The Relation Between a Sense of Meaning in Life and Suicide Potential Among Disadvantaged Adolescent Girls

Suicidal ideation and suicide attempts among students aged 12 to 24 after the lifting of COVID-19 restrictions in China: prevalence and associated factors

Objective

To investigate the prevalence and associated factors of suicidal ideation and suicide attempts among adolescent and young adults in China from December 14, 2022 to February 28, 2023, when COVID-19 restrictions were lifted.

Methods

Students in middle and high schools and colleges and universities in the province of Sichuan, China were asked to complete on-line cross-sectional surveys. Information was collected about sociodemographics, experiences related to the COVID-19 pandemic, suicidal ideation and suicide attempts. Participants also filled out the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Social Support Rate Scale surveys. Factors associated with suicidal ideation or suicide attempts were explored using logistic regression.

Results

Of the 82,873 respondents (aged 12 to 24 years), 21,292 (25.7%) reported having thought of suicide at least once in their lifetime, 10,382 (12.5%) reported having thought about suicide within the previous 12 months, and 1,123 (1.4%) reported having attempted it within the previous 12 months. Risk of lifetime suicidal ideation was higher among middle school students than among older students. Risk of suicidal ideation and risk of suicide attempts correlated directly with severity of symptoms of depression and anxiety, and inversely with level of social support. Greater risk of suicidal ideation and suicidal attempts was associated with: being female, living in an urban environment, attending a boarding school, currently being in love, having parents who divorced or remarried, having parents who exhibit non-authoritative parenting behavior, having higher family income, having been COVID-19 infected, having been quarantined for a long time, and being dissatisfied with one's education.

Conclusions

Suicidal ideation and suicide attempts remain prevalent among young people in China. The potential associated factors identified in our study may be useful for targeting appropriate psychosocial interventions and developing mental health policies.

Originalarbeiten / Original Articles. Die Bedeutung der Freizeitgestaltung für die Suizidalität bei Jugendlichen und jungen Erwachsenen

The Importance of Leisure Activities for Suicidality in Adolescents and Young Adults Leisure time is important for the development of adolescents. It influences adolescents' psychological well-being and psychosocial development. It may also have a protective effect on suicidality. This study investigates how adolescents' leisure time is related to suicidality, distinguishing between general aspects and various specific leisure time activities. Data from adolescents in counseling (n = 25) and the general population (n = 57) were analyzed. Adolescents who spend most of their leisure time alone are more suicidal than adolescents who spend their leisure time with others. General aspects of leisure activities were related to suicidality; among specific activities, only sports activities were found to be significant.The strongest association with suicidality was shared activities with others. Based on these results, it can be shown that leisure time activities could be effective as a preventive measure. In particular, social activities in leisure time should be encouraged.

How rumination influences meaning in life among Chinese high school students: the mediating effects of perceived chronic social adversity and coping style

Meaning in life can be affected by many factors during adolescence. This study explored the relationship between rumination and meaning in life among high school students, as well as the mediating effect of perceived chronic social adversity and coping style. A sample of 1,275 Chinese high school students were surveyed using four questionnaires. Data analysis was conducted using Harman's single-factor test, Pearson's correlation coefficient with confidence intervals (CI), and a structural equation model. We found that rumination significantly negatively affected meaning in life among high school students (β = -0.28, 95% CI = -0.33-0.23). Perceived chronic social adversity (β = -0.14, 95% CI = -0.29-0.02) and negative coping style (β = -0.09, 95% CI = -0.16-0.04) each had mediating effects between rumination and meaning in life. Further, perceived chronic social adversity and coping style had chain-mediating effects between rumination and meaning in life, with both positive (β = -0.11, 95% CI = -0.17-0.07) and negative (β = -0.08, 95% CI = -0.13-0.04) coping styles showing significant effects. To enhance the meaning in life among high school students, appropriate strategies to reduce the levels of rumination and perceived chronic social adversity are needed, while also fostering appropriate coping styles.

Profiles, Transitions, and Resilience Factors of Suicide Risk in Early Chinese Adolescents

As a severe public health concern directly endangering life safety, adolescent suicide has been extensively investigated in variable-centered studies. However, gaps remain in the knowledge of heterogeneous suicide risk patterns and their developmental nature. Additionally, little is known about protective factors associated with suicide risk patterns and changes. This study applied person-centered approaches to explore suicide risk profiles and transitions over time in early Chinese adolescents, along with their protective factors. A total of 1518 junior high school students (49.6% girls, Mage = 13.57, SD = 0.75) participated in two surveys within a 12-month interval. Latent Profile Analysis and Latent Transition Analysis were used to model the profiles and transitions of suicide risk. Three risk profiles were identified at both time points: low risk profile (73.9, 78.3%), medium risk-high threat profile (16.2, 10.2%), and high risk profile (9.9, 10.2%). Low risk profile was stable, while medium risk-high threat and high risk profiles showed great transitions over 12 months. Sense of control, meaning in life, and regulatory emotional self-efficacy served as protective factors against suicide risk profiles and transitions. Findings underscore the importance of comprehensively illustrating suicide risk states from multiple aspects, as well as understanding the fluid nature of transitions between different risk states. Prevention and intervention strategies aimed at enhancing resilience, such as increasing sense of control, perceived meaningfulness, and belief in emotional regulation, may contribute to reducing the risk of suicide among adolescents.

The association between nation-level social and economic indices and suicide rates: A pilot study

Ever since the pioneering work of Emile Durkheim, it has been known that regional or national suicide rates can be influenced by a variety of social and economic factors. Recent research has found a robust association between two country-level economic indices-gross national product and unemployment rate-and suicide rates, particularly in men. However, the association between other country-level social indices-such as measures of social integration, inequality, environmental preservation and political freedom-and suicide rates has not been studied at the cross-national level. In the current study, national suicide rates for men and women were examined in relation to seven indices measuring subjective wellbeing, sustainable development, type of political regime, economic and gender inequality, and social capital. It was found that the Happy Planet Index, a composite measure of subjective wellbeing and sustainable development, was negatively associated with suicide rates independent of gender, and even after adjusting for possible confounding factors. Economic inequality was associated with suicide in men, and social capital was associated with suicide in women. Moreover, the strength and direction of the associations observed between socioeconomic indices and suicide varied across income groups. These results highlight the need for a closer evaluation of the link between large-scale ("macro") social factors and individual ("micro") psychological factors, as well as the importance of integrating these factors into suicide prevention programmes at the national level.

The Near-Death Experience and Suicidal Ideation

The near-death experience (NDE) most generally refers to a state of altered consciousness with various features that can occur during real or presumed near-death circumstances and/or life-threatening incidents. Some NDEs are associated with a nonfatal suicide attempt. This paper discusses how a belief by suicide attempters that their NDEs are a true portrayal of objective spiritual reality can at least in some cases be positively associated with a persistence or increase of suicidal ideation and on occasion lead to further suicide attempts, while also exploring why at other times such a belief may reduce the risk of suicide. The formulation of suicidal ideation associated with NDEs among some of those who did not initially try to kill themselves is also explored. Various examples related to NDEs and suicidal ideation are provided and discussed. Furthermore, this paper also offers some theoretical insights related to this matter and points out some specific therapeutic concerns based on this discussion.

Psychometric properties of the Patient Health Questionnaire-4 among Hong Kong young adults in 2021: Associations with meaning in life and suicidal ideation

Background

Young adults in Hong Kong are subject to elevated psychological distress given the societal stressors such as civil unrest and COVID-19 pandemic and suicide is a leading cause of death among them. The present study aimed to evaluate the psychometric properties and measurement invariance of the 4-item Patient Health Questionnaire-4 (PHQ-4) as a brief measure of psychological distress and its associations with meaning in life and suicidal ideation (SI) in young adults.

Materials and methods

A mobile survey recruited a large and random sample of 1,472 young adults (Mean age = 26.3 years, 51.8% males) in Hong Kong in 2021. The participants completed the PHQ-4 and Meaning in Life Questionnaire–short form (MLQ-SF) for presence of meaning in life (MIL), SI, COVID-19 impact, and exposure to suicide. Confirmatory factor analysis was conducted to examine the factorial validity, reliability, and measurement invariance of PHQ-4 and MLQ-SF across gender, age, and distress subgroups. Multigroup structural equation model evaluated and compared the direct and indirect effects of latent MIL factor on SI via latent PHQ-4 factor across distress groups.

Results

Both MIL and PHQ-4 supported a 1-factor model with good composite reliability (Ω = 0.80–0.86) and strong factor loadings (λ = 0.65–0.88). Both factors showed scalar invariance across gender, age, and distress groups. MIL showed significant and negative indirect effects (αβ = −0.196, 95% CI = −0.254 to −0.144) on SI via PHQ-4. PHQ-4 showed a stronger mediating role between MIL and SI in the distress group (Δ = −0.146, 95% CI = −0.252 to −0.049) than the non-distress group. Higher MIL predicted higher likelihoods of help-seeking (Odds ratios = 1.46, 95% CI = 1.14–1.88).

Conclusion

The present results support adequate psychometric properties in terms of factorial validity, reliability, convergent validity, and measurement invariance for the PHQ-4 in young adults in Hong Kong. The PHQ-4 demonstrated a substantial mediating role in the relationship between meaning in life and SI in the distress group. These findings support clinical relevance for using the PHQ-4 as a brief and valid measure of psychological distress in the Chinese context.

Testing the Effectiveness of a Salutogenic Model for Reducing Suicidal Tendencies in a Population of Elderly and Young Adults

Suicide is a leading cause of mortality worldwide, with the elderly having the highest suicide rates. This study tests the effectiveness of a salutogenic model in normative elderly people compared with young adults in protecting against risk behaviors and suicidal tendencies, based on two variables: locus of control and meaning in life (mediating variable between locus of control and suicidal tendency). Participants were 191 people aged 65 to 100 years and 200 young adults aged 18 to 28 years old. Participants completed questionnaires on locus of control and purpose in life and were assessed for suicidal tendencies. Findings reveal a negative effect of age on locus of control, purpose in life, and a negative correlation between purpose in life and internal locus of control and suicidal tendency. Purpose in life mediates between internal locus of control and suicidal tendency in both populations. The salutogenic model has significant implications and can be used to reduce suicidal tendencies.

The Meaning in Life in Suicidal Patients: The Presence and the Search for Constructs. A Systematic Review

Background and Objectives: Research on suicidal behavior (SB) has frequently focused more on risk factors than protective factors. Since the historic works of Viktor E. Frankl, who inquired how some Nazi concentration camps prisoners maintained their will to live though confronted with pervasive absurdity, Meaning in Life (MiL) has been interpreted as a potent resiliency factor. MiL then declined along a multitude of theoretical perspectives and was associated with various functioning domains of the individual. Surprising, few studies investigated the role of MiL on SB. We aimed to review and synthetize current literature on possible associations between MiL and SB, which included suicidal ideation (SI), suicidal attempts (SA), and completed suicide, focusing on two MiL constructs (the presence of MiL and search for MiL) from the Michael F. Steger’s recent conceptualization. Material andMethods: A systematic strategy following PRISMA guidelines was used to search for relevant articles in Pubmed/MEDLINE, Scopus, PsycINFO, and ScienceDirect (January 1980–February 2019) and yielded 172 articles, 37 of which met our inclusion criteria. Results: MiL emerged as a protective factor against SI, SA, and completed suicides, directly or through mediation/moderation models with other SB-related variables. When distinguishing the presence of MiL and the search for MiL, a consensual protective impact was described for the former. Data for the latter were less consistent but rather oriented towards a non-protective impact Conclusions: These findings could have clinical repercussions for SB prevention, in both suicide risk assessment refinement and psychotherapeutic interventions. Further research is needed to examine the dynamic interplay of the two constructs.

Meaning in life, self-control and psychological distress among adolescents: A cross-national study

Meaning in life refers to the sense made of, and significance felt regarding, the nature of one's being and existence and includes two dimensions (i.e., presence of meaning and search for meaning, Steger et al., 2006). This research aimed to: (1) compare the mean level differences in presence of meaning and search for meaning among Chinese and Italian adolescents; (2) examine the association between presence of and search for meaning and psychological distress; (3) test self-control as a mediator in the aforesaid relationship, and (4) compare the direct and the indirect effects between the two samples. To this end, self-report questionnaires were administered to Chinese (N = 270) and Italian (N = 279) adolescents. Results showed that Chinese adolescents reported greater search for meaning than their Italian counterparts. Moreover, presence of meaning was negatively related to psychological distress whereas search for meaning was positively related to psychological distress, through self-control in both samples with similar magnitude. Collectively, the findings contribute to the knowledge about the influence of meaning in life on adolescent psychological health and the underlying mechanisms. The dialectic model of meaning in life, a model that assumes cultural differences in presence of meaning and search for meaning, is partially supported.

Meaning in life among adolescents: Factorial invariance of the purpose in life test and buffering effect on the relationship between emotional dysregulation and hopelessness

OBJECTIVE

The purpose of the present study was threefold: first, to analyse the psychometric properties of a 10-item Spanish version of the Purpose in Life Test, which assesses meaning in life (MiL), in a sample of community adolescents; second, to analyse the differences between the age and gender groups; and third, to analyse whether MiL buffers the relationship between emotional dysregulation and hopelessness.

METHOD

Participants were 1,599 adolescents from 12 to 19 years old, M = 15.69, SD = 2.14. The Purpose in Life Test-10 Items, the Beck Hopelessness Scale, and the Difficulties in Emotional Regulation Scale were used.

RESULTS

A nine-item version showed good fit, psychometric properties (internal consistency, construct, and concurrent validity), and factorial invariance across gender and age (12-15 years/16-19 years). Difference in MiL between boys and girls was not significant, whereas between age groups was significant. MiL had a strong buffering effect on the relationship between emotional dysregulation and hopelessness.

DISCUSSION

It is desirable to promote the sense of MiL in adolescents. MiL plays a significant and strong mediator role in the relationship between emotional dysregulation and hopelessness, reinforcing the positive role of MiL in mental health and as a resource for facing adversity.