the hopelessness depression symptom … the hopelessness depression symptom questionnaire (hdsq;...

Cognitive Therapy and Research, Vol. 21, No. 3, 1997, pp. 359-384

The Hopelessness Depression SymptomQuestionnaire1

Gerald I. Metalsky2

Lawrence University

Thomas E. Joiner, Jr.University of Texas Medical Branch at Galveston

Evaluated the Hopelessness Depression Symptom Questionnaire (HDSQ;Metalsky & Joiner, 1991). The HDSQ is a 32-item self-report measure of eightsymptoms posited by L. Abramson, G. Metalsky, and L. Alloy (1989) tocomprise a specific subtype of depression—hopelessness depression. Factoranalytic results from 435 subjects suggested that: (a) Each of the eight subscalesof the HDSQ reflects a distinct symptom of hopelessness depression; and (b)The eight subscales, taken together, reflect one higher-orderconstruct—Hopelessness Depression Symptoms. Diathesis-stress results from asubset of 174 subjects indicated that the attributional diathesis x stressinteraction predicted onset of hopelessness depression symptoms on the HDSQbut not nonhopelessness depression symptoms. The HDSQ should allow forenhanced precision in tests of the hopelessness theory of depression.

KEY WORDS: attributional style; hopelessness; depressed symptoms.

The hopelessness theory of depression (Abramson, Metalsky, & Alloy,1989) posits the existence of a subtype of depression—hopelessness depres-sion—which is hypothesized to have a characteristic cause, symptom profile,course, treatment, and prevention. The symptoms of hopelessness depres-

1Preparation of this article was supported by research grants from Lawrence University andthe Hogg Foundation for Mental Health to Gerald Metalsky, by a Young Investigator Awardto Thomas Joiner from the National Alliance for Research on Schizophrenia and AffectiveDisorders (NARSAD), and by a research grant to Thomas Joiner from the University ofTexas Medical Branch at Galveston, the funds of which derive from the Pearl and AaronForman Research Foundation and the John Sealy Memorial Endowment Fund.

2 All correspondence concerning this article should be addressed to Gerald I. Metalsky, De-partment of Psychology, Lawrence University, P.O. Box 599, Appleton, Wisconsin 54912-0599.

359

0147-5916/97/0600-0359$12.50/0 C 1997 Plenum Publishing Corporation

360 Metalsky and Joiner, Jr.

sion are posited to include: (a) retarded initiation of voluntary responses(motivational symptom), (b) sad affect, (c) suicidality, (d) lack of energy,(e) apathy, (f) psychomotor retardation, (g) sleep disturbance, (h) difficultyin concentration, and (i) mood-exacerbated negative cognitions. Althoughlow self-esteem and interpersonal dependency also are posited to be partof the clinical picture under specified conditions (see Abramson et al., 1989,p. 363, for a discussion of this issue), recent work (e.g., Metalsky, Joiner,Hardin, & Abramson, 1993; Roberts & Monroe, 1992) suggests that lowor labile self-esteem may best be viewed as part of the causal sequencewhereas interpersonal dependency may indeed be a symptomatic featureof hopelessness depression (Metalsky & Joiner, 1997).

In spite of a growing body of research on the hopelessness theory ofdepression, no measurement instrument currently exists for measuring thesymptoms of hopelessness depression. Instead, when testing the hopeless-ness theory, investigators typically rely on extant measures of depressivesymptoms, such as the Beck Depression Inventory (BDI; Beck, 1967; Beck,Rush, Shaw, & Emery, 1979; Beck & Steer, 1987). Regardless of whetherdepressive symptoms are measured by self-report or by interview, the sameproblem exists: All current measures of depressive symptoms do not meas-ure the symptoms of hopelessness depression with sufficient precision.There are two main reasons for this problem. First, extant measures typi-cally include some symptoms that are not posited to be part of hopelessnessdepression ("errors" of commission). Second, extant measures typically donot include some of the symptoms that are posited to be part of hopeless-ness depression ("errors" of omission).

Of course, we do not fault the existing measures hi that none weredeveloped for the express purpose of measuring the symptoms of hope-lessness depression. Nonetheless, it is important to emphasize that relianceon such measures in tests of the hopelessness theory can lead to findingsthat are misleading in terms of evaluating the validity of the theory. Forexample, of the 21 items on the BDI, only nine (42.86%) include symptomsof hopelessness depression. With several items measuring nonhopelessnessdepressive symptoms, it would not be very surprising if an investigator wereto obtain null findings when testing the hopelessness theory, even if thetheory is valid. On the other hand, if a given group of subjects were toshow elevations on the BDI due to an endorsement of items that assesshopelessness depression, then we would expect the results to be in linewith the hopelessness theory, if the theory is true. Thus, when using theBDI or any other extant measure of depressive symptoms, it is extremelydifficult to interpret the findings in terms of the validity of the hopelessnesstheory. Simply put, a precise test of the hopelessness theory can not beaccomplished when using measures that are comprised of an admixture of

Hopelessness Depression Symptom Questionnaire 361

hopelessness depression symptoms and non-hopelessness depression symp-toms.

In order to fill this void, we report on a new measure—the Hopeless-ness Depression Symptom Questionnaire (HDSQ; Metalsky & Joiner,1991)—which was expressly designed to measure the symptoms of hope-lessness depression. The HDSQ is a 32-item self-report measure that allowsinvestigators to examine individual and combined symptoms of hopeless-ness depression. The format is similar to the BDI. Each symptom is meas-ured by a cluster of four items (e.g., for psychomotor retardation, itemsask about difficulty with slowed speech, thoughts, and so on). Thus, thereare a total of eight subscales, each comprised of four items, and each meas-uring a different symptom of hopelessness depression. Scores on each itemrange from 0 to 3 and, for a given subscale, from 0 to 12, with higherscores reflecting greater severity of a given symptom. The HDSQ is pre-sented in the Appendix.

In the present study we evaluate the reliability and validity of theHDSQ. As can be seen in the Appendix, the HDSQ was designed to meas-ure the following symptoms: (a) Motivational Deficit (retarded initiationof voluntary responses; items 1-4); (b) Interpersonal Dependency (items5-8); (c) Psychomotor Retardation (items 9-12); (d) Anergia (items 13-16);(e) Apathy/Anhedonia (items 17-20)3; (f) Insomnia (items 21-24); (g) Dif-ficulty in Concentration/Brooding (items 25-28); and (h) Suicidality (items29-32).4 We tested whether each of these eight symptoms reflects a distinctsymptom of hopelessness depression. In addition, we tested whether onelatent variable—Hopelessness Depression Symptoms—is indicated by the

3Although Abramson et al. (1989) included apathy, not anhedonia, as a proposed symptomof hopelessness depression, we view our inclusion of anhedonia as being consistent with thelogic of the hopelessness theory. In line with Beck (1967), Abramson et al. (1989, p. 363)argued that apathy, anergia, and psychomotor retardation are, in part, concomitants of asevere decrease in the motivation to initiate voluntary responses. Following Beck (1967), lackof enjoyment when engaging in normally pleasurable activities (anhedonia) also should be aconcomitant of the motivational deficit. As Beck et al. (1979; pp. 182,183) have argued, theloss of motivation typically is accompanied by both a lack of interest in, and a lack of en-joyment from, normally pleasurable activities. Of interest in this context, apathy, by definition,includes both lack of interest and lack of enjoyment (see Oxford English Dictionary). As willbe seen, the results support our position of including anhedonia as a symptom of hopelessnessdepression.

4The HDSQ does not measure two of the proposed symptoms of hopelessness depres-sion—sadness and mood-exacerbated negative cognitions. When the HDSQ was developed(Metalsky & Joiner, 1991), other measures were available for assessing depressed mood. Wetherefore had planned to combine the HDSQ with an extant measure of depressed mood.Nevertheless, for simplicity and convenience, it would be preferable to have a HDSQ subscalethat assesses sadness directly. We are now in the process of adding such a subscale to theHDSQ. We also are in the process of adding a subscale to assess mood-exacerbated negativecognitions. Such a subscale was included when the HDSQ was being developed but was laterdiscarded because the items were not clear enough in reflecting a worsening of cognitions asa function of worsening mood.


eight symptom subscales of the HDSQ. Finally, we used a prospective de-sign to test the diathesis-stress component of the hopelessness theory usingthe HDSQ, BDI, and the Positive Affect Negative Affect Schedule(PANAS; Watson, Clark, & Tellegen, 1988). We predicted that the attribu-tional diathesis (i.e., style to attribute negative events to stable, globalcauses) would interact with the presence of negative life events to predictonset of hopelessness depression symptoms. We further predicted that theattributional diathesis x stress interaction would not predict onset of non-hopelessness depressive symptoms.

METHOD

Participants and Procedure

A combined sample of 435 (248 women; 187 men) participants wereincluded in at least one aspect of the present study. Participants were drawnfrom Introductory Psychology classes at a large southwestern university. As-sessed in groups of approximately 30-50 students, participants were in-formed that they would be filling out questionnaires about their personalviews, feelings, and attitudes. All 435 students completed the HDSQ at T1,and were included in the factor-analytic phase of the study.

A subset of participants (n = 174; 102 women; 72 men) also wereincluded in the diathesis-stress phase of the study. These students returnedfor a second assessment session, 10 weeks after the first, in which theyagain completed questionnaires about personal feelings and attitudes. AtT1, participants completed the Extended Attributional Style Questionnaire,the HDSQ, and BDI. At T2, participants completed the Negative LifeEvents Questionnaire, the HDSQ, and BDI. Also, at T1 and T2, some par-ticipants completed the PANAS.

Materials

Hopelessness Depression Symptom Questionnaire

All 435 participants completed the HDSQ (Metalsky & Joiner, 1991)at T1. The alpha coefficients for each subscale in the present sample were:(a) Motivational Deficit (retarded initiation of voluntary responses; alpha= .70); (b) Dependency (alpha = .72); (c) Psychomotor Retardation (alpha= .74); (d) Anergia (alpha = .86); (e) Apathy/Anhedonia (alpha = .75);(f) Insomnia (alpha = .81); (g) Difficulty in Concentration/Brooding (alpha= .80); and (h) Suicidal ideation/impulses (alpha = .86). The alpha coef-ficient for the full HDSQ was .93.


Extended Attributional Style Questionnaire (EASQ)

For the diathesis-stress phase of the current study, 174 participantscompleted the EASQ (Metalsky, Halberstadt, & Abramson, 1987) at T1.The EASQ consists of 12 hypothetical negative life events and, similar tothe original ASQ (Peterson et al, 1982: Seligman, Abramson, Semmel, &von Baeyer, 1979) participants write down the one major cause of a givenevent, in an open-ended format, and then rate the cause on a 1 to 7 scaleseparately for degree of internality, stability, and globality. The EASQalong with the original scale has been well-validated (Metalsky et al., 1987;Metalsky & Joiner, 1992; Metalsky et al, 1993; see Peterson & Seligman,1984 for a review of the original scale). Consistent with the hopelessnesstheory (Abramson et al., 1989) and with past research (e.g., Metalsky etal., 1987, 1993), we focused on the Generality subscale (generality = sta-bility + globality) in testing our predictions.

Negative Life Events Questionnaire (NLEQ)

Participants in the diathesis-stress phase of the study completed theNLEQ (Saxe & Abramson, 1987), which was developed specifically for usewith college students and includes several categories to ensure broad cov-erage (e.g., school, work, family, friends, etc.). Similar to past work (e.g.,Metalsky & Joiner, 1992; Needles & Abramson, 1990), the scale was con-densed to include 66 negative life stressors (e.g., "Fight or disagreementwith romantic partner"). Items were rated on a 0 to 4 scale (0 = "Neverpresent"; 4 = "always present") on how frequently they had occurred dur-ing the past 10 weeks. Scores can range from 0 to 264. Scores were alsocomputed using a dichotomous criterion (0 = event absent; 1 = event pre-sent). Results were similar to those using the 0 to 4 scale.

The scale is reliable and well-validated (Metalsky & Joiner, 1992; Nee-dles & Abramson, 1990; Saxe & Abramson, 1987). The NLEQ was admin-istered at T2 to 174 participants, covering the 10-week interval betweenT1 and T2, similar to the procedure used by several other investigators(e.g., Alloy & Clements, 1992; Barnett & Gotlib, 1988; Metalsky & Joiner,1992; Needles & Abramson, 1990).

Beck Depression Inventory (BDI)

For the diathesis-stress phase of the study, 174 participants completedthe BDI at T1 and T2. Each item is rated on a 0 to 3 scale; inventoryscores thus may range from 0 to 63. The BDI (Beck et al., 1979; Beck &


Steer, 1987) is a reliable and well-validated measure of general depressivesymptomatology (alpha in present sample was .89; see Beck, Steer, & Gar-bin, 1988 for a review; see also Kendall, Hollon, Beck, Hammen, & Ingram,1987). The BDI contains several hopelessness depression symptom items(i.e., Items 1, 4, 9, 12, 13, 15, 16, 17, and 21) as well as nonhopelessnessdepression symptom items (i.e., Items 10, 11, 18, 19, and 20; the remainingitems are cognitive items that could not be included in either category be-cause it could not be determined that these items reflect mood-exacerbatednegative cognitions). We constructed two BDI subscales, comprised ofhopelessness depression and non-hopelessness depression items, in orderto further test our diathesis-stress predictions.

Positive Affect Negative Affect Schedule (PANAS)

The PANAS (Watson, Clark, & Tellegen, 1988) includes two 10-itemscales, one for Positive Affect (PA; the extent to which a person feels en-thusiastic, active, and alert) and one for Negative Affect (NA; the extentto which a person experiences subjective distress such as anger, disgust,guilt, and fear). Each item is rated on a 1 to 5 scale; thus scores for PAand NA can each range from 10 to 50 (for reliability and validity data, seeWatson, 1988; Watson, Clark, & Carey, 1988; Watson, Clark, & Tellegen,1984, 1988). Participants indicated how they felt over the past 2 weeks(similar to the time frame for the HDSQ and BDI).

It should be noted that low PA is viewed as an index of anhedonia,which we have proposed as a symptom of hopelessness depression. Clarkand Watson (1991) argued that anhedonia distinguishes depression fromother syndromes, such as those associated with anxiety. In contrast, NA isviewed as a nonspecific index of generalized emotional distress, which isnot posited to be a symptom of hopelessness depression.

Due to time constraints, we had complete data on a random 90 of174 participants at T1 and T2. Thus, self-selection was not responsible forthe smaller portion of subjects who completed the PANAS. The results per-taining to the PANAS are presented as a supplement to the HDSQ andBDI findings.

Data-Analytic Strategy

Factor-Analytic Phase of the Study

The HDSQ was factor analyzed using principal components analysis(PCA) and principal axis factoring (PAF). As is commonly the case, thePCA and PAF results were highly similar. The PCA results are presented


Table I. Means, Standard Deviations, and Ranges of theHDSQ Subscales and Full Scalea

AnergiaPsychomotor retardationSuicidalityInsomniaDependencyApathy/anhedoniaConcentration difficultyMotivational deficitFull scale

Mean

1.701.110.401.442.361.002.071.40

11.38

StandardDeviation

1.971.521.251.901.711.631.981.579.67

Range

0-110-80-100-100-100-90-100-90-58

aHDSQ= Hopelessness Depression Symptom Questionnaire.

below. To enhance the interpretability of the rotated factor solution, anorthogonal rotation procedure was selected (Varimax; this approach is con-sistent with Nunnalty's (1978, p. 418) recommendation; for the sake of thor-oughness, oblique solutions were also examined, and yielded quite similarresults. Accordingly, the orthogonal results are presented below).

The following estimation criteria for extraction of factors were used:(1) Kaiser's (1961) criterion to retain factors with unrotated eigenvaluesgreater than one; (2) a scree test (Cattell, 1966); and (3) the interpretabilityof resulting factor structures (Gorsuch, 1983), which involves examining so-lutions with different extraction criteria to determine the point at whichtrivial or redundant factors emerge (see, for example, Tobin, Johnson, Ste-inberg, Staats, & Dennis, 1991).

Next, the second-order factor structure of the HDSQ was examinedusing LISREL structural equation modeling. This procedure allowed us totest our prediction that a one factor solution would be an adequate modelfor the inter-relations between the HDSQ subscales.

Diathesis-Stress Phase of the Study

Consistent with the recommendations of Cohen and Cohen (1983), asetwise hierarchical multiple regression procedure was used to test predic-tions pertaining to the Attributional Diathesis x Stress interaction. T2 de-pression scores (as measured by the HDSQ, and by the BDI) served asthe dependent variable. T1 (baseline) depression scores were entered firstinto the regression equation, thereby creating residual change scores in de-pression from T1 to T2. This, of course, also controls for T1 depression.Next, ASQ generality scores and Negative Life Events scores were enteredinto the regression equation simultaneously as a set, followed, at Step 3,

367Hopelessness Depression Symptom Questionnaire


by entry of the ASQ x Stress interaction term. Consistent with Cohen andCohen (1983), individual variables within a given set were not interpretedunless the set as a whole was significant, thereby reducing Type I errors.The assumption of homogeneity of covariance was tested and met for allregression analyses (cf. Joiner, 1994). An important aspect of our analyticapproach was the comparison of diathesis-stress results using the HDSQversus the BDI. This same procedure was used to compare diathesis-stressresults predicting PA versus NA scores.

RESULTS

Descriptive statistics, including means, standard deviations, and ranges,for each HDSQ subscale, and for the full HDSQ, are presented in Table I.

Factor Analytic Findings

First-Order Factor Analyses

Eight factors possessed eigenvalues greater than one. Among the firsteight factors, each was interpretable, nonredundant, and non-trivial. The onlyclear "scree" occurred after the first factor (Eigenvalues—10.31,2.52,2.23,1.59,1.33, 1.14, 1.04, & 1.00). Despite the scree result, eight factors were retained,because eight factors produced eigenvalues greater than one, and each of thesewere interpretable. Furthermore, this pattern of results is highly consistent withour overall conceptualization that the HDSQ measures eight facets of one con-struct (i.e., hopelessness depression symptoms; cf. LISREL results below).

Table II displays the rotated factor loadings, eigenvalues, and commu-nalities for the analysis extracting eight Varimax-rotated factors. Factor load-ings that are italicized represent "on-factor" loadings (i.e., loadings of itemson factors on which they are hypothesized to load). Factor loadings that arenot italicized represent "off-factor" loadings (i.e., loadings of items on factorson which they are hypothesized not to load). Finally, factor loadings in boldtype represent loadings that did not fully conform to prediction.

As can be seen in Table II, in general, the eight factors correspondedto the eight HDSQ subscales. Indeed, with two interesting exceptions (dis-cussed below), "on-factor" loadings were higher—usually substantiallyhigher—than "off-factor" loadings. The average loading for "on-factor"items was .64; average loading for "off-factor" items was .13.

The two exceptions involve Items 3 and 4, and Items 25 and 26. Items3 and 4 were developed as measures of Motivational Deficit, and like theother two Motivational Deficit items (Items 1 & 2), they load on the Mo-tivational Deficit factor. However, Items 3 and 4 load more highly on the


Table III. Intercorrelations of HDSQ Subscalesa

Item

1.2.3.4.5,6.7.8.

Factor 1Anergia

-.66.31.31.44.57.66.54

Factor 1Psycho-motor

Retarda-tion

-.33.30.44.58.66.60

Factor 3Suicidal-

ity

-.18.15.39.32.33

Factor 4Insomnia

-.27.30.35.30

Factor 5Depen-dency

-.36.52.44

Factor 6Apathy/Anhe-donia

-.64.54

Factor 7Concen-tration

Difficulty

-.57

Factor 8Motiva-tionalDeficit

-aHDSQ = Hopelessness Depression Symptom Questionnaire. All correlations are significantto the ,001 level.

Psychomotor Retardation factor than on the Motivational Deficit factor.The statistical overlap between these two factors is not surprising givenAbramson et al.'s (1989) suggestion that psychomotor retardation shouldbe a symptom of hopelessness depression to the extent that it is a con-comitant of the motivational deficit.

Items 25 and 26 were developed as Concentration Difficulty items,and they do load moderately on the Concentration Difficulty factor (Factor7). However, they load more substantially on the Anergia factor. Two pointsare noteworthy regarding this finding. First, within the four items developedto assess Concentration Difficulty, two assess concentration (Items 25 &26), and two assess brooding/distraction (Items 27 & 28). The distinctionbetween concentration and brooding/distraction, while subtle, may be im-portant. Second, it is of interest to note that the relation between lack ofconcentration and anergia is consistent with Beck's (1967, p. 35) findingsthat lack of energy was most highly associated with indecisiveness (as wellas psychomotor retardation, anhedonia, and hopelessness) on the BDI.

In summary, the results regarding the first-order factor structure of theHDSQ were consistent with its intent—to measure the eight symptoms ofhopelessness depression. Next, we address whether these eight subscales arefacets of one higher-order construct (i.e., symptoms of hopelessness depression)or whether the second-order factor structure of the HDSQ is more complex.

LISREL Analyses of Subscale Intercorrelations

The intercorrelations between the eight subscales of the HDSQ arepresented in Table III. In line with prediction, we tested whether a LISREL


Fig. 1. One-factor model of hopelessness depression symptoms, as measured by HDSQsubscales, with parameter estimates from LISREL confirmatory factor analyses.

model, with eight HDSQ factors loading onto one Hopelessness DepressionSymptom latent variable, would provide a good fit to the observed data.

As is depicted in Fig. 1, one latent variable was specified (Symptoms ofHopelessness Depression), which was measured by eight observed variables(i.e., the original eight HDSQ subscales). Consistent with the recommenda-tions of Byrne (1989), and with past work (e.g., Holahan & Moos, 1991), toprovide a metric for the latent constructs and to identify the measurementmodel, one loading per latent construct was set to 1.0 (cf. Holahan & Moos,1991; Joiner & Rudd, 1996). As is frequently the case (Gerbing & Anderson,1984; Tanaka & Huba, 1984), a better solution was obtained when certainerror residuals were estimated by the LISREL program, as opposed to beingfixed in advance. The path coefficients in Fig. 1 were calculated using theLISREL packages option for completely standardized solution.

The results of the LISREL test of the model are shown in Fig. 1,which includes the parameter estimates for the measurement (Lambda X)and residual (Theta Delta) matrices.

The measurement model was adequate (total coefficient of determi-nation = .92). The loadings of the observed variables onto the latent con-struct conformed to the hypothesized model without exception; allparameter estimates were highly significant.

The overall goodness of fit for the model was reasonable: Overall chi-square (df = 18) = 27.63, p = ns, goodness of fit index= .986, Adjusted


goodness of fit index = .972. All of these figures meet accepted criteriafor goodness of fit.

To compare the model depicted in Fig. 1 to alternative models, a LIS-REL analysis was conducted with each variable loading onto its own con-struct (i.e., the "null" model). Fit indices were as follows: Overall chi-square(df= 28) = 1517.57,p <.0001; goodness-of-fit index = .408; adjusted good-ness-of-fit index = .239. Rentier and Bonnett (1980) have provided anormed fit index for comparison of specified models to the null model.When this index is computed for the one-factor model as it compares tothe null model, the fit index for the one-factor model is .982.

In addition, we attempted comparison of the one-factor model to atwo-factor model, with Anergia, Apathy/Anhedonia, Psychomotor Retarda-tion, and Motivational Deficit grouped on one factor (a Deficit Model),and the remaining subscales grouped on a second factor. This was doneto provide a potentially strong alternative against which to compare theone-factor model in that Abramson et al. (1989, p. 363) posited lack ofenergy, apathy, and psychomotor retardation as concomitants of the moti-vational deficit. Interestingly, the LISREL program failed to converge ona solution. Diagnostic indices provided by the program suggested that avery high correlation between the two factors contributed to the conver-gence problem, consistent with the view that a one-factor model is theo-retically and empirically preferable.

In summary, the psychometrics of the HDSQ perform essentially asintended. At the first-order level, the eight subscales each appear to reflecta distinct hopelessness depression symptom; at the second-order level, onelatent variable—Symptoms of Hopelessness Depression—is indicated bythe eight HDSQ subscales. The HDSQ also is internally consistent, yieldingan alpha coefficient of .93 in the present sample.

Diathesis-Stress Results

HDSQ Results

Regression analysis indicated that, consistent with prediction, the ASQx Negative life Events interaction was significant in predicting residualchanges in HDSQ scores from T1 to T2 (see Table IV; pr = .16, t (169)= 2.12, p < .05).

To examine whether the form of the two-way interaction conformedto prediction, following Cohen and Cohen (1983, p. 323, 419), residualHDSQ change scores were computed by inserting specific values for ASQand Negative Life Events (i.e., 1 standard deviation above and below themean) into the regression equation summarized in Table IV (see Metalsky


Table IV. Negative Attributional Style, Negative Life Events, and the ASQ x Negative LifeEvents Interaction at Time 1 Predicting Residual Changes in HDSQ Depression from Time1 to Time 2a

Order ofEntry of

Set

1.

2,

3.

Predictors in Set

BaselineTime 1 HDSQ

Main effectsTime 1 ASQTime 1 negative events

Two-way interactionASQ x negative events

F for Set

109.12c

17.24c

4.49b

t forWithin SetPredictors

10.45c

1.835.24c

2.12b

df

1,172172

2,170170170

1,169169

PartialCorrelation

(PR/pr)

.62

.62

.42

.14

.37

.16

.16aASQ = Attributional Style Questionnaire, Generality Subscale. HDSQ = Hopelessness De-pression Symptom Questionnaire. PR = Multiple partial correlation for a set of predictors;pr = partial correlation for within set predictors.

bp < ,05.cp < .01.

et al., 1987, 1993). The results of this analysis are depicted in Fig. 2. Ascan be seen in Fig. 2, subjects with a negative attributional style who ex-perienced negative life stress were prone to increases in HDSQ symptomswhereas other subjects were not.

Concerning the individual subscales of the HDSQ, regression analysesindicated that the ASQ x Negative Life Events interaction was significantfor Anergia (pr= .21, p < .01), Motivational Deficit (pr= .15, p < .05),Dependency (pr= .21, p < .01), but not for the remaining subscales (pr'sranged from .04 to .12, all p's= ns). These findings should be interpretedwith caution, however, in view of the problem of restricted range on someof the HDSQ subscales (e.g., suicidality; see Table I). In addition, in termsof number of items, the HDSQ is 8 times longer than each of the subscales;thus, one would expect greater prediction with the HDSQ than with itssubscales (see Epstein, 1979; Nunnally, 1978). In fact, alpha for the fullscale was .93 compared to alphas for the subscales, which averaged .78.

BDI Analyses

Regression analysis indicated that the ASQ x Negative Life Eventsinteraction was not significant in predicting residual changes in BDI de-pression scores from T1 to T2 (see Table V; pr = .05, t (169) = 0.70, p=ns). This finding held when we examined BDI subscales comprised of non-hopelessness depression items (pr = .06, t (169) = 0.74, p= ns) and hope-lessness depression items (pr = .07, t (169) = 0.88, p= ns). These BDIsubscale findings are difficult to interpret, however, because of low reli-ability (e.g., alpha= .40 at T1 and .17 at T2 for the nonhopelessness de-


Fig. 2. Residual Change in HDSQ Scores as a Func-tion of Attributional Style and Negative Life Events.

pression subscale) and because of lack of any previous research concerningthe validity of these subscales. In contrast, the full BDI had a reliability of.89 in the present sample (comparable to the .93 for the HDSQ) and ofcourse has been well-validated as a measure of general depressive symp-toms. We therefore focus on the full BDI in interpreting our findings.

PA and NA Analyses

Insofar as PA but not NA assesses a hopelessness depression symptom(i.e., anhedonia), as proposed in the present study, we expected the ASQx Negative Life Events interaction to predict changes in PA but not in NA.Results were fully in line with expectation. The ASQ x Negative Life Eventsinteraction was significantly associated with changes in PA from T1 to T2(pr = -.23, t (79) = -2.11, p < .05), but not with changes in NA from T1to T2 (pr = .04, t (79) = 0.33, p = ns). Follow-up analysis of the PA resultsrevealed a similar form to the interaction as that depicted in Fig. 2 for theHDSQ results. Subjects with a negative attributional style who experiencednegative life stress were more prone to decreases in PA (i.e., increases inanhedonia) than were other subjects. It should be noted that the standarddeviations for NA were comparable to those for PA, all falling between8.04 and 8.81. Thus, the absence of effect for NA was not due to a re-stricted range in NA scores.


Table V. Negative Attributional Style, Negative Life Events, and the ASQ x Negative LifeEvents Interaction at Time 1 Predicting Residual Changes in BDI Depression from Time 1to Time 2a

Order ofEntry of

Set

1.

2.

3.

Predictors in Set

BaselineTime 1 BDI

Main effectsTime 1 ASQTime 1 negative events

Two-way interactionASQ x Negative events

F for Set

88.33*

6.99b

0.48

t forWithin SetPredictors

9.40b

0.353.61*

0.70

df

1,172172

2,170170170

1,169169

PartialCorrelation

(PR/pr)

.58

.58

.28

.03

.27

.05

.05aASQ = Attributional Style Questionnaire, Generality Subscale. BDI = Beck Depression In-ventory. PR - Multiple partial correlation for a set of predictors; pr = partial correlationfor within set predictors.

bp < .01.

DISCUSSION

Would the HDSQ provide a useful measure in future tests of the hope-lessness theory of depression? In our view, it would. Based on the presentfindings, each of the eight subscales of the HDSQ appears to reflect a dis-tinct symptom of hopelessness depression. In addition, these symptoms,taken together, appear to reflect one higher-order construct—HopelessnessDepression Symptoms. Finally, the diathesis-stress component of the hope-lessness theory was supported when predicting onset of hopelessness de-pression symptoms, perhaps especially anergia, motivational deficit, anddependency, but not when predicting an admixture of hopelessness andnon-hopelessness depression symptoms on the BDI. Overall, the resultssuggest that the HDSQ would allow investigators to provide more precisetests of the hopelessness theory than would extant measures of depressivesymptoms.

We are not suggesting that investigators abandon use of extant meas-ures of depressive symptoms when testing the hopelessness theory. To fullyevaluate the hopelessness theory it is crucial to determine whether thecausal pathway proposed in the theory contributes to the specified symp-toms of hopelessness depression and not to other symptoms. Thus, we rec-ommend that future investigators assess both hopelessness andnonhopelessness depressive symptoms in order to provide a more compre-hensive test of the theory (see Alloy & Clements, 1997; Alloy, Just & Pan-zarella, 1997, this issue). On the other hand, it should be kept in mind thatthe hopelessness theory of depression is fluid, not fixed; we anticipate thatadditional symptoms will need to be included in, or excluded from, thetheory as future work examines the symptom component of the theory.


We are aware of five studies (Alloy & Clements, 1997; Alloy et al.,1997; Haslam & Beck, 1994; Spangler, Simons, Monroe, & Thase, 1993;Whisman, Miller, Norman, & Keitner, 1995) that have examined the symp-tom component of the hopelessness theory directly. All of these studiesused items from extant or modified measures of depressive symptoms (e.g.,BDI; Hamilton Rating Scale for Depression; Hamilton, 1960; Schedule forAffective Disorders and Schizophrenia; Endicott & Spitzer, 1978; ModifiedInventory for Behavioral Variation; Alloy et al., 1997) in order to createmeasures of hopelessness depression symptoms. These investigators re-ported either little support (Haslam & Beck, 1994), partial support (Span-gler et al., 1993; Whisman et al., 1995) or strong support (Alloy &Clements, 1997; Alloy et al., 1997) for the symptom component of thehopelessness theory. Such mixed findings may be due, in part, to the useof measures that were not specifically designed to measure hopelessnessdepression symptoms. As Spangler et al. argued, "... The method of pool-ing individual items from instruments designed to yield overall scores ... isnot ideal. However, no existing measure of depressive symptomatology as-sesses the set of symptoms proposed to characterize the hopelessness de-pression subtype . . ." (p. 598). In view of the favorable findings for theHDSQ, and as Alloy et al. (1997) have suggested, future studies hopefullywill benefit from the use of the HDSQ or other measures specifically de-signed to assess hopelessness depression symptoms.

In addition to being used in tests of the hopelessness theory of de-pression, we believe the HDSQ also would be useful clinically and whentesting theories other than the hopelessness theory. The HDSQ's subscaleseach measure a given depressive symptom, thereby allowing clinicians andresearchers to examine individual depressed symptoms separately (e.g., psy-chomotor retardation; sleep disturbance; suicidality; etc.) as opposed tosimply examining a single score that reflects overall severity. We thereforerecommend use of the HDSQ as a supplement to other measures when itis important to examine individual depressive symptoms separately. How-ever, we also caution that the individual subscales each contain only fouritems and are in need of further validation.

Concerning identification of the proposed subtype of hopelessness de-pression, it is important to keep in mind that the hopelessness theory takesa theory-based rather than a symptom-based approach to classification.That is, hopelessness depression is not defined solely on the basis of itssymptoms but, instead, on the basis of its proposed cause, course, treat-ment, prevention, as well as its proposed symptom profile. Consequently,the identification of hopelessness depression can not be accomplished sim-ply on the basis of elevated HDSQ scores alone (see Alloy, Hartlage, &Abramson, 1988 for a discussion of this issue). Nonetheless, if investigators


were to identify individuals who develop hopelessness and who do not sub-sequently develop the symptoms assessed by the HDSQ, such findingsclearly would be at odds with the postulates of the hopelessness theory.Thus, in comparison to measures comprised of an admixture of hopeless-ness and non-hopelessness depressive symptoms, the HDSQ should allowinvestigators to conduct more precise tests of the etiological, symptom, andsubtype components of the hopelessness theory.

Although Abramson et al. (1989) included apathy, not anhedonia, asa proposed symptom of hopelessness depression, we have departed fromthis aspect of the theory, proposing instead that both apathy and anhedoniaare, in part, concomitants of a severe decrease in the motivation to initiatevoluntary responses (Beck, 1967; Beck et al., 1979; see footnote 3). It isof interest to consider this issue in historical context. There has been muchcontroversy concerning the issue of whether animals exposed to uncon-trollable shocks fail to initiate voluntary responses to terminate shocks inthe future because they have a response initiation deficit (including apathy)caused by an expectation of no control (the Seligman position; e.g., Selig-man, 1975) or because they experience much less pain after repeated ex-posure to uncontrollable shock (the "anhedonia" position). Abramson etal. (1989) drew upon Seligman's work when postulating apathy (loss of in-terest; passivity; etc.) as a symptom of hopelessness depression. Of consid-erable interest, contemporary research on learned helplessness with animalshas revealed an impairment in sensitivity to reward (anhedonia) as reflectedby suppressed intracranial self-stimulation to specific "pleasure centers" ofthe brain following exposure to inescapable shock (see Willner, 1993 for areview). These findings in conjunction with those of the present study sug-gest that future work needs to reconsider whether or not anhedonia shouldbe explicitly postulated as a symptom of hopelessness depression.

Limitations with the present investigation should be noted. First, aspreviously mentioned, the current version of the HDSQ does not assesstwo of the proposed symptoms of hopelessness depression—sadness andmood-exacerbated negative cognitions. We are in the process of addingthese two additional subscales to the HDSQ. Second, future work needsto examine whether the findings of the present study apply to the devel-opment of more severe symptoms of hopelessness depression in responseto severe life stress. Third, the present study did not test whether the at-tributional diathesis x stress interaction predicted onset of hopelessness de-pression symptoms through the operation of hopelessness (mediationcomponent of the theory). Fourth, the 10-week time-lag between T1 andT2 probably was not ideal. Prior research (e.g., Metalsky et al., 1987, 1993)has suggested that time-lags can profoundly affect the findings of a givenstudy and that, in general, studies with shorter time-lags (e.g., Metalsky &


Joiner, 1992) are more likely to yield positive findings than studies withlonger time-lags. The relatively long time-lag in the present study may bepartly responsible for the small effect sizes for the diathesis- stress inter-actions. Fifth, future work needs to determine why some studies have re-ported positive attributional style x stress findings with the BDI (e.g.,Metalsky & Joiner, 1992) while others have reported negative findings withthe BDI (e.g., present study). As we argued earlier, use of the BDI to testthe diathesis-stress component of the hopelessness theory of depressionshould yield mixed findings across studies depending, in part, on the per-centage of subjects in a given sample who exhibit elevated BDI scores dueto high levels of hopelessness depression symptoms. If few subjects in agiven sample score high on the BDI because of elevated hopelessness de-pression symptoms, then negative findings are likely to be obtained. In con-trast, if many subjects in a given sample score high on the BDI becauseof elevated hopelessness depression symptoms, then positive findings arelikely to be obtained. We emphasize that we are not criticizing the BDI,which was intended to measure severity of general depressive symptoms,not severity of hopelessness depression symptoms.

We believe that depression researchers will find the HDSQ useful notonly as a tool for testing the hopelessness theory of depression but as ameans of approaching the assessment of depressed symptoms in an indi-vidualized manner for both clinical work and for research purposes. Forexample, the HDSQ can be used to derive a profile depicting which par-ticular symptoms are elevated, and which are not, for a given patient. Thus,an important task for future research is to compile normative data for clini-cal use of the HDSQ.

APPENDIX

The Hopelessness Depression Symptom Questionnaire

Instructions: On this questionnaire are groups of statements. Please readall of the statements in a given group. Then pick out the one statementin each group which describes you best for the past TWO WEEKS. If severalstatements in the group seem to apply equally well, choose the highernumber. Do not choose more than one number for a given group of state-ments. BE SURE TO READ ALL OF THE STATEMENTS IN EACHGROUP BEFORE MAKING YOUR CHOICE.

1.0= I have not stopped trying to get what I want.1=I have stopped trying to get what I want in some situations.2= I have stopped trying to get what I want in most situations.


3= I have stopped trying to get what I want in all situations.

2.0= I am not passive when it comes to getting what I want these days.1= In some situations I'm passive when it comes to getting what I want

these days.2= In most situations I'm passive when it comes to getting what I want

these days.3= In all situations I'm passive when it comes to getting what I want these days.

3.0= I have not given up trying to accomplish what's important to me.1= I have given up trying to accomplish some things that are important

to me.2= I have given up trying to accomplish most things that are important to

me.3= I have given up trying to accomplish all things that are important to

me.

4.0= My motivation to get things done is as good as usual.1= In some situations, my motivation to get things done is lower than usual.2= In most situations my motivation to get things done is lower than usual.3= In all situations my motivation to get things done is lower than usual.

5.0= I need little or no support from other people.1= I need some support from other people.2= I need a lot of support from other people.3= I need total support from other people.

6.0= I don't rely on other people to do things for me.1= Sometimes I rely on other people to do things for me.2= Most of the tune I rely on other people to do things for me.3= All of the time I rely on other people to do things for me.

7.0= These days I am not overly dependent on other people.1= Sometimes these days I am overly dependent on other people.2= Most of the time these days I am overly dependent on other people.3= These days I am always overly dependent on other people.

8.0= I am not a burden to other people.


1= I am a burden to other people sometimes.2= I am a burden to other people most of the time.3= I am a burden to other people all of the time.

9.0= I am not doing things in "slow motion" these days.1= Sometimes I do things in "slow motion" these days.2= Most of the time I do things in "slow motion" these days.3= I always do things in "slow motion" these days.

10.0= I do not walk around like a zombie these days.1= Sometimes I walk around like a zombie these days.2= Most of the time I walk around like a zombie these days.3= I always walk around like a zombie these days.

11.0= My speech is not slowed down.1= My speech is somewhat slowed down.2= My speech is very slowed down.3= My speech is extremely slowed down.

12.0= My thoughts are not slowed down.1= My thoughts are somewhat slowed down.2= My thoughts are very slowed down.3= My thoughts are extremely slowed down.

13.0= My energy is not lower than usual.1= My energy is somewhat lower than usual.2= My energy is much lower than usual.3= My energy is extremely lower than usual.

14.0= I can get things done as well as usual.1= In some situations I can't get things done as well as usual.2= In most situations I can't get things done as well as usual.3= In all situations I can't get things done as well as usual.

15.0- I have as much energy as usual.1= In some situations I have less energy than usual.2= In most situations I have less energy than usual.3- In all situations I have less energy than usual.


16.

0= I do not get tired out more easily than usual.1= In some situations I get tired out more easily than usual.2= In most situations I get tired out more easily than usual.3= In all situations I get tired out more easily than usual.

17.0= I enjoy things as much as usual.1= In some situations I don't enjoy things as much as usual.2= In most situations I don't enjoy things as much as usual.3= In all situations I don't enjoy things as much as usual.

18.0= When doing things I normally enjoy (e.g., work; being with people) I

have as much fun as usual.1= When doing things I normally enjoy (e.g., work; being with people) I

have somewhat less fun than usual.2= When doing things I normally enjoy (e.g., work; being with people) I

have much less fun than usual.3= When doing things I normally enjoy (e.g., work; being with people) I

don't have fun at all anymore.

19.0= When it comes to the things in life that count, I am as interested as

usual.1= When it comes to the things in life that count, I am somewhat less

interested than usual.2= When it comes to the things in life that count, I am much less interested

than usual.3= When it comes to the things in life that count, I don't have any interest

at all anymore.

20.0= I enjoy sex as much as usual.1=I enjoy sex somewhat less than usual.2= I enjoy sex much less than usual.3= I do not enjoy sex at all anymore.

21.0= I do not have trouble falling asleep.1= It takes me somewhat longer to fall asleep than usual (i.e., up to one

hour longer).2= It takes me much longer to fall asleep than usual (i.e., up to 2 hours

longer).

Hopeleisness Depression Symptom Questionnaire 381

3= It takes me substantially longer to fall asleep than usual (i.e., morethan 2 hours longer).

22.0= I do not have trouble sleeping through the night.1= Sometimes I have trouble sleeping through the night.2= Most of the time I have trouble sleeping through the night.3= I always have trouble sleeping through the night.

23.0= I do not wake up early in the morning and have trouble falling back

to sleep.1= Sometimes I wake up early in the morning and have trouble falling

back to sleep.2= Most of the time I wake up early in the morning and have trouble

falling back to sleep.3= I always wake up early in the morning and have trouble falling back

to sleep.

24.0= I can fall asleep as well as usual.1= Sometimes I have trouble falling asleep.2= Most of the time I have trouble falling asleep.3= I always have trouble falling asleep.

25.0= My concentration is as good as usual.1= My concentration is somewhat less focused than usual.2= My concentration is much less focused than usual.3= I can hardly concentrate at all anymore.

26.0= I can concentrate as well as usual.1= In some situations I can not concentrate as well as usual.2= In most situations I can not concentrate as well as usual.3= In all situations I can not concentrate as well as usual.

27.0= I do not brood about unpleasant events these days.1= Sometimes I brood about unpleasant events these days.2= Most of the time I brood about unpleasant events these days.3= I always brood about unpleasant events these days.

28.0= I am not distracted by unpleasant thoughts.


1= In some situations I am distracted by unpleasant thoughts.2= In most situations I am distracted by unpleasant thoughts.3= In all situations I am distracted by unpleasant thoughts.

29.0= I do not have thoughts of killing myself.1= Sometimes I have thoughts of killing myself.2= Most of the time I have thoughts of killing myself.3= I always have thoughts of killing myself.

30.0= I am not having thoughts about suicide.1= I am having thoughts about suicide but have not formulated any plans.2= I am having thoughts about suicide and am considering possible ways

of doing it.3= I am having thoughts about suicide and have formulated a definite plan.

31.0= I am not having thoughts about suicide.1= I am having thoughts about suicide but have these thoughts completely

under my control.2= I am having thoughts about suicide but have these thoughts somewhat

under my control.3= I am having thoughts about suicide and have little or no control over

these thoughts.

32.0= I am not having impulses to kill myself.1= In some situations I have impulses to kill myself.2= In most situations I have impulses to kill myself.3= In all situations I have impulses to kill myself.

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