A Shortened Version of the Reasons for Living—Older Adults Scale for Clinical and Research Utility

Abstract

The shorter RFL-OA has good psychometric properties among community-dwelling older adults. It may have greater utility, compared to the original 69-item measure, for clinicians and researchers with limited time but who want to assess protective factors against suicidal behavior in late life.

Assessing suicide ideation among older adults: a systematic review of screening and measurement tools

“…We identified seven individual scales across the ten articles included for review that were a mixture of those measuring negative (wish/will to die) factors and those focusing on reasons, or wishes, to live. The measures included the Reasons for Living scale-Older Adults (RFL-OA), reported on by three of the articles included for review: an adaption by Edelstein et al (2009) for older adults, a shortened version developed by Lutz et al, (2019), and one article examining the resiliency to suicide subscale individually (Wadhwa and Heisel, 2019). The psychometric properties of Geriatric Suicide Ideation Scale (GSIS) (which was originally developed by Heisel and Flett in 2006) were reported by two Screening for suicide risk in older adults 3…”

“…The included articles represent a range of countries with three from the USA (Edelstein et al, 2009;Lutz et al, 2019;Nugent and Cummings, 2014), two from Canada (Heisel and Flett, 2016;Wadhwa and Heisel, 2019), and one each from Japan (Awata et al, 2007), Taiwan (Lee et al, 2017), Israel (Carmel, 2017), and Switzerland (Durst et al, 2020), with one further article using social media to recruit an international sample (O' Rourke et al, 2018). Measurement development and validation across the different scales were conducted with community, out-patient, and clinical samples ranging in age from 50 to 99 years.…”

“…Six of the articles reviewed were based on selfreported measures (Durst et al, 2020;Edelstein et al, 2009;Heisel and Flett, 2016;Lutz et al, 2019;O'Rourke et al, 2018;Wadhwa and Heisel, 2019), three used clinician interviews and interpretation to administer the measure and score responses (Awata et al, 2007;Carmel, 2017;Nugent and Cummings, 2014), while administration was not reported for the TSII (Lee et al, 2017). A number stated the purpose of their measures were to aid clinical detection of suicide ideation or assess risk factors for suicide in older adults, while some were presented as screening tools that could be used in more general assessment of well-being, referral decisions or support needs.…”

“…A number stated the purpose of their measures were to aid clinical detection of suicide ideation or assess risk factors for suicide in older adults, while some were presented as screening tools that could be used in more general assessment of well-being, referral decisions or support needs. However, the rationale for using exclusively community samples (Awata et al, 2007;Carmel, 2017;Heisel and Flett, 2016;Lutz et al, 2019;O'Rourke et al, 2017), mental health patient (either inpatient or outpatient) clinical samples (Durst et al, 2020;Edelstein et al, 2009;Lee et al, 2017;Nugent and Cummings, 2014), or a combination of both (Wadhwa and Heisel, 2019) in order to pilot and psychometrically test their measures was not presented in these articles.…”

“…Durst et al, (2020) adapted two scales (CADO and SAHD) to measure the presence and intensity of suicide ideation in their sample. Meanwhile, Lutz et al, (2019) re-examined data from previous research and performed exploratory factor analyses to create a shortened version of the RFL scale before testing it psychometrically with a community sample recruited online. The remaining scales (Heisel and Flett, 2016;Nugent and Cummings, 2014;O'Rourke et al, 2018;Wadhwa and Heisel, 2019) were developed through a combination of reviews of existing literature and theory, clinical experience of the authors and, in the case of the TSII (Lee et al, 2017), the use of a Delphi panel.…”