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Protocol - Deterrents to Suicide - Clinical - Adult

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Description:

The Reasons for Living (RFL) inventory includes 48 self-report items that measures the respondent’s various reasons for living and their attitudes about living versus attempting or committing suicide. The RFL includes subscales for survival and coping beliefs, responsibility to family, child-related concerns, fear of suicide, fear of social disapproval, and moral objections. Each item is rated on a 6-point Likert scale ranging from 1 ("not at all important") to 6 ("extremely important"). Ratings on the individual items are added together to give scores for individual subscales or to obtain an overall score for the whole inventory. Higher scores reflect greater reasons for living.

Protocol:

Reasons for Living

INSTRUCTIONS:

Many people have thought of suicide at least once. Others have never considered it. Whether you have considered it or not, we are interested in the reasons you would have for not committing suicide if the thought were to occur to you or if someone were to suggest it to you.

On the following pages are reasons people sometimes give for not committing suicide. We would like to know how important each of these possible reasons would be to you at this time in your life as a reason to not kill yourself. Please rate this in the space at the left on each question.

Each reason can be rated from 1 (Not At All Important) to 6 (Extremely Important). If a reason does not apply to you or if you do not believe the statement is true, then it is not likely important and you should put a 1. Please use the whole range of choices so as not to rate only at the middle (2, 3, 4, and 5) or only at the extremes (1, 6).

Even if you never have or firmly believe you never would seriously consider killing yourself, it is still important that you rate each reason. In this case, rate on the basis of why killing yourself is not or would never be an alternative for you.

1. I have a responsibility and commitment to my family.

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

2. I believe I can learn to adjust or cope with my problems

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

3. I believe I have control over my life and destiny

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

4. I have a desire to live

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

5. I believe only God has the right to end a life

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

6. I am afraid of death

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

7. My family might believe I did not love them

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

8. I do not believe that things get miserable or hopeless enough that I would rather be dead

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

9. My family depends upon me and needs me

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

10. I do not want to die

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

11. I want to watch my children as they grow

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

12. Life is all we have and is better than nothing

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

13. I have future plans I am looking forward to carrying out

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

14. No matter how badly I feel, I know that it will not last

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

15. I am afraid of the unknown

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

16. I love and enjoy my family too much and could not leave them

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

17. I want to experience all that life has to offer and there are many experiences I haven’t had yet which I want to have

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

18. I am afraid that my method of killing myself would fail

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

19. I care enough about myself to live

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

20. Life is too beautiful and precious to end it

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

21. It would not be fair to leave the children for others to take care of

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

22. I believe I can find other solutions to my problems

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

23. I am afraid of going to hell

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

24. I have a love of life

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

25. I am too stable to kill myself

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

26. I am a coward and do not have the guts to do it

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

27. My religious beliefs forbid it

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

28. The effect on my children could be harmful

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

29. I am curious about what will happen in the future

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

30. It would hurt my family too much and I would not want them to suffer

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

31. I am concerned about what others would think of me

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

32. I believe everything has a way of working out for the best

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

33. I could not decide where, when, and how to do it

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

34. I consider it morally wrong

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

35. I still have many things left to do

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

36. I have the courage to face life

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

37. I am happy and content with my life

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

38. I am afraid of the actual "act" of killing myself (the pain, blood, violence)

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

39. I believe killing myself would not really accomplish or solve anything

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

40. I have hope that things will improve and the future will be happier

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

41. Other people would think I am weak and selfish

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

42. I have an inner drive to survive

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

43. I would not want people to think I did not have control over my life

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

44. I believe I can find a purpose in life, a reason to live

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

45. I see no reason to hurry death along

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

46. I am so inept that my method would not work

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

47. I would not want my family to feel guilty afterwards

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

48. I would not want my family to think I was selfish or a coward

[ ] 1 Not At All Important

[ ] 2 Quite Unimportant

[ ] 3 Somewhat Unimportant

[ ] 4 Somewhat Important

[ ] 5 Quite Important

[ ] 6 Extremely Important

Scoring:

Survival and Coping Beliefs: items 1-24.

Responsibility to Family: items 25-31.

Child-Related Concerns: items 32-34.

Fear of Suicide: items 35-41.

Fear of Social Disapproval: items 42-44.

Moral Objections: items 45-48.

Ratings on the individual items are added together to give scores for individual subscales or to obtain an overall score for the whole inventory. Higher scores reflect greater reasons for living.

Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Life Stage:

Adult

Participants:

Adults, ages 18 and older

Specific Instructions:

This protocol includes questions that can potentially identify respondents who are at risk of suicide. Investigators implementing this protocol should consider developing a risk management plan specific to their study to ensure the safety of participants. The following links provide additional information and guidelines for suicide-related research:

ora.research.ucla.edu/OHRPP/Documents/Policy/8/Risk_of_Suicide.pdf

www.nimh.nih.gov/health/topics/suicide-prevention/issues-to-consider-in-intervention-research-with-persons-at-high-risk-for-suicidality.shtml

Selection Rationale

The Reasons for Living (RFL) inventory is a brief, low-burden, widely used questionnaire with good internal reliability, test-retest reliability and concurrent validity. The RFL can also be used to capture changes in beliefs (e.g., reductions in suicide behaviors).

Language

Chinese, English, French, Romanian

Standards
StandardNameIDSource
Common Data Elements (CDE) Adult Reasons for Living (RFL) Inventory Score 4588829 CDE Browser
Derived Variables

None

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

Linehan, M., Goodstein, J. L., Nielsen, S. L., & Chiles, J. A. (1983). Reasons for staying alive when you are thinking about killing yourself: The Reasons For Living Inventory. Journal of Consulting and Clinical Psychology, 51(2): 276-286.

General References

Britton, P. C., Duberstein, P. R., Conner, K. R., Heisel, M. J., Hirsch, J. K., & Conwell, Y. (2008). Reasons for living, hopelessness, and suicide ideation among depressed adults 50 years or older. American Journal of Geriatric Psychiatry, 16(9), 736-741.

Richardson-Vejlgaard, R., Sher, L., Oquendo, M. A., Lizardi, D., & Stanley, B. (2009). Objections to suicide among depressed patients with alcohol use disorders. Journal of Affective Disorders, 117(3), 197-201.

Protocol ID:

640902

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX640902_Suicide_Afraid_Of_Death PX640902010600 I am afraid of death 4 N/A
PX640902_Suicide_Afraid_Of_Hell PX640902012300 I am afraid of going to hell 4 N/A
PX640902_Suicide_Afraid_Of_Killing PX640902013800 I am afraid of the actual "act" of killing myself (the pain, blood, violence) 4 N/A
PX640902_Suicide_Afraid_Of_Unknown PX640902011500 I am afraid of the unknown 4 N/A
PX640902_Suicide_Better_Than_Nothing PX640902011200 Life is all we have and is better than nothing 4 N/A
PX640902_Suicide_Care_To_Live PX640902011900 I care enough about myself to live 4 N/A
PX640902_Suicide_Children_Grow PX640902011100 I want to watch my children as they grow 4 N/A
PX640902_Suicide_Concerned_About_Others PX640902013100 I am concerned about what others would think of me 4 N/A
PX640902_Suicide_Control_Over_Life PX640902014300 I would not want people to think I did not have control over my life 4 N/A
PX640902_Suicide_Cope_With_Problems PX640902010200 I believe I can learn to adjust or cope with my problems 4 N/A
PX640902_Suicide_Could_Not_Decide PX640902013300 I could not decide where, when, and how to do it 4 N/A
PX640902_Suicide_Courage_To_Face_Life PX640902013600 I have the courage to face life 4 N/A
PX640902_Suicide_Coward PX640902012600 I am a coward and do not have the guts to do it 4 N/A
PX640902_Suicide_Curious_About_Future PX640902012900 I am curious about what will happen in the future 4 N/A
PX640902_Suicide_Desire_To_Live PX640902010400 I have a desire to live 4 N/A
PX640902_Suicide_Drive_To_Survive PX640902014200 I have an inner drive to survive 4 N/A
PX640902_Suicide_Effect_On_Children PX640902012800 The effect on my children could be harmful 4 N/A
PX640902_Suicide_Enjoy_Family PX640902011600 I love and enjoy my family too much and could not leave them 4 N/A
PX640902_Suicide_Experience_Life PX640902011700 I want to experience all that life has to offer and there are many experiences I haven't had yet which I want to have 4 N/A
PX640902_Suicide_Family_Feel_Guilty PX640902014700 I would not want my family to feel guilty afterwards 4 N/A
PX640902_Suicide_Family_Love PX640902010700 My family might believe I did not love them 4 N/A
PX640902_Suicide_Family_Needs PX640902010900 My family depends upon me and needs me 4 N/A
PX640902_Suicide_Family_Think_Selfish PX640902014800 I would not want my family to think I was selfish or a coward 4 N/A
PX640902_Suicide_Find_Reason_To_Live PX640902014400 I believe I can find a purpose in life, a reason to live 4 N/A
PX640902_Suicide_Find_Solutions_To_Problems PX640902012200 I believe I can find other solutions to my problems 4 N/A
PX640902_Suicide_Future_Plans PX640902011300 I have future plans I am looking forward to carrying out 4 N/A
PX640902_Suicide_Happy_With_Life PX640902013700 I am happy and content with my life 4 N/A
PX640902_Suicide_Have_Control_Over_Life PX640902010300 I believe I have control over my life and destiny 4 N/A
PX640902_Suicide_Hurt_Family PX640902013000 It would hurt my family too much and I would not want them to suffer 4 N/A
PX640902_Suicide_Inept_Not_Work PX640902014600 I am so inept that my method would not work 4 N/A
PX640902_Suicide_Killing_Method_Fail PX640902011800 I am afraid that my method of killing myself would fail 4 N/A
PX640902_Suicide_Leave_Children_For_Others PX640902012100 It would not be fair to leave the children for others to take care of 4 N/A
PX640902_Suicide_Life_Is_Beautiful PX640902012000 Life is too beautiful and precious to end it 4 N/A
PX640902_Suicide_Love_Of_Life PX640902012400 I have a love of life 4 N/A
PX640902_Suicide_Morally_Wrong PX640902013400 I consider it morally wrong 4 N/A
PX640902_Suicide_Not_Miserable_Enough PX640902010800 I do not believe that things get miserable or hopeless enough that I would rather be dead 4 N/A
PX640902_Suicide_Not_Solve_Anything PX640902013900 I believe killing myself would not really accomplish or solve anything 4 N/A
PX640902_Suicide_No_Reason_Death PX640902014500 I see no reason to hurry death along 4 N/A
PX640902_Suicide_Other_Think_Weak PX640902014100 Other people would think I am weak and selfish 4 N/A
PX640902_Suicide_Religious_Beliefs_Forbid PX640902012700 My religious beliefs forbid it 4 N/A
PX640902_Suicide_Responsibility_To_Family PX640902010100 I have a responsibility and commitment to my family 4 N/A
PX640902_Suicide_Right_To_End_Life PX640902010500 I believe only God has the right to end a life 4 N/A
PX640902_Suicide_Scoring PX640902014900 Ratings on the individual items are added together to give scores for individual subscales or to obtain an overall score for the whole inventory. Higher scores reflect greater reasons for living. 4 N/A
PX640902_Suicide_Stable PX640902012500 I am too stable to kill myself 4 N/A
PX640902_Suicide_Things_Left PX640902013500 I still have many things left to do 4 N/A
PX640902_Suicide_Things_Will_Improve PX640902014000 I have hope that things will improve and the future will be happier 4 N/A
PX640902_Suicide_Want_To_Die PX640902011000 I do not want to die 4 N/A
PX640902_Suicide_Will_Not_Last PX640902011400 No matter how badly I feel, I know that it will not last 4 N/A
PX640902_Suicide_Working_Out PX640902013200 I believe everything has a way of working out for the best 4 N/A
Research Domain Information
Measure Name:

Deterrents to Suicide

Release Date:

November 21, 2014

Definition

A questionnaire to assess protective factors that are deterrents to suicide behavior.

Purpose

The presence of protective factors and their interaction with risk factors can help indicate suicide risk.

Keywords

Suicide, Suicide deterrents, Protective factors, Religiosity, Religion, Morality, Morals, Reasons for Living for Adolescents inventory, RFL-A