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The Gerontologist Advance Access published online on June 21, 2009
The Gerontologist, doi:10.1093/geront/gnp052
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Development and Psychometric Evaluation of the Reasons for Living—Older Adults Scale: A Suicide Risk Assessment Inventory

Barry A. Edelstein, PhD1,2, Marnin J. Heisel, PhD3,4, Deborah R. McKee, PhD2, Ronald R. Martin, PhD2, Lesley P. Koven, PhD2, Paul R. Duberstein, PhD3 and Peter C. Britton, PhD3,5

2 Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
3 Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York
4 Center of Excellence, Canandaigua VA Medical Center, Canandaigua, New York
5 Canandaigua VA Medical Center, Canandaigua, New York

1 Address correspondence to Barry A. Edelstein, PhD, Department of Psychology, West Virginia University, Morgantown, WV 26506-6040. E-mail: barry.edelstein{at}mail.wvu.edu.


  Abstract

Purpose: The purposes of these studies were to develop and initially evaluate the psychometric properties of the Reasons for Living Scale—Older Adult version (RFL-OA), an older adults version of a measure designed to assess reasons for living among individuals at risk for suicide. Design and Methods: Two studies are reported. Study 1 involved instrument development with 106 community-dwelling older adults, and initial psychometric evaluation with a second sample of 119 community-dwelling older adults. Study 2 evaluated the psychometric properties of the RFL-OA in a clinical sample. One hundred eighty-one mental health patients 50 years or older completed the RFL-OA and measures of depression, suicide ideation at the current time and at the worst point in one’s life, and current mental status and physical functioning. Results: Strong psychometric properties were demonstrated for the RFL-OA, with high internal consistency (Cronbach's alpha coefficient). Convergent validity was evidenced by negative associations among RFL-OA scores and measures of depression and suicide ideation. RFL-OA scores predicted current and worst-episode suicide ideation above and beyond current depression. Discriminant validity was evidenced with measures of current mental status and physical functioning. Criterion-related validity was also demonstrated with respect to lifetime history of suicidal behavior. Implications: These findings provide preliminary support for the validity and reliability of the RFL-OA. The findings also support the potential value of attending to reasons for living during clinical treatment with depressed older adults and others at risk for suicide.

Keywords: Suicide, Reasons for living, Suicide risk, Resilience

Received July 23, 2008; Accepted January 8, 2009

Decision Editor: William J. McAuley, PhD


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