Hope and Hopelessness: The Role of Hope in Buffering the Impact of Hopelessness on Suicidal Ideation

RESEARCH ARTICLE Hope and Hopelessness: The Role of Hope in Buffering the Impact of Hopelessness on Suicidal Ideation Jenny M. Y. Huen1, Brian Y. T. Ip2, Samuel M. Y. Ho3, Paul S. F. Yip1,4* 1 Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong Special Administrative Region, China, 2 Department of Psychology, University of Hong Kong, Hong Kong Special Administrative Region, China, 3 Department of Applied Social Sciences, College of Liberal Arts and Social Sciences, City University of Hong Kong, Hong Kong Special Administrative Region, China, 4 Department of Social Work and Social Administration, University of Hong Kong, Hong Kong Special Administrative Region, China * Abstract OPEN ACCESS Citation: Huen JMY, Ip BYT, Ho SMY, Yip PSF (2015) Hope and Hopelessness: The Role of Hope in Buffering the Impact of Hopelessness on Suicidal Ideation. PLoS ONE 10(6): e0130073. doi:10.1371/ journal.pone.0130073 Editor: Thomas Niederkrotenthaler, Medical University of Vienna, AUSTRIA Objectives The present study investigated whether hope and hopelessness are better conceptualized as a single construct of bipolar spectrum or two distinct constructs and whether hope can moderate the relationship between hopelessness and suicidal ideation. Received: February 9, 2015 Accepted: May 15, 2015 Methods Published: June 24, 2015 Hope, hopelessness, and suicidal ideation were measured in a community sample of 2106 participants through a population-based household survey. Copyright: © 2015 Huen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Results Data Availability Statement: The core descriptive data, methods and study results have all been included in the manuscript. The primary dataset was generated from the population-based household survey in a prevalence study whose authors may be contacted at the Hong Kong Jockey Club Centre for Suicide Research and Prevention. Interested readers may obtain third-party data independently from the Hong Kong Jockey Club Centre for Suicide Research and Prevention by contact Rickey Yau ( csrp@hku. hk). Funding: The authors received no specific funding for this work. Confirmatory factor analyses showed that a measurement model with separate, correlated second-order factors of hope and hopelessness provided a good fit to the data and was significantly better than that of the model collapsing hope and hopelessness into a single second-order factor. Negative binomial regression showed that hope and hopelessness interacted such that the effect of hopelessness on suicidal ideation was lower in individuals with higher hope than individuals with lower hope. Conclusions Hope and hopelessness are two distinct but correlated constructs. Hope can act as a resilience factor that buffers the impact of hopelessness on suicidal ideation. Inducing hope in people may be a promising avenue for suicide prevention. PLOS ONE | DOI:10.1371/journal.pone.0130073 June 24, 2015 1 / 18 Hope and Hopelessness Competing Interests: The authors of this manuscript have the following competing interests: Co-author Prof. Ho Mun Yin (Samuel M. Y. Ho) is a member of the PLOS ONE editorial board. There are no further patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials. Introduction People react differently to stressors in life, with some individuals deliberately putting an end to their lives in the face of adversity and others endeavouring to proceed. The key to this difference has given rise to suicidology, the scientific study of suicide. Over the last few decades, suicidology has focused on the relationship between various risk factors (in particular negative cognitive factors) and suicide [1–5]. For example, the association between suicidal ideation and psychopathological constructs such as depressive symptoms and hopelessness have been addressed extensively [6–8]. Although the presences of these psychopathological constructs are strong predictors of suicidality, it should not be overlooked that some individuals deal with their hardship in a positive way. The positive elements that motivate people to adopt coping strategies instead of suicidal behaviour in the face of adversity, like any other content associated with a decrease in suicide, may be conceptualized as Papageno effect [9]. Papageno is a character in the famous Mozart’s opera “The Magic Flute” and in one of the scenes Papageno despairs at losing his beloved girl and attempts suicide. His suicidal act is immediately stopped by three child-spirits who later on advise Papageno of a coping strategy. Papageno eventually copes positively with the suicidal crisis after adopting the coping strategy. Niederkrotenthaler and his colleagues [9] studied the associations between media content and suicide rates and they found that coverage on positive coping in adverse circumstances in media reports about suicidal ideation has a Papageno effect and decreases suicide. Existing models of psychopathology and suicidality, with a focus on the association between psychopathological constructs and suicide, cannot account for the Papageno effect exerted by the positive elements which motivate people to face their adverse circumstances in a positive way. This limitation has led to a positive psychology movement for the use of positive psychological constructs in the investigation of psychopathology and suicidality [10–13]. For example, there is on-going interest in incorporating the concept of resilience into the suicidality paradigm [10,14]. Johnson and her colleagues [10] performed an extensive review of 77 suicidality studies that investigated the role of at least one positive psychological construct (a.k.a. resilience factor) in moderating the association between a risk factor and an outcome of suicidality, and introduced a buffering framework to investigate the role of resilience factors (e.g. positive attributional styles & agency) in buffering the impact of risk factors (e.g. hopelessness & perfectionism) on suicidality. Using this framework, the buffering effect of a wide range of positive psychological constructs on suicidal thoughts and behaviours can be explored. Kleiman and his colleagues [15] examined the roles of gratitude and grit as resilience factors against suicidal ideations and they found that gratitude and grit interacted that individuals with higher levels of gratitude and grit at baseline have fewer suicidal ideations over time. In another study [16], Kleiman and his colleagues further provided evidence for the role of gratitude in buffering the association between suicidal ideation and its high risk factors, hopelessness and depressive symptoms. Yet, they did (...truncated)