Attachment D14
Beck Hopelessness
 
	Form
	Approved 
	OMB
	No. 0920-xxxx 
	Exp.
	Date xx/xx/20xx
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). 
	 
	
| 
				 | 
				 | (1) (2) | 
| 1 | I look forward to the future with hope and enthusiasm. | |
| 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 | 
	
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Sawyer, Tamela (CDC/NIOSH/OD/ODDM) | 
| File Modified | 0000-00-00 | 
| File Created | 2022-05-05 |