Study On Association Between Psychological Strain And Suicidal Ideation Among College Students

Backgrounds:Suicide ranks the fifth among all dead causes in China, and ranks the second among people aging15-34. Suicide has caused severe health and economy burden for young people in China. As a special group, college students are confronting with various kinds of stress from resulting from various issues, ending up with serious mental problems among them. Mental health issues among college students have been popular topic of the media, society, and suicide researchers, and are now a problem that should never be left without attention.Generally, there are three stages in the process of an individual committing suicide:suicidal ideation-suicide plan-suicide attempt. Suicidal ideation is recommended by the WHO to be the most significant indicator to assess the suicide risk of a certain individual. According to Xiao Shui-Yuan et al., said suicidal ideation means "Individual with clear thought and will to kill him/herself, yet without either detailed suicide plan or any preparation for the plan, not to mention actual attempts to hurt him/herself". Suicidal ideation is one of the most sensitive indicators to predict future suicide behavior, and the scope of risk factors for suicidal ideation overlaps substantially with that of suicide attempts and suicide deaths. Therefore, studying on suicidal ideation and its risk factors is of particular significance in the field of suicide research by providing practical evidence for identifying high risk individuals and for coming up with intervention and prevention strategies.Research in suicide in China has a short history but is with some inspiring findings. Risk factors already identified by most Chinese sociologists are gender, personality disorder, mental disorders, family economy, social support, negative life events, frustration of study or love affairs, etc. which are also mostly discussed by researchers in other countries in this area.Suicide behavior and suicidal ideation are results of the comprehensive effects by biological, social, and psychological factors. Based on database among the suicide victims and among the general populations, Zhang Jie and his team came up with the Psychological Strain Theory of Suicide to explain the deep motivation of suicide. The Psychological Strain consists of four major aspects:(1) the Value Strain, emerging when an individual experiences two or more conflicting and both internalized values;(2) the Aspiration Strain, felt when there is obvious discrepancy between one’s aspiration or goal and the actual reality one is in;(3) the Deprivation Strain, which is caused by caused by relative poverty or relative deprivation; and (4) the Coping Strain, felt by an individual confronting with some crisis but being unable to deal with it properly.The Strain Theory of Suicide could be a promising new area concerning suicide prevention and intervention, In this research, we studied the prevalence of suicidal ideation among college students, explored the risk factors for suicidal ideation, especially assessed the correlations between suicidal ideation and Psychological Strain, and came up with corresponding advice for suicide prevention and intervention among college students.Objectives:1. To investigate the prevalence of suicidal ideation among college students;2. To explore the risk factors for suicidal ideation among college students;3. To evaluate the reliability and validity of PSS among college students; 4. To explore correlates between Psychological Strain and suicidal ideation among college students;5.. To come up with corresponding advice for suicide prevention and intervention focused on college students.Methods:1. Subjects:We sampled college students from3universities in Shandong Province with different levels and various majors. The study was carried out by filling up questionnaires.2. Contents:(1) Social-economic information:We designed our own scale to investigate basic information of the subjects, including personal information and family information.(2) Daily activities and habits:Information about exercise, sleep, internet, smoking, drinking, etc.(3) Suicidal ideation and attitudes towards suicide:By using the QSA and several independent questions, we investigated the attitude towards suicide, and suicidal ideation of the subjects.(4) Psychological status:By employing the CES-D, and the BHS, we evaluated the psychological status of subjects in the near past of this study. We evaluated the psychological strain(s) and extents the subjects were feeling by employing the PSS.3. Quality control: We used multiple quality control strategies throughout the design, conduction, and the data analyses processes to assure the reliability and validity of our data collected, and to protect the privacy of our subjects.4. Statistical analyses:We used the SPSS16.0Software for the database building and analyzing. Distribution characteristics were achieved by descriptive methods. Cronbach’s a indexes were calculated and sensitivities of scale items to evaluate the reliabilities of the instruments; Correlation analyses and factor analyses were carried out to evaluate the validities of the four sub-scales of PSS.Student’s t tests or x2tests were carried out for univariate analyses; significant level was a=0.05. Multivariate analyses were carried out by Logistic regression model.Results:1. Reliability and validity:Cronbach’s a values for most instruments were over0.7. As for each of the four sub-scale in PSS, all Cronbach’s a values when each item was deleted were over0.8; and Cronbach’s a values for each sub-scale with one item deleted were significantly close.Scores of all four PSS sub-scales were proved to be positively correlated with scores of CES-D with all P<0.05. KMO tests and Bartlett’s tests proved all four PSS sub-scales suitable for factor analyses. We extracted5,4,4, and4factors respectively for the four sub-scales according to the initial design, explaining64.81%,63.65%,71.61%, and64.00%of the total variance for each subscale.2. General information:We collected a total of815valid questionnaires, and defined two groups of subjects:141(17.3%) as the case group (with suicide ideation), and674(82.7%) as the control group (without suicide ideation). Differences in distribution of gender, age, level, whether single child or not, family economy between the two groups were not statistically significant; yet the marriage status of parents, study status, and plans after graduation were statistically different between the two groups.3.Health and behavior profile:Compared to the control group, the case group was found to be featured as exercise less days a week (2.4±2.00vs.2.8±2.06; P=0.039), sleep shorter at night (8.6±4.29vs.9.5±4.00; P=0.015), more likely to be with sleep problems (43.3%vs.31.8%; P=0.011), to have nightmares (24.1% poor health status than the control group (P<0.001).Within the case group, the percent of students with previous suicide attempts was19.1%, which was significantly higher than the percent in the control group (2.4%). In terms of suicide attitude, the control group got significantly higher scores than the case group (2.9±0.35vs.2.7±0.38; P<0.001), meaning that the control group was more likely to hold a negative attitude toward suicide than the case group.What’s more, the scores of the CES-D (18.6±9.93vs.12.0±9.14; P<0.001) and the BHS (5.2±3.53vs.3.9±3.18; P<0.001) of the case group were both statistically higher than those of the control group.4. Psychological Strain: For of each PSS subscale, students of the case group got statistically higher scores than students of the control group (P<0.001).5. Multivariate analyses:Nine variables were included in the Logistic regression model after adjusted by age and gender. Good psychological status and negative attitudes toward suicide were found to be protective factors for suicide ideation (OR<1), while other factors in the model appeared to be risk factors in the process of suicide ideation emerging (OR>1), including depression. The four kinds of psychological strain were all identified as risk factors for suicidal ideation.Conclusions:1. All instruments employed in our research had good reliabilities and validities;2. The prevalence of suicidal ideation among Chinese college students was seriously high;3. Suicidal ideation was affected by various factors, among which social-psychological factors were of special significance;4. All four kinds of the Psychological Strain were statistically correlated with suicidal ideation, and higher strain played as risk factor for suicidal ideation; 5. Prevention and intervention for suicidal ideation and suicide behavior among college students might vary according to different situations, and Psychological Strain Theory could be a promising area to make a difference;6. There were both strengths and limitations for our research, but this current research could act as pioneering evidence for future relative studies.