A scale designed to quantify hopelessness was administered to several diverse samples of patients to assess its psychometric properties. This scale was found to have a high degree of internal consistency and showed a relatively high correlation with the clinical ratings of hopelessness and other self-administered measures of hopelessness. Furthermore, the scale was sensitive to changes in the patient's state of depression over time. An affective, a motivational, and a cognitive factor were extracted.

The measurement of pessimism: the hopelessness scale.

A model of the neuropsychology of anxiety is proposed. The model is based in the first instance upon an analysis of the behavioural effects of the antianxiety drugs (benzodiazepines, barbiturates, and alcohol) in animals. From such psychopharmacologi-cal experiments the concept of a “behavioural inhibition system” (BIS) has been developed. This system responds to novel stimuli or to those associated with punishment or nonreward by inhibiting ongoing behaviour and increasing arousal and attention to the environment. It is activity in the BIS that constitutes anxiety and that is reduced by antianxiety drugs. The effects of the antianxiety drugs in the brain also suggest hypotheses concerning the neural substrate of anxiety. Although the benzodiazepines and barbiturates facilitate the effects of γ-aminobutyrate, this is insufficient to explain their highly specific behavioural effects. Because of similarities between the behavioural effects of certain lesions and those of the antianxiety drugs, it is proposed that these drugs reduce anxiety by impairing the functioning of a widespread neural system including the septo-hippocampal system (SHS), the Papez circuit, the prefrontal cortex, and ascending monoaminergic and cholinergic pathways which innervate these forebrain structures. Analysis of the functions of this system (based on anatomical, physiological, and behavioural data) suggests that it acts as a comparator: it compares predicted to actual sensory events and activates the outputs of the BIS when there is a mismatch or when the predicted event is aversive. Suggestions are made as to the functions of particular pathways within this overall brain system. The resulting theory is applied to the symptoms and treatment of anxiety in man, its relations to depression, and the personality of individuals who are susceptible to anxiety or depression.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0140525X00013066

Précis of The Neuropsychology of Anxiety: An Enquiry into the Functions of the Septo-Hippocampal System..

Hope is defined as the perceived capability to derive pathways to desired goals, and motivate oneself via agency thinking to use those pathways. The adult and child hope scales that are derived from hope theory are described. Hope theory is compared to theories of learned optimism, optimism, self-efficacy, and self-esteem. Higher hope consistently is related to better outcomes in academics, athletics, physical health, psychological adjustment, and psychotherapy. Processes that lessen hope in children and adults are reviewed. Using the hope theory definition, no evidence is found for "false" hope. Future research is encouraged in regard to accurately enhancing hope in medical feedback and helping people to pursue those goals for which they are best suited.

Hope theory: Rainbows in the mind.

Coping styles in animals: current status in behavior and stress-physiology.

Alzheimer’s Dementia

Summary
This is one of a series of studies being made to investigate the relationship of “separation and depression” to the onset of medical disease.
In this report a group of 42 semiprivate hospitalized medical patients between the ages of 18 and 45 was studied for predisease setting based on reported object-relationship changes and reported and observed major affective reactions to such changes.
Twenty-nine patients and/or family members reported loss of an object and feelings of helplessness and hopelessness immediately preceding the onset of the symptoms of the illness which led to hospitalization.
Five patients reported feelings of helplessness or hopelessness prior to the onset of symptoms but reported no loss of an object.
In 41 of the 42 patients the investigator felt that there was verbal and/or nonverbal evidence for the interpretation of actual, threatened, or symbolic object loss as well as evidence for feelings of helplessness or hopelessness prior to the onset of disease.
Thirty-one patients developed the onset of their disease within one week after what was considered the final or only change in relationship to which the patient experienced a feeling of helplessness or hopelessness.
Early life losses or threats of loss, past conflicts reawakened or still unresolved, and the incidence of past separations preceding changes in past health of this group of patients were also reported.
"Separation and depression" as defined refers to the psychic pattern of unsuccessful resolution of object loss. Starting with a change in a relationship, this concept involves the actual or fantasied loss of an object upon which the self has real or symbolic dependence and includes the attempts and final failures to reestablish or give up the lost or threatened relationship, as evidenced by feelings of helplessness or hopelessness.
Case examples are appended to illustrate how the setting of the current disease onset was reported and how the investigator made his interpretations of this material.

Relationship of separation and depression to disease. I. A report on a hospitalized medical population.

Conservation‐Withdrawal: A Primary Regulatory Process for Organismic Homeostasis

One hundred forty-four patients and 68 physicians at three cancer centers were studied for their perceptions of the consent procedure, in which they participated one to three weeks earlier, for chemotherapy by one of 65 investigational protocols. Patients recalled the procedure positively and relied heavily on physician's advice. They felt most physicians wanted them to accept; 29% felt their participation in the decision was not encouraged. Primary reasons for accepting were trust in the physician, belief the treatment would help, and fear the disease (viewed as highly serious) would get worse without it. Nearly a fourth did not recall the information given that treatment was investigational. The consent form played no role in decision-making for 69%. Physicians believed therapeutic benefits would exceed potential problems for most patients; they viewed 41% of the patients as less than eager for details of treatment, a third as avoiding the seriousness of the discussion, and a third as passive in decisio...

Informed consent for investigational chemotherapy: patients' and physicians' perceptions.

A randomized nonblinded study was performed in three cancer centers to test over a 10-day period the efficacy of (1) a triazolobenzodiazepine, alprazolam, 0.5 mg three times a day and (2) use of a behavioral technique in which patients were trained in progressive muscle relaxation at an initial session with a behavioral psychologist and then asked to listen at home to an audiotape of the session three times a day. Of 147 cancer patients who met entry levels of distress and completed the study, uncontrolled for site or disease stage, 70 were randomized to drug, 77 to relaxation. Four measures of anxiety and depression were used: Covi, Raskin, Affects Balance, and Symptoms Checklist-90 (SCL-90). Results showed that both treatment arms resulted in significant (P less than .001) decrease in observer and patient-reported anxious and depressed mood symptoms. Although both treatment arms were effective, patients receiving the drug showed a slightly more rapid decrease in anxiety and greater reduction of depressi...

A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms.

Forty women were studied who were discovered on repeated routine examination to have cervical cytology suspicious for cancer. Although all subjects were asymptomatic for cervical disease all had cytological evidence of dysplasia. Biopsy revealed 14 subjects with carcinoma, in 13 of whom the disease

Arthur H. Schmale

Papers

Relationship of separation and depression to disease. I. A report on a hospitalized medical population.

Conservation‐Withdrawal: A Primary Regulatory Process for Organismic Homeostasis

Informed consent for investigational chemotherapy: patients' and physicians' perceptions.

A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms.

The Affect of Hopelessness and the Development of Cancer: I. Identification of Uterine Cervical Cancer in Women with Atypical Cytology