Assessment of Discriminant Validity for Measures of Hope and Hopelessness in Adults With an Acute Cardiac Event

Hope and hopelessness are sometimes considered to be two ends of a spectrum. Hope is associated with positive health outcomes in healthy and ill populations. Conversely, hopelessness has been associated with increased adverse clinical events and death in patients with ischemic heart disease (IHD). The aim of the study was to determine the discriminant validity of the Dunn State-Trait Hopelessness Scale and the Snyder Adult State Hope and Adult Trait Hope Scales. A total of 156 participants were enrolled in a randomized controlled trial testing a motivational intervention to promote physical activity and reduce hopelessness in adults hospitalized with ischemic heart disease. Data were collected 2 weeks after hospital discharge. Participants were male (68%), white (88.2%), married (60.8%), with a mean age of 62 years. There were moderately strong negative correlations (r = -0.54 to -0.66) between total Dunn State-Trait Hopelessness Scale and Snyder Adult State and Trait Hope scales. Correlations were virtually unchanged adjusting for age, sex, diagnosis, and marital status (r = -0.5 to -0.63, p < 0.001) indicating that as hopelessness increases, hope decreases. Principal components analysis revealed four factors that explained 64.7% of the variance in scores while demonstrating conceptual distinctions between the Dunn State-Trait Hopelessness Scale and Snyder Hope scales. We found a proportion of patients with hopelessness who still expressed hope for the future. Discriminant validity was supported by inverse correlations and factor analyses indicating conceptual distinctions between the two instruments. Findings suggest important implications for assessment of both hope and hopelessness in patients recovering from an IHD event since the two are conceptually distinct yet can occur simultaneously, and state hopelessness may improve through recovery.