as measured by the BHS, significantly correlated in the expected direction with suicidal ideation (r = .36), depression (r = .53) and life satisfaction (r = -.53). Strict measurement invariance could be established regarding gender and depression status. Due to limited research regarding the interpretation of fit indices with dichotomous data, interpretation of CFA results needs to remain tentative.ConclusionThe BHS is a valid measure of hopelessness in various subgroups of the general population. Future research could aim at replicating these findings using item response theory and cross-cultural samples. A one-dimensional bi-factor model seems appropriate even in a non-clinical population.

Project description:BACKGROUND:Parents often use digital media to search for information related to their children's health. As the quantity and quality of digital sources meant specifically for parents expand, parents' digital health literacy is increasingly important to process the information they retrieve. One of the earliest developed and widely used instruments to assess digital health literacy is the self-reported eHealth Literacy Scale (eHEALS). However, the eHEALS has not been psychometrically validated in a sample of parents. Given the inconsistency of the eHEALS underlying factor structure across previous reports, it is particularly important for validation to occur. OBJECTIVE:This study aimed to determine the factor structure of the German eHEALS measure in a sample of parents by adopting classic and modern psychometric approaches. In particular, this study sought to identify the eHEALS validity as a unidimensional index as well as the viability for potential subscales. METHODS:A cross-sectional design was used across two purposive sampling frames: online and paper administrations. Responses were collected between January 2018 and May 2018 from 703 Swiss-German parents. In addition to determining the sampling characteristics, we conducted exploratory factor analysis of the eHEALS by considering its ordinal structure using polychoric correlations. This analysis was performed separately for online-based and paper-based responses to examine the general factor strength of the eHEALS as a unidimensional index. Furthermore, item response theory (IRT) analyses were conducted by fitting eHEALS to a bifactor model to further inspect its unidimensionality and subscale viability. RESULTS:Parents in both samples were predominantly mothers (622/703, 88.5%), highly educated (538/703, 76.9%), of Swiss nationality (489/703, 71.8%), and living with a partner (692/703, 98.4%). Factor analyses of the eHEALS indicated the presence of a strong general factor across both paper and online samples, and the Wilcoxon rank-sum test indicated that the eHEALS total sum score was not significantly different between the paper and online samples (P=.12). Finally, the IRT analyses indicated negligible multidimensionality, insufficient subscale reliability after accounting for the eHEALS general factor, and a reduced subset of items that could serve as a unidimensional index of the eHEALS across the paper and online samples. CONCLUSIONS:The German eHEALS evidenced good psychometric properties in a parent-specific study sample. Factor analyses indicated a strong general factor across purposively distinct sample frames (online and paper). IRT analyses validated the eHEALS as a unidimensional index while failing to find support for subscale usage.

Project description:BackgroundA diagnosis of dementia in middle-aged and elder people is often complicated by physical frailty and comorbid neuropsychiatric symptoms (NPSs). Previous studies have identified NPSs as a risk factor for dementia. The aim of this study was to figure out to what extent individual NPS and certain demographic factors increased the risk of dementia in middle-aged and senior psychiatric inpatients.MethodsOne hundred twenty-seven middle-aged and senior patients admitted to psychiatric wards for late-onset (age ≥ 50 years) psychiatric symptoms were included and categorized into dementia or non-demented psychiatric disorders (NDPD). The patients' demographic information and medical records were collected during the first hospitalization and subjected to statistical analyses.Results41.73% of the registered psychiatric inpatients were diagnosed as dementia in which Alzheimer's disease (AD) was the dominant subtype. The NDPD group consisted of nine individual diagnoses, except for schizophrenia. The frequencies of dementia inpatients increased with first episode age while that of NDPD inpatients decreased with first episode age. In the enrolled inpatients, most of dementia patients were males while females accounted for a higher proportion of NDPD patients. 58.49% of enrolled dementia inpatients presented cognitive deficit (CD) as the initial symptom while the remaining 41.51% showed NPS as initial symptom. Of the 12 NPSs, agitation and apathy greatly and significantly increased risk of dementia in psychiatric inpatients with late-onset psychiatric symptoms.ConclusionsThese results added evidence that the demented patients admitted to psychiatric ward are more likely to be male, older first episode age, and have characteristic NPS including aberrant motor behavior (AMB), hallucinations, agitation, irritability and apathy. Further, this study emphasized the importance of agitation and apathy of NPSs functioning as risk factors of dementia in these inpatients.

Dataset Information

Further Insights Into the Beck Hopelessness Scale (BHS): Unidimensionality Among Psychiatric Inpatients.

Publications

Further Insights Into the Beck Hopelessness Scale (BHS): Unidimensionality Among Psychiatric Inpatients.

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