Translation and validation of the reasons for living inventory (RFLI) for use in India

Suicide is a major public health concern in India, while reasons for living may act as protective factors against self-harm. Reasons for living inventory (RFLI) for evaluating such factors is not available in Hindi.

We aimed to translate and validate RFLI in Hindi and test on persons with depression.

In this four-step cross-sectional study, International Test Commission (ITC) guidelines were followed for translation and validation. Healthy participants aged 18-60 years, all genders, proficient in both Hindi and English, participated in the three-step process (sample I; n = 10, II; n = 40, and III; n = 20). Subscales, total, and mean scores were calculated. Another sample IV (n = 130) of persons with depression was recruited to evaluate the association of reasons for Living (RFL) with depression (Beck Depression Inventory). Correlation between depression and RFLI subscales was calculated.

After due translation, back-translation and finalization of items, the scale was administered on sample I. Items were modified if needed. In sample II, Cronbach alpha for Hindi version was 0.721 (Total RFL). Intraclass correlation of translated Hindi version was examined with a 95% confidence interval. Mental health and language experts modified it. In sample III, the Cronbach alpha improved to 0.775. There was a significant correlation between Hindi and English versions of final scale and statistically significant negative correlation between Survival Coping Beliefs Subscale (SCBS) score of RFLI and scores on BDI (r = -.383, P < .0001), BSS (r = -.474, P < .0001) and HAM-D (r = -.218, P < .0001).

RFLI was translated into simple, comprehensible Hindi, had high Cronbach alpha. Higher the SCBS, the lower the depression (BDI) and suicidality (BSS).