The Living Ladder: Introduction and Validity Over 6‐Month Follow‐Up of a One‐Item Measure of Readiness to Continue Living in Suicidal Patients. Issue 5 (28th March 2020)

• Record Type: Journal Article
• Authors: Britton, Peter C.; Conner, Kenneth R.; Maisto, Stephen A.
• Is Part Of: Suicide and life-threatening behavior. Volume 50:Issue 5(2020:Oct.)
• Page Start: 1025
• Page End: 1040
• Publication Date: 2020-03-28
• Subjects: Suicide -- Periodicals; Suicide -- Prevention -- Periodicals; Behavior -- Periodicals; Suicide -- Periodicals; 362.28
• DOI: 10.1111/sltb.12635
• Languages: English
• ISSNs: 0363-0234

Abstract

Abstract : Objective: 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. Methods: 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. Results: 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. Conclusions: 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.