BMJ Open 4:e005093 doi:10.1136/bmjopen-2014-005093
  • Epidemiology
    • Research

Identifying hopelessness in population research: a validation study of two brief measures of hopelessness

  1. Usha Menon1
  1. 1Department of Women's Cancer, UCL Institute for Women's Health and NIHR University College London Hospitals Biomedical Research Centre, London, UK
  2. 2University College London Hospitals NHS Foundation Trust, London, UK
  3. 3Faculty of Medicine & Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
  4. 4Free University of Brussels (VUB), Faculty of Medicine & Pharmacy, Brussels, Belgium
  1. Correspondence to Lindsay Fraser; l.fraser{at}
  • Received 19 February 2014
  • Revised 28 April 2014
  • Accepted 12 May 2014
  • Published 30 May 2014


Objective Hopelessness is an important construct in psychosocial epidemiology, but there is great pressure on the length of questionnaire measures in large-scale population and clinical studies. We examined the validity and test–retest reliability of two brief measures of hopelessness, an existing negatively worded two-item measure of hopelessness (Brief-H-Neg) and a positively worded version of the same instrument (Brief-H-Pos).

Design Cohort study.

Setting Control arm of the UK Collaborative Trial of Ovarian Cancer Screening.

Participants A non-clinical research-based sample of 5000 postmenopausal women selected from 56 512 participants.

Primary and secondary outcome measures Spearman's rank correlation of brief measures of hopelessness with the Beck Hopelessness Scale (BHS). Spearman's rank correlation with the Centre for Epidemiological Studies Depression Scale (CES-D) and change in mean score on repeat testing.

Methods Two short hopelessness measures, a negatively worded brief measure of hopelessness (Brief-H-Neg) and a positively worded brief measure of hopelessness (Brief-H-Pos), were administered by postal questionnaire to 5000 women together with the 20-item BHS and 20-item CES-D. The Brief-H-Neg and Brief-H-Pos were readministered to 500 women after a 2-week interval.

Results 2413 postmenopausal women (mean age 68.9 years) completed the questionnaire. The Brief-H-Neg and Brief-H-Pos correlated 0.93 and 0.87 with the BHS after correction for attenuation and their association with the CES-D mirrored that seen with the BHS (Spearman's rank correlation 0.88 and 0.68, respectively). There was no change in mean scores on the two measures with repeat testing in the 433 women who completed them and test–retest reliability was good (intraclass correlations Brief-H-Neg 0.67 and Brief-H-Pos 0.72).

Conclusions These findings provide support for the validity of the Brief-H-Neg and Brief-H-Pos. These brief measures are likely to be useful in large population studies assessing hopelessness.

Trial registration number NCT00058032.

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