Toward an assessment of escape/avoidance coping in depression.

Models of animal behavior suggest that anxiety and major depressive disorder (MDD) may be characterized by different profiles of escape and avoidance behavior. However, the literature on coping strategies fails to distinguish between avoidance and escape coping patterns, instead grouping escape behaviors into the larger category of avoidant coping. We argue that investigating both escape and avoidance coping behavior in those with anxiety and depression may reveal distinct behavioral profiles, whereas the current conceptual framework has failed to find significant differences coping style.

Considerations in the Use of Interactive Voice Recording for the Temporal Assessment of Suicidal Ideation and Alcohol Use.

BACKGROUND: A greater understanding of the temporal variation of suicidal ideation and suicidal behavior is needed to inform more effective prevention efforts. Interactive voice recording (IVR) allows for the study of temporal relationships that cannot be captured with most traditional methodologies. AIMS: To examine the feasibility of implementing IVR for the assessment of suicidal ideation. METHOD: Participants (n = 4) receiving a brief intervention based on dialectical behavior therapy were asked to respond to three phone-based surveys each day over 6 weeks that assessed suicidal ideation and alcohol consumption. RESULTS: Participants completed 77.7% of daily assessments, reported that calls were not burdensome, and indicated that calls were sometimes helpful in interrupting suicidal ideation. CONCLUSION: The preliminary data reported here provide optimism for the use of IVR and other forms of ecological momentary assessment in the exploration of the antecedents of suicidal behavior.

Development and psychometric evaluation of the reasons for living--older adults scale: a suicide risk assessment inventory.

PURPOSE: The purposes of these studies were to develop and initially evaluate the psychometric properties of the Reasons for Living Scale-Older Adult version (RFL-OA), an older adults version of a measure designed to assess reasons for living among individuals at risk for suicide. DESIGN AND METHODS: Two studies are reported. Study 1 involved instrument development with 106 community-dwelling older adults, and initial psychometric evaluation with a second sample of 119 community-dwelling older adults. Study 2 evaluated the psychometric properties of the RFL-OA in a clinical sample. One hundred eighty-one mental health patients 50 years or older completed the RFL-OA and measures of depression, suicide ideation at the current time and at the worst point in one's life, and current mental status and physical functioning. RESULTS: Strong psychometric properties were demonstrated for the RFL-OA, with high internal consistency (Cronbach's alpha coefficient). Convergent validity was evidenced by negative associations among RFL-OA scores and measures of depression and suicide ideation. RFL-OA scores predicted current and worst-episode suicide ideation above and beyond current depression. Discriminant validity was evidenced with measures of current mental status and physical functioning. Criterion-related validity was also demonstrated with respect to lifetime history of suicidal behavior. IMPLICATIONS: These findings provide preliminary support for the validity and reliability of the RFL-OA. The findings also support the potential value of attending to reasons for living during clinical treatment with depressed older adults and others at risk for suicide.