Measuring elderly people's quality of life through the Beck Hopelessness Scale: a study with a Spanish sample

[Determinants of unwanted loneliness in older adults: An analysis of psychological and sociodemographic factors]

BACKGROUND AND OBJECTIVE

Loneliness in old age is associated with a decline in quality of life, so it is important to identify the risk factors for loneliness. This study examines the predictors of loneliness in individuals over 65 years of age, focusing on sociodemographic variables (age, marital status, and educational level) and psychological factors (depressive symptoms and hopelessness).

METHODS

An analysis was conducted with 246 older adults over 65 years who lived independently. Variables were assessed using the following instruments: the Center for Epidemiological Studies Depression Scale (CES-D) for depression, the Beck Hopelessness Scale (BHS) for hopelessness, and the UCLA Loneliness Scale for loneliness. Binary logistic regression was applied to evaluate the relationship between these variables, as well as age, marital status, and educational level, and the likelihood of experiencing loneliness.

RESULTS

The results indicate that age and high scores on depression (CES-D) and negative expectations (BHS) significantly increase the likelihood of experiencing loneliness. A higher educational level was found to be a protective factor, reducing the likelihood of loneliness. However, neither marital status nor loss of motivation on the BHS were significant predictors.

CONCLUSIONS

The study confirms that both sociodemographic and psychological factors influence the perception of loneliness in old age. Promoting social and educational activities could reduce the risk of loneliness, and addressing depressive symptoms and negative thoughts may improve well-being in older adults.

Addressing loneliness in older adults: predictors, protective factors, and implications for social work practice

Loneliness significantly impacts the mental well-being of older adults, prompting an examination of psychological predictors and buffering factors associated with it in this demographic. A cross-sectional study involving 246 community-dwelling older adults was conducted. The UCLA Loneliness Scale identified predictors of loneliness, including negative mood, hopelessness (negative future expectations and loss of motivation), and despair. Buffering factors included ego-integrity, personal growth, and purpose in life. Regression analysis revealed that negative mood, negative future expectations, and despair increased loneliness, with negative mood showing a strong association. Conversely, ego-integrity, personal growth, and purpose in life reduced loneliness. The study underscores the complex interplay of psychological factors shaping loneliness in older adults, highlighting the importance of addressing both risk and protective factors. Social work practitioners in healthcare settings can play a pivotal role in addressing loneliness among older adults by leveraging these factors.

Beck Hopelessness Scale-20: Dimensionality and Nomological Validity Among Colombian School-Age Adolescents

To establish the validity of the BHS-20, a sample of 2064 adolescent students aged 14 and 17 years (M = 15.61, SD = 1.05) were invited to participate in the research. Cronbach's alpha (α) and McDonald's omega (ω) were computed to evaluate the internal consistency. Confirmatory factor analysis was used to test the dimensionality of the BHS-20. The Spearman correlation (rs) with depressive symptoms and risk of suicide scores of the Plutchik Suicide Risk Scale were computed to explore the nomological validity. The BHS-20 showed a high internal consistency (α = .81, ω = .93), an adequate one-dimensional structure with an excellent adjustment [χ2 S-B = 341, df = 170, p < .01, Comparative Fit Index = .99, RMSEA = .03] and acceptable nomological validity with depressive symptoms (rs = .47, p < .01) and scores for suicide risk (rs = .33, p < .01). In conclusion, current results suggest that the BHS-20 demonstrates validity and reliability among Colombian adolescent students.

The safe pilot study: A prospective naturalistic study with repeated measures design to test protective factors against violence in and after discharge from forensic facilities

Assessing violence risk amongst forensic patients is a vital legal and clinical task. The field of violence risk assessment has developed considerably over the past two decades but remains primarily risk focused. Despite this, growing attention to and work on protective factors or strengths has occurred. In this prospective naturalistic study with repeated observer-rated measures of 27 forensic patients, we tested the role of three potentially important but understudied dynamic protective factors: hope, insight, and resilience, along with a history of criminality, in terms of their impact on violence. Main effects models indicated that higher hopelessness and past criminal convictions were predictive of violence acts; higher resilience was associated with lower violence. In interaction models, hopelessness remained predictive. Importantly, there were significant interactions between resilience and past criminal convictions, with higher levels of resilience leading to lower violence, most amongst those with criminal convictions, and between resilience and hopelessness related emotional distress, in that higher resilience at high levels of patient acknowledged emotional distress due to hopelessness led to lower violence. Findings indicate the importance of focusing on strengths or protective factors in the assessment of risk and treatment planning for forensic patients. Despite the small sample, the repeated measures design was feasible and informative.

The Beneficial Effects of Professional Identity: The Mediating Role of Teaching Identification in the Relationship between Role Stress and Psychological Distress during the COVID-19 Pandemic

At the start of the COVID-19 pandemic, teachers and students rapidly transitioned to remote teaching and learning. In South Africa, this initial transition was followed by periods of reopening and closing of schools during the various waves of the pandemic. When schools were reopened, rotational schooling was implemented, with students attending in shifts. All this change created a climate of uncertainty for teachers. The current study investigates the relationship between role stress and indices of psychological distress, as well as the potential mediating role of teaching identification in this relationship, using a cross-sectional survey design. Participants (n = 355) were school teachers in South Africa who completed the Role Stress Questionnaire, the Professional Identification Scale, the trait scale of the State-Trait Anxiety Inventory, and the Beck Hopelessness Scale during the second wave of the pandemic (May-July 2021). The results of a structural equation analysis indicate significant positive direct effects of role conflict and ambiguity on anxiety and hopelessness, as well as significant negative direct effects of teaching identification on anxiety and hopelessness. In addition, teaching identification was found to mediate the effect of role conflict and ambiguity on anxiety and hopelessness. The demonstrated role of teaching identification has implications that suggest the importance of leadership and supervisory support, as well as enhancing the societal value of teaching as a profession.

Factors Related to Suicidal Ideation and Prediction of High-Risk Groups among Youngest-Old Adults in South Korea

(1) Background: The suicide of older adults shows different factors between the youngest-old adults and the old-old adults. This study aimed to identify factors predicting suicidal ideation among youngest-old adults (ages 65 to 74 years) and predict high-risk groups’ characteristics. (2) Methods: The subjects of this study were 970 youngest-old adults who participated in the Korean National Health and Nutrition Examination Survey (KNHANES VIII Year 1, 2019). Logistic regression analysis identified factors related to suicidal ideation, and decision tree analysis identified combined characteristics among high-risk groups. Data were analyzed using SPSS 27.0. (3) Results: Suicidal ideation became more common among those with relatively lower income levels (OR = 1.48, 95% CI = 1.04−2.12), those whom had experienced depression (OR = 9.28, 95% CI = 4.57−18.84), those with relatively higher stress levels (OR = 2.42, 95% CI = 1.11−5.28), and those reporting a relatively worse perceived health (OR = 1.88, 95% CI = 1.23−3.11). Complex characteristics that combined depression, low personal income level, and low perceived health predicted a high risk of suicidal ideation (64.6%, p < 0.05). (4) Conclusions: The findings indicate that this high-risk group should be prioritized when developing suicide prevention strategies.

Reverse-Coded Items Do Not Work in Spanish: Data From Four Samples Using Established Measures

The potential for suboptimal psychometric performance of reverse-coded items may be particularly pronounced when scales are translated and administered in Spanish with these problems exacerbated in youth respondents. This is a significant concern, given the rapid rise in Hispanic-American and Spanish-speaking individuals in the US and their rightful, growing representation in psychological research and clinical care. The aim of this study was to examine the psychometric performance of reverse-coded items across four Spanish-speaking samples spanning developmental stages including youth, college students, and parents (N = 1,084; Adolescents n = 107; M = 19.79; SD = 2.09; 41.1% female; Caregivers n = 58; M = 40.79; SD = 7.94; 60.3% female; Spanish-speaking adults in the US n = 157; M = 33.4; SD = 9.5; 68.8% female; and College students living in Latin America n = 783; M = 21.04; SD = 3.13; 69.2% female) and four scales (Big Five Inventory; Strengths and Difficulties Questionnaire; Difficulties in Emotion Regulation Scale; Beck Hopelessness Scale); we expected reverse-coded items would demonstrate inadequate item–total correlations and their inclusion would compromise scale internal consistency. Hypotheses were supported with evidence of poor psychometric performance for at least two reverse-coded items on each instrument, such that un-reversing the items improved their item–total correlations. Across every instrument, alpha was either improved by excluding reverse-coded items or by including them in an un-reversed fashion and, overall, there was a moderate, negative effect of reverse-coded items on scale alphas. In growing consensus with previous authors, we recommend that reverse-coded items not be included in Spanish scales.

Emotional intelligence predicting ego integrity in healthy older adults

OBJECTIVES

A characteristic task in aging is the process of reevaluating and reflecting on one's life in order to give it meaning. The successful resolution of this task is defined as ego-integrity, and it is related to various psychological phenomena that foster the person's adaptation to change. The objective was to adapt an ego-integrity scale in a sample of older adults and study the relationships between emotional intelligence, coping strategies, and mood to find out whether they are predictors of ego-integrity.

METHODS

The sample included 401 healthy older adults (241 women; ages 65-95, M = 73.69, SD = 6.83). Statistical analyses included structural equation models. Northwestern Ego-integrity Scale 9-item was tested showing that a structure with two unrelated factors fitted the data well. The internal consistency was satisfactory (.82 integrity and .72 despair).

RESULTS

Emotional intelligence positively predicted problem-focused adaptive coping strategies (problem solving and positive reassessment) and negatively predicted state of mind (depression and hopelessness), whereas adaptive coping positively predicted integrity, and mood predicted it negatively.

CONCLUSION

Emotional intelligence skills, adaptive coping strategies, and mood largely determine the successful resolution of the ego integrity conflict and are relevant resources in successful aging.

[Hopelessness as a predictor of loneliness in older adults]

BACKGROUND AND OBJECTIVE

Hopelessness is characterized by a set of negative cognitive schemas about the future, conceptualized on the basis of three dimensions: affective, motivational and cognitive. This construct is linked to loneliness, the incidence of which in older adults is increasingly high. The aim of this research is to test whether hopelessness factors predict levels of loneliness in older adults.

MATERIAL AND METHODS

138 non-institutionalized persons from Valencia city between 65-90 years old participated, with a mean age of 73.67 (SD=4.8), and 59.4% were women. The Beck Hopelessness Scale (BHS) and University of California Los Angeles Loneliness Scale (UCLA) were administered to assess participants.

RESULTS

The motivational and cognitive factors acted as statistically significant predictors of loneliness, while the affective factor was not presented as a significant factor. The final model obtained an R²adj=.442, F(3, 87)=23.97, p<.001.

CONCLUSIONS

Loneliness is a phenomenon of great concern in the field of gerontology due to its high incidence and impact. The results indicate that hopelessness, specifically loss of motivation and negative expectations about the future, are critical issues for the development of feelings of loneliness in older adults. Thus, it is relevant to pay attention to these variables in order to apply loneliness prevention programs.

Emotional intelligence intervention in older adults to improve adaptation and reduce negative mood

OBJECTIVES

Emotional intelligence (EI) is a strong predictor of negative mood. Applying emotional skills correctly can help to increase positive emotional states and reduce negative ones. This study aims to implement EI intervention designed to improve clarity, repair EI dimensions and coping strategies, and reduce negative mood in older adults.

DESIGN

Participants were randomly assigned to the treatment or control group.

SETTING

Participants were evaluated individually before and after the intervention.

PARTICIPANTS

Participants included 111 healthy older adults; 51 in the treatment group and 60 in the control group.

INTERVENTION

An EI program was implemented. The program was administered over 10 sessions lasting 90 min each.

MEASUREMENTS

EI dimension (attention, clarity, and repair), coping strategies, hopelessness, and mood were assessed.

RESULTS

Analysis of variance for repeated measures was applied. In the treatment group, scores on clarity and emotional repair increased and attention to emotions decreased; problem-focused coping (problem-solving, positive reappraisal, and seeking social support) showed significant increases, whereas emotion-focused coping (negative self-focused and overt emotional expression) obtained significant decreases; scores on negative mood measures declined significantly.

CONCLUSIONS

An intervention based on EI is effective in older adults. After the EI intervention, the participants showed significant increases in their levels of clarity and emotional repair and intermediate levels of attention. In addition, the intervention was found to influence adaptation results, increasing the use of adaptive coping strategies and decreasing the use of maladaptive strategies, as well as reducing hopelessness and depressive symptoms.

Determinants of Suicidal Ideation among Older Adults

Abstract. This study examined the relationship of depression and life satisfaction with suicidal ideation among older Iranian adults. In this cross-sectional study, a total of 159 older adults in Tehran (73% community-residing, 60 years or older) participated. The data were gathered using the Beck Scale for Suicidal Ideation (BSSI), the Geriatric Depression Scale (GDS), and the Life Satisfaction Index-Z (LSIZ). According to the results, depression and life satisfaction are significantly related to suicidal ideation; the two variables predict 0.39% of the variance of suicidal ideation in older adults ( p < .01). The interaction between depression and life satisfaction is a stronger predictor of suicidal ideation in older adults than each of the variables alone.

Escala de Desesperanza de Beck (BHS): ventajas de una administración adaptativa

La escala de Desesperanza de Beck (BHS) es usada con frecuencia como screening para la detección de riesgo suicida y/o depresión aun cuando, por su extensión de 20 ítems, resulta poco eficiente. En este trabajo se analiza si una estrategia de administración adaptativa podría abreviar el tiempo de aplicación de la BHS. Participaron 783 individuos de población general (50.9% mujeres). Se seleccionó aleatoriamente un 70% de los casos para calibrar los ítems con el Modelo Logístico de 2 parámetros de la Teoría de Respuesta al Ítem. Se eliminaron dos elementos que presentaron funcionamiento inadecuado. El 30% restante de la muestra se utilizó para simular una administración adaptativa de los 18 ítems calibrados. Se compararon dos modalidades de interrupción: a) al administrar 9 ítems y b) al alcanzar un error de estimación ≤ 0.35 o administrar 9 ítems (criterio mixto). Bajo ambas condiciones se registraron correlaciones de .95 con el nivel de Desesperanza estimado a partir de los 18 ítems. No obstante, la interrupción basada en el criterio mixto no mostró un impacto adicional en la eficiencia de la medida. Al igual que la versión de 18 ítems, las aplicaciones adaptativas estimaron con más precisión los niveles elevados del rasgo. La medición adaptativa no afectó las evidencias de validez al estudiar la asociación del rasgo con facetas del Neuroticismo y dimensiones sintomatológicas. Se concluye que una administración adaptativa de 9 ítems puede abreviar considerablemente la BHS sin perjudicar la validez y confiabilidad de la medida.

What Is the Difference in the Risk of Suicide Death Between Spine Fracture in Patients Older Than 65 Years and Matched Controls? A Large-database Study from South Korea

BACKGROUND

Pain and kyphotic deformity after spinal fractures can result in a decrease in a patient's physical function and quality of life. Furthermore, physical illness, such as respiratory compromise, or mental illness, including depression, may be exacerbated by a spinal fracture. Complications caused by spinal fractures and old age are risk factors for suicide, but studies on these patients are rare.

QUESTIONS/PURPOSES

(1) What is the incidence rate of death by suicide after a spinal fracture in patients older than 65 years? (2) How much does the risk of death by suicide increase in patients older than 65 years who have spine fractures compared with well-matched controls? (3) How does this risk change as a function of increasing time after injury?

METHODS

Spinal fractures in patients older than 65 years and matched controls were selected from the National Health Insurance Service-Senior cohort (NHIS-Senior) of South Korea. The NHIS-Senior consists of 558,147 people selected by 10% simple random sampling method from a total of 5.5 million people 60 and older in 2002; all people were followed through 2015. A total of 31,357 patients with spine fractures and their 62,714 matched controls remained in the study. The mean follow-up time was 4.3 ± 3.0 years (135,229 person-years) in the spine fracture group and 4.6 ± 3.0 years (290,096 person-years) in the matched control group. We matched the groups for demographic factors such as age, gender, Charlson Comorbidity Index score, medication history, medical history, preoperative disability, number of hospital admissions, as well as socioeconomic factors such as household income level, residential district, and type of national health insurance using a 1:2 risk set propensity score matching by a nearest-neighbor matching algorithm with a maximum caliber of 0.1 of the hazard components. The incidence rate of suicide and the 95% confidence interval were calculated based on a generalized linear model with a Poisson distribution. The effect size was presented as a hazard ratio (HR) using Cox's proportional hazard model with robust variance estimator that accounts for clustering within matched pairs.

RESULTS

The overall risk of death by suicide throughout the surveillance period, expressed as an incidence rate, was 116 per 100,000 person-years in spinal fracture (157 deaths by suicide over 135,229 person-years). Throughout the entire surveillance period, the risk of death by suicide was greater among patients with spinal fractures than it was in the control group (HR 1.8 [95% CI 1.5 to 2.2]; p < 0.01). This difference was greatest in the first 365 days after the fracture (HR 2.5 [95% CI 1.6 to 3.8]; p < 0.01) (45 deaths by suicide, incidence rate: 156 per 100,000 person-years in spinal fracture). The risk of suicide death in patients with spine fracture from 365 days to the last follow-up was also higher than that of matched controls (HR 1.6 [95% CI 1.3 to 2.1]; p < 0.01).

CONCLUSIONS

Considering the substantially increased risk of death by suicide in patients with spine fractures who are older than 65 years, surgeons should consider offering psychiatric evaluation and management more frequently, particularly in patients with chronic pain, functional disability, and depressive mood. Future studies should investigate the underlying causes of suicide, such as deteriorating socioeconomic support or depression, and whether early initiation of psychological support after injury can reduce the suicide rate.

LEVEL OF EVIDENCE

Level III, prognostic study.

Evidencias de validez factorial de la Escala de desesperanza de Beck en español con muestras clínicas y no clínicas

El propósito del presente estudio fue evaluar la estructura interna de la adaptación al español de Escala de Desesperanza de Beck et al. (1974), dada su utilidad y relevancia en la predicción de conductas suicidas. Para esto, se analizaron las respuestas a la escala de 1260 estudiantes universitarios (M = 4.79; DT = 4.29) y de una muestra clínica en la que participaron 150 jóvenes con intento de suicidio de alta letalidad (M = 8.51; DT = 2.38). Se examinó la estructura interna por medio del Análisis factorial confirmatorio (AFC) en tres fases: en la primera, se comparó el modelo original con cuatro modelos encontrados en las diferentes adaptaciones al español; en la segunda, se tomaron en cuenta modelos que analizan la aquiescencia; y en la tercera, se hizo una validación cruzada de esos modelos con población clínica. Los resultados señalan que la escala es unidimensional tanto en el caso de las muestras clínicas (χ2 = 154.84, gl = 135, p < 0.001, CFI = 0.99, TLI = 0.99,RMSEA = 0.03) como en la población universitaria; sin embargo, a esta última se le añadió un factor de método para el tratamiento de la aquiescencia (χ2 = 252.14, gl = 134, p < 0.001, CFI = 0.95, TLI = 0.94, RMSEA = 0.03). Los resultados muestran la importancia de utilizar análisis y modelos que consideren la naturaleza de los datos y las características de la muestra para aportar evidencias más sólidas para la validez de constructo.

Hopelessness and its correlates with clinical outcomes in an outpatient setting

INTRODUCTION

This study examined whether patients with hopelessness and those without may significantly differ regarding their main presentations and clinical course in a large Italian population.

METHODS

The recruited sample included 583 currently euthymic outpatients with major affective disorders. The Beck Hopelessness Scale (BHS) assessed hopelessness using a cutoff score of 9 or higher. Participants were categorized based on the presence/absence of hopelessness. A binary logistic regression analysis -accounting for age and gender and considering history of psychotherapy, emotional/physical abuse, depressive symptoms, Toronto Alexithymia Scale (TAS) total score, difficulties identifying and communicating feelings as potential predictors- was carried out in order to detect the variables associated with hopelessness.

RESULTS

Individuals with hopelessness, compared to those without, were more likely to be older (p=0.005), females (p=0.01), to have a unipolar depressive disorder (p≤0.05), be prescribed antidepressants and psychotherapy in the past (p=0.001 and p≤0.05). Moreover, individuals with hopelessness scored higher on the Montgomery-Asberg Depression Rating Scale (p≤0.05) and on the emotional (p=<0.001), physical abuse (p≤0.01) and physical neglect (p≤0.05) subscales of the Childhood Trauma Questionnaire - Short form, and reported more difficulties identifying (p≤0.001) and communicating feelings (p≤0.001) than those without hopelessness. The multivariate analysis showed that having difficulties identifying feelings is independently associated with hopelessness.

DISCUSSION

These findings indicate that individuals with difficulties identifying feelings are at higher risk of hopelessness and of negative outcomes. Further studies need to explore the impact of alexithymia on hopelessness and clinical outcomes in the lifetime illness course.

Models of suicide in elderly: a protocol for a systematic review

INTRODUCTION

The rates of suicide in the elderly population are generally higher than other age groups. Models of suicide that explain the phenomenon of suicide in later life may have research, clinical and educational implications for the field of ageing. The primary purpose of this systematic review is to identify and review existing models of suicide that have a particular focus on the elderly.

METHODS AND ANALYSIS

The authors intend reviewing the findings of observational studies including cohort studies, cross-sectional studies, case-control studies, and qualitative studies such as grounded theory designs which are published in Google Scholar, Scopus, PsycINFO, PubMed, Web of Science, Cochrane Database of Systematic Reviews and research-related journals. Models of suicide which specifically describe, explain and predict late life suicides will be included. Therapeutic, interventional and rehabilitation models, as well as models related to assisted suicide, will be excluded. The EndNote software will be employed for data management. Two independent reviewers will extract data. Methodological quality and the risk of bias of quantitative studies will be assessed using the Newcastle-Ottawa Scale and the Newcastle-Ottawa Scale adapted for cross-sectional studies, while that of qualitative studies will be assessed using the Critical Appraisal Skills Programme and the evaluative criteria of credibility, transferability, dependability and confirmability. The final report will present a range of models of suicide with a list of different subgroups.

ETHICS AND PUBLICATION

There are no predictable ethical issues related to this study. The findings will be published in prestigious journals and presented at international and national conferences.

PROSPERO REGISTRATION NUMBER

CRD42017070982.

Cultural and emotional determinants of cervical cancer screening among older Hispanic women

Older adults are at highest risk of cancer and yet have the lowest rates of cancer screening participation. Older minority adults bear the burden of cancer screening disparities leading to late stage cancer diagnoses. This investigation, utilization data from the 2008 wave of the Health and Retirement study examined the cultural and emotional factors thought to influence cervical cancer screening among older Hispanic women. We utilized logistic regression models to conduct the analyses. Findings indicate that the emotional factors were not significant but the cultural factor, time orientation was a significant predictor for older Hispanics' cervical cancer screening behaviors.