Many risk factors have been put forward to account for the significant increase in adolescent male suicide over the last 20 years, and the pronounced sex difference in suicide statistics. In particular, hopelessness has been shown to be a strong indicator of suicidality. This study investigated the relationship of gender role, stress, and coping to hopelessness in a normal adolescent population. It was hypothesized that stress, coping and a masculine gender role would contribute to hopelessness. 288 adolescent students between the ages of 15 and 18 were surveyed using the Adolescent Stress Scale, the Beck Hopelessness Scale, the Australian Sex Role Scale, and the Adolescent Coping Scale. Contrary to expectation, having a masculine gender role was not related to hopelessness; students with an undifferentiated gender role had higher levels of hopelessness than androgynous, masculine, and feminine students. However, the majority of students who had an undifferentiated gender role were male. Hopelessness was also associated with high levels of stress and the use of avoidance coping strategies. The results are discussed within the transactional stress model and the stress-diathesis model.

The purpose of this study is to evaluate the factor structure of the Emotional Distress Inven-tory (EDI) in a sample of 238 cancer patients. The conceptual framework that guided the development of the EDI, factor structure, internal consistency, and convergent validity are reported. Emotional distress items were developed and administered to cancer patients who initiated chemotherapy and/or radiation treatments at Morton Plant Hospital Cancer Center in Clearwater, Florida, USA. Item responses were examined by factor analyses of principal components with promax rotations. The EDI presents three subscales that assess anxiety/depression, hopelessness, and anger expression as components of emotional distress. We also discuss the important implications of these subscales, particularly the inclusion of anger expression and hopelessness in the assessment of emotional distress in cancer patients. / El propósito de este estudio es avanzar en la construcción del Inventario de Distrés Emocional (IDE) como un instrumento de screening, fácilmente accesible, administrable, ypsicométricamente válido y confiable, en la medición del distrés emocional en pacientes con cáncer. Se llevó a cabo un análisis factorial mediante componentes principales y método de rotación promax en una muestra de 238 pacientes con cáncer que iniciaron sus tratamientos con radioterapia y/o quimioterapia en el Hospital Morton Plant en la ciudad de Clearwater, Florida, EE. UU. Los resultados obtenidos nos indican que el IDE presenta una estructura factorial consistente con el marco conceptual en el cual se basó la construcción del instrumento, como también un elevado nivel de consistencia interna y validez convergente.

Självstigma hos personer med allvarlig psykisk störning behöver undersökas med tanke på att den psykiska ohälsan ökar. Syftet med studien var att undersöka hur självstigma påverkat individer med allvarlig psykisk störning. Studien utfördes som en litteraturstudie och resultatet utgjordes av tre kategorier: Att bli sin diagnos, Att känna skam och Att känna hopplöshet. Självstigma påverkar personer med allvarlig psykisk störning genom att försvåra förutsättningarna till återhämtning. Kombinationen av en allvarlig psykisk störning och självstigma skapar negativa konsekvenser utifrån individens egna stereotypa och fördomsfulla föreställningar. Individerna har svårt att känna mening med livet och undviker att söka hjälp på grund av skam och hopplöshet. Detta i sin tur kan leda till förvärrade symptom och ökat lidande. Sjuksköterskan behöver därför vara medveten kring problematiken med självstigma och vara observant kring individens egna fördomar, skamkänslor och känsla av hopplöshet kring sin diagnos. Det är av vikt att skapa förutsättningar för empowerment i vårdsituationen. Interventioner och omvårdnad bör ha som målsättning att minska symptomen av självstigma hos individer med allvarlig psykisk störning. Interventioner torde kunna utformas, men behöver anpassas utifrån vilket samhälle som vården utförs i. Det finns begränsningar i aktuell forskning och fler studier där självstigma som fenomen belyses vore önskvärt, liksom longitudinella studier för att ge en djupare förståelse. / Severe mental illness is a growing health problem. Severe mental illness and self-stigma in combination needs to be examined to clarify what impact they have in combination for each individual. The purpose of this study was to examine what kind of impact self-stigma has to individuals with severe mental illness. The study was conducted as a literature review and the results consisted of three categories: Becoming ones illness Feeling of shame and Feeling of hopelessness. Self-stigma affects the individuals negatively and makes it harder for them to recover. The combination of severe mental illness and self-stigma creates negative consequences from the stereotypical and jaundiced. Individuals have problems with finding meaning of life and are reluctant to seek treatment for their symptoms because of the feeling of shame and hopelessness. In return the symptoms of the mental illness increases and provides more suffering and decreases the meaning of life. It is important that nurses are aware of and are mindful to the individuals prejudice, feelings of shame and hopelessness about their mental illness. Nurses need to make sure that it is possible to be empowered as a patient. Interventions and nursing that aim to reduce the symptoms of self-stigma in severe mental illness should be adapted to the prejudice of the society. More scientific research is needed because of the limited number of present studies concerning self-stigma. There is a need to further investigate self-stigma in severe mental illness. Preferably studies with longitudinal design that focus on the phenomenon self-stigma and how it affects people with severe mental illness, to give a greater understanding.

<p>Syftet med denna studie är att belysa situationen för asylsökande barn med uppgivenhetssymptom utifrån behandlarens perspektiv. Syftet är vidare att undersöka behandlarens upplevelser och erfarenheter av att vårda och stödja dessa barn.</p><p>Frågeställningarna som är i fokus berör den vård och stöd som behandlarna erbjuder till barnen och deras familjer, effekter av behandlingen samt specifika behandlingar som är särskilt verksamma i förhållande till de aktuella barnens tillstånd och behov.</p><p>Studien är av en kvalitativ design och den vetenskapliga positionen av konstruktivistisk karaktär. Det empiriska materialet består av intervjuer med nio behandlare som varit i direkt kontakt med barnen och deras föräldrar. Kommande tre teman har varit grundläggande i intervjuerna; symtombilden, vägen ut ur tillståndet och slutligen behandlarens reflektioner kring problemet/fenomenet.</p><p>Studiens teoretiska perspektiv som valdes i syfte att nå en ökad kunskap och förståelse kring fenomenet är; pervasive refusal syndrome, depressiv devitalisering, kvävande moderskap, hopplöshet hos barn, simulering samt munchenhausen by Proxy.</p><p>Studiens resultat och analys kom att visa att fenomenet apatiska flyktingbarn är mycket komplext i sig. Alla behandlare anser att en del barn är verkligt sjuka men att majoriteten av barnen avsiktligt framkallar detta tillstånd. Behandlare har kunnat bevittna flera tillfällen då barnet eller barnen kunde sitta utan hjälp samt gå och äta själva. Alla behandlare upplevde att det var svårt att samarbeta med en del av föräldrarna samt att det fanns ett starkt motstånd till behandlingsarbetet från föräldrarnas sida.</p>

Psychosis encompasses a constellation of symptoms that have far-reaching social, physical and functional consequences for sufferers. One of the key clinical concerns in the management of psychotic illnesses is the risk of suicide, which is greatest in the early stages of psychosis. Hopelessness is consistently associated with risk for suicide but as a concept it is not well defined and is not specific enough to be of use in prediction of suicide. Future-directed thinking, particularly regarding positive future events, constitutes an aspect of hopelessness that is closely associated with risk for suicide. This study employed the Future Thinking Task to investigate whether future-directed thinking in first episode psychosis is significantly different from that of matched controls in performance or content, and to clarify the nature of its association with suicide risk in this patient group. In addition, the association of future-directed thinking with the negative symptoms of psychosis was investigated. The results showed that individuals with psychosis were impaired in future-directed thinking globally, particularly with respect to the coming year. Specific deficits were shown in the domains of relations with other people and personal development and understanding. Associations were shown between future-directed thinking and suicide, and reduced positive future-directed thinking was shown to be strongly associated with increased severity of negative symptoms. The results suggest avenues for novel interventions to improve hopelessness, suicide risk and the severity of negative symptoms in psychotic illness, and thereby improve functional outcomes.

Suicidal behavior, including ideation and attempts, is a significant public health problem. Due to the complexity of suicidal behavior, it is necessary to consider an array of factors that could serve as risk and protective factors. Previous research has shown that deficits in social problemsolving ability are associated with increased risk for suicidal ideation and attempts; conversely, problem solving strengths are associated with reduced risk. This dissertation project, consisting of 3 individual manuscripts, was designed to explore the relationship between social problemsolving ability and suicidal behavior in low-income primary care patients. Furthermore, additional constructs including health related quality of life, interpersonal needs, neuroticism, and hopelessness were also explored as they related to social problem solving and suicidal behavior. In a sample of 220 primary care patients ages 19-79 (M = 44.08; SD = 12.11), we examined the following: 1) health related quality of life as a mediator of the relationship between social problem solving and suicidal behavior, 2) interpersonal needs as a mediator of the relationship between social problem solving and suicidal behavior, and 3) the potential mediating role of hopelessness on the relation between neuroticism and suicidal behavior and the moderating role of social problem-solving ability on these associations. Participants completed self-report questionnaires including the Social Problem Solving Inventory-Revised-Short Form, Suicidal Behaviors Questionnaire-Revised, Short-Form 36, Interpersonal Needs Questionnaire, NEO-Five Factor Inventory, and the Beck Hopelessness Scale. Scores were analyzed using bootstrapped mediation and moderated mediation techniques. In Manuscript 1 mediating effects were found for mental health related quality of life. In Manuscript 2 thwarted belongingness and perceived burdensomeness mediated the relationship between social problem solving and suicidal behavior. Finally, in Manuscript 3 there was a significant indirect effect of neuroticism on suicidal behavior through hopelessness, and this indirect effect was moderated by social problem-solving ability. Our findings indicate that social problem-solving ability serves as both a risk and protective factor for suicidal behavior and impacts other variables that influence suicide risk among primary care patients. Interventions that bolster social problem-solving ability may reduce suicide risk in primary care.

The present study investigated loneliness and positive life events as predictors of psychological maladjustment (viz., depression, hopelessness, & suicidal behaviors) in a sample of 327 adults. Beyond the expected role of loneliness in psychological maladjustment, positive life events were found to further augment the prediction of depression, hopelessness, and suicidal behaviors. In addition, the presence of positive life events was found to buffer the positive association between loneliness and maladjustment. Specifically, the positive association between loneliness and psychological maladjustment was found to be weaker for those who experienced a high number of positive life events, as opposed to those who experienced a low number of positive life events. Some implications for helping adults perceive or appreciate the presence of positive events in their lives are discussed.

This aim of this study was to answer the research question: "What is the Life Pattern of the Person with Spinal Cord Injury?" The unitary appreciative inquiry design, which has conceptualized through Rogers' (1986) science of unitary human beings, provided an approach for understanding the phenomenon in the context of human wholeness. The data, obtained through the methodology of unitary appreciative inquiry, led to the development of individual synopses for each of the participants. Once the synopses were completed, a composite pattern profile was constructed by the researcher that was indicative of the life pattern of people with spinal cord injury. The participants in the study validated the synopsis and pattern profile as accurate representations of their experience with spinal cord injury. This qualitative study, which was comprised of eight people who had undergone a spinal cord injury more than two years prior to the study, discovered three shared pattern manifestations: depersonalization; loss; and hopelessness. Although each person within this inquiry had a very good physical outcome concerning their spinal cord injury, the participants were not pleased with their current state of being. The pattern of despair, which was validated by the participants, was manifested through the profound sense of depersonalization, loss, and hopelessness.

Syftet med denna studie är att belysa situationen för asylsökande barn med uppgivenhetssymptom utifrån behandlarens perspektiv. Syftet är vidare att undersöka behandlarens upplevelser och erfarenheter av att vårda och stödja dessa barn. Frågeställningarna som är i fokus berör den vård och stöd som behandlarna erbjuder till barnen och deras familjer, effekter av behandlingen samt specifika behandlingar som är särskilt verksamma i förhållande till de aktuella barnens tillstånd och behov. Studien är av en kvalitativ design och den vetenskapliga positionen av konstruktivistisk karaktär. Det empiriska materialet består av intervjuer med nio behandlare som varit i direkt kontakt med barnen och deras föräldrar. Kommande tre teman har varit grundläggande i intervjuerna; symtombilden, vägen ut ur tillståndet och slutligen behandlarens reflektioner kring problemet/fenomenet. Studiens teoretiska perspektiv som valdes i syfte att nå en ökad kunskap och förståelse kring fenomenet är; pervasive refusal syndrome, depressiv devitalisering, kvävande moderskap, hopplöshet hos barn, simulering samt munchenhausen by Proxy. Studiens resultat och analys kom att visa att fenomenet apatiska flyktingbarn är mycket komplext i sig. Alla behandlare anser att en del barn är verkligt sjuka men att majoriteten av barnen avsiktligt framkallar detta tillstånd. Behandlare har kunnat bevittna flera tillfällen då barnet eller barnen kunde sitta utan hjälp samt gå och äta själva. Alla behandlare upplevde att det var svårt att samarbeta med en del av föräldrarna samt att det fanns ett starkt motstånd till behandlingsarbetet från föräldrarnas sida.

The main purpose of the present study was to examine the relationship between vocational maturity and hopelessness among female and male twelfth grade students. The sample of the present study was composed of 523 (341 female, 182 male) twelfth grade students attending four high schools in Ankara and in izmir. The data were gathered using the Vocational Maturity Scale, the Beck Hopelessness Scale and a demographic information form. The overall mean and standard deviation were 145.68 and 18.44 for vocational maturity scale / 5.41 and 5.18 for hopelessness scale of 523 twelfth grade students. It was found that there was a negatively significant correlation between the hopelessness and vocational maturity. Moreover, findings related to correlation between vocational maturity and hopelessness seperately in female and male students also indicated that there were negatively significant correlations between vocational maturity and hopelessness in females and males.