BACKGROUND: Hopelessness is considered a pre-eminent risk factor for suicide and non-fatal self-harm. We aimed to quantify the ability of the Beck Hopelessness Scale (BHS) to predict these two outcomes. METHOD: Medline, Embase, PsycINFO and Cinahl were searched to January 2006. We included cohort studies in which the BHS was applied and patients were followed-up to establish subsequent suicide or non-fatal self-harm. Four studies provided usable data on suicide, and six studies provided data on non-fatal self-harm. Summary sensitivity, specificity, likelihood ratios and diagnostic odds ratios (DORs) were calculated for each study. Random effects meta-analytic pooling across studies at the standard cut-off point (> or =9) was undertaken and summary receiver operating characteristic (ROC) curves constructed. RESULTS: For suicide, pooled sensitivity was 0.80 [95% confidence interval (CI) 0.68-0.90], pooled specificity was 0.42 (95% CI 0.41-0.44), and the pooled DOR was 3.39 (95% CI 1.29-8.88). For non-fatal self-harm, pooled sensitivity was 0.78 (95% CI 0.74-0.82), pooled specificity was 0.42 (95% CI 0.38-0.45), and the pooled DOR was 2.27 (95% CI 1.53-3.37). CONCLUSION: The standard cut-off point on the BHS identifies a high-risk group for potential suicide, but the magnitude of the risk is lower than previously reported estimates. The standard cut-off point is also capable of identifying those who are at risk of future self-harm, but the low specificity rate means it is unlikely to be of use in targeting treatment designed to lower the rate of repetition.
BACKGROUND: Hopelessness is considered a pre-eminent risk factor for suicide and non-fatal self-harm. We aimed to quantify the ability of the Beck Hopelessness Scale (BHS) to predict these two outcomes. METHOD: Medline, Embase, PsycINFO and Cinahl were searched to January 2006. We included cohort studies in which the BHS was applied and patients were followed-up to establish subsequent suicide or non-fatal self-harm. Four studies provided usable data on suicide, and six studies provided data on non-fatal self-harm. Summary sensitivity, specificity, likelihood ratios and diagnostic odds ratios (DORs) were calculated for each study. Random effects meta-analytic pooling across studies at the standard cut-off point (> or =9) was undertaken and summary receiver operating characteristic (ROC) curves constructed. RESULTS: For suicide, pooled sensitivity was 0.80 [95% confidence interval (CI) 0.68-0.90], pooled specificity was 0.42 (95% CI 0.41-0.44), and the pooled DOR was 3.39 (95% CI 1.29-8.88). For non-fatal self-harm, pooled sensitivity was 0.78 (95% CI 0.74-0.82), pooled specificity was 0.42 (95% CI 0.38-0.45), and the pooled DOR was 2.27 (95% CI 1.53-3.37). CONCLUSION: The standard cut-off point on the BHS identifies a high-risk group for potential suicide, but the magnitude of the risk is lower than previously reported estimates. The standard cut-off point is also capable of identifying those who are at risk of future self-harm, but the low specificity rate means it is unlikely to be of use in targeting treatment designed to lower the rate of repetition.
Authors: Kimberly A Van Orden; Tracy K Witte; Kelly C Cukrowicz; Scott R Braithwaite; Edward A Selby; Thomas E Joiner Journal: Psychol Rev Date: 2010-04 Impact factor: 8.934
Authors: Tracy K Witte; Madelyn S Gould; Jimmie Lou Harris Munfakh; Marjorie Kleinman; Thomas E Joiner; John Kalafat Journal: J Clin Psychol Date: 2010-09
Authors: Carol Chu; Melanie A Hom; Ian H Stanley; Anna R Gai; Matthew K Nock; Peter M Gutierrez; Thomas E Joiner Journal: J Consult Clin Psychol Date: 2017-11-27
Authors: Jeff C Huffman; Julia K Boehm; Scott R Beach; Eleanor E Beale; Christina M DuBois; Brian C Healy Journal: J Psychiatr Res Date: 2016-03-07 Impact factor: 4.791