Depression, Suicidal Ideation, and Knowledge of Suicidal Behavior among Chinese University Freshmen

By Chen, Yirong; Kang, Yongle et al. | Social Behavior and Personality: an international journal, September 2017 | Go to article overview

Depression, Suicidal Ideation, and Knowledge of Suicidal Behavior among Chinese University Freshmen


Chen, Yirong, Kang, Yongle, Lin, Yongle, Social Behavior and Personality: an international journal


Suicide is a substantial public health problem among Chinese youth and adolescents (J. Zhang, Sun, Liu, & Zhang, 2014). In the global context, an estimated 22% of suicides occur in China, where suicide accounts for roughly 200,000 deaths every year, according to a World Health Organization report (Hvistendahl, 2012). Suicide is the primary reason for death among people aged from 15 to 34 years in China (Phillips, Li, & Zhang, 2002). Nearly 90% of those who commit suicide were previously diagnosed with a mental health disorder (Casey, Jabbar, O'Leary, & Doherty, 2015; J. Zhang, Xiao, & Zhou, 2010), and depression is the strongest predictor of suicidal ideation among individuals with a mental health disorder (Izadinia, Amiri, Jahromi, & Hamidi, 2010).

Recently, researchers have revealed that depression and suicidal ideation are related and that depression is a risk factor for suicidal behavior (Casey et al., 2015; L. F. Chan, Shamsul, & Maniam, 2014; Keilp et al., 2012). Izadinia et al. (2010) suggested that anxiety, depression, poor mental health, and daily stress might lead to suicidal ideation, and other researchers have suggested that positive factors, such as having hope and reasons for living, may protect against suicidal ideation and suicide attempts among inpatients being treated for depression (Hollingsworth, Wingate, Tucker, O'Keefe, & Cole, 2016; Luo, Wang, Wang, & Cai, 2016). Depression is important in the prediction of suicidal ideation, but is difficult to detect in university students because it may be seen as a normal transitional problem for teenagers and not as a mental health problem (Mustaffa, Aziz, Mahmood, & Shuib, 2014).

Most Chinese researchers of suicide among Chinese students have focused on risk factors for suicidal ideation and suicide attempts, instead of examining measures that may help to prevent suicide. Relatively few researchers have focused on preventive measures for suicide among university students, such as suicide education (Stuber & Quinnett, 2013). Sun, Chiang, Lin, and Chen (2014) found that suicide education generated a positive attitude, and S. S. Chan et al. (2011) found that suicide education reduced the rate of suicide in a group identified as being at high risk of attempted suicide in Hong Kong, China. Tait and Michail (2014) proposed, on the basis of a systematic review of previous studies, that interventions that include education on risk factors, suicide-related behavior, and attitudes toward suicide risk, can improve clinical management of at-risk individuals and reduce suicide mortality. However, there is not enough empirical research to support the conclusion that education interventions have a beneficial effect. Therefore, it is necessary to determine whether or not knowledge of suicide risk factors and suicide-related behavior is a protective factor against suicide among university students.

H.-J. Kim et al. (2015) found that knowledge of suicidal behavior helped mental health workers in Korea identify risk factors and assess and manage their own risk, and that it could help influence attitudes toward suicide. Chen, Lian, Chen, and Ke (2015) examined the mediating role of knowledge of suicidal behavior in their study on the relationship between depressive symptoms and suicidal ideation in freshmen. They found that knowledge of suicidal behavior included suicide risk factors, crisis intervention, and responsibility consciousness. Chinese scholars believe that knowledge of suicidal behavior is indispensable for everyone as suicidal behavior is a serious psychological disorder (Chen et al., 2015). Psychological problems and mental health issues play an important role in suicidal ideation (Izadinia et al., 2010). It is common among people in the general population who attempt suicide to lack knowledge of suicidal behavior (Chen et al., 2015). Knowledge of suicidal behavior may provide a guarantee for the prevention of this behavior and of a suicidal attitude, as its prediction of life satisfaction and positive emotions, such as feelings of hope, reduces the risk of suicidal behavior (Kleiman & Beaver, 2013; Luo et al. …

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