46 46
Measurement and Evaluation in
Counseling and Development
Volume 42 Number 1
April 2009 46-63
© 2009 The Author(s)
10.1177/0748175609333562
http://mec.sagepub.com
Differentiating Between Depression,
Hopelessness, and Psychache in
University Undergraduates
Michelle M. DeLisle
Ronald R. Holden
Queen’s University, Kingston, Ontario, Canada
The overlap between depression, hopelessness, and psychache constructs was investigated
using 587 undergraduates. Analyses indicated three correlated dimensions; among these,
psychache accounts for more variance in depression and hopelessness than these latter vari-
ables account for in psychache. All constructs demonstrated convergent validity, but psych-
ache was associated with the widest range of suicide criteria. These findings support that
psychache is a leading variable associated with suicide risk.
Keywords: psychache; hopelessness; depression; suicidality
ripe for developing more integrative models
of suicidality. An important step toward this
goal lies in understanding the degree of
overlap or independence between the three
key statistical suicide prediction models.
Depression, Hopelessness,
and Psychache
Beck’s (1967) cognitive model is the
broadest in scope, and it proposes that the
primary causes of depression are one’s dys-
functional beliefs about the self, the world,
and the future—together constituting a
depressive triad. Approximately two thirds of
individuals, at the time of their first hospital-
ization for attempting suicide, are diagnosed
Authors’ Note: This research was supported in part
by grants from the Social Sciences and Humanities
Research Council of Canada. Correspondence con-
cerning this article should be addressed to Ronald R.
Holden, Department of Psychology, Queen’s University,
Kingston, Ontario K7L 3N6, Canada; e-mail: holdenr@
queensu.ca.
S
uicide is a major public health concern.
In the United States, the suicide rate is
11 per 100,000 people, which translates to
an average of 85 suicide deaths every day
(Moscicki, 1999). The enormous scope of
this issue can be further understood by con-
sidering the potential impact of suicide
attempts in general. For every suicide death,
there are up to 10 times more suicide attempts
that result in hospitalization (Holley, Fick, &
Love, 1998) and between 50 to 100 times
more suicide attempts that result in injuries
not requiring inpatient admission (Pagliaro,
1995). To respond to calls for broad-based
national suicide prevention strategies (Weir,
2001), it is imperative to first understand the
key conditions associated with suicide risk.
Suicidal behavior is complex and multiply
determined; as such, suicide prevention pro-
grams can address only potentially modifi-
able risk factors (Brown, Beck, Steer, &
Grisham, 2000). Research over the past 40
years has emphasized the role of psycho-
logical variables in suicide risk, and of these,
depression, hopelessness, and psychache
have gained preeminence. The time is now
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