Study On The Relationship Between Cognitive Flexibility And Suicidal Behavior Among College Students

BackgroundSuicide is one of the most important issue and an important part of the psychological crisis in today's society.Suicide has an adverse effect on the development of society,families and individuals,studies have shown that individual suicide will bring at least 6 relatives and friends to psychological harm for nearly 10 years or more.The researches on the related factors of suicidal behavior is an essential measure to prevent suicide.At present,the researches mostly focuses on the precipitating factors of suicidal ideation or suicide attempt at home and abroad,and focuses less on the dynamic development process of suicide behavior,that is,most researches focus on the characteristics of suicide ideation or suicide attempts while few researches focus on state of suicide ideation to suicide attempt.Epidemiological studies show that the number of people with suicide ideation is much larger than the number of people who had suicide attempt,and suicide attempt may have a greater impact on personal safety and social stability.Therefore,exploring the factors that influence suicide attempts in the development process of suicidal ideation to suicide attempt is more likely to prevent this path from deepening continuously.Cognitive factor is one of the important factors of suicidal behavior among various cognitive factors,cognitive flexibility,as the reconciler of cognitive operations,has an important impact on suicidal behavior.Cognitive flexibility was introduced by Spiro in the early 1990s to describe individuals' cognitive changes under situational changes,it mainly refers to the ability of individuals to freely change their cognition to cope with different stimuli or environmental changes.At present,cognitive flexibility is mainly assessed through behavioral experiment methods in the researches on relationship between cognitive flexibility and suicidal behavior,that is,the researchers describe personal cognitive flexibility from the perspective of cognitive process,and explore the flexible switching of cognitive processing process.Although the participants can be control better and the relationship between independent variables and dependent variables can be explored more scientifically in experimental study,there are deficiencies in the connotation of cognitive flexibility measurement.Cognitive flexibility questionnaire content is closer to life,it can reflect the characteristics of individual's cognitive flexibility in daily life,and the individual's cognitive style,also is the result of cognitive processing.However,although questionnaire and experimental studies of cognitive flexibility can collect data in a shorter period of time,they all reflect the characteristics of individuals' cognitive flexibility that are stable and trait,and they are unable to sensitively explore cognitive flexibility of the dynamic development of suicidal behavior,while qualitative research can do this.In summary,the current researches on suicide behavior and cognitive flexibility mainly inquire into the trait and seldom explore of their state the role of cognitive flexibility in the transition from suicidal ideation to suicide attempt.Therefore,this study combines questionnaire study,experimental research and qualitative research to complement each other and explore the characteristics and state of the features of suicidal ideation,suicide attempts,and cognitive flexibility.Section 1 Questionnaire study of the relationship between cognitive flexibility and suicidal behavior among college studentsObjectiveTo explore the characteristics of college students' cognitive flexibility,and the relationship between cognitive flexibility and suicidal behavior.Subjects and methodsSelecting undergraduates as the research object among a medical school,questionnaires were made using self-made basic information questionnaires,CFI,SDS and SBQ-R.A total of 2158 valid questionnaires were retrieved.Statistical analysis was performed on the data using SPSS 21.0 and AMOS 22.0,statistical methods included t test,F test,correlation analysis and structural equation model.Results1.The cognitive flexibility of men is significantly higher than that of women((78.10±10.47)vs(74.97±9.49),P<0.05);the only child's cognitive flexibility is significantly higher than non-only children((77.63±10.36)vs(75.40±9.70),P<0.05);people living in big cities have significantly higher cognitive flexibility than people living in rural areas or small towns((77.33±9.61)vs(74.87±9.56),P<0.05);those with good family economic status have significantly higher cognitive flexibility than those with poor family economic status((78.37±9.52)vs(74.35±9.77),P<0.05);people with mental disorders in school have significantly lower cognitive flexibility than those without psychosis((69.40±12.72)vs(76.12±9.93)P<0.05);those who accept attitude toward suicide have worse cognitive flexibility((69.83±10.82)vs(76.67±9.84),P<0.05);suicidal actors during college have poor cognitive flexibility(70.98±10.17)vs(76.73±9.75),P<0.05).2.Suicide behavior is negatively correlated with dimension score and total score of cognitive flexibility(0.190? r?<0.297,P<0.05).3.College students' depression plays an intermediary role between cognitive flexibility and suicidal behavior,the direct effect of cognitive flexibility on suicidal behavior has changed from-0.29 to-0.07,and it is significant.The mediating effect occupies 78.79%of the total effect(X2/df=4.12,NFI=0.992,RFI=0.982,IFI=0.994,CFI=0.994,RMSEA=0.038).ConclusionMale students,only children,living in cities,good family economic conditions,no mental disorders during college,no suicidal behavior,and individuals who have a rejection attitude towards suicide have higher cognitive flexibility;cognitive flexibility is closely related to suicidal behavior,the lower the score of cognitive flexibility,the higher the risk of suicide.College students' cognitive flexibility plays an intermediary role between depression and suicidal behavior.Section 2 Experimental study of the relationship between cognitive flexibility and suicidal behavior among college studentsObjectiveTo explore differences in cognitive flexibility between suicide behavior(suicide behavior including suicide attempt and suicidal ideation)and healthy groups.Subjects and methodsBased on the inclusion criteria and exclusion criteria,49 participants of suicidal behavior(including 17 participants of suicide attempter and 32 participants of suicidal ideation)and 22 participants of health were selected for the study.The MINI,CFI,SBQ-R,WCST,TMT and STROOP were investigated.Statistical analysis was performed on the data using SPSS 21.0,statistical methods included t test and F test.Results1.Suicidal behavior group's scores of WCST,TMT,and STROOP were higher than those of the healthy group but there was no significant difference((10.22±4.43)vs(9.14±4.17),cohen'sd=0.248;(11569.67±17013.96)vs(7769.00±11512.44),cohen'sd=0.245;(182.17±152.72)vs(179.19±168.00),cohen's d=0.019.All P>0.05);the scores of controllability and total CFI of suicidal behavior group were higher than those of the healthy group((23.33±4.57)vs(27.62±3.63),cohen'sd=-0.996,(72.02±11.06)vs(79.43±8.58),cohen's d=-0.715.All P<0.08).2.Suicide attempter group's scores of WCST were higher than those of the suicidal ideation group and healthy group but there was no significant difference((11.06±4.32)vs(9.78±4.49)vs(9.14±4.17)cohen'sd=0.294,P>0.05);Suicide attempter group's scores of controllability dimension score and total score of cognitive flexibility were higher than those of the suicidal ideation group and healthy group((22.47±4.21)vs(23.83±4.76)vs(27.62±3.53),cohen's d=-0.311,(70.41±9.19)vs(72.97±12.07)vs(79.43±8.58),cohen's d=-0.242.All P<0.05).ConclusionCognitive flexibility from the perspective of cognitive process is not sensitive between different suicide groups.Section 3 Qualitative study of the relationship between cognitive flexibility and suicidal behavior among college studentsObjectiveTo explored the state of suicide attempt and the features of cognitive flexibility when attempting.Subjects and methodsBased on the inclusion criteria and exclusion criteria,11 participants of suicidal behavior were selected for the study.Interviewees were interviewed using a semi-structured interview method based on the interview outline,interview content was coded and analyzed by open coding,generic analysis and scenario analysis.Results1.Respondents had significant differences in their cognitive flexibility between daily and suicide attempts.2.Feeling of siege in the heart:the interviewee felt be caught in a yoke,the darkness slowly moved closer to them,and they were trapped in a small space without sunlight but they could not escape.3.Feeling of loss of control of themselves:Everyone has the right to control their thoughts and actions,but there are differences in their abilities.The individual's thoughts and actions may be trapped under the influence of the outside world.If they cannot control their own status in a timely and effective manner,they will be very likely to lost in losing control,and serious ones will go to extremes in the absence of control.4.Feeling of loss of control of the environment:when the outside world can be changed by their own efforts,it bring joy to these individuals.When individuals fall into the dilemma of inability to change,and when they are struggling and howling,they may go to extremes.5.Attribution individuation:There are many alternative perspectives to view things.The landscapes seen from different perspectives may not be the same,and the experience will also be different.If the problem is attributed to oneself,the individual will fall into the cycle of self-criticism.Serious people will want to stop the problem through death.6.Death liberation:there are more than one key to open the lock.There are countless ways to face difficulties that can be tried.If you cannot develop new ways to deal with problems,you are limited to ineffective methods,it will stand still.Serious people will want to get rid of hardship through death.ConclusionThe cognitive flexibility of college students is not static,and the individual's when the individuals attempted suicide,their cognitive flexibility is worse than their daily state.When individuals try to commit suicide,they firstly experience siege feelings because of events or depression.Because of this narrow space of thinking,individuals cannot see the wider world outside and cannot see the richness of the formation of all things in the world.Therefore,individuals who are caught in inflexible cognition think themselves as the culprit of causing suffering in the predicament and think only death can make themselves free.Thus,individuals trapped in this situation are highly likely to attempt suicide.Innovation and further research planInnovation1.Innovation of research methods:this research adopts three methods including questionnaire,experiment and qualitative research,and explores the relationship between cognitive flexibility and suicidal behavior from three perspectives(i.e.cognitive style,cognitive process and state).2.Innovation of research content:explore the relationship between cognitive flexibility and suicidal behavior and confirm the role of state-based cognitive flexibility in the transition from suicidal ideation to suicide attempt.Further research plan1.Future research can be grouped more detailed and can be improved cognitive flexibility to sensitivity on suicide populations.2.Future research can involve more college students,explore the characteristics of cognitive flexibility at the time of suicide attempts,and block the development process of suicidal ideation toward suicide attempts.