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Journal of Psychopathology and Behavioral Assessment (JOBA) pp1116-joba-480582 January 28, 2004 10:57 Style file version June 25th, 2002

Journal of Psychopathology and Behavioral Assessment, Vol. 26, No. 2, June 2004 (°
C 2004)

Purpose in Life, Satisfaction With Life, and Suicide

Ideation in a Clinical Sample

Marnin J. Heisel1,3 and Gordon L. Flett2

Accepted November 4, 2003

This study examined the role of purpose in life and satisfaction with life in protecting against suicide
ideation in a clinical psychiatric sample. Forty-nine psychiatric patients completed self-report mea-
sures of suicide ideation, purpose in life, satisfaction with life, neuroticism, depression, and social
hopelessness. Zero-order correlations indicated significant associations between suicide ideation and
the various predictors, in the hypothesized directions. Regression analyses illustrated that purpose in
life and satisfaction with life accounted for significant additional variability in suicide ideation scores
above and beyond that accounted for by the negative psychological factors alone. Purpose in life also
mediated the relation between satisfaction with life and suicide ideation and moderated the relation
between depression and suicide ideation. These findings demonstrate the potential value of attending
to both resilience and pathology when building predictive models of suicide ideation and of attending
to key existential themes when assessing and treating suicidal individuals.

KEY WORDS: suicide; ideation; depression; hopelessness; meaning; purpose.

Suicide is currently the eighth leading cause of death
in the United States (United States Department of Health
and Human Services, Public Health Service, 2001). Re-
searchers have sought to understand, predict, and pre-
vent suicide by examining the potential contributions of
psychological factors to suicidal thoughts and behaviors.
Much of this research has focused upon risk factors and
psychopathological predictors of suicidal thoughts and be-
havior with far less attention paid to protective factors,
mirroring a general trend in the mental health literature
of focusing on pathology rather than on strength and re-
siliency (e.g., Seligman & Csikszentmihalyi, 2000). The
present study was conducted to explore the roles of recog-
nition of purpose in life and appraisals of life satisfac-
tion in protecting against suicide ideation in a clinical
sample.
1 Department of Psychiatry, University of Rochester School of Medicine
and Dentistry, Rochester, New York.
2 Department of Psychology, York University, Toronto, Ontario, Canada.
3 To
whom correspondence should be addressed at Department of
Psychiatry, University of Rochester School of Medicine and Dentistry,
300 Crittenden Blvd., Rochester, New York 14642-8409; e-mail:
marnin heisel@urmc.rochester.edu.
Scant research has been conducted on factors that
might protect against suicidal thoughts among clinical
samples. Past research has explored life satisfaction (e.g.,
Haight & Hendrix, 1998), purpose in life (e.g., Ulmer,
Range, & Smith, 1991), and reasons for living (e.g.,
Linehan, Goodstein, Nielsen, & Chiles, 1983; Range &
Penton, 1994) as factors potentially protective against
hopelessness and suicide ideation. There appears to be
theoretical overlap between the latter two constructs, with
reasons for living providing specific indices of purpose
in life. Frankl (1971) suggested that asking about a suici-
dal person’s reasons for not choosing suicide was a useful
method of inquiring into potential sources of meaning or
purpose in his or her life.
Satisfaction with life, the “cognitive judgmental”
component of subjective well-being (Diener, Emmons,
Larsen, & Griffin, 1985, p. 71), has been consistently
positively associated with psychological adjustment (e.g.,
Diener, Sapyta, & Suh, 1998) and negatively associated
with depression (Pavot & Diener, 1993), suicidal ideation
and intent (Haight & Hendrix, 1998), self-reported suicide
attempts (Heisel & Fusé, 1999), and eventual suicide over
a 20-year period (Koivumaa-Honkanen et al., 2001). The
link between satisfaction with life and suicidal thoughts

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and behavior may be due to associations among satisfac-
tion with life, happiness, and general well-being. Pres-
ence of satisfaction with life may be insufficient to deter
suicidality as life satisfaction may serve as a proxy for,
rather than having a direct influence upon, psychologi-
cal well-being (e.g., Haight, Michel, & Hendrix, 1998).
Hence, the relation between satisfaction with life and
suicide ideation may be mediated by psychological fac-
tors more directly protective against suicide, such as the
recognition of meaning or purpose in life.
Perceptions of meaninglessness and purposelessness
have long been postulated as central to suicidal crises
(e.g., Frankl, 1971, 1985; Von Andics, 1947). Frankl
(1985) detailed the role of meaning in life in promot-
ing survival and preventing despair, hopelessness, and
suicide among prisoners of Nazi concentration camps.
Von Andics (1947) found similarly that meaninglessness
was strongly related to suicidal tendencies among a clin-
ical population in second-world-war era Austria. Frankl
(1985) observed that the pursuit of meaning in life is a
central human endeavor involving one’s responses to ob-
jective challenges in everyday life experiences that inter-
act with one’s unique talents, abilities, and life history.
The search for, and actualization of, these “calls to mean-
ing” can be challenging; however, Frankl noted that the
search for meaning in life is not a sign of psychopathol-
ogy. Frankl further noted that recognition of meaning
in life might obviate pathological responses to negative
situations and prevent suicidality, as in the Nietzschean
dictum “he who has a why to live for can bear with al-
most any how” (Frankl, 1985, p. 97; italics in the origi-
nal). Heikkinen, Aro, and Lönnqvist (1993) suggested that
social supports might protect against suicidality among
those having experienced negative life events “by provid-
ing the feeling of necessity and the meaning for living
or by providing a buffer against the effects of adverse
experiences” (p. 354, italics added). A number of difficul-
ties can arise when this natural meaning-seeking human
propensity goes awry; including attempts to ignore mean-
ingful possibilities, or to circumvent the process of engag-
ing in transcendent meaningful pursuits by directly pursu-
ing pleasure, power, self-actualization, or life satisfaction,
rather than allowing these other benefits to ensue as un-
intended by-products of the search for meaning. These
missed opportunities to pursue meaning in life can lead
to states typified by perceptions of existential emptiness
and purposelessness, which may in turn engender despair,
depression, and suicidality. Similarly, Baumeister (1990)
theorized that suicide might be perceived as an attempt to
escape from painful self-awareness by way of cognitive
constriction and a dulling of the recognition of meaning
in life.
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Heisel and Flett
Research findings have documented positive rela-
tions between meaning or purpose in life and adaptive
psychological factors, such as life satisfaction and psy-
chological well-being (Kafka & Kozma, 2002; Zika &
Chamberlain, 1992) and perceived social support (Ulmer
et al., 1991); and negative relations with indices of psy-
chopathology (e.g., Kish & Moody, 1989) and with sui-
cide ideation (e.g., Edwards & Holden, 2001; Heisel &
Flett, in press; Petrie & Brook, 1992; Ulmer et al., 1991).
However, these studies did not specifically demonstrate
that recognition of purpose in life protected against suici-
dal thoughts within high-risk clinical samples. Purpose in
life moderates the negative effects of bereavement and is
positively associated with satisfaction with life, perceived
social support, and reasons for living (Ulmer et al., 1991).
It is unclear whether these findings might generalize to
clinical samples of psychiatric patients or to those with
suicidal thoughts, and so further research is needed ad-
dressing this question.
Meaning recognition has been shown to buffer the
associations among coping style, suicide ideation, self-
reported suicide attempts, and self-reported likelihood of
future suicidal behavior (Edwards & Holden, 2001). These
findings were limited to a sample of university-student par-
ticipants and thus may not generalize to clinical samples
at risk of suicidal thoughts and behavior. Meaning recog-
nition significantly predicted suicide ideation at time of
general hospital admission (Petrie & Brook, 1992). These
findings were limited by computerized administration of
measures and use of a brief and relatively nonspecific mea-
sure of suicide ideation. Moreover, these studies both as-
sessed meaning recognition with the Meaning subscale
of the Orientation to Life Questionnaire (also referred to
as the Sense of Coherence scale), a measure that was not
developed for division into subscales (see Antonovsky,
1993). Further, this scale assesses meaning recognition as
a component of Antonovsky’s sense of coherence (SOC;
Antonovsky, 1993) construct, comprising trust in personal
resources to respond to life challenges (Manageability) in
a predictable manner (Comprehensibility) wherein these
challenges are deemed worthy of personal engagement
and investment (Meaning). Hence, results generally sup-
port a link between meaninglessness and suicidality; how-
ever, their interpretation is somewhat less clear and not
necessarily generalized to psychiatric samples.
Heisel and Flett (in press) found significant positive
associations between suicide ideation and negative psy-
chological factors (depression, and global and social hope-
lessness) and significant negative associations between
suicide ideation and positive psychological factors (psy-
chological well-being, satisfaction with life, and meaning
and purpose in life) in 107 seniors. Perceptions of meaning
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Suicide Ideation and Purpose in Life
in life significantly moderated the association between de-
pression and suicide ideation and were most protective
against suicidal thoughts among seniors with elevated de-
pression scores. These findings supported the contention
that perceptions of meaning or purpose in life are protec-
tive against suicidal cognitions among a heterogeneous
sample of older adults. Research is needed exploring these
links among psychiatric patients.
Overall, research has demonstrated a link between
purpose in life and suicide ideation, with limitations re-
lated to use of older adults or other nonclinical samples
or idiosyncratic measures of purpose in life or suicide
ideation. This study examined satisfaction with life and
purpose in life as potential protective factors against sui-
cide ideation in a clinical psychiatric sample, after ac-
counting for negative psychological variables (neuroti-
cism, depression, and social hopelessness) to contribute
to theory-building and clinical interventions with at-risk
clinical samples. Suicide ideation was chosen as the main
outcome variable, because it is more prevalent than suici-
dal behavior and has significantly predicted eventual sui-
cide among clinical samples (e.g., Brown, Beck, Steer,
& Grisham, 2000; Fawcett et al., 1990). Purpose in life
was predicted to mediate the relation between satisfaction
with life and suicide ideation and moderate the association
between depression and suicide ideation.
METHOD
Sample
The participants were 49 patients of a tertiary care
psychiatric hospital, including 40 inpatients and 9 out-
patients some of whom had recent hospital admissions.
No significant differences emerged between inpatients
and outpatients on the outcome variables; and inpatient
status was thus ignored in all subsequent analyses and
the groups aggregated. Participants were approached if a
referring clinician identified them as meeting inclusion
and exclusion criteria; being between 18 and 65 years
of age and cognitively capable of completing the ques-
tionnaire measures, and neither being actively psychotic
at the time of testing nor having neurological impair-
ment. The sample included 15 men and 34 women with
a mean age of 37.5 years (SD = 8.2). Women scored
significantly higher than men on measures of depres-
sion (M = 28.1, SD = 12.9 and M = 16.1, SD = 13.0,
respectively; F(1, 47) = 8.9, p < .01), social hopeless-
ness (M = 70.8, SD = 17.0 and M = 59.3, SD = 15.3,
respectively; F(1, 47) = 5.0, p < .05), and neuroticism
(M = 17.9, SD = 4.1 and M = 12.5, SD = 6.7, respec-
January 28, 2004 10:57 Style file version June 25th, 2002
129
tively; F(1, 47) = 12.5, p < .01), and significantly lower
in satisfaction with life (M = 10.3, SD = 5.8 and M =
15.2, SD = 8.7, respectively; F(1, 47) = 5.5, p < .05).
As no significant gender differences emerged with re-
gard to suicide ideation and purpose in life scores, and
further given sample size limitations, gender differences
were not explored further. Eighteen of the participants
were married, 16 were single, and 15 listed their marital
status as being either divorced or separated. Involvement
in a romantic relationship was not related to the outcome
variables.
Participants gave informed consent to access their
clinical records for the purpose of recording relevant de-
mographic and diagnostic information. A total of 119 di-
agnoses were found in the 49 participants’ clinical records,
yielding multiple diagnoses for 41 participants with 18
participants having received three or more clinical diag-
noses. Structured clinical interviews were not conducted,
potentially limiting this study’s findings, because of bud-
getary restrictions and concern about questionnaire bur-
den on the participants. Number of clinical diagnoses was
associated with suicide ideation (r = .34, p < .05), de-
pression (r = .33, p < .05), social hopelessness (r = .29,
p < .05), and purpose in life scores (r = −.42, p < .01).
A majority of the participants were depressed (n = 21) or
dysthymic (n = 25). Thirty-eight participants (78%) had
Axis II diagnoses, the majority with borderline (n = 19) or
avoidant (n = 9) personality disorders. Anxiety disorders
(n = 11) and substance abuse/dependence (n = 5) were
less common and dissociative (n = 3), psychotic spectrum
(n = 1), and eating disorders (n = 1) even less frequent.
Measures
Suicide ideation was measured with the 8-item sui-
cide ideation subscale (SPS-SI) of Cull and Gill’s 36-item
Suicide Probability Scale (SPS; Cull & Gill, 1988). The
suicide ideation subscale includes items assessing sui-
cidal cognitions, negative affect, and presence of a sui-
cide plan. Subscales assessing hopelessness, negative self-
evaluation, and hostility were not included, so as to prevent
questionnaire burden, and to reduce content overlap with
the other study measures. The suicide ideation subscale
has demonstrated high internal consistency (α = .91 in
this study), criterion validity discriminating between nor-
mal, psychiatric inpatient, and suicide attempter groups,
and convergent and discriminant validity with various
MMPI clinical scales (Cull & Gill, 1988; Tatman, Greene,
& Karr, 1993). Scoring consists of summing weighted
scores for the eight subscale items. Scores on this mea-
sure potentially range from 8 to 39.
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130
Neuroticism was measured with the 24-item Neuroti-
cism subscale (EPQ-N) of the Eysenck Personality Ques-
tionnaire (EPQ; Eysenck & Eysenck, 1975). This measure
assesses thoughts, feelings, and actions of individuals with
emotional instability, typified by excessive anxiety, mood-
iness, depression, and feelings of guilt and inferiority. The
neuroticism subscale has demonstrated high internal con-
sistency (α = .88 in this study) and test–retest reliability
(r = .89 for men, r = .80 for women, and r = .86 over-
all) over a 1-month period (Eysenck & Eysenck, 1975).
Scores on this measure potentially range from 0 to 24.
Depression was measured with the Beck Depres-
sion Inventory (BDI; Beck, Ward, Mendelson, Mock,
& Erbaugh, 1961), a 21-item self-report questionnaire
assessing aspects of depressive symptomatology. The
BDI has demonstrated excellent internal reliability (α =
.94 in this study), split-half reliability (r = .93; Beck
et al., 1961), and convergent validity, significantly predict-
ing hopelessness, suicide ideation, and eventual suicide
(Brown et al., 2000). Scores on this measure potentially
range from 0 to 63.
Social hopelessness was measured with the Social
Hopelessness Questionnaire (SHQ; Flett, Hewitt, Heisel,
Davidson, & Gayle, 2003), a 20-item Likert-scored mea-
sure of hopelessness regarding social or interpersonal cog-
nitions and expectations for one’s future relationships. The
SHQ items assess interpersonal themes, including “the
type and availability of relationships, exposure to mis-
treatment, lack of support, exposure to criticism, negative
social comparisons, and direct estimates of hopelessness
(e.g., some people do little to inspire hope in me)”; (Flett &
Hewitt, 1994). The SHQ has demonstrated high internal
consistency (α = .92 in this study). Significant correla-
tions between the SHQ and measures of hopelessness and
depression attest to the scale’s validity (Flett et al., 2003;
Heisel, Flett, & Besser, 2002; Heisel, Flett, & Hewitt,
2003). Scores on this measure potentially range from 20
to 100.
Satisfaction with Life was measured with Diener
et al.’s 5-item Satisfaction with Life Scale (SWLS; Diener
et al., 1985) assessing subjective well-being. The SWLS
has demonstrated strong psychometric properties, includ-
ing internal consistency (α = .84 in this study), test–retest
reliability over periods of two months (r = .82; Diener
et al., 1985) and four years (r = .54; Pavot & Diener,
1993), respectively, and convergent and discriminant va-
lidity; relating positively to measures of well-being, nega-
tively with measures of distress, and nonsignificantly with
emotional intensity (Pavot & Diener, 1993). Scores on this
measure potentially range from 5 to 35.
Purpose in Life was measured with the purpose in life
(PIL) subscale of a shortened version of Ryff’s multidi-
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Heisel and Flett
mensional measure of Psychological Well-Being (PWB;
Ryff, 1989). The 9-item PIL subscale measures purpose in
life, defined as a “clear comprehension of life’s purpose, a
sense of directedness, and intentionality” (Ryff & Singer,
1996, p. 15). This subscale has demonstrated strong psy-
chometric properties, including internal consistency (α =
.84 in this study), test–retest reliability (r = .82 over a
6-week period for a 20-item PIL subscale), convergent va-
lidity with measures of psychological adjustment (Ryff,
1989), and discriminant validity with measures of de-
pression, hopelessness, and suicide ideation among se-
niors (Heisel & Flett, in press). Scores on this measure
potentially range from 9 to 54.
Procedure
Research participants were recruited during ward
meetings on various inpatient units of a tertiary-care psy-
chiatric facility or by clinician referral. Participants were
asked to volunteer for an unpaid study relevant to the expe-
riences of individuals receiving mental health treatment.
Participants judged to be at imminent risk of self-harm
based on their responses to the study measures (n = 5)
were referred to appropriate clinical staff for treatment
consideration. Their data were included in this study.
RESULTS
The sample demonstrated moderate to high scores
on the measure of suicide ideation (SPS-SI; see Table I).
Specifically, 18 (37%) of the participants endorsed
T scores greater than 70 on the SPS-SI, corresponding
to “highly significant” clinical elevations on this measure
(Cull & Gill, 1988, p. 14), and 29 (59%) endorsed T scores
greater than 60, the recommended threshold for clinical
evaluation of suicide risk.
Zero-order correlations (see Table I) revealed that
suicide ideation was significantly positively correlated
with neuroticism (r = .47; p < .001), depression (r =
.75, p < .001), and social hopelessness (r = .77, p <
.001), and significantly negatively correlated with satis-
faction with life (r = −.33, p < .05) and purpose in life
(r = −.69, p < .001).
A hierarchical multiple regression analysis (see
Table II) was conducted to test the hypothesis that satis-
faction with life and purpose in life would explain signifi-
cant additional variability in suicide ideation scores above
and beyond the negative factors (neuroticism, depression,
and social hopelessness) alone. The negative factors were
entered as a block on Step 1 and together accounted for
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Suicide Ideation and Purpose in Life 131

Table I. Zero-Order Correlations and Descriptive Statistics for the Measures Examined

1 2 3 4 5 6

1. SPS-SI 1.00 .47∗∗∗ .75∗∗∗ .77∗∗∗ −.33∗ −.69∗∗∗

2. EPQ-N 1.00 .61∗∗∗ .66∗∗∗ −.44∗∗ −.48∗∗∗
3. BDI 1.00 .81∗∗∗ −.55∗∗∗ −.76∗∗∗
4. SHQ 1.00 −.58∗∗∗ −.68∗∗∗
5. SWLS 1.00 .53∗∗∗
6. PIL 1.00
M 18.0 16.3 24.4 67.3 11.8 30.5
SD 9.6 5.6 13.9 17.2 7.1 9.5

Note. N = 49, pairwise deletion was utilized. SPS-SI = Suicide Ideation subscale of the Suicide Probability
Scale; EPQ-N = Eysenck Personality Questionnaire (Neuroticism subscale); BDI = Beck Depression Inventory;
SHQ = Social Hopelessness Questionnaire; SWLS = Satisfaction with Life Scale; PIL = Purpose in Life
subscale of the Psychological Well-Being measure (PWB).
∗ p < .05. ∗∗ p < .01. ∗∗∗ p < .001.

approximately 64% of the variance of the suicide ideation
scores (R 2 = .64, Adjusted R 2 = .62, Standard Error of
the Estimate = 5.91, p < .001). When entered as a block
on Step 2, satisfaction with life and purpose in life ex-
plained an additional 6% of the variance (F-change(2,
43) = 4.54, p < .05), significantly improving the predic-
tion of suicide ideation above and beyond the contribution
of the negative psychological factors alone.
A test of the difference in correlations indicated that
purpose in life (r = −.69) was significantly more protec-
tive against thoughts of suicide than was satisfaction with
life (r = −.33; Z = −3.43, p < .001). Frankl (1971)
contended that recognition of meaning or purpose in life
is central to psychological adjustment and well-being,
and that satisfaction with life might be an unintended by-
product of the search for meaning. Support for Frankl’s
thesis would be provided by results demonstrating that PIL
significantly mediates the relation between satisfaction
with life and suicide ideation. A regression approach was
used to test this hypothesis applying Baron and Kenny’s
guidelines (Baron & Kenny, 1986) for determining media-
tion in psychological research. The results of a regression

Table II. Summary of a Hierarchical Multiple Regression Analysis Predicting Suicide

Ideation (SPS-SI) With the Negative (EPQ-N, BDI, SHQ) and Positive (SWLS, PIL)
Psychological Factors

Variable B β t

Step 1
Intercept −4.717 −1.15
EPQ-N −0.191 −.11 −0.92
BDI 0.281 .41 2.64∗
SHQ 0.283 .51 3.11∗∗
Step 2
Intercept −0.814 −0.11
EPQ-N −0.151 −.09 −0.78
BDI 0.197 .29 1.73†
SHQ 0.310 .56 3.54∗∗∗
SWLS 0.353 .26 2.49∗
PIL −0.280 −.28 −2.10∗

Note. R 2 = .64 (adjusted R 2 = .62), F(3, 45) = 27.1, p < .001 for step 1; R 2 = .71
(adjusted R 2 = .67, R 2 -change = .06), F-change (2, 43) = 4.5, p < .05 for step 2. SPS-
SI = Suicide Ideation subscale of the Suicide Probability Scale; EPQ-N = Neuroticism
subscale of the Eysenck Personality Questionnaire (EPQ); BDI = Beck Depression
Inventory; SHQ = Social Hopelessness Questionnaire; SWLS = Satisfaction with Life
Scale; PIL = Purpose in Life subscale of the Psychological Well-Being measure (PWB).
∗ p < .05. ∗∗ p < .01. ∗∗∗ p < .001. † p < 0.10.
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132 Heisel and Flett

analysis, regressing PIL on SWLS scores, supported the
association of the independent variable with the mediator
(t(1, 47) = 4.26, p < .001); and the results of a second
regression analysis, regressing SPS-SI on SWLS scores,
demonstrated an association between the independent and
dependent variables (t(1, 47) = −2.38, p < .05). The fi-
nal requirements for mediation were tested by regressing
SPS-SI on both SWLS and PIL scores, the results of which
indicated that PIL scores significantly predicted SPS-SI
(t(1, 46) = −5.73, p < .001) and that SWLS scores no
longer did so when in the presence of PIL scores (t(1,
46) = 0.40, ns). Results of Sobel’s test for mediation (see
Baron & Kenny, 1986) indicated that purpose in life sig-
nificantly mediated the association between satisfaction
with life and suicide ideation (Z = −3.38, p < .001).
A hierarchical multiple regression analysis was con-
ducted to examine purpose in life as a potential moder-
ator of the association between depression and suicide
ideation, and to test Frankl’s contention (Frankl, 1985)
that recognition of meaning or purpose in the face of suf-
fering (operationalized as depression scores in the present
study) can effectively stave off suicidality. Purpose in life
scores were entered into the equation first, followed by
depression scores and then by their centered interaction
term. The interaction term explained an additional 4% of
the variance in suicide ideation scores over and above that
accounted for by the main effects of purpose in life and
depression scores (F-change(1,45) = 4.39, p < 0.05; see
Table III). The interaction effect was plotted next, with
suicide ideation scores predicted by a linear combination
of the intercept and the respective weighted depression,
purpose in life, and interaction terms that emerged from
the regression analysis (see Fig. 1). Purpose in life ap-
peared most protective against suicide ideation at high
levels of depression with a decreasing protective effect of
purpose in life on suicide ideation with decreasing levels
of depression.
Hierarchical multiple regression analysis was re-
peated entering satisfaction with life scores in place of
the purpose in life scores to assess whether the interaction
effect was specific to purpose in life. The results indi-
cated that the interaction of depression and satisfaction
with life did not explain additional variance above and be-
yond that of the unique predictors (F-change(1,45) = 0.38,
ns), supporting the specific protective effect of purpose in
life against thoughts of suicide in the presence of reports
of depression.
DISCUSSION
This study examined the roles of purpose in life and
satisfaction with life in protecting against thoughts of sui-
cide in a clinical sample. The findings demonstrated that

Table III. Summary of a Hierarchical Multiple Regression Analysis Predicting Sui-

cide Ideation (SPS-SI) With Recognition of Purpose in Life (PIL), Depression (BDI),
and Their Interaction Term

Variable B β t

Step 1
Intercept 39.385 11.55∗∗∗
PIL −0.701 −.69 −6.55∗∗∗
Step 2
Intercept 17.618 2.70∗∗
PIL −0.284 −.28 −1.95†
BDI .371 .54 3.75∗∗∗
Step 3
Intercept 17.081 2.71∗∗
PIL −0.297 −.29 −2.11∗
BDI 0.354 .51 3.69∗∗∗
PILXBDI −0.014 −.19 −2.10∗

Note. R 2 = .48 (adjusted R 2 = .47), F(1, 47) = 42.9, p < .001 for step 1; R 2 = .60
(adjusted R 2 = .58, R 2 -change = .12), F-change (1, 46) = 14.1, p < .001 for step
2; R 2 = .64 (adjusted R 2 = .61, R 2 -change = .04), F-change (1, 45) = 4.4, p < .05
for step 3. SPS-SI = Suicide Ideation subscale of the Suicide Probability Scale; PIL
= Purpose in Life subscale of the Psychological Well-Being measure (PWB); BDI
= Beck Depression Inventory; PILXBDI = Interaction of PIL and BDI (Centered by
subtracting mean PIL and BDI scores).
∗ p < .05. ∗∗ p < .01. ∗∗∗ p < .001. † p < 0.10.
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Suicide Ideation and Purpose in Life
30
20
10
SPS-SI
0
BDI
-10 High
Medium
-20 Low
0 10 20 30 40 50 60
PIL
Fig. 1. The interaction of depression and recognition of purpose in life on
suicide ideation. Note. SPS-SI = Suicide Ideation subscale of the Suicide
Probability Scale; PIL = Purpose in Life subscale of the Psychological
Well-Being measure (PWB); BDI = Scores on the Beck Depression
Inventory lying at the sample mean (BDI = 24.4) for Medium, one
standard deviation above the mean (BDI = 38.3) for High, and one
standard deviation below the mean (BDI = 10.5) for Low. This figure was
produced by plotting best-fitting regression functions for three levels of
BDI scores, given unstandardized regression weights found in Table III.
As this figure represents an idealized, error-free model, SPS-SI scores
occasionally dropped below 0.
these variables protected against suicide ideation even
after accounting for the significant influence of neuroti-
cism, depression, and social hopelessness. Purpose in life
was more strongly associated with suicide ideation than
was satisfaction in life, significantly mediated the associ-
ation between these two variables, and significantly mod-
erated the association between depression and suicide
ideation.
The findings support the assessment of both negative
and positive psychological factors in clinical samples at
elevated risk for suicidality, given the significant positive
associations among neuroticism, depression, social hope-
lessness, and suicide ideation, and given the significant
negative associations among satisfaction with life, recog-
nition of purpose in life, and suicide ideation. A conser-
vative interpretation of the significant regression analysis
is that subjective experiences of neuroticism, depression,
and social hopelessness may be insufficient to evoke suici-
dality, but rather that suicidal thoughts may depend upon
both a presence of negative psychological factors and an
absence of positive ones.
The findings further demonstrated salutary proper-
ties of perceptions of purpose in life in protecting against
suicide ideation, with life satisfaction possibly serving a
more secondary role in deterring suicidal contemplation.
January 28, 2004 10:57 Style file version June 25th, 2002
133
The findings of the mediational analysis demonstrated that
degree of perception of purpose in life significantly ex-
plained the relation between satisfaction with life and sui-
cide ideation. These findings have theoretical implications
for models of psychological well-being and for the pre-
vention of significant psychological distress. Specific sup-
port was provided for Frankl’s contention (Frankl, 1971,
1985) that one is unlikely to attain life satisfaction by
directly pursuing happiness or subjective well-being, but
rather that such positive outcomes might ensue from the
intentional pursuit of meaningful tasks, experiences, and
attitudes. The mediational findings suggest that improve-
ment in psychological functioning might be achieved by
clinical interventions targeting perceptions of meaning-
lessness and lack of meaningful pursuits in addition to
dissatisfaction with one’s life. Research evidence indicates
that positive emotions can significantly improve problem-
solving, enhance emotional well-being, and reduce suicide
ideation (Joiner et al., 2001). Controlled clinical interven-
tion studies are needed to evaluate the enduring effec-
tiveness of meaning-centered therapy for despairing and
suicidal individuals beyond improvements associated with
positive emotion states.
Purpose in life significantly moderated the associa-
tion between depression and suicide ideation and was most
protective against suicide ideation with increasing levels
of subjective depression. The clinical implication of this
finding is that attending to the sense of purposelessness
in a client reporting little subjective depression may con-
tribute to overall psychological resiliency, yet doing so for
a client reporting more subjective depression may serve a
powerful role in deterring suicidal thoughts thereby poten-
tially decreasing suicide risk. The modest incremental in-
crease in variance explained by the interaction effect may
be accounted for by the large amount of variance already
explained by the main effects of depression and purpose
in life on suicide ideation. The results thus suggest the po-
tential value of guiding a client’s search for meaning and
purpose in life in promoting psychological well-being and
in preventing expressions of suicidality and further sup-
port past research findings (e.g., Heisel & Flett, in press;
Petrie & Brook, 1992; Ulmer et al., 1991).
Although it was not a main study focus, the present
work established a link between suicide ideation and social
hopelessness, as assessed by the SHQ. Past research has
used either a single-item measure of social hopelessness
(see Hewitt, Norton, Flett, Callander, & Cowan, 1998) or
the SHQ with primarily non-clinical samples (see Heisel
et al., 2003). The current findings suggest that the SHQ
may prove to be a potentially useful measure in clinical
settings given its convergence with measures of neuroti-
cism, depression, and suicide ideation within this clinical
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Journal of Psychopathology and Behavioral Assessment (JOBA) pp1116-joba-480582 January 28, 2004
134
sample. The strong link between social hopelessness and
suicide ideation in the current study may signify the po-
tential usefulness of including an interpersonal focus in
interventions with the potentially suicidal. Research evi-
dence has demonstrated an association between poor so-
cial support and suicide ideation (e.g., Clum, Esposito,
Hirai, & Nelson, 2000; Heikkinen et al., 1993); and future
research is needed establishing the role of social hope-
lessness in suicidal behavior. Clinical researchers might
examine social hopelessness as a potential moderator of
response to treatment for depression in a clinical sample
with suicidal features.
The present effort was conducted in a relatively small
sample thus warranting replication among larger clini-
cal samples and in diverse populations. It may be that
the protective role of purpose in life functions differently
among adolescent and non-psychiatric adult populations,
and among seniors than among clinical populations (e.g.,
Heisel & Flett, in press). This study is restricted by use
of a cross-sectional design, and there is a need for a lon-
gitudinal analysis of the potential roles of positive and
negative psychological factors in influencing the devel-
opment and course of suicide ideation. Present findings
may also have been limited by possible multicollinearity
among the measures examined, although the intercorrela-
tions among the study’s measures were not of sufficient
magnitude (i.e., above r = .90, see Tabachnick & Fidell,
1996) to indicate a spurious inflation of the correlational
findings. Researchers are encouraged to examine alternate
measures of the main variables studied to overcome pos-
sible limitations of the measures applied in this study. For
example, the Satisfaction with Life Scale may have under-
estimated the role of life satisfaction in protecting against
suicidality given findings that life satisfaction can be mea-
sured in a number of domains (e.g., Alfonso, Allison,
Rader, & Gorman, 1996). As the present work explored
suicidal cognitions, it remains for researchers to examine
the contribution of these and other relevant psychological
factors to suicidal behavior and to completed suicide. Ed-
wards and Holden’s findings (Edwards & Holden, 2001)
with a university student sample suggest that a potentially
useful direction for clinical research might include ex-
amining aspects of meaning in life in conjunction with
coping variables when predicting suicidal thoughts and
behavior.
The present results support the examination of both
pathology and adjustment in the investigation of suicide
ideation and further demonstrate the potential role of
meaning or purpose in life in decreasing suicide ideation
among clinical samples, in mediating the association be-
tween satisfaction with life and suicide ideation, and
in moderating the association between depression and
10:57 Style file version June 25th, 2002
Heisel and Flett
suicide ideation. Much of the research on correlates of
suicide ideation has focused on negative psychological
variables, likely because suicidality is rarely documented
in the absence of psychological difficulty and perhaps be-
cause of a paucity of empirically validated existential treat-
ments for psychopathology and suicide risk. The present
findings suggest clinical and theoretical value in attend-
ing to existential themes when studying, assessing, and
treating individuals at risk for suicide and in promoting
psychological well-being.
ACKNOWLEDGMENTS
This research was funded by a Doctoral Fellowship
from the Social Science and Humanities Research Council
of Canada awarded to the first author and by a grant from
the Social Science and Humanities Research Council of
Canada awarded to the second author. The second author
was also supported by a sabbatical leave fellowship from
the Faculty of Arts at York University. The authors thank
Dr. Gary Challis, the Research Ethics Committee, and the
staff of the Whitby Mental Health Centre for their sup-
port and assistance in conducting this study. The authors
also thank the participants for volunteering their time and
effort toward this study, and Dr. Avi Besser, Professor
Toyomasa Fusé, Dr. Paul Links, and members of
the Toronto Logotherapy community for their helpful
comments on this project.
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