Positive and Negative Expectations of Hopelessness as Longitudinal Predictors of Depression, Suicidal Ideation, and Suicidal Behavior in High-Risk Adolescents


  • The authors thank Polly Y. Gipson, Tasha Kelley-Stiles, Bianca Burch, Alan Hackett, and Ryan Hill for their assistance with study implementation. The authors also thank participating emergency department staff and Dr. Rebecca Cunningham for clinical and administrative support, as well as all participating youth and their families. This study was supported by two National Institute of Mental Health Awards to Cheryl A. King (R34 MH079123; K24 MH77705) and a University of Michigan Rackham Graduate Student Research Award to Adam G. Horwitz.


The relationship between hopelessness and depression in predicting suicide-related outcomes varies based on the anticipation of positive versus negative events. In this prospective study of adolescents at elevated risk for suicide, we used two Beck Hopelessness Scale subscales to assess the impact of positive and negative expectations in predicting depression, suicidal ideation, and suicidal behavior over a 2- to 4-year period. In multivariate regressions controlling for depression, suicidal ideation, and negative-expectation hopelessness, positive-expectation hopelessness was the only significant predictor of depressive symptoms and suicidal behavior. Clinical interventions may benefit from bolstering positive expectations and building optimism.