title: Risks and Protective Factors of Suicidality for Undergraduate Students in China
Creators: name: Lew, Bob
Publisher: name: Griffith University
Year: 2023
Subjects: subject: suicide
subject: China
subject: undergraduate students
subject: protective factors

description: In 2019, there were over 700,000 suicides globally, and suicide is the leading cause of death among young people aged 15-29 years. Although suicide rates in China have declined from over 20 per 100,000 population in the 1990s to 8.1 in 2019, ongoing efforts are required to prevent suicide, especially among youth. Current research gaps include: (1) limited number of studies on suicide in China compared to Western countries, especially for younger age groups including undergraduates; (2) lack of studies of protective factors against suicidality involving undergraduate students; and (3) lack of theoretical models applied when conducting suicide studies on risk and protective factors. Therefore, this research project aimed to identify the prevalence of suicidality and further risk and protective factors of suicidality among undergraduate students (18-24 years old) in China. More specifically, the research aims were: (1) Comparing the prevalence of suicide risk between Chinese and US college students; (2) Identifying the main risk and protective factors of suicidal ideation and attempt among undergraduates in China; (3) Investigating whether religion is a protective factor against suicidality for undergraduates in China; and (4) Investigating how purpose and meaning in life are associated with suicidality in undergraduates in China. Three theoretical models of suicide were used to guide the thesis, comprising: (1) Shneidman’s psychache theory of suicide; (2) Zhang’s psychological strain theory of suicide; and (3) Klonsky’s three-step theory of suicide. This research project utilised a cross-sectional study design involving a cluster sample of more than 13,000 students from seven universities in seven provinces each. Chinese undergraduates reported lower suicidality compared to their counterparts in the US (lifetime suicidal ideation: 26.5% vs. 28.0%; lifetime suicide attempt: 1.9% vs. 4.5%; past-year suicidal ideation: 19.2% vs. 32.9%; and suicidal behaviour risk (future): 17.0% vs. 24.3%). Key risk factors for suicidality included psychache, psychological strains, and depression, while key protective factors comprised self-esteem, purpose and meaning in life. Religion was not found to be universally protective; more specifically, Muslim religion was found to have a protective effect among undergraduate students in China, while Christianity increases the risk of suicidality compared to those reporting not affiliated to any religion. Meaning in life was found to be a protective factor for Chinese undergraduate students and it was also found to mediate the relationship between hopelessness and suicidal ideation and attempt. The findings of the project can be used to inform the development of suicide intervention programmes and to improve existing suicide prevention strategies targeting young adults and undergraduate students. Key limitations involve the use of a cross-sectional study design, which does not enable inference of causality. Future research should utilise longitudinal study designs, analyse specific subgroups and test specific suicide prevention interventions among university students in China. This research project is one of the largest studies comprising undergraduate students; furthermore, it is to the best knowledge of the author that this is the largest study to investigate the relationship between religion and suicidality in China. Thus, the findings from such a large-scale study including diverse samples from different provinces provide a better representation compared to previous research. Identification of one’s relevant risk and protective factors earlier in life is useful for early intervention and also in creating awareness among young adults.