Résumé
Reasons for Living (RFL) are reasons that persons identify for staying alive when otherwise considering suicide, including elements of life such as beliefs and values, interpersonal relationships, and socio-cultural and religious/spiritual concerns. Hence, they are specifically linked to the concept of resilience to suicidality. Aims of this chapter are (1) to provide a broad overview of the link between RFL and suicidal thoughts and behaviors, focusing on the different scales developed for assessing RFL; and (2) to describe specific therapeutic strategies for suicide prevention connected to RFL enhancement.
A literature web search was performed to identify studies focusing on the link between RFL and suicidal thoughts and behaviors from 1983 until June 2017. Since our aim was not to perform a systematic review, the most representative studies have been included.
Eight scales have been described and compared: the Reasons for Living Inventory (RFLI), the Reasons for Living inventory for Adolescents (RFL-A), the College Student Reasons for Living Inventory (CS-RFLI), the Reasons for Living inventory for Young Adults (RFL-YA), the Reasons for Living for Older Adults scale (RFL-OA), the Chinese-language Motivations for Living Inventory (CMLI), the Protective Reasons against Suicide Inventory (PRSI), and the Reasons for Living versus Reasons for Dying Assessment developed in the context of the Collaborative Assessment and Management of Suicidality (CAMS). Most historical evidence was attributed to the most studied measure, the RFLI: overall, a high total score was found to be potentially protective against both suicidal ideation and suicide attempts in clinical and non-clinical samples. Promising treatments specifically focusing on RFL enhancement include Dialectical Behavior Therapy (DBT) and CAMS, as well as Mindfulness Based Cognitive Therapies (MBCT), Positive Psychology (PP), Acceptance and Commitment Therapy (ACT), and problem-solving therapies.
Further investigation of RFL differences among different cultures and ages is warranted and should also account for major social changes occurring since the development of the first instruments. Moreover, our suggestion is that a focus on RFL has the potential to be integrated into every therapeutic intervention aiming at suicide prevention.