Reasons for Living, Hopelessness, and Suicide Ideation Among Depressed Adults 50 Years or Older

Abstract

Objective-Adults with mood disorders are at elevated risk for suicide. Psychological features such as hopelessness increase their risk for suicide ideation. Few studies have examined psychological constructs posited to lower risk for suicide ideation. The authors tested the hypothesis that reasons for living (RFL) are inversely related to suicide ideation. Design-This report is a secondary analysis of cross-sectional data.Setting-Participants were recruited from the clinical services of three teaching hospitals in Rochester, NY.Participants-The sample consisted of 125 adults 50 years or older receiving treatment for a mood disorder.Measurements-A diagnostic interview and measures of suicide ideation, depression, hopelessness, and RFL were included in the assessment battery. Dependent variables were presence and severity of suicide ideation. Data were analyzed using multivariate logistic and linear regressions.Results-Patients who reported higher levels of fear of suicide were less likely to report suicide ideation. The relationships between hopelessness and both the presence and severity of suicide ideation were stronger among those who reported greater levels of responsibility to family.Conclusions-Clinicians working with at-risk older adults are encouraged to explore their patients' RFL. These cross-sectional findings point to the need for prospective research examining the associations among different RFL, hopelessness, and suicide ideation in depressed older adults. KeywordsAging; suicide ideation; reasons for living; hopelessness; depression More than 12,000 adults in the United States over the age of 50 die by suicide annually, 1 most of whom suffer from a mood disorder, typically major depression. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript however, never consider suicide, 4 suggesting the need to examine psychological processes that may confer or reduce risk for suicide ideation in this population.Hopelessness, defined as a system of negative beliefs and expectancies concerning oneself and one's future, 5 is an important risk factor for both suicide ideation and death by suicide in depressed adults over 50. It is associated with suicide ideation in diverse samples. [6][7][8][9][10] Prospective studies of patients seen in mental health treatment settings suggest that it also confers risk for death by suicide. 11,12 Reasons for living (RFL) are beliefs or expectancies thought to mitigate risk for suicide, and include survival and coping beliefs, responsibility to family, child-related concerns, fear of suicide, fear of social disapproval, and moral objections. 13 Few studies have examined these constituent components, [14][15][16][17][18] and most have focused on younger adults, 13,14,16 but older and younger adults may have different RFL. 19 RFL may also weaken the association between hopelessness and suicide ideation. Individuals who believe they have more RFL may be better prepared to buffer the negative effects of hopelessness. Just as optimism and attitudes to...

A controlled trial of individual cognitive behavior therapy for unipolar mood disorders with suicidal ideation outpatients: exploring risk and protective factors

“…The overall findings of this thesis are consistent with previous studies in the West suggesting that patients with suicidal behavior showed significantly higher risk factors (Briton et al, 2008;Beck, Steer, Beck & Newman, 1993;Uncapher, Thompson, Osgood and Bongar, 1997; and lower protective factors for suicidal behavior.…”

“…In the Western literature, some of the factors which had been identified as the risk factors for suicidal behavior include having mood disorders (Wulsin, Vaillant & Wells, 1999;Sokero et al, 2005;Botswick & Pankratz, 2000;Pietrzak et., 2010), anxiety disorder (Kamath, 2007;, borderline personality disorder (Pompili, Girardi & Ruberto, 2005), schizophrenia (Palmer, Pankratz & Bostwick, 2005); PTSD (Pietrzak et al, 2010), hopelessness (Beck, Steer, Kovacs, & Garrison, 1985;Wetzel, 1976;Brown et al (2000); Malone et al 2000;Briton et al, 2008), misuse of alcohol and substance (Cherpitel, Borges & Wilcox, 2004;Neeleman, 2001;Kaslow et al 2002;Pietrzak et al, 2010), severe negative life events, a history of child maltreatment, high levels of psychological distress and depression, hopelessness about the future (Kaslow et al 2002), life hassle , lacking a partner, previous suicide attempt, total time spent in major depressive episode (Sokero, et al, 2005), psychosocial difficulties and lack of social support (Pietrzak, 2010). Meanwhile in Malaysia, based on literature review by Aishvarya et al, 2013, having depression (Peng & Chia, 1997;Azizul, 2001, Suziah, 2003, Type 2 diabetes mellitus (Ong, 2004), migraine (Tan, 2006), poor social support (Zuraida, 2000), history of previous suicide attempt (Suziah, 2003, Chan 2012, poor social network (Zuraida, 2000); follicular phase of the menstrual cycle (Ainsah, Norharlina & Osman, 2008), medical illness (Hamidin & Maniam 2011), severity of suicide ideation, recent life events and comorbid alcohol use …”

What Protects Adolescents from Suicidal Attempt: A Qualitative Study

“…Research suggests an inverse relationship between fear of death and suicidal attempt so that people who are afraid of death are less likely to report suicidal ideation (37,38).…”

Prevention, assessment and treatment of suicidal behavior. [Prevención, evaluación y tratamiento de la conducta suicida]

“…Community-led programs that promote positive mental health are also useful when it comes to suicide prevention, as are suicide crisis centers and free phone helplines which are of paramount importance in suicide prevention efforts in some communities. -The need to implement suicide prevention programs in high-risk populations (young people aged between 16 and 35 and people aged over 50) (Britton et al, 2008;Gould and Kramer, 2001;Russell and Joyner, 2001;Ryan and Futterman, 1997). In addition, the efficacy of suicide prevention programs according to sex has been demonstrated in various investigations (Gunnell, 2000;Gutiér-anales de psicología, 2014, vol.…”