Department of Veterans Affairs, Finger Lakes Healthcare System, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, USA.
Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
Suicide Life Threat Behav. 2020 Oct;50(5):1025-1040. doi: 10.1111/sltb.12635. Epub 2020 Mar 28.
The ability to predict suicide outcomes is limited by the lack of consideration of protective factors. This study examined the validity of the Living Ladder, a measure of readiness to continue living among individuals thinking of suicide.
The Living Ladder consists of one item that assesses an individual's readiness to continue living when thinking about suicide. Participants (N = 130) completed the Living Ladder in-person at baseline and by-phone at 1-, 3-, and 6-month follow-up. The prospective association of the Living Ladder with suicidal ideation and risk for a suicide attempt was examined using models adjusting for baseline ideation and suicide attempts, respectively.
Each rung on the Living Ladder was associated with 18% lower likelihood of suicidal ideation, OR (95% CI) = 0.82 (0.68, 0.96), and less severe suicidal ideation among those with ideation. Scores >2, indicating contemplation of living, were associated with 64% lower risk for a suicide attempt, HR (95% CI) = 0.36 (0.13, 0.98). Findings for suicidal ideation were replicated when administered by-phone.
The Living Ladder is a one-item measure that is prospectively associated with suicidal ideation and suicide attempts. Findings support the relevance of motivation to live to suicide outcomes.
自杀结局的预测能力受到缺乏对保护因素考虑的限制。本研究检验了生存阶梯的有效性，这是一种衡量自杀意念个体继续生存意愿的方法。
生存阶梯由一个项目组成，评估个体在考虑自杀时继续生存的意愿。参与者（N=130）在基线时亲自完成生存阶梯，在 1、3 和 6 个月的随访时通过电话完成。使用分别调整基线意念和自杀尝试的模型，检验生存阶梯与自杀意念和自杀企图风险的前瞻性关联。
生存阶梯的每一级与自杀意念的可能性降低 18%相关，OR（95%CI）=0.82（0.68，0.96），并且在有自杀意念的个体中，自杀意念的严重程度较低。得分>2，表明考虑生存，与自杀企图的风险降低 64%相关，HR（95%CI）=0.36（0.13，0.98）。通过电话管理时，自杀意念的发现得到了复制。
生存阶梯是一个与自杀意念和自杀企图具有前瞻性关联的单项测量方法。研究结果支持了生存意愿与自杀结局的相关性。
