J Relig Health DOI 10.1007/s10943-014-9893-4 ORIGINAL PAPER

‘Give Me a Reason to Live!’ Examining Reasons for Living Across Levels of Suicidality Slade J. Rieger • Tracey Peter • Lance W. Roberts

Ó Springer Science+Business Media New York 2014

Abstract Scholarly research focusing on social psychological factors (e.g. mental health) and social environmental factors (e.g. childhood trauma) has found these measures to be correlated with suicidality. However, such literature has tended to overlook what may impact one’s reasons for living. Using a sample of over 1,200 students from a Canadian university, the goal of the current study is to empirically test, by employing multivariate nested regression models (by levels of suicidal behaviour), known and relative unknown correlates with reasons for living, with a particular focus on strength of religious faith, which is a well-known predictor for suicidality, but less studied as a reason for living. Results show that, among students with serious suicidal ideation and/or a previous suicide attempt, the strongest predictor for student’s reasons for living was strength of religious faith. Strength of religious faith has seldom been acknowledged or identified as an important measure in assessing one’s reasons to live. These findings have implications for the role of religiosity among suicidality research, especially studies that focus on reasons for living. Keywords Reasons for living inventory for young adults (RFL-YA)
Suicidality
Strength of religious faith
MHI-5
Childhood trauma

Introduction Suicide and suicidal behaviour are pre-eminent social problems. According to the World Health Organization (WHO), globally, there is one completed suicide every 40 s, and it is predicted that by 2020, this rate will increase to one every 20 s (Gvion and Apter 2012). In the United States, suicide completion rates among college students are estimated to be 7.5 per 100,000 (Lamis et al. 2009) and is the second leading cause of death (preceded by

S. J. Rieger (&)
T. Peter
L. W. Roberts University of Manitoba, Winnipeg, Canada e-mail: [email protected]

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accidents); however, these rates are significantly lower than peers their age who are not in school (Schwartz 2011). Youth suicide patterns are similar for Canada. Suicide accounts for 23 % of deaths among youth between the ages of 20–24, which is the second leading cause of death (behind unintentional accidents) (Statistics Canada 2010). Suicidal attempts and suicidal ideation are intrinsically related to deaths by suicide (Furr et al. 2001; Groholt et al. 2000; Malone et al. 2000; Westefeld et al. 2005). In terms of college students, Drum et al. (2009) found in a large-scale American study that 18 % of undergraduates seriously considered suicide at some point in their lifetime, while 6 % reported serious suicidal ideation in the past 12 months. Depression as a risk factor has been well documented among suicidology research (Fergusson et al. 2003; Kisch et al. 2005; Malone et al. 2000), and college students who suffer from depression or exhibit depressive symptoms also experience significantly higher rates of suicidality (Garlow et al. 2008). Although depression is arguably one of the strongest risk factors for suicidal behaviour (i.e. ideation or attempt), evidence indicates that suicidal tendencies among individuals with depression or depressive symptoms are often never developed (Fergusson et al. 2003). As such, it is prudent to examine other factors that protect against suicidal behaviour. Studies suggest that the reasons a person has for living can aid in resisting suicidal ideations and attempts (Ellis and Lamis 2007; Linehan et al. 1983). Other studies suggest that religiosity is another protective factor against suicidality (Eskin 2004; Gearing and Lizardi 2008; Osafo et al. 2011; Rasic et al. 2011; Whalen 1964). However, although scholarly research has examined religious and moral objections to suicide in older adults (Ellis and Lamis 2007; McClaren 2011; Miller et al. 2001; Segal and Needham 2007; Segal et al. 2012), few studies have analysed religiosity as a significant mediator among young adults as reasons for not engaging in suicidal behaviour. Moreover, while the reasons for living (RFL) inventory (Linehan et al. 1983) has been a popular measure in terms of a significant protective factor against suicidality, the more resent RFL index specific to young adults (RFL-YA; Gutierrez et al. 2002) has not been used as extensively in scholarly literature, and none have linked the RFL-YA inventory with religiosity. Finally, the vast majority of empirical research on suicidal behaviour tends to examine levels of suicidality as a dichotomous dependent variable (i.e. suicidal ideation/no suicidal ideation or suicide attempt/no previous suicide attempt), even though there is evidence that such behaviour exists across a continuum (Mazza 2006; Reynolds 1988; Stanley et al. 1992). Given these shortcomings in the literature, the goal of the current study is to examine young adults reason for living across levels of suicidality (never suicidal, brief suicidal ideation, and serious suicidal ideation and/or previous suicide attempt), with a particular focus to religious ideology.

Literature Review Suicide Adolescence and emerging adulthood has been identified as a significant period for the development of suicidal thoughts and ideations (Jacobson et al. 2011; Miranda et al. 2012; Peter et al. 2008; Ruetter et al. 2008; Schilling et al. 2009). In one college sample, Garlow and colleagues (2008) found that 11.1 % of students reported suicidal ideation in the past 4 weeks, and 16.5 % had made an attempt in their lifetime. Disturbingly, suicidal ideation has been demonstrated to disrupt young adults’ ability to seek help when suicide risk is high (Barnes et al. 2001; Pisani et al. 2012).

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Risk factors for adolescent suicide are many and varied, but depressive symptoms are frequently cited in the literature (Dugas et al. 2012; Foley et al. 2006). For example, Garlow et al. (2008), students exhibiting moderate to high depressive symptoms were 2.6 times more likely to have reported suicidal ideation in the past month than participants with no or low levels of depression. Substance abuse, specifically alcohol abuse, is also empirically supported as a risk factor for youth suicidality (Lamis et al. 2009; Schilling et al. 2009; Swahn and Bossarte 2007). Childhood trauma has also been studied as a correlate for youth suicidality, and it has been documented that exposure to childhood trauma (e.g. abuse and/or neglect) increases the risk for suicidal behaviour (Fergusson and Mullen 1999; Fergusson et al. 1996; Wagner et al. 1995). For example, Fergusson et al. (2003), using data from a 21-year longitudinal study of subjects (from birth to 21 years of age) found that child abuse significantly elevated suicidality. Reasons for Living (RFL) Scholarly research has demonstrated that, although RFL vary across the life span, overall RFL is a protective factor for suicide prevention (Miller et al. 2001; Wang et al. 2007). In terms of research investigating suicidal behaviour among young adults and RFL, Pinto et al. (1998) discovered that positive expectations about the future and ability to cope effectively with life problems significantly differed between suicidal and non-suicidal youth. Wang et al. (2007) compared two groups (no suicidal thoughts or attempts versus a history of suicidal thoughts or attempts) and found that participants with a history of suicide attempts experienced higher levels of depression and had fewer RFL than participants with no suicidal thoughts or previous suicide attempts. In another study utilizing the expanded RFL inventory (Linehan et al. 1983), Ellis and Lamis (2007) found that ideators scored significantly lower on survival and coping beliefs than non-ideators. In an examination of suicidal behaviour in a college population, Connell and Meyer (1991) categorized participants into four distinct groups (never suicidal, brief suicidal ideation, serious suicidal ideation, and parasuicides) to assess differences in RFL. Among respondents, those who had never experienced suicidal thoughts had greater coping beliefs, felt greater responsibility to family, and expressed more moral objections to suicide. Suicidology research has also examined gender differences in its relationship to RFL. For example, Ellis and Lamis (2007) found that women scored significantly higher than men on survival and coping beliefs, responsibility to family, child-related concerns, and fear of suicide subscales on the RFL inventory. Westefeld et al. (1996) further reported that moral objections, fear of suicide, and responsibility to family and friends were stronger deterrents to suicide among females, in comparison with male undergraduates. Another study by Pompili et al. (2007) compared gender with RFL and found that women reported higher scores, particularly in relation to concerns about their children, fear of suicide, survival and coping beliefs, and responsibility to their family. Overall, research supports the notion that women not only score higher on total RFL (Dobrov and Thorell 2004; Ellis and Lamis 2007; Segal and Needham 2007), but also identify a broader range of reasons to stay alive (McClaren 2011). Religion and Suicide/RFL Religion as a buffer for suicide risk was first introduced by Durkheim (1951), who hypothesized that religious organizations integrate members into a collective society that serves as a protective factor for individuals at risk for suicide. Durkheim’s theory has been

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well critiqued (Stack 1983, 1992), and it is now understood by many that, rather than integration, religion acts as a buffer to suicidality through commitment to core ‘life-saving’ beliefs (e.g. belief in an afterlife) (Greening and Stoppelbein 2002; Stack 1992). Moreover, suicide is considered to be a ‘sin’ by most religious denominations; thus, the life-saving orientation of most religions serves as a buffer against suicide (Dervic et al. 2004; Gearing and Lizardi 2008). Due, in part, to these critiques, some scholarly literature that focuses on religion makes the distinction between public expressions of faith (e.g. frequency of religious service attendance) and private forms of faith (e.g. meaning of existential questions such as the meaning/purpose in life, how to achieve happiness, and end suffering). According to some, private expressions of faith may be a better measure of religiosity, especially among youth, because the very definition of religiosity is becoming more personal and fluid (Davie 2008). Put another way, what you believe matters more than what you do. Previous research has empirically tested the relationship between both private and public forms of faith. In general, researchers have found an inverse relationship between religious individuals and suicidal ideation and previous suicide attempts (Greening and Stoppelbein 2002). In terms of public expressions of faith, most studies have demonstrated that religious service attendance is associated with decreased suicide risk (Dervic et al. 2004; Lizardi et al. 2007; Martin 1984) and symptoms of depression (Koenig 2001, 2005; Koenig et al. 1998). Empirical tests of private faith have been less frequent, but have shown significant results. For example, Gearing and Lizardi (2009) found a significant correlation between RFL and greater moral objections to suicide. Although an empirical link has been established between forms of religiosity, depression, RFL, and suicidality, little research has analysed these connections with a psychometrically validated index of private faith (Bibby 2002). An example of such an index is the Santa Clara Strength of Religious Faith (SCSORF, Plante and Boccaccini 1997), which is used in the current study.

Hypotheses The brief review of the literature supports the correlation between suicidality among youth and RFL, and to a lesser extent, private forms of religiosity. However, most of the research provides a simplistic measure of suicidality within a dichotomous dependent variable. In this regard, participants are grouped in absolute terms, as either being at risk for suicidal ideation or attempts, or not being suicidal at all. While studies using a binary method of assessing suicide risk in young adults are important contributors, only a limited amount of research has looked at suicidal progression beyond such a bifurcation. Further, only a limited number of studies have looked at religiosity as a predictor for RFL, and none have explored whether the predictors change across levels of suicidality. Finally, although several studies have explored young adults’ RFL using the RFL inventory (Linehan et al. 1983), little academic research has assessed young adults’ RFL with an age appropriate index (the RFL-YA). Given these limitations, the goal of the current research is to empirically determine the predictors that influence RFL, and whether these predictors change across levels of suicidality. This goal gives rise to two hypotheses. The first hypothesis is that respondents who reported never being suicidal will report more reasons to live than respondents who have had either brief or serious suicidal ideations/attempts. Second, we hypothesize that religiosity is a protective factor against suicidality.

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Method Data Data from the 2008 Health and Well-Being Survey (HWBS) were collected at a university in the prairie region of central Canada. The HWBS is a non-probability convenience sample comprising mostly of first-year university students from 17 introductory sociology classes and two research methods classes (a second-year course). Students who agreed to participate (via a consent form as part of obligations with the Ethics review board) completed a self-report, paper, and pencil survey in one of their regularly scheduled class periods. The survey consisted of 52 items and took about 30 min to complete. Data collection took place over a period of 2 months in the fall of 2008. The overall response rate was 80.2 %, creating a total sample size of 1245. The age ranged from 17 to 45 with a mean age of 20. Overall, 90 % of respondents were under the age of 24. Consistent with the overall enrolment of Canadian university students, 62.4 % of participants were female and 37.6 % were male (see Statistics Canada 2006a for Canadian enrolment data). The specific codes and computations of the independent and dependent variables are discussed in detail below. Variables Reasons for Living Reasons that respondents had for living were measured using The Reasons for Living Inventory for Young Adults (RFL-YA) (Gutierrez et al. 2002). The RFL-YA was specifically created to determine what reasons young adults might have for not completing suicide. The RFL-YA is a 32-item self-reported measure consisting of five subscales: family relations, coping beliefs, peer relations, future expectations, and positive selfevaluation (Wang et al. 2007). Each item is rated on a 6-point Likert scale, ranging from 1 (‘not an important reason at all’) to 6 (‘an extremely important reason’). The RFL-YA has been demonstrated to have strong concurrent validity, convergent-discriminant validity, and criterion validity (Gutierrez et al. 2002). After performing an exploratory factor analysis (orthogonal with a varimax rotation) on the RFL-YA, we found that the overall inventory was best represented as four sub-scales: family as reasons, self-image, friends as reasons, and looking towards the future. Suicidality Levels of suicidality were based on the Suicide Behaviors Questionnaire-Revised (SBQ-R) and consists of 4 items, each measuring a different dimension of suicidality (Osman et al. 2001), which are: (1) lifetime suicide ideation and/or attempt; (2) threat of a suicide attempt; (3) frequency of suicidal ideation over the past 12 months; and (4) likelihood of suicidal behaviour in the future. Following the suggested suicidality groupings, responses on the SBQ-R were coded into 3 mutually distinct categories: never suicidal (55 %); brief suicidal ideation (28.6 %); and serious suicidal ideation and/or a previous suicide attempt (16.4 %). Finally, for the purpose of running some ANOVAs with suicidality as the outcome measure, a composite index was computed; however, due to the high number of students reporting no suicidality, the index was transformed using a base-10 logarithm.

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Religiosity In the current study, the Santa Clara Strength of Religious Faith questionnaire (SCSORF; Plante and Boccaccini 1997) was used. Strength of religious faith is a latent construct, which attempts to capture cognitive aspects of religion or, what we have labelled as, private faith (e.g. ‘My faith is an important part of who I am as a person’). The SCSORF consists of a ten-item 7-point Likert scale, which ranged from ‘strongly disagree’ to ‘strongly agree.’ Items were computed into an overall composite index where higher values represent stronger religious faith. Mental Health Respondents mental health was assessed using the Mental Health Inventory-5 (MHI-5), which is a 5-item measure of mental health and is often used as an operationalized form of assessing depressive symptoms and anxiety states (Yamazaki et al. 2005). Questions contained in the instrument asked respondents how much of the time during the last month they have (1) been a very nervous person (reverse coded); (2) felt downhearted and blue (reverse coded); (3) felt calm and peaceful; (4) felt so down in the dumps that nothing could cheer you up (reverse coded); and (5) been a happy person? Responses were rated on a 6-point Likert scale with higher values representing greater mental health. The MHI-5 has been demonstrated to have adequate psychometric properties (McCabe et al. 1996), which was consistent in the current study. Childhood Trauma In order to assess the relationship between RFL and child abuse/neglect, the childhood trauma questionnaire (CTQ) was purchased for use. The CTQ consists of 20 items asking respondents about emotional abuse, emotional neglect, sexual abuse, physical abuse, and physical neglect (Bernstein et al. 1997). Response categories ranged from 0 ‘never true’ to 4 ‘very often true’ where the higher values represent incidences of child abuse. Due to the high degree of positive skew (most respondents were not victims of childhood trauma), the overall composite measure was transformed using a base-10 logarithmic equation, which resulted in a substantial reduction in both skew and kurtosis. Alcohol Abuse A modified version of the Rutgers Alcohol Problem Index (RAPI) (White and Labouvie 1989) was used to assess alcohol abuse among respondents. We created an index consisting of 5 questions from the RAPI in order to measure the frequency of alcohol-related consequences that occurred in the past year (e.g. ‘Went to work or school drunk’). After creating an index of the items, the continuous measure was both positively skewed and revealed positive kurtosis, which was not significantly reduced after performing several data transformations. As such, the index was recoded into a dummy variable where the value of 1 represents respondents who indicated 2 or more negative experiences due to alcohol use. Forgiveness Likelihood Although the association between forgiveness likelihood and suicide prevention is less studied (see Hirsch et al. 2011 as an exception), there is a theoretical link between religion

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J Relig Health Table 1 Descriptive statistics Continuous measures Reasons for living (RFL: YA) RFL—self-image

Mean

SD

Alpha

104

17.0

.96

24.9

5.5

.93

RFL—thinking about the future

37.2

6.2

.91

RFL—family as reasons

20.8

4.3

.93

RFL—friends as reasons

.91

20.7

4.0

Mental Health Inventory-5 Index

13.2

2.8

.78

Childhood Trauma Questionnaire (logged)

.89

.34

.88

Santa Clara Strength of Religious Faith Questionnaire

25.5

19.8

.98

Forgiveness Likelihood Scale

8.4

3.2

.66

Suicidality (logged)

.29

.33

.82

Respondent age

20.2

3.6

Socioeconomic status

7.3

1.5

Dummy/discrete variables

% Yes

Respondent sex(female)

62.4 %

Immigration status(immigrant)

14.0 %

Ethnic identity—first Nations/Me´tis/Inuit

5.7 %

Ethnic identity—other visible minority

27.4 %

Ethnic identity—white

66.8 %

Alcohol abuse

50.6 %

with forgiveness. For example, in the Christian New Testament (31:34), Jeremiah states, ‘I will remember their sin no more.’1 Given the significance of forgiveness among many religious traditions, as well as the lack of empirical research examining the link between forgiveness as a protective factor with suicidality and RFL, we included an adapted version of the Forgiveness Likelihood scale (Rye et al. 2001). The index measured the likelihood of forgiving an ‘offender’ in 5 hypothetical situations based on Guttman scaling (e.g. ‘You share something embarrassing about yourself to a friend who promises to keep the information confidential. However, the friend breaks his/her promise and proceeds to tell several people. What is the likelihood that you would choose to forgive your friend?’). Responses were coded on a 5-point scale ranging from 0 ‘not at all likely’ to 4 ‘extremely likely.’ Higher scores on the computed index indicate willingness to forgive. Socio-demographics To accurately assess participants’ RFL across levels of suicidal behaviour, several sociodemographic variables were included: sex: (1 = female), age, socioeconomic status (SES), immigration status (1 = immigrant), and ethnicity. Subjective SES is considered to be a more precise measure of social position (Singh-Manoux et al. 2005). Subjective SES was included on a ten-point ‘ladder’ where higher values represent greater SES status. Ethnicity was analysed through the following discrete variables: non-white/white; non-aboriginal/ aboriginal; and non-visible minority/visible minority, with the white/non-white item being 1

The Book of Jeremiah is also considered to be part of its cannon in Judaism, which sees Jeremiah as the second of all major prophets. Islamic religion, like Christianity, considers Jeremiah as a prophet.

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excluded from statistical tests. Descriptive statistics for all measures used in the study are reported in Table 1.

Results Multivariate OLS regression models were used, overall as well as splitting the model across the three levels of suicidal behaviour. As illustrated in Table 2, the overall model assessing the direct associations between predictive measures and RFL show that the MHI5 is the strongest predictor (b = .28, p \ .001), followed closely by childhood trauma (b = -.26, p \ .001). Thus, as expected, students with higher levels of mental health (i.e. exhibited less depressive symptoms and anxiety) and those who experienced little or no childhood trauma reported more RFL. Females (b = .16, p \ .001), respondents who scored higher on the SCSORF (b = .13, p \ .001), students from higher SES backgrounds (b = .10, p \ .001), and immigrants (b = -.08, p \ .05) reported more RFL than their respective counterparts. When the overall model was split across levels of suicidal behaviour, results indicate that childhood trauma exhibited the strongest correlation with RFL for respondents with no prior suicidal ideation (b = -.23, p \ .001). Other significant associations among those with no prior suicidal ideation were respondent sex (female, b = .19, p \ .001), the MHI-5 (b = .15, p \ .001), and SES (b = .11, p \ .05). Results differ slightly for students who have experienced brief suicidal ideation. For instance, although childhood trauma remains the most significant predictor on the RFL index (b = -.24, p \ .001), the MHI-5 emerges as the second strongest correlate (b = .16, p \ .05), followed by sex (female, b = .14, p \ .05). For respondents with serious suicidal ideation or a previous suicide attempt, the MHI-5 is the strongest predictor for RFL (b = .35, p \ .001). However, the SCSORF index now becomes the second strongest correlate (b = .30, p \ .001), followed by sex (female, b = .24, p \ .01). The RFL inventory was divided into four distinct subgroups based on factor analysis results: looking towards the future; friends as reasons; family as reasons; and self-image/ evaluation. Mental health was a significant correlate for RFL across all levels of suicidality when looking towards the future. Strength of religious faith was the strongest predictor for RFL among serious suicidal ideators when looking towards the future (b = .36, p \ .001). Childhood trauma was also a significant predictor for RFL among respondent who had no (b = -.13, p \ .01) and brief (b = -.14, p \ .05) suicidal ideation. Results for friends as reasons reveal that respondent sex (female) was significant across all levels of suicidal behaviour and was the only significant correlate for respondents experiencing serious ideation or had a previous suicide attempt. Negative coefficients were found for respondents who experienced childhood trauma among those with no (b = -.20, p \ .001) and brief (b = -.16, p \ .05) suicidal ideation. The MHI-5 was only significant for students with no suicidal ideation (b = .12, p \ .05). Results differed considerably when examining the family as reasons subgroup. Not surprisingly, students who experienced childhood trauma where significantly less likely to indicate that their family was a RFL across all levels of suicidal behaviour and was the strongest predictor for each level (none, b = -.26, p \ .001; brief, b = -.42, p \ .001; and serious, b = -.37, p \ .001). Respondent sex was significant and positive across all levels of suicidality. Strength of religious faith was also a significant correlate, but only for students who had experienced brief suicidal ideation (b = .14, p \ .05).

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J Relig Health Table 2 Unstandardized and standardized coefficients for predictive measures on reasons for living (overall and across suicidal behaviour grouping) Variables

Overall

b

Never Suicidal b

b

Brief suicidal ideation b

89.56 (6.71)***

b

b

b

b

Constant

71.39 (5.23)***

Mental Health Inventory5 Index

1.66 (.19)***

.28

0.80 (.25)***

.15

0.94 (.40)*

.16

2.41 (.59)***

.35

Rutgers alcohol problem index

.75 (1.02)

.02

-50 (1.23)

-.02

2.30 (2.11)

.07

1.74 (3.57)

.04

Santa clara strength of religious faith

.12 (.03)***

.13

0.04 (.03)

.06

0.10 (.06)

.13

0.34 (.10)***

.30

Childhood trauma

-12.94 (1.61)***

-.26

-9.13 (1.95)***

-.23

-13.52 (3.78)***

-.24

-9.39 (5.88)

-.15

Forgiveness Likelihood

.26 (.16)

.05

0.26 (.20)

.06

0.03 (.33)

.01

0.34 (.51)

.06

Sex

5.50 (1.05)***

.16

5.07 (1.25)***

.19

4.41 (2.10)*

.14

11.04 (3.78)**

.24

Age

.28 (.14)

.06

0.17 (.19)

.04

0.25 (.31)

.05

0.39 (.42)

.09

Immigrant status

-3.87 (1.60)*

-.08

-2.28 (1.88)

-.06

-6.06 (3.20)

-.13

-6.24 (5.26)

-.10

SES ladder

1.14 (.34)***

.10

0.97 (.41)*

.11

-0.13 (.77)

-.01

0.84 (1.01)

.07

Aboriginal status

.68 (2.20)

.01

-2.49 (2.75)

-.04

0.16 (4.77)

.002

3.10 (6.99)

.04

Visible minority

-.49 (1.29)

-.01

-0.96 (1.59)

-.03

-2.37 (2.51)

-.07

2.28 (4.44)

.05

R2

.28

.19

92.29 (11.70)***

Serious ideation or previous attempt

.16

39.27 (14.52)**

.35

Standard errors shown in parentheses * p \ .05; ** p \ .01; *** p \ .001

Finally, as expected, the MHI-5 was a significant predictor across all levels of suicidality when the outcome measure was self-image/evaluation as a RFL (none, b = .18, p \ .001; brief, b = .26, p \ .001; and serious, b = .48, p \ .001). Childhood trauma was significant among respondents with no (b = -.20, p \ .001) and brief (b = -.16, p \ .05) suicidal ideation. Respondent sex (b = .13, p \ .01) and SES (b = .10, p \ .05) were also significant predictors of self-image as reasons among students with no previous suicidal ideation. Strength of religious faith (b = .28, p \ .01) and sex (b = .17, p \ .05) were also significant correlates for the self-image as a reason to live outcome measure.

Discussion Suicide among young adults continues to be a serious societal issue in Canada as it is elsewhere. As such, examining the reasons that young adults have for living are important in determining various risk and protective factors, especially when examined across levels

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of suicidal behaviour. The goal of the current study is to attempt to delineate what predictors most strongly influence young adults RFL, and whether they change as a function of suicidality level, which combined, have been neglected in empirical research. The study was framed around two hypotheses. The first was that student’s who never experienced suicidal ideation would disclose more RFL, which was confirmed. Similar to a study by Connell and Meyer (1991), findings illustrate that, for students with no previous suicidal ideation, RFL does act as a protective factor against suicidality, which was further supported by a strong Pearson’s r coefficient between suicidality and RFL (r = -.47, p \ .001). The second hypothesis was also supported; among participants with serious ideation or a previous suicide attempt, religiosity emerged as a significant protective factor against suicidal behaviour. Such a result is consistent with previous research that has consistently found a negative relationship between religiosity and suicidal behaviour (Dervic et al. 2004; Gearing and Lizardi 2009; Martin 1984; Stack 1983; Stack and Lester 1991). Results from the present study differ slightly in that religiosity, at least measured through cognitive measures of private faith, acts as a protective factor only among students with higher levels of suicidal behaviour when assessing RFL. Of further note is the significance of religiosity as a protective factor against suicidality among female participants. More specifically, female students and respondents with high levels of strength of religious faith reported more RFL. It has been well established in the literature that suicidal ideation and previous attempts are more frequent among females than males (Ellis and Lamis 2007; Greening and Stoppelbein 2002; Swahn and Bossarte 2007), which our findings lend partial support to, especially in relation to varying suicidality levels and RFL. Childhood trauma was also a significant, inverse, predictor of RFL for students with no or brief suicidal ideation, but not for respondents who experienced serious ideation or a previous attempt. Although not significant at the highest level of suicidality, religiosity became an important factor and the MHI-5 continues to have a strong association with RFL. One possible explanation may be that students who have been victimized as children and who have received therapy and/or have found other means of maintaining higher levels of mental health (i.e. strength of religious faith) are not as suicidal as those who have not enhanced such protective factors. It would be useful for future research to explore, either quantitatively or qualitatively, the connection between childhood trauma, levels of suicide, mental health, religiosity, and RFL in more detail. Nevertheless, our findings add to the literature on childhood trauma, namely that exposure to childhood trauma increases the risk of suicidal behaviour (r = .40; p \ .001) and that experiences of trauma decreases one’s RFL (r = .39, p \ .001). The connection with suicidality is consistent with previous literature (Fergusson et al. 2003; Fergusson and Mullen 1999); however, to our knowledge, previous studies have not addressed the relationship between childhood trauma and RFL. A direction for future research would be to examine the correlation between trauma and RFL, but in more detail; for example, exploring different types of childhood trauma at different subscales of RFL. One non-significant finding is noteworthy of some discussion—namely alcohol abuse across all levels of suicidal behaviour when regressed on RFL. Studies of suicidality and risk factors for college students have consistently shown that alcohol and substance abuse increases suicidal ideation and suicide attempt (Lamis and Bagge 2011; Lamis et al. 2010; Westefeld et al. 2005). Our non-significant association should in no way suggest that these previous studies are now falsified. A more plausible explanation is the insufficient nature of the variable we used to measure alcohol abuse. As discussed, due to a series of failed data

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transformations, a dummy variable was computed, which decreased the variability of the measure. Future research should include a more robust measure of alcohol abuse, especially when using the RFL as an outcome variable. Four subscales of RFL were computed in order to analyse whether some items were more salient than others. The first factor, examining RFL when looking towards the future, showed that strength of religious faith was the strongest predictor among serious ideators and those who had a previous suicide attempt. One possible reason why religiosity is such a strong correlate for RFL among students with high levels of suicidality is the futureoriented nature of many religious faiths (Linehan et al. 1983). Stack (1992) found that belief in an afterlife involving the promise of happiness and harmony might moderate various adversities individuals may face. To this end, suffering may be more readily endured if it is believed to be short-lived and not eternal. Students may rely more heavily on religion in times of serious suicidal risk because they focus on the future consequences of committing such an act, and how their decision to complete suicide may impact their spiritual future. In the second factor, self-image, the MHI-5 was the strongest predictor for respondents with brief and serious suicidal behaviour, while childhood trauma was significant only among respondents with little or no previous suicidal ideation. Similar to RFL for the future, strength of religious faith was a significant correlate for the RFL self-image among participants with high levels of suicidality. The link between mental health and self-image is consistent with a study conducted by Wang et al. 2007, who found that positive mental health (e.g. using effective coping strategies and perceived purpose in life) were important predictors of suicidality, and may reduce the risk of heightened suicidal thoughts and behaviours. In this regard, strength of religious faith may moderate, to some extent, ones self-image as a RFL among individuals with higher levels of suicidality. It would be helpful for future research to examine how childhood trauma influences suicidal behaviour based on self-image/evaluation, and explore why trauma is significant only for individuals who are at little risk for suicidal behaviour. As with all empirical research, limitations to the current study must be mentioned. First, the study data are based on a convenience non-probability sample, which makes generalizations and predictions to larger populations erroneous. Even though the demographic breakdown of the sample is consistent with all the university students at the university where the data were collected (Dengate 2009), as well as across Canada (Statistics Canada 2006b), the results should be interpreted with caution and be verified in future probability samples of Canadian youth. Second, given that our findings are based solely on selfreported information, social desirability and respondent bias may have influenced the results, which is not uncommon when dealing with sensitive topics such as suicidal behaviour (Miotto and Preti 2008). Our survey did not include measures of socially desirable responding, which would have allowed us to consider the impact of socially desirable responses and thus help improve the internal validity of our findings. In conclusion, suicide and suicidal behaviour among young adults have long been considered a serious societal concern. The current study is an important addition to the suicidology literature as it demonstrates the importance of RFL as an outcome measure among youth across varying degree of suicidality. Accordingly, research investigating suicidal behaviour among youth would benefit from the inclusion of RFL-YA either as a predictor for suicidality or as an outcome measures across levels of suicidal behaviour. Our research has also demonstrated that there are several significant covariates that seem to be more specific for respondents with high levels of suicidality—namely strength of religious

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faith. Given these findings, the RFL inventory should continue to be used and analysed in future studies, especially research that focuses on religiosity. Acknowledgements Monetary support for this article was provided by a grant from the University of Manitoba’s University Research Grants Program (URGP) as well as a University of Manitoba Undergraduate Student Research Award.

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