Factors Associated With Reasons for Living Among Suicidal Adolescents

Objective The objective of this study was to identify baseline demographic and clinical factors associated with higher scores on the Reasons for Living Inventory for Adolescents (RFL-A) at baseline and over follow-up.Method Using data from a pilot clinical trial of a brief intervention for suicidal youth transitioning from inpatient to outpatient, we identified univariate associations of baseline characteristics with RFL-A and used regression to identify the most parsimonious subset of these variables. Finally, we examined to what extent changes in these characteristics over time were related to changes in RFL-A.Results Univariate analyses found that better external functional emotion regulation and social support were associated with higher RFL-A scores; more self-reported depression, internal dysfunctional emotion regulation, sleep disturbance, anxiety, and distress tolerance were associated with lower RFL-A scores. Multiple linear regression identified internal dysfunctional emotion regulation and external functional emotion regulation as the most parsimonious set of characteristics associated with RFL-A. Improvement in internal emotion regulation, sleep, and depression were related to improvements in RFL-A over time.Conclusion Our findings indicate that emotion regulation—specifically maladaptive internal strategies and use of external resources—is strongly associated with RFL-A. Improvements in internal emotion regulation (r = 0.57), sleep (r = −0.45), and depression (r = −0.34) were related to increases in RFL-A.HIGHLIGHTSIn the literature, greater reasons for living are associated with lower risk for future suicidal ideation and suicide attempts.The most salient correlate of concurrent and future lower RFL-A was dysfunctional internal emotion regulation. Improved sleep and decreases in depression were correlated with increases in RFL-A.