Geriatric Suicide Ideation Scale Research Articles

ASSESSING THE PSYCHOMETRIC PROPERTIES OF THE GERIATRIC SUICIDE IDEATION SCALE IN MIDDLE-AGED AND OLDER MEN

Abstract Middle-aged and older men have high rates of suicide, necessitating risk detection. We developed the Geriatric Suicide Ideation Scale (GSIS; Heisel & Flett, 2006) as an age-specific, multidimensional suicide risk assessment tool. The GSIS has shown strong psychometric properties in clinical, community, and residential samples (see Heisel & Flett, 2016), yet research has lagged investigating its utility with middle-aged and older men. The purpose of the present study was thus to assess the psychometric properties of the GSIS administered to 82 men, 55 years and older (M=63.3, SD=4.6 years), who participated in a meaning-centered psychological intervention group for those concerned about or struggling with the transition to retirement (Heisel et al., 2020). Psychometric analyses included investigation of participant response characteristics, internal consistency, and construct validity. Findings demonstrated acceptable internal consistency for GSIS totals (α =.88) and for its Suicide Ideation, Death Ideation, Loss of Personal and Social Worth, and Perceived Meaning in Life subscales (α =.62-.81). Positive associations between the GSIS and negative psychological factors (depression, anxiety, hopelessness, loneliness, perceived lack of mattering to others, and history of suicidal behavior; r =.30 to .51) and negative associations with positive factors (life satisfaction, psychological well-being, perceived support, and meaning in life; r = -.21 to -.51) supported its construct validity. These and other findings will be discussed in the broader context of upstream population level approaches to suicide risk detection and prevention. (Note: this abstract was accepted for the 2022 GSA meeting, but we had to withdraw due to family loss)

Overview of Suicide Risk in Elderly at Nursing Home of Jember

The risk of suicide is one of the most vulnerable nursing problems experienced by the elderly. The risk of suicide occurs because of several suicide risk factors experienced by the elderly. This study aims to describe the risk of suicide in the elderly at UPT PSTW (nursing home) Jember. The research design used is a descriptive survey. The sampling technique used is total sampling. The sample used in this study was 76 elderly who were selected based on inclusion and exclusion criteria. Data were collected using the Geriatric Suicide Ideation Scale (GSIS) questionnaire to determine the risk of suicide in the elderly. The One Sample Kolmogorov-Smirnov test was used to achieve the objectives of this study. The results showed that the elderly experienced a significant risk of suicide but in the low category Md (P25-75)= 62(60-65); Z=0.151; p-value=0.000. This study concludes that there is a significant risk of suicide in the elderly at UPT PSTW Jember. Therefore, it is necessary to increase the spirit of life for the elderly by always reminding the elderly that there is still life and hope for them.

Prevalence and Predictors of Suicide Ideation among Elderly Mentally Ill Population in a Tertiary Psychiatric Hospital

BACKGROUND
 Suicide attempts in elderly people has higher risk of mortality. The elderly are more vulnerable to depression and other psychological and social factors that may contribute to higher risk of suicide. Studies have suggested that suicide in elderly is strongly associated with depression and lack of social support. Factors that increase risk of suicide are also found to increase the risk for suicide ideation. Suicide ideation is an important predictor of suicide attempts and completed suicide.
 Aims: Our study aims at estimating the prevalence of suicide ideation among mentally ill geriatric population and identifying potential predictors of suicide ideation among elderly.
 METHODS
 A cross-sectional study involving 50 persons with mental illness aged above 60 years and 50 persons with no previous psychiatric history. The was conducted at a tertiary psychiatric hospital. Geriatric Suicide Ideation Scale, Geriatric Depression scale and other psychopathology assessment tools were used.
 RESULTS
 The GSIS scores were significantly higher among those elderly persons with mental illness and the scores were higher in our study when compared to the community-dwelling elderly persons without psychiatric illness. It was observed that geriatric depression was an important predictor of suicide ideation followed by previous suicide attempt. The study also finds significant difference in the subscales of GSIS and we constructed an ROC for optimal cut-off point for the Indian population.
 CONCLUSIONS
 Geriatric suicide ideation is a less studied area with suicide ideation in elderly person with mental illness having various determinants and risk factors. It is for further research to identify feasible means of assessing suicide ideation among the elderly person receiving care from primary care physicians.

Beyond maintaining safety: Examining the benefit of emotion-centered problem solving therapy added to safety planning for reducing late life suicide risk

Few clinical trials have examined brief non-pharmacological treatments for reducing suicide risk in older Veterans, a high-risk group. Problem Solving Therapy (PST) is a promising psychosocial intervention for reducing late life suicide risk by increasing adaptive coping to problems through effective problem solving and related coping skills. The current randomized clinical trial will compare the efficacy of six telephone-delivered sessions of Safety Planning (enhanced usual care; EUC) only or an updated version of PST (emotion-centered PST [EC-PST]) + EUC to determine the added clinical benefit of EC-PST for reducing severity of suicidal ideation and for increasing reasons for living, a critical protective factor. Participants randomized to EC-PST + EUC or EUC only will be 150 Veterans (75 each) with active suicidal ideation who are aged 60 or older; have a current DSM-5 anxiety, depressive, and/or trauma-related disorder; and without significant cognitive impairment. Primary outcomes (Geriatric Suicide Ideation Scale and Reasons for Living-Older Adults scale) will be assessed at 11 timepoints: baseline, after each of 6 treatment sessions, posttreatment, and at follow-up at 1, 3, and 6 months posttreatment, and analyzed using mixed effects modeling. Additionally, moderators and mediators of primary outcomes will be examined—functional disability, executive dysfunction, and problem-solving ability. Qualitative feedback from participants will identify potential Veteran-centric changes to the EC-PST protocol and to EUC. Ultimately, the goal of this study is to inform the evidence-based clinical practice guidelines for treatments to reduce suicide risk in older Veterans and specifically to inform clinical decision-making regarding the merit of adding EC-PST to EUC.

IS NARCISSISTIC PERSONALITY ASSOCIATED WITH SUICIDE IDEATION IN MIDDLE-AGED AND OLDER MEN?

Abstract Older adults have high rates of suicide, necessitating theory and research on factors that contribute to suicide risk and may be targets for intervention. Clark (1993) theorized that age-related losses and transitions can trigger narcissistic injury in older men, and lead to mood decline, substance misuse, loss of insight, and suicide ideation and behavior. We tested elements of Clark’s model in a secondary analysis of a geriatric depression clinic database (n=574), and reported a positive association between clinician-diagnosed Narcissistic Personality (NP) and suicide ideation and behavior, controlling for depression severity (Heisel et al., 2007). We sought to replicate and extend these findings in 82 community-residing men, 55 years and older (M=63.3, SD=4.6), who participated in a trial of Meaning-Centered Men’s Group (MCMG; Heisel et al., 2020) for those concerned about or struggling with the transition to retirement. Participants completed the Pathological Narcissism Inventory (Pincus et al., 2009), Geriatric Suicide Ideation Scale (Heisel & Flett, 2006), and Geriatric Depression Scale (Yesavage et al., 1983). Linear regression analyses indicated a significant association between PNI-Contingent Self-Esteem and GSIS totals (t=2.41, p=.019) and GSIS Loss of Personal Worth (t=2.10, p=.040) and Perceived Meaning in Life Subscales (t=2.80, p=.007), controlling for depressive symptom severity (Geriatric Depression Scale; Yesavage et al., 1983), suggesting an association between suicide ideation and self-esteem issues. These and other findings will be discussed in a broader thematic context regarding masculinity, loss, life transitions, and suicide prevention.

ASSESSING THE PSYCHOMETRIC PROPERTIES OF THE GERIATRIC SUICIDE IDEATION SCALE (GSIS) IN MIDDLE-AGED AND OLDER MEN

Abstract Middle-aged and older men have high rates of suicide, necessitating focused risk detection. We developed the Geriatric Suicide Ideation Scale (GSIS; Heisel & Flett, 2006) as an age-specific, multidimensional suicide risk assessment tool. The GSIS has shown strong psychometric properties in clinical, community, and residential samples (see Heisel & Flett, 2016), yet research has lagged investigating its utility with middle-aged and older men. The purpose of the present study was thus to assess the psychometric properties of the GSIS administered to 82 men, 55 years and older (M=63.3, SD=4.6 years), who participated in a meaning-centered psychological intervention group for those concerned about or struggling with the transition to retirement (Heisel et al., 2020). Psychometric analyses included investigation of participant response characteristics, internal consistency, and construct validity. Findings demonstrated acceptable internal consistency for GSIS totals (α =.88) and for its Suicide Ideation, Death Ideation, Loss of Personal and Social Worth, and Perceived Meaning in Life subscales (α =.62-.81). Positive associations between the GSIS and negative psychological factors (depression, anxiety, hopelessness, loneliness, perceived lack of mattering to others, and history of suicidal behavior; r =.30 to .51) and negative associations with positive factors (life satisfaction, psychological well-being, perceived support, and meaning in life; r = -.21 to -.51) supported its construct validity. These and other findings will be discussed in the broader context of upstream population level approaches to suicide risk detection and prevention.

Evaluating the Validity of the Columbia-Suicide Severity Rating Scale for Lonely Older Adults

Social support exchanges are an integral part of older adults’ well-being. Yet, we know little about how older adults' marital status may influence their support exchanges with different social partners in everyday life, and whether the effect of support exchanges on daily well-being vary by marital status. Adults aged 65+ (N = 278) completed an initial interview about their background and close social networks; then, participants reported whether they provided or received support from their close social partners and rated their psychological well-being for 5 to 6 days. Multilevel logistic models revealed that married older adults were more likely to provide or receive daily support from their close partners than widowed or divorced older adults. However, with respect to specific non-spousal ties, married older adults were less likely to provide support to siblings, friends or others (acquaintances, neighbors) compared to divorced older adults. Although married older adults were more likely to receive support from children than divorced older adults, they were less likely to receive support from siblings and friends compared to widowed or divorced older adults. Furthermore, receiving support from other familial ties (grandchild, other relatives) was associated with reduced daily well-being for widowed older adults whereas married older adults were able to maintain their daily well-being in such situation. Findings highlight the central role siblings and friends play in unmarried older adults' daily support networks and suggest that receiving support could have differential impact on daily well-being depending on older adults’ marital status.

The Social Hopelessness Questionnaire (SHQ): Psychometric properties, distress, and suicide ideation in a heterogeneous sample of older adults

BackgroundOlder adults have high rates of suicide, necessitating attention to psychological factors that confer risk for suicide. Hopelessness is significantly associated with psychological despair and suicide risk factors; however, research has been limited by unidimensional treatment of the construct. The purpose of the present study was thus to investigate the psychometric properties of the Social Hopelessness Questionnaire (SHQ; Flett et al., 2021), a 20-item measure of hopelessness in the interpersonal domain, in a heterogeneous sample of older adults. MethodsNinety adults 65 years of age or older were recruited from community, residential, or healthcare facilities in the context of a validation study of the Geriatric Suicide Ideation Scale (GSIS; Heisel & Flett, 2006). Participants voluntarily completed the SHQ, a demographics form, and concurrent measures of global hopelessness, depressive symptom severity, suicide ideation, and subjective well-being. ResultsThe SHQ demonstrated strong internal consistency, construct validity by way of significant positive associations with negative psychological factors and negative associations with positive factors, and differentiated older adults recruited from community and mental health settings. It also explained significant variability in depression, suicide ideation, and subjective well-being beyond that accounted for by an age-specific measure of global hopelessness. LimitationsFindings were limited by a small clinical sub-sample, relatively few male participants, cross-sectional analysis, and focus on suicide ideation rather than suicide behavior. ConclusionThese findings suggest that the SHQ is a reliable and valid measure of an interpersonal form of hopelessness for use with older adults across diverse settings.

Pengaruh Perceived Burdensomeness, Thwarted Belongingness, dan Religiusitas Terhadap Ideasi Bunuh Diri pada Lansia

Suicidal ideation in elderly is rarely a society’s concern even though elderly is the age group most vulnerable to suicide. This study was conducted to prove the effect of perceived burdensomeness, thwarted belongingness, religiosity, and demographic factors (gender and education level) on suicidal ideation in the elderly. The subjects of this study were 230 respondents aged 60 years and over who were obtained using accidental non-probability sampling techniques. The measuring instrument used were the adaptation and modification of the Geriatric Suicide Ideation Scale, the Interpersonal Needs Questionnaire, and the Centrality of Religiosity Scale. The validity test of the instrument was carried out using Confirmatory Factor Analysis (CFA), while the hypothesis testing was carried out using multiple regression analysis. The results showed that there was a significant effect of perceived burdensomeness and the ideological dimensions of religiosity. The results of this study are expected to be an input for readers to pay more attention to the perceived burdensomeness and ideology of religiosity in the elderly as factors that can influence suicidal ideation. Subsequent researchers can also develop this research by adding other independent variables to be analyzed, such as health conditions and living arrangements.

Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen

Objectives To initially assess psychometric properties of two abbreviated versions of the Geriatric Suicide Ideation Scale (GSIS): a 10-item Brief Geriatric Suicide Ideation Scale (BGSIS), and a 5-item Geriatric Suicide Ideation Scale-Screen (GSIS-Screen). Methods A series of psychometric analyses was conducted, assessing the internal consistency, test–retest reliability, construct and predictive validity of the abbreviated GSIS scales. This was done by selecting-out GSIS items from a combined dataset of studies on suicide ideation in older adults: 1) The GSIS scale development study (n = 107); 2) A clinical trial of Interpersonal Psychotherapy (IPT) modified for suicidal older adults(n = 25); 3) A longitudinal study of risk and resiliency to suicide ideation in community-residing older adults (n = 173). Results Overall findings demonstrated strong internal consistency, test–retest reliability, concurrent and predictive validity for the BGSIS and GSIS-Screen with older adults across community, clinical, and residential settings. Conclusion Study findings support the use of the abbreviated GSIS scales when conducting research on suicide risk identification among older adults. Future research is recommended testing these scales prospectively in public health, residential, and clinical settings, in research and healthcare delivery contexts.

Improvements in Functional Disability After Psychotherapy for Depression Are Associated With Reduced Suicide Ideation Among Older Adults

ObjectiveTo evaluate the association between changes in functional disability and suicide ideation among older adults following psychotherapy for depression. MethodsSixty-five participants (65–91 years old, 72% White, and 66% female) with depression completed 12 sessions of problem solving therapy (PST) and completed measures of disability (WHO Disability Assessment Schedule 2.0) and suicide ideation (Geriatric Suicide Ideation Scale [GSIS]) at baseline and post-treatment. ResultsHierarchical linear regressions found that reductions in functional disability were associated with overall reductions in suicide ideation on the GSIS (F[4,60] = 4.06, p < 0.01), particularly with the Loss of Worth GSIS subscale (F[4,60] = 7.86, p < 0.001, ΔR2 = 0.140). ConclusionsResults suggest decreased functional disability following depression treatment is associated with decreased suicide ideation, especially thoughts regarding loss of worth. These results highlight the potential for treatments that reduce functional disability (e.g., PST) to reduce risk of suicide among older adults.

Peer Companionship for Mental Health of Older Adults in Primary Care: A Pragmatic, Nonblinded, Parallel-Group, Randomized Controlled Trial

To determine whether peer companionship delivered by an aging services agency to socially-disconnected older adult primary care patients was associated with improvement in suicidal ideation depression, anxiety, and psychological connectedness. Pragmatic, nonblinded, parallel-group, randomized controlled trial comparing peer companionship, The Senior Connection (TSC), to care-as-usual (CAU). Lifespan, a nonmedical, community-based aging services agency. Adult primary care patients ages 60 years or older who endorsed feelings of loneliness or being a burden on others. TSC was delivered by Lifespan volunteers who provided supportive visits and phone calls in the subjects' homes. CAU involved no peer companion assignment. The primary outcome was suicidal ideation assessed by the Geriatric Suicide Ideation Scale; secondary outcomes were depression, anxiety, and feelings of belonging and being a burden on others. Data were collected at baseline, 3-, 6-, and 12-months. Subjects (55% female) had a mean age of 71 years. There was no difference between groups in change in suicidal ideation or belonging. Subjects randomized to TSC had greater reduction in depression (PHQ-9; 2.33 point reduction for TSC versus 1.32 for CAU, p = 0.05), anxiety (GAD-7; TSC 1.52 versus CAU 0.28, p = 0.03), and perceived burden on others (INQ; 0.46 TSC versus 0.09 CAU, p <0.01). TSC was superior to CAU for improving depression, anxiety, and perceived burden, but not suicidal ideation. Although effect sizes were small, the low-cost and nationwide availability of peer companionship justify further examination of its effectiveness and scalability in improving mental health outcomes of socially disconnected older adults.

Measuring character strengths as possible protective factors against suicidal ideation in older Chinese adults: a cross-sectional study

BackgroundSuicide is a global issue among the elderly. The number of older people committing suicide is proliferating, and the elderly suicide rate is the highest among all age groups in China. A better understanding of the possible protective factors against suicidal ideation is necessary to facilitate prevention and intervention efforts. The objectives of the present study are threefold. First, this study aims to examine the psychometric properties of the three-dimensional inventory of character strengths (TICS) with a sample of older adults. Second, this study intends to investigate correlations among suicide ideation, wellbeing, and character strengths. Third, the study seeks to explore the possible protective roles of the three character strengths and wellbeing in explaining suicidal ideation among older adults.MethodsA cross-sectional study comprising 308 older adults aged at least 50 years old from nursing homes was conducted. Four questionnaires, namely, the TICS, the Geriatric Suicide Ideation Scale—10 items, the Brief Inventory of Thriving, and the Satisfaction with Life Scale, were used. Exploratory structural equation modeling, intraclass correlation coefficients, partial correlations, and sets of hierarchical regressions were adopted to estimate and report the results.ResultsTICS could be used to assess the character strengths (i.e., caring, inquisitiveness, and self-control) among older adults with an acceptable goodness-of-fit (chi square = 157.30, df = 63, p < 0.001, CFI = 0.94, TLI = 0.90, RMSEA = 0.07, 90% CI = [0.06, 0.08]). Wellbeing and character strengths exhibited a negative association with suicidal ideation among older adults. Moreover, character strengths showed an independently cross-sectional relationship with suicidal ideation, explaining 65.1% of the variance of suicidal ideation after controlling for the wellbeing and demographics.ConclusionThis study indicated that character strengths were associated with low levels of suicidal ideation. Therefore, the protective factors against suicidal ideation among older adults should be given additional attention.

Peer Companionship for Mental Health of Older Adults in Primary Care: A Pragmatic, Non-Blinded, Parallel-Group, Randomised Controlled Trial

Background: Social disconnectedness is associated with suicide in later life. We investigated whether peer companionship delivered by a community aging services agency to socially-disconnected older adult primary care patients was associated with improvement in suicidal ideation depression, anxiety, and psychological connectedness. Methods: Subjects recruited from primary care were enrolled in a 12-month, non-blinded, randomised controlled trial comparing a peer companion intervention, The Senior Connection (TSC), to care as usual (CAU). TSC was delivered by volunteers who provided supportive visits and phone calls.Data were collected at baseline, 3-, 6-, and 12-months. The primary outcome was suicidal ideation as measured by the Geriatric Suicide Ideation Scale; secondary outcomes were measures of depression, anxiety, and feelings of belonging and being a burden on others. Of 369 subjects randomised, 58 were lost to follow up and 56 others lacked 12-month outcome data because the study ended before they completed full participation. Intent-to-treat analyses with all 369 subjects used weighted generalized estimating equations to address all sources of missing data. Findings: Subjects (55% female) had a mean age of 71 years. There was no difference between groups in change in suicidal ideation or belonging. Subjects randomised to TSC had greater reduction in depression (PHQ-9; 2·33 point reduction for TSC vs. 1·32 for CAU, p= 0·05), anxiety (GAD-7; TSC 1·52 vs. CAU 0·28, p= 0·03), and perceived burden on others (INQ; 0·46 TSC vs. 0·09 CAU, p< 0·01). Interpretation: TSC was superior to CAU for improving depression, anxiety, and perceived burden, but not suicidal ideation. Although effect sizes were small, the low-cost and nationwide availability of peer companionship justify more research to examine its effectiveness and scalability in improving mental health outcomes of socially disconnected older adults. Trial Registration: TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01408654 Funding Statement: The U.S. Centers for Disease Control and Prevention and the National Institutes of Health. Primary support for the study was provided through a cooperative agreement between the grantees and CDC (U01CE001942) Declaration of Interests: Dr. Stone and Ms. McIntosh were employees of the Center for Disease Control and Prevention, which funded the study. Drs. Conwell, Tu, and Van Orden receive funding from the U.S National Institutes of Health for research unrelated to this study. Dr. Conwell has received support from the Office of the Attorney General of Canada for expert consultation on late life suicide. None of the authors have conflicts of interest to disclose, currently or in the last three years, including specific financial interests and relationships and affiliations relevant to the subject of this manuscript. Ethics Approval Statement: The University of Rochester Research Subjects Review Board approved all procedures and all subjects provided written informed consent after the procedures had been fully explained. Prior approval for the study was obtained from the GR-PBRN executive committee.

Functional disability, depression, and suicidal ideation in older prisoners

BackgroundThe population of older prisoners (age ≥50), a group with high suicide rates, is growing. We sought to explore the associations among functional disability, depression, and suicidal ideation (SI) among older prisoners, focusing on the mediating role of depression. MethodsStudy participants were 220 sentenced male inmates age ≥50 who were incarcerated in 8 prisons. Face-to-face interviews were conducted following consent. Functional disability was assessed objectively, using the Short Physical Performance Battery (SPPB), and via self-report by asking participants their level of difficulty climbing stairs and completing activities necessary for daily living in prison (PADLS) such as standing in line for medications. The PHQ-9 and the Geriatric Suicide Ideation Scale assessed depressive symptoms and SI, respectively. Data were analyzed using linear regression models and causal mediation models. ResultsParticipants were racially diverse and ranged from age 50 to 79 years. Whereas each functional disability measure was significantly associated with depressive symptoms, difficulty climbing stairs and PADL disability, but not SPPB score, were independently associated with SI. Depressive symptoms mediated the relationship between functional disability, assessed both objectively and via self-report, and SI. LimitationsCross-sectional study design; possible under-sampling of participants with depressive symptoms and SI. ConclusionsOur findings have implications for suicide prevention in older prisoners. As this population continues to grow, prevention efforts should target those with depression, including but not limited to those with functional disability. Furthermore, assessing functional disability may offer a means of identifying those who should be screened for depression and suicidal ideation.

Measuring suicide risk in the elderly with non-institutionalized depression: an integrative review.

Analyze the state of the art about instruments, at national and international levels, for assessing the risk of suicide in elderly people with depression assisted in the community. Integrative review of 38 complete articles, published in journals indexed in the databases: US National Library of Medicine (PubMed Central), Scopus, CINAHL and Web of Science, located using controlled descriptors combined with Boolean operators: elderly OR aged OR older OR elder OR geriatric AND depression AND suicide AND risk assessment. Six instruments were found, all international and published in the English language, in order to identify suicidal behavior and ideation in the elderly. Of these, two are specific scales for assessing the risk of suicide in the elderly in the community: 5-item GDS subscale and Geriatric Suicide Ideation Scale. With the scarcity of national instruments to assess such risk, research is recommended to cross-culturally adapt one of these scales to the Brazilian Portuguese language.

The relationship of frailty and disability with suicidal ideation in late life depression

Objectives Frailty and disability are commonly found in Late Life Depression (LLD) and have been associated with increased depression severity, health comorbidities and mortality. Additionally, physical frailty has been associated with suicide in later life, independent of presence of a mood disorder. The objective of our study was to assess the associations of physical frailty and functional disability with suicidal ideation, controlling for depression severity and demographic factors, in an older depressed sample. Methods This study used data from community-dwelling older adults with major depression. Eligible participants were ≥ 65 years old, completed measures of depression symptom severity (Hamilton Depression Rating Scale-24 item; HDRS-24), current suicidal ideation (Geriatric Suicide Ideation Scale; GSIS), and physical frailty/functional capacity measures. Results Participants were 88 older adults with a mean age of 71.5 (SD = 6.0) and 66% of the sample was female. Poorer performance on frailty measures of gait speed (B = .239, p = .003) and muscle weakness (B = −.218, p = .01) were significantly associated with higher levels of suicidal ideation, independent of depression severity and demographic factors. Functional disability was also significantly related to suicide ideation, specifically impairment in financial capacity (B = −.290, p = .008), social interaction (B = .408, p < .001), and communication skills (B = .373, p = .001). Conclusion Our findings show that, in LLD, frailty and functional disability are significantly associated with higher levels of suicide ideation, independent of depression symptom severity.

CHANGES IN FUNCTIONAL DISABILITY AND SUICIDAL IDEATION ASSOCIATED WITH PSYCHOTHERAPY FOR DEPRESSION

Given the association between functional disability and suicidal ideation (SI) in late life (Lutz & Fiske, 2017), this study examined associations between functional disability and SI among older adults receiving problem solving therapy (PST) for depression. PST is a promising intervention for SI (e.g., Gustavson et al., 2016) and has been shown to be effective in reducing functional disability among older adults with depression (e.g., Choi et al., 2014). Regression analyses with adults age 65-91 (n=65) found that level of SI (Geriatric Suicide Ideation Scale) at baseline was not significantly associated with change in SI from pre- to post-treatment. However, lower baseline disability (WHODAS-II; ΔR2=.08, p=.022) and greater reduction in disability (ΔR2=.12, p=.004) were significantly associated with greater reduction in SI after controlling for age and baseline SI. These results suggest that treatments that decrease disability may be particularly advantageous for reducing SI in older depressed adults.

Enhancing the Assessment of Resiliency to Suicide Ideation among Older Adults: The Development and Initial Validation of the Reasons for Living-Suicide Resiliency Scale (RFL-SR)

ABSTRACTObjectives: To derive a brief late-life suicide resiliency scale from the 69-item Reasons for Living Scale-Older Adult version (RFL-OA).Methods: We conducted a series of secondary analyses of RFL-OA data (N = 204) from a dataset combining: 1. A follow-up assessment of nursing home residents in the Geriatric Suicide Ideation Scale (GSIS) development study; 2. A trial of Interpersonal Psychotherapy (IPT) with suicidal older adults; 3. A longitudinal study of risk and resiliency to late-life suicide ideation. We specifically assessed the distributions of RFL-OA items and their associations with suicide ideation and behavior to create an RFL-Suicide Resiliency subscale (RFL-SR); we then tested the psychometric properties of this measure’s items drawn from the larger RFL-OA.Results: Nine RFL-OA items were significantly associated with suicide ideation and history of suicide behavior and were not highly correlated with social desirability. Psychometric analyses supported the internal consistency, test–retest reliability, and construct validity of this scale.Conclusions: The items of the RFL-SR demonstrated strong psychometric properties with older adults in clinical and community settings.Clinical Implications: The RFL-SR may make a useful addition to suicide risk assessment in gerontological research and clinical practice.

Determinants of Suicide-related Ideation in Late Life Depression: Associations with Perceived Stress

ABSTRACTObjectives: Perceived stress is emerging as a potential contributing factor in suicide-related ideation in older adults. We hypothesized higher levels of perceived stress would be associated with increased self-reported suicidal ideation independent of depressive symptom severity.Methods: This study used data from community-dwelling older adults aged ≥65 with a current diagnosis of major depression. Eligible participants completed measures of depression symptom severity (Hamilton Depression Rating Scale-17 item), current suicidal ideation (Geriatric Suicide Ideation Scale), and perceived stress (Perceived Stress Scale).Results: Participants were 225 older adults with a mean age of 71.4 (SD = 5.6). Sixty-five percent of the sample was female. Fifteen percent of the variance in suicidal ideation was accounted for by lower education (p = .03), male sex (p = .03) and higher current perceived stress (p < .001). Specifically, stress accounted for 12% of the variance.Conclusions: Perceived stress is an important avenue to increase identification of individuals with a higher risk of suicide-related ideation among older adults with a current diagnosis of major depression.Clinical Implications: Screening for perceived stress may allow for improved screening and prevention of suicidal activity in depressed older adults.