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Los manuscritos son evaluados, antes de ser aceptados, por revisores externos peer-review. Only a few scales have been validated in Spanish for the assessment of suicide risk, and none of them have achieved predictive validity..
To determine the validity and reliability of the Beck Hopelessness Scale in patients with suicide risk attending the specialist clinic.. The Beck Hopelessness Scale, reasons for living inventory, and the suicide behaviour questionnaire were applied in patients with suicide risk attending the psychiatric clinic and the emergency department.
A new assessment was made 30 days later to determine the predictive validity of suicide or suicide attempt.. The evaluation included a total of patients, with a mean age of The internal consistency was. It was positively correlated with the suicidal behaviour questionnaire Spearman. The Beck Hopelessness Scale in Colombian patients with suicidality shows results similar to the original version, with adequate reliability and moderate concurrent and predictive validity..
Pocas escalas se han validado en castellano para el riesgo suicida y en ninguna de ellas se ha hallado la validez predictiva.. Determinar la validez y confiabilidad de la Escala de Desesperanza de Beck en pacientes con suicidabilidad que acuden a consulta especializada.. Se aplicaron la Escala de Desesperanza de Beck, el Inventario de Razones para Vivir y el Cuestionario de Comportamiento Suicida a pacientes con suicidabilidad que asistieron a consulta externa y urgencias.
Nevertheless, this figure is considered to be an under-estimate as suicide is a sensitive subject. It is even illegal in several countries, so that it is not reported; additionally, in countries where it is properly reported it is often poorly classified as accidental death or other causes of death.
Attempting suicide is the most important risk factor for suicide in the general population. In Colombia in the medical system reported a mortality rate due to suicide of 4. The highest rate per , inhabitants 6. Suicide is a public health problem that can be prevented by low-cost evidence-based interventions.
These tools have to evaluate risk factors. A great many risk factors have been described in the literature, and they include hopelessness. Self-administered scales and instruments have been shown to be a good alternative for this evaluation in emergency and out-patient departments, as they are easy and fast to apply.
Although several scales are used, the oldest and one of those to have been evaluated for predictive validity is the Beck Hopelessness Scale BHS. This scale was selected because it was the first to be designed exclusively to evaluate hopelessness, and this has been correlated with a higher risk of suicide.
The aim of this research is to determine the validity and reliability of the BHS in patients at risk of suicide who attend a specialised surgery in the city of Bucaramanga, Colombia. A diagnostic test was subjected to a validation study. All of the participants were asked to give their informed consent before commencing the study. They gave their consent after receiving an explanation and understanding the research objectives. They took part voluntarily and with the guarantee of confidentiality according to the Colombian regulations governing health research and the Helsinki Declaration.
Beck et al. The scale is composed of 20 propositions that can be defined as true or false, and they evaluate the scope of negative expectations about the immediate and long-term future. The items that indicate hopelessness score 1 point, while those that do not indicate it score 0 points. The number of points measure the severity of hopelessness: 0—3 is minimum or normal, 4—8 is mild, 9—14 is moderate and 15—20 is severe.
It contains questions on suicidal thoughts and behaviour in the past and future. The SBQ-R is a Likert-type questionnaire, and it consists of questions about the frequency of the emergence of suicidal ideation, the communication of suicidal thoughts to others, attitudes and expectations regarding the current suicide attempt. The maximum score is 18, and the scale takes approximately 5 min to complete.
It has suitable internal consistency, test-retest reliability and concurrent validity. This scale evaluates the adaptive positive beliefs and expectations for not committing suicide.
The factors analysed are divided into dimensions and indicate the 6 main reasons for living: a beliefs about survival and facing up to things 24 items ; b family responsibility 7 items ; c concerns in connection with children 3 items ; d fear of suicide 7 items ; e fear of social disapproval 3 items , and f moral objections 4 items.
The study universe was composed of all the patients who visited either the emergency department or the outpatient surgery of the Instituto del Sistema Nervioso de Oriente ISNOR with suicidal tendencies. To ensure that the sample was collected, the psychiatrist marked a predetermined box in the electronic clinical history once a patient with suicidal tendencies had been detected.
This sign informed the group of researchers of the presence of a patient with suicidal tendencies so that they could be included in the study. To calculate the size of the sample the sum of the 20 items in the BHS was used. The recommendation to recruit 10 patients per item was taken into account, to make it possible to validate the construct in this case, at least patients.
Patients with suicidal tendencies were defined as all of those with suicidal thoughts, ideas or plans and behaviour or attempted suicides. All of the patients who voluntarily agreed to participate in the study and who had suicidal tendencies according to their doctor were included in the study. Those with psychosis were excluded, as were those with cognitive functioning that would prevent them from answering the interview or those who were incapable of understanding the questions of the scale due to their educational level.
All of the patients were interviewed by one of the researchers with previous training in evaluation of the risk of suicide. They conducted a semi-structured interview that asked about demographic characteristics, the main risk factors such as alcohol consumption, family problems or problems with their partner, as well as protective factors such as having children and being older.
A researcher interviewed the patient 30 days later to establish whether there had been an attempted or consummated suicide, and the BHS was applied again. The reason why a 30 day follow-up was selected is that it is in the first 2 weeks that the highest number of attempts or suicides is observed in patients with suicidal tendencies. A maximum of 3 appointments were made for this follow-up, and if the patient did not keep the appointment they were declared to have abandoned the study.
Based on the fact that the BHS is a dichotomic scale, internal consistency was determined using the Kuder—Richardson 20 coefficient. The majority of the patients were women, which can be expected as they are the population which consult the most; the average age was Table 1 shows the sociodemographic characteristics of the population.
Table 2 shows the suicide protective or risk factors which were clinically evaluated using the semi-structured interview. Table 3 shows the main diagnoses of the population studied.
No consummated suicides occurred and there were 10 attempted suicides in the 30 day follow-up. Sociodemographic variables of the patients with suicidal tendencies. Risk and protective factors for patients with suicidal tendencies. Main diagnoses of the patients with suicidal tendencies. The average score on the BHS was 7. The minimum score was 0 and the maximum score was The total average for the women was 7. Analysis of factors. The KMO sample suitability test showed it to be suitable 0.
These dimensions were denominated: 1 expectations for the future self-evaluated 6. Internal consistency. The Kuder—Richardson 20 coefficient was.
The Kuder—Richardson values for each one of the dimensions were as follows: 0. Concurrent validity. A positive correlation was found with the SBQ Spearman. Predictive validity. The area under the ROC curve was 0. With this cut-off point the negative predictive value was This study shows that in the Colombian population the BHS has similar dimensions to the original version, with suitable reliability and good concurrent validity. Nevertheless, the utility of the scale may be affected by its low positive predictive value.
Although it is similar to the original, the factorial structure of the BHS in a Colombian population has an additional factor. In the original validation by Beck et al. In a subsequent validation by Steer et al. Additionally, a validation carried out in in Lima, Peru, found 6 factors, although 2 of them only contained one item.
These would lead the dimensions to vary with the population, although in any case they would still follow a relevant and representative intrinsic logic in connection with the concept of hopelessness. In spite of the difference in the construct, the BHS worked correctly in our population given that the total internal consistency of the scale was excellent and each one of the factors had an internal consistency that was from good to very good.
This indicates that there are no redundant questions in the scale and that nor are any items lacking in each factor. As expected, the BHS had a diverging correlation with the RFL, given that the latter is constructed using positive statements about life, children, the family or religion. It is also logical for it to have a converging correlation with the SBQ-R and number of attempted suicides, given that hopelessness has been associated with such behaviour.
The correlation with the number of suicide attempts had been determined previously. With respect to predictive validity, a high negative predictive value was found, making the scale useful in departments where swift evaluation by a psychiatrist would be difficult. This is because the scale guarantees with a low margin of error that those who score less than 12 will have a lower probability of attempted suicide.
Nevertheless, its positive predictive value was very low, leading to a high percentage of false positives. The result of this characteristic of the scale is that when a score is 12 or more it is impossible to determine whether there is a real high risk of suicide. It is therefore impossible to use the scale alone as the only tool in evaluating the risk of suicide. This has to be evaluated by a psychiatrist or expert in the evaluation of this risk.
These predictive values are similar to those found in previous studies, so that the APA recommended that these scales should not be used in clinical practice to estimate the risk of suicide. They took a sample of patients with affective disorders and suicidal ideas from September Each patient had to complete the BHS.
The follow-up included those patients who had finished their treatment in the hospital until To document whether any of the participants committed suicide a 43 month follow-up study was carried out of death certificates registered in the local Philadelphia and national offices; 31 participants died 1. They found that the patients who committed suicide had a higher score on the scale than the patients who died from natural causes.
They found a cut-off point for the BHS of 9, unlike this study, in which the cut-off point for the BHS was found at
Clinical Assessment Canada
Los manuscritos son evaluados, antes de ser aceptados, por revisores externos peer-review. Only a few scales have been validated in Spanish for the assessment of suicide risk, and none of them have achieved predictive validity.. To determine the validity and reliability of the Beck Hopelessness Scale in patients with suicide risk attending the specialist clinic.. The Beck Hopelessness Scale, reasons for living inventory, and the suicide behaviour questionnaire were applied in patients with suicide risk attending the psychiatric clinic and the emergency department. A new assessment was made 30 days later to determine the predictive validity of suicide or suicide attempt..
Beck Hopelessness Scale
This powerful predictor of eventual suicide assists you to measure three major aspects of hopelessness: feelings about the future, loss of motivation, and expectations. Responding to the 20 true or false items on the Beck Hopelessness Scale BHS , patients can either endorse a pessimistic statement or deny an optimistic statement. For more information, please visit HelloQ. Please note: Q-global reports may take up to two business days before appearing in your inventory. Details regarding the system and how it is used are provided on the Q-global product page HelloQ.
Beck Hopelessness Scale® (BHS®)
Aaron T. Beck that was designed to measure three major aspects of hopelessness: feelings about the future, loss of motivation, and expectations. It measures the extent of the respondent's negative attitudes, or pessimism, about the future. It may be used as an indicator of suicidal risk in depressed people who have made suicide attempts. The test is multiple choice. It is not designed for use as a measure of the hopelessness construct but has been used as such.