Suicide Ideation Among College Students Evidencing Subclinical Depression

Abstract

Identifying elevated suicide ideation in college students is a critical step in preventing suicide attempts and deaths by suicide on college campuses. Although suicide ideation may be most prominent in students with severe depression, this should not suggest that only students with severe depression experience significant risk factors for suicide. Objective: The purpose of these 3 studies was to explore the relation between suicide ideation and severity of depressive symptoms in college students. Participants: In each study a sample of college students were recruited for participation. Methods: Participants completed self-report assessments of depressive symptoms and suicide ideation. Results: The results of these studies suggest that although the greatest elevation in suicide ideation occurs at the highest depressive symptoms, significant suicide ideation is also experienced by college students with mild and moderate depressive symptoms. Conclusions: The implications of these findings for the assessment of suicide ideation are discussed.     

Knowledge of Suicide Risk Factors,But Not Suicide Ideation Severity,Is Greater Among College Students Who Viewed 13 Reasons Why

Abstract

Objective: To test associations between viewing 13 Reasons Why, Season 1 and past week suicide ideation severity, behavior risk, stigma, and knowledge in college students. To explore whether personal exposure to suicide and depressive symptom severity moderated these associations. Participants: Eight-hundred and eighteen college students, 64% (n?=?522) of whom watched 13 Reasons Why. Methods: Students completed surveys online. Multivariate negative binomial regressions were used to test associations between watching 13 Reasons Why and suicide-related variables, and interaction terms. Results: Suicide ideation severity and suicide behavior risk were not significantly associated with viewing 13 Reasons Why; however, there was limited statistical power to detect associations. The association between watching 13 Reasons Why and greater suicide knowledge was stronger among those who did not have personal exposure to suicide. Conclusions: 13 Reasons Why may be a platform for psychoeducation on suicide, particularly among those who do not have personal exposure.     

Positive Social Support,Negative Social Exchanges,and Suicidal Behavior in College Students

Abstract

Objective: Risk for suicide is often higher among college students, compared to same-age noncollegiate peers, and may be exacerbated by quality of social support and interactions. The authors examined the independent contributions of positive social support and negative social exchanges to suicide ideation and attempts in college students. Participants: Participants were 439 volunteer undergraduate students, who were primarily female (71%). Methods: Cross-sectional, survey design. Participants completed measures assessing positive social support, including emotional, informational, and tangible support; negative social exchanges; and suicidal behavior, including ideation and attempts. Results: Positive social support, particularly tangible support, and negative social exchanges were significantly predictive of greater suicidal behavior. Conclusions: Practical manifestations of support may buffer against suicide risk for college students, whereas conflict-based interactions may contribute to increased risk. At the institutional, parental, and peer levels, promotion of supportive relationships may be an important suicide prevention strategy.     

Factors associated with emotional distress and suicide ideation among international college students

Abstract

Objective: To identify risk and protective factors associated with greater emotional distress and suicide ideation among international college students. Participants: International students (n?=?435) from two Midwestern and two Southeastern universities in the US. Methods: Online surveys were administered that measured emotional distress, past-year suicide ideation, entrapment, cultural stress, family conflict, perfectionism, ethnic discrimination, interpersonal needs, ethnic identity, and cultural sanctions against suicide. Results: In final linear regression analyses, higher levels of entrapment, unmet interpersonal needs, and ethnic discrimination were significantly associated with increased emotional distress. Only unmet interpersonal needs remained significantly associated with greater past-year suicide ideation in a multivariate regression analysis. Conclusions: Clinicians working with international students and prevention programmers targeting this population should address students’ perceptions of entrapment, ethnic discrimination, and especially unmet interpersonal needs in efforts to decrease or prevent students’ feelings of emotional distress and suicide ideation.     

The indirect effect of perceived burdensomeness on the relationship between indices of social support and suicide ideation in college students

Objective: Research has demonstrated that a lack of social support is related to suicide risk. This study examines perceived burdensomeness and thwarted belongingness, of the Interpersonal Theory of Suicide, as mechanisms of the social support–suicide relationship in college students. Method: The study consisted of 207 students from a Midwestern university. Data were collected from 2007 to 2008. Two multiple mediation analyses were conducted to examine whether perceived burdensomeness and thwarted belongingness mediated the relationship between indices of social support and suicide ideation. Results: Perceived burdensomeness mediated the relationships between perceived social support and suicide ideation (95% confidence interval [CI] ?.02 to ?.00, effect size = ?.01) and social connectedness and suicide ideation (95% CI ?.03 to ?.00, effect size = ?.03). Thwarted belongingness did not mediate either relationship. Conclusions: Results suggest that a lack of social support could lead to perceptions of being a burden on others, which could lead to suicide ideation.     

Spiritual Well-Being and Suicidal Ideation Among College Students

Objective: This study explored whether specific dimensions of spiritual well-being (religious well-being and existential well-being) relate to reduced suicidal ideation, and whether associations persisted after controlling for religiosity and psychosocial variables associated with suicide. Participants: Participants were 457 college students who completed measures that assessed spiritual well-being, religiosity, hopelessness, depression, social support, and suicidal ideation. Methods: The authors used linear regression modeling to assess religious and spiritual correlates of suicidal ideation. Results: After controlling for demographic variables and psychosocial factors, neither involvement in organized religion nor religious well-being significantly contributed to suicidal ideation. However, even after controlling for significant correlates, existential well-being remained a significant predictor of suicidal ideation. Conclusions: This investigation highlighted existential well-being as an important factor associated with lower levels of suicidal ideation among college students. Findings from this study focusing on the association between spiritual well-being and suicidality may prove especially beneficial to suicide prevention efforts.     

Suicidality among homeless people: Testing the mediating effects of self-efficacy and depression

ABSTRACT

This cross-sectional study examined the mediating effect of PTSD on suicide ideation and suicide attempt through two mediators, self-efficacy and depression, among homeless adults. We recruited a non-random, purposive sample of 156 homeless adults from seven homeless people shelters in Kansas. SEM results suggest that self-efficacy and depression were significant mediators between PTSD and suicide ideation, but not between PTSD and suicide attempt. This study’s findings can be used to identify risk factors associated with suicidal behaviors that can be used to design service programs aimed at preventing suicidal ideation and attempt among people who are homeless.     

Parent–Child Conflict and Suicide Rumination in College Students: The Mediating Roles of Depressive Symptoms and Anxiety Sensitivity

Abstract

Objective: Parent–child conflict, depressive symptoms, and anxiety sensitivity have each been identified as risk factors for suicide ideation in college students. This study examined the relations among these risk factors and suicide rumination utilizing transition theory to guide the hypothesized relations. Participants: Undergraduate college students participated in this study in the spring of 2012 (January to May). Methods: Participants completed self-report measures of parent–child conflict, depressive symptoms, anxiety sensitivity, and suicide rumination, among other measures. Hypothesized pathways and mediation were tested using path analysis. Results: Suicide rumination was positively and uniquely predicted by depressive symptoms, anxiety sensitivity, and parent–child conflict. The relation between parent–child conflict and suicide rumination was, in part, accounted for by depressive symptoms and anxiety sensitivity. Conclusions: Results suggest that it would be advisable for clinicians to assess for students’ conflicts with their parents in conjunction with their levels of depression and anxiety when assessing for suicide risk.     

Health attitudes and suicidal ideation among university students

ABSTRACT

Objective: The purpose of this study was to examine whether positive health attitudes are associated with suicidal ideation among university students after accounting for other health risk factors linked to suicidal ideation. Participants: Participants were 690 undergraduates from a large midwestern university during fall semester 2011. Methods: Participants reported demographics and health characteristics. Regression models compared individuals who reported suicidal ideation and those who did not. Results: In unadjusted models, suicidal ideation was significantly negatively associated with positive health attitudes, and positively associated with depression, drug use problems, sleep problems, and being overweight. In adjusted models, more positive health attitudes continued to be significantly negatively associated with suicidal ideation. Conclusions: This study suggests a link between positive health attitudes and lower probability of suicidal ideation. Additional research is needed to assess enhancing general health attitudes as a suicide prevention effort.     

The effects of familial acculturative stress and hopelessness on suicidal ideation by immigration status among college students

Objectives: Based on acculturative family distancing theory, we examined whether familial acculturative stress interacted with hopelessness to predict suicidal ideation differentially among emerging adult immigrant versus nonimmigrant college students. Participants: We recruited 152 generationally and racially/ethnically diverse college students (42 immigrants) from 2012 to 2013. Methods: Participants completed measures of hopelessness, depressive symptoms, ethnic identity, familial acculturative stress, and suicidal ideation. Results: Immigrant status interacted with hopelessness and familial acculturative stress. Hopelessness was associated with less suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score below the 11th percentile, but greater suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score above the 72nd percentile. Conclusions: Familial acculturative stress may exacerbate the effect of hopelessness on suicidal ideation among immigrant college students, and should be monitored during suicide risk assessment and treatment.     

Suicide Ideation Among US College Students Associations With Other Injury Risk Behaviors

Abstract

Suicide, the endpoint of a continuum that begins with suicide ideation, is the third leading cause of death among the US college-aged population. The first and second leading causes of death among this age group, unintentional injury and homicide, may also be linked to suicide ideation. We used data from the National College Health Risk Behavior Survey to examine the association between suicide ideation and injury-related behaviors among 18- to 24-year-old college students. Students who reported suicide ideation were significantly more likely than students who did not report considering suicide to carry a weapon, engage in a physical fight, boat or swim after drinking alcohol, ride with a driver who had been drinking alcohol, drive after drinking alcohol, and rarely or never used seat belts. Given this clustering of injury-related risk behaviors, college prevention programs should aim to reduce risks for injuries comprehensively, rather than addressing each risk behavior separately.     

Mental Health Treatment Barriers Among Racial/Ethnic Minority Versus White Young Adults 6 Months After Intake at a College Counseling Center

Abstract

Objective: This study examined mental health treatment barriers following intake at a counseling center among racially/ethnically diverse college students. Methods: College students (N = 122) seen for intake at a college counseling center in 2012–2013 completed self-reports of depressive symptoms, suicidal ideation, and mental health treatment barriers 6 months later. Results: Racial/ethnic minority students less often reported previous mental health treatment and treatment after being seen at the counseling center, compared with white students. They also endorsed more treatment barriers—most commonly, financial concerns and lack of time—and more often endorsed stigma-related concerns. Treatment barriers were associated with not following through with counseling center recommendations and with greater depressive symptom severity but not with suicidal ideation during follow-up. Conclusions: Improving mental health treatment seeking among racial/ethnic minority college students should involve decreasing treatment barriers, improving access to affordable options, providing flexible scheduling or time-limited options, and decreasing stigma.,     

Suicide ideation,anxiety, and depression: Are children a protective factor for male Veterans?

ABSTRACT

Numerous mental health disorders plague our veterans when they return from deployment including anxiety and depressive disorders, which have been linked to elevated suicide risk when left untreated. Family factors, such as parenthood status, may serve as a protective factor against these mental health issues. This study examined the role of parenthood status of male veterans (N = 234) based on age of the child in order to determine whether a child’s age (minor children v. adult children) affects the likelihood of meeting diagnosis criteria for anxiety, depression, and suicide ideation after controlling for marital status. Three hierarchical binary logistic regression models were constructed to assess the predictive influence of children 18 years old and younger, children older than 18, and no children with the results indicating that parenthood status did meaningfully enhance the prediction of suicide ideation. Complete findings, clinical implications, and future considerations are discussed.     

Impact of the Most Frequently Reported Traumatic Events on Community Mental Health Clients

This survey of 354 community mental health clients examined the relative impact of client self-reported events that they deemed “most traumatic” for predicting posttraumatic stress syndrome (PTSD) symptom severity. Results of the voluntary survey revealed the most traumatic lifetime events to be (in descending order of frequency): sudden death of a loved one, sexual abuse, physical abuse, suicide attempt, and having been in a serious/life-threatening accident. These factors were then tested for gender differences, and regression models were developed to test the predictive power of traumatic events relative to primary diagnosis, psychosocial well-being, other key psychiatric indicators, and drinking to cope with negative emotions. Results demonstrated that sexual abuse was reported to be among the strongest predictors of PTSD symptom severity. Separate regression models also revealed important gender differences. Implications for social work assessment of seriously mentally ill clients are suggested.     

Young Adult Suicide and Sexual Orientation

ABSTRACT

The current project focused on the suicidal ideation and risk potential of young adults (N = 312) and explored scores on self-report measures of suicidal ideation inclusive of various sexual orientations. Results suggest that the Lesbian, Gay, and Bisexual (LGB) youth surveyed (N = 73) differ in their display of suicide risk with significantly higher Beck Hopelessness Scale (BHS) and Suicide Probability Scale (SPS) scores. Social support served as a mitigating factor relating significantly to lower levels of hopelessness and suicidal ideation, especially among those LGB participants. The SPS held a significant relationship to suicide attempt in the past year, while the BHS held a significant relationship to suicide attempt in the past six months. Implications for counselors serving young adults are addressed, including specific suggestions to enhance counselor education and supervision related to suicide assessment and LGB counselor competency.     

Suicide prevention on college campuses: What works and what are the existing gaps? A systematic review and meta-analysis

Abstract

Objective: To examine the effects of universal and targeted suicide prevention programs on relevant outcomes in college campuses. Methods: College suicide prevention programs published from 2009 to 2018 were assessed on outcomes including knowledge, skills, self-efficacy, suicidal ideation, and suicidal behaviors. Effects of the interventions on outcome variables with sufficient studies to warrant meta-analysis (ie, knowledge, skills, and self-efficacy) were meta-analyzed. Studies reporting on the remaining outcomes (ie, suicidal ideation and behaviors) were systematically reviewed. Results: Significant increases in suicide prevention knowledge, skills, and self-efficacy were observed in universal prevention interventions that typically employed gatekeeper prevention strategies. Evidence of reductions in suicidal ideation and behaviors was observed across targeted suicide prevention programs for at-risk students. Conclusion: Prevention programs are beneficial for training those likely to come in contact with people endorsing suicidality, but further research is needed to show that suicide interventions can consistently have significant effects on suicidal students as well.     

Perceived need for care and mental health service utilization among college students with suicidal ideation

ABSTRACT

Objective: This study aimed to identify correlates of service utilization and perceived need for care among college students with suicidal ideation. Participants: Respondents were recruited from introductory psychology courses at an undergraduate college during the Fall 2014 semester. Methods: Independent correlates of (1) mental health service utilization, (2) self-perceived need, and (3) other-perceived need for mental health services among college students (N = 190) with suicidal ideation were identified. Results: Service utilization was associated with need for care as perceived by others. Perceived need for care by others was associated with suicidal ideation intensity and suicide attempt history. Perceived need by the respondents themselves was correlated with depression severity, sex, and race but was not independently associated with actual service utilization. Conclusions: Perceived need by others was the sole significant correlate of service utilization, suggesting it is an important target for public health interventions aimed at facilitating pathways into mental health treatment.     

Predictors of suicidal ideation among college students: A prospective cohort study

ABSTRACT

This prospective cohort study investigated longitudinal predictors of suicidal ideation among college students. A non-clinical cohort of college students (N = 171) completed baseline and 3-month follow-up surveys. Depressive symptoms, worst-point suicidal ideation, and suicide attempt history significantly predicted follow-up suicidal ideation severity after adjusting covariates. Similarly, depressive symptoms and worst-point suicidal ideation (but not attempt history) were significant predictors of follow-up suicidal ideation intensity in an adjusted model. The results suggest that current depressive symptoms and lifetime worst-point suicidal ideation are independently valuable constructs that may provide relatively short-term predictive information when screening for suicidal ideation among college students.     

Suicidal behavior and associated factors in sexually abused adolescents

Objectives

The aim of the present study is to determine the rate of suicidal ideation and suicide attempts in sexually abused adolescents and to determine the factors associated with suicidal behavior.

Method

106 adolescents between the ages of 12–18 (94 girls, 12 boys) who were exposed to sexual abuse and referred for the preparation of forensic reports were included in the study. The investigators retrospectively examined the case files, forensic reports and social worker reports.

Results

It has been found that in cases exposed to sexual abuse, suicidal ideation developed in 63.2% (n = 67) of the individuals and 24.5% (n = 26) of them attempted suicide. The rate of suicidal ideation and suicide attempts was higher in cases who live separately from one or both parents, those who have ASD or PTSD after sexual abuse, cases in which abuse involved penetration, cases who were abused by someone known or someone from the family, cases where sexual abuse was accompanied by coercion and physical violence, and those who were exposed to abuse continuously. Among girls, in cases who have suicide history before sexual abuse and those who were abused by more than one abuser, the rate of suicidal ideation was higher.

Conclusion

It has been shown in many studies that sexual abuse in childhood increases the risk of suicidal behavior. Consideration of the factors associated with suicidal behavior in victims of sexual abuse will be helpful to clinicians in preventing suicide attempts.