Form 0920- Beck Hopelessness

Attachment D14

Beck Hopelessness

Form Approved

OMB No. 0920-xxxx

Exp. Date xx/xx/20xx

Beck Hopelessness

V. This section consists of 20 statements. If the statement describes your attitude for the past week including today, put a circle around the “T” indicating TRUE in the column next to the statement. If the statement does not describe your attitude, put a circle around the “F” indicating FALSE in the column next to the statement. Please be sure to read each statement carefully.

Public reporting burden of this collection of information is estimated to average 2 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (XXXX).

		True False (1) (2)
1	I look forward to the future with hope and enthusiasm.	T F
2	I might as well give up because there is nothing I can do about making things better for myself.	T F
3	When things are going badly, I am helped by knowing that they cannot stay that way forever.	T F
4	I can’t imagine what my life will be like in ten years.	T F
5	I have enough time to accomplish the things I want to do.	T F
6	In the future, I expect to succeed in what concerns me most.	T F
7	My future seems dark to me.	T F
8	I happen to be particularly lucky, and I expect to get more of the good things in life than the average person.	T F
9	I just can’t get the breaks, and there’s no reason I will in the future.	T F
10	My past experiences have prepared me well for the future.	T F
11	All I can see ahead of me is unpleasantness rather than pleasantness.	T F
12	I don’t expect to get what I really want.	T F
13	When I look ahead to the future, I expect that I will be happier than I am now.	T F
14	Things just don’t work out the way I want them to.	T F
15	I have great faith in the future.	T F
16	I never get what I want, so it’s foolish to want anything.	T F
17	It’s very unlikely that I will get any real satisfaction in the future.	T F
18	The future seems vague and uncertain to me.	T F
19	I can look forward to more good times than bad times.	T F
20	There’s no use in really trying to get anything I want because I probably won’t get it.	T F