1. Associations between reasons for living, depression, and suicide symptoms in a sample of active duty military
personnel
Erika M. Roberge 1,2, Gena Atkinson 1,2, Nick Oakey 1,2, Amanda Mahon-Snyder 1,2, Tracy A. Clemans 1, Jim Mintz 3, M. David Rudd 1,4, Bruce Leeson 5, Timothy
Burchm 5 & Craig J Bryan 1,2
1 National Center for Veteran Studies
2 The University of Utah
3 The University of Texas Health Science Center at San Antonio
4 The University of Memphis
5 Fort Carson, Colorado
Methods
.
Introduction DiscussionResults
References
Suicide is the 10th leading cause of death in the U.S. [1] and
the 2nd leading cause of death among U.S. military members [2].
• Increased depression and hopelessness are related to higher
levels of suicidal ideation and cognitive rigidity [3], as well as
fewer reasons for living [4].
• Most research has attempted to explain what factors predict
suicide ideation and behavior [5,6].
• Total reasons for living are negatively correlated with suicidal
behaviors and hopelessness among clinical and community
populations, and have been found to be mediating variables
between hopelessness and past year suicide attempt [7,8].
• Reasons for living may serve as protective factors for suicidal
people.
Hypotheses:
1) Number of reasons for living will be negatively associated with
depression and suicide ideation severity.
2) Longer response latency will be positively correlated with
depression and suicide ideation severity.
Procedures:
• Suicidal participants were asked their reasons for living
• Reasons for living and other qualitative aspects of
responses were coded by a team of 3 coders
• Response latency was measured to quantify the amount
of time participants took to generate a reason for living
• Participants completed measures of depression,
hopelessness, and suicide ideation
Participants:
N= 96 military personnel
Average age= 26.17 years (SD= 6.38), Range= 19-53
Gender: 77.3% male (n=75)
Measures:
Depression: Beck Depression Inventory-II (BDI) [9]
Suicide Ideation: Beck Scale for Suicide Ideation-current
(BSSI) [10]
Pessimism: Beck Hopelessness Scale (BHS) [11]
Hopefulness: Suicide Cognitions Scale (SCS) [12]
Past suicide ideation and behavior: Suicide Behaviors
Questionnaire (SBQ-R #1)[13]
Chance of Future Suicidal Behavior: SBQ-R #4 [13]
1. Centers for Disease Control and Prevention. (2014). National Suicide Statistics.
Retrieved October 20, 2015, from
http://www.cdc.gov/violenceprevention/suicide/statistics/index.html
2. Corr, W. P. (2014, October). Suicides and Suicide Attempts Among Active Component
Members of the U.S. Armed Forces, 2010–2012: Methods of Self-Harm Vary by
Major Geographic Region of Assignment. Medical Surveillance Monthly Report , 2-5.
3. Bonner, R., & Rich, A. (1987). Toward a predictive model of suicidal ideation and
behavior: Some preliminary data in college students. Suicide and Life-Threatening
Behavior, 17, 50-63.
4. Ellis, J. B., & Lamis, D. A. (2007). Adaptive characteristics and suicidal behavior: A
gender comparison of young adults. Death Studies, 31, 845–854.
5. Beck, A. T., Steer, R. A., Kovacs, M., & Garrison, B. (1985). Hopelessness and
eventual suicide: A 10 year prospective study of patients hospitalized with suicidal
ideation. American Journal of Psychiatry, 142, 559-563.
6. National Institute of Mental Health. (2011). Suicide in the U.S.: Statistics and
Prevention. Retrieved from http://www.nimh.nih.gov/health/publication/suicide-in-the-
us-statistics-and-prevention/index.shtml
7. Gutierrez, P., Osman, A., Barrios, F., Kopper, B., Baker, M., & Haraburda, C. (2002).
Development of the Reasons for Living Inventory for Young Adults. Journal of Clinical
Psychology, 58, 339–357.
8. Linehan, M., Goodstein, J., Nielsen, S., & Chiles, J. (1983). Reasons for staying alive
when you are thinking of killing yourself: The reasons for living inventory. Journal of
Consulting and Clinical Psychology, 51, 276-286.
9. Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the Beck Depression
Inventory-II. San Antonio, TX: Psychological Corporation.
10. Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The
Scale for Suicide Ideation. Journal Of Consulting And Clinical Psychology, 47(2), 343-
352. doi:10.1037/0022-006X.47.2.343
11. Beck, A.T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of
pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42,
861-865.
12. Rudd, M. D., Schmitz, B., McClenen, R., Joiner, T., Elkins, G., & Claassen, C.(in
press).The Suicide Cognitions Scale: A suicide-specific measure of hopelessness.
Psychological Assessment.
13. Osman A, Bagge CL, Guitierrez PM, Konick LC, Kooper BA, Barrios FX., The
Suicidal Behaviors Questionnaire- Revised (SBQ-R): Validation with clinical and
nonclinical samples, Assessment, 2001, (5), 443-454.
• Amount of time to respond to RFL prompt was correlated with
depression, hopelessness, and future chance of suicide
attempt.
• Number of reasons for living was not correlated with
depression or any suicide ideation measures.
• Depression is a better predictor of suicide ideation than
response latency.
• Qualities of reasons for living may not impact depression,
suicide ideation, or suicide behavior in military samples.
Limitations:
• Homogenous sample limits generalizability
• Prospective analyses not available at this time to determine if
changes in reasons for living influence suicide-related
outcomes
• Participants reported between 0
and 11 RFLS (M= 3.31, SD=2.28).
• Most participants listed 2 RFLs.
• 45% (n=43) of participants
reported family as a reason for
living, and 10% reported future
plans and goals as reasons for
living.
• Externally or internally motivated
RFLs did not predict depression or
suicide ideation severity.
• Specificity of reasons for living
(e.g. saying, “my daughter” vs.
“family”) was not associated with
measures of suicide or
depression.
“What are your reasons for living, or not killing yourself?”
For more information, contact: Erika Roberge, BA
Erika.Roberge@utah.edu
46%
10%6%
9%
7%
6%
3%
4% 4% 2%
0%
2%
1%
RFL Frequency
Family
Friends
Responsibility
Burden
Plans & Goals
Hopefulness
Enjoyable
things
Morals
Self
Fear of death
Fear of social
disapproval
No SI
Miscellaneous
Figure 3. Standardized regression coefficients for the relationship between response latency and
chance of future suicide attempt. This relationship is fully mediated by depression.
Figure 2. Intra-class correlations of demographic, reasons for living, and outcome
variables. ap<.08, *p < .05, ** p< .01, ***p<.001
Figure 1. Chart of RFL frequencies