1. • Demographic variables were
not correlated with measures
of reasons for living,
suicide, or depression.
• Total number of words used
was not correlated with
measures of suicide or
depression.
• Response latency was
positively correlated with
suicide ideation, as well as
self-reported and estimated
risks of future suicidal
behavior.
Associations between reasons for living, depression, and suicide symptoms in a sample of active duty military
personnel
Nick Oakey 1,2, Erika M. Roberge 1,2, Gena Atkinson 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].
• Few studies have attempted to identify protective factors for
individuals contemplating suicide.
• 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 words used in the response will be negatively
associated with suicide ideation and depression measures.
2) Response latency will be positively associated with suicide
measures.
3) Response latency will be a better predictor of suicide scores than
depression severity.
Procedures:
• Suicidal participants of a clinical trial were randomized to complete
a crisis response plan (CRP) or complete a CRP and asked about
their reasons for living (CRP + RFL)
• CRP + RFL participants were included in these analyses
Participants:
N= 52 military personnel
Average age= 24.962 years (SD= 4.98), Range= 19-40
Gender: 80.8% male (n=42)
Measures:
Reasons for Living: CAMS Manual [9]
Depression: Beck Depression Inventory-II (BDI) [10]
Suicide Ideation: Beck Scale for Suicide Ideation-current (BSSI) [11]
Past suicide ideation and behavior: Suicide Behaviors Questionnaire-
revised Item 1 (SBQ-R #1)[12]
Chance of Future Suicidal Behavior: SBQ-R #4 [12]
Risk for Suicidal Behavior (SBQ-R Total) [12]
1. Centers for Disease Control and Prevention. (2014). National Suicide Statistics. Retrieved
October 20, 2015, from Centers for Disease Control and Prevention:
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. Jobes, D. A., Lento, R., & Brazaitis, K. (2012). An evidence-based clinical approach to
suicide prevention in the Department of Defense: The Collaborative Assessment and
Management of Suicidality (CAMS). Military Psychology, 24(6), 604-623.
doi:10.1080/08995605.2012.736327
10. Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Manual for the Beck Depression
Inventory-II. San Antonio, TX: Psychological Corporation.
11. 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
12. Osman A (2002a), Suicide Behavior Questionnaire-Revised (SBQ-R) University of
Northern Iowa, Dept. of Psychology. Available from Auguston Osman, PhD, Department
of Psychology, University of Northern Iowa, Cedar Falls, IA 50614;
augustin.osman@uni.edu
13. Jobes, D. A. & Mann, R. E. (1999) Reasons for Living versus Reasons for Dying:
Examining the Internal Debate of Suicide. Suicide and Life Threatening Behavior, 29 (2),
• Length of response to RFL prompt did not predict suicide or
depression measures.
• Response latency predicted suicide ideation severity and risk of
future suicidal behavior.
• Response latency and depression severity each uniquely predicted
future suicide risk. Response latency predicted past week SI.
• Our findings are consistent with Jobes in that “Strong family
influences and a future with vague and specific plans and goals
accounts for 53% of reasons why [his] sample of suicidal patients
would want to stay alive” [13].
Limitations:
• Sample size limits detectability of relationships
• Homogenous sample limits generalizability
Less face-valid indicators of suicide risk may be particularly
useful in military samples that may under report psychological
symptoms.
• Participants reported between 0 and 11
RFLS (M= 3.54).
• Most participants listed 2 RFLs.
• Family (n=64, 45%) and perceived
burdensomeness (n=17, 12 %) were the
most commonly reported reasons for
living.
• Morals were not reported by any
participant.
• 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?”
*p < .05, ** p< .01, ***p<.001
Table 1. Inter-item correlations
For more information or questions, contact: Nick Oakey at dnoakey88@gmail.com
1 2 3 4 5 6 7 8
1. Gender 1.00
2. Age -.184 1.00
3. Sum
words
-.177 .047 1.00
4. Response
latency
.095 -.076 .015 1.00
5. BSSI -.009 -.094 -.196 .366* 1.00
6. SBQ-R #4 .232 -.230 -.149 .333* .513*** 1.00
7. SBQ-R
Total
.232 -.230 -.090 .375** .452*** .868*** 1.00
8. BDI-II .027 .068 .047 .117 .097 .330* .377** 1.00
45%
10%
6%
12%
8%
6%
4%
4%
1%
3%
RFL Frequency Family
Friends
Resp.
Burden
F. Plan
Hope
Enjoy
Moral
Self
FOD
FOSD
NSI
B SE β p
Gender -.843 2.150 -.054 .697
Age .026 .177 .021 .882
BDI -.011 .082 -.018 .897
SBQ-R #1 2.698 1.054 .357 .014*
Response
latency
.414 .161 .351 .014*
*p < .05, ** p< .01, ***p<.001
Table 2. Simultaneous regression predicting BSSI
• After controlling for the effects
of gender, age, depression, and
history of suicide attempts,
response latency is a
significant predictor of past
week SI.
• This model explains 25.6% of
the variance in past week SI
(F(5,46)= 2.823, p= .028).