Abstract 11970: A Valid and Reliable Scale to Differentiate State and Trait Hopelessness in Patients with Coronary Heart Disease

Abstract

Introduction: Coronary heart disease (CHD) and depression are highly prevalent, comorbid health problems associated with increased morbidity and mortality. Hopelessness is a factor related to depression, but less well understood. Hopelessness has been identified as important in the development and progression of CHD, and more recently has been linked to substantial morbidity and mortality. Hopelessness may represent a temporary response to a new CHD diagnosis (a state), but may also reflect a patient’s chronic outlook toward life (a trait). Commonly used measures for hopelessness are reliable and valid, yet fail to differentiate state from trait hopelessness. This differentiation is important, as state hopelessness may be more responsive to interventions commonly used in a cardiac rehabilitation setting. Purpose: The purpose of this research was to develop and test a scale to differentiate state and trait hopelessness as separate psychological constructs in patients with CHD.

Methods: Using a longitudinal design, 520 patients hospitalized with CHD completed a state-trait hopelessness scale. Cronbach’s alpha was used to assess reliability. Pearson correlations were used to assess concurrent validity and predictive validity of the State-Trait Hopelessness Scale (STHS). Exploratory factor analysis was conducted to examine the potential factor structure of the scale.

Results: Both the state (0.88) and trait (0.91) hopelessness scales had high reliability. Concurrent validity was established with the Beck Hopelessness Scale and Patient Health Questionnaire (PHQ-9). Predictive validity was established using the Activity Status Index. The 23-items of the STHS showed expected factor structure: state hopelessness, trait hopelessness, and a reverse-coded factor/hope.

Conclusions: This study demonstrated that the STHS has acceptable reliability and validity in differentiating state and trait hopelessness in patients with CHD. The tool is now ready for use in intervention studies focused on the treatment of state and trait hopelessness. State hopelessness, involving new symptoms of a temporary nature, may be successfully treated with short-term cognitive interventions, whereas trait hopelessness may require long-term cognitive therapy.