Skip to main content

Advertisement

Log in

Predictors of Suicidal Ideation Among Children and Adolescents: Roles of Mental Health Status and Meaning in Life

  • Original Paper
  • Published:
Child & Youth Care Forum Aims and scope Submit manuscript

Abstract

Background

Meaning in life has been depicted as an important psychological resource for both children and adults.

Objective

The specific aims of this study were to quantify the rates and severity of suicidal ideation in a sample of 6165 Chinese children and adolescent students from a wide range of areas across China and to investigate whether mental health status and meaning in life would be the predictors for suicidal ideation. More importantly, meaning in life was investigated as a possible moderator and a mediator of the influence of mental health status on suicidal ideation.

Methods

Descriptive statistical analyses, Pearson correlation analyses, and hierarchical regression analyses were adopted as methods of data analyses.

Results

Approximately 33.71% of students reported having suicidal ideation. Both mental health status and meaning in life were strong predictors of suicidal ideation. Results indicated that poorer mental health status was significantly associated with more severe suicidal ideation, whereas a weaker sense of meaning in life was significantly correlated with greater suicidal ideation. Mediation analysis showed that meaning in life partially mediated the link between mental health status and the severity of suicidal ideation. Specifically, students who experienced poorer mental health status might be more likely to report having a weaker sense of meaning in life, which in turn promotes greater suicidal ideation. Moderation analysis showed that the impact of mental health status on suicidal ideation was significantly greater among children and adolescents with a weaker sense of meaning in life.

Conclusions

Results are discussed with regard to the potential value of meaning in life and mental health status in building predictive models of suicidal ideation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Thousand Oaks: Sage.

    Google Scholar 

  • Amanda, G., Garcia, W., Lauren, M., & Nadine, J. K. (2014). Mental health status and suicide behavior among graduate students. Academic Psychiatry, 38, 554–560.

    Article  Google Scholar 

  • Arria, A. M., O’Grady, K. E., Caldeira, K. M., Vincent, K. B., Wilcox, H. C., & Wish, E. D. (2009). Suicidal ideation among college students: A multivariate analysis. Archives of Suicide Research, 13, 230–246.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bamonti, P. M., Lombardi, S., Duberstein, P. R., King, D. A., & Van Orden, K. A. (2015). Spirituality attenuates the association between depression symptom severity and meaning in life. Aging & Mental Health, 20(5), 494–499.

    Article  Google Scholar 

  • Berman, S. L., Weems, C. F., & Stickle, T. R. (2006). Existential anxiety in adolescents: Prevalence, structure, association with psychological symptoms and identity development. Journal of Youth and Adolescence, 35(3), 285–292.

    Article  Google Scholar 

  • Caldwell, T. M., Jorm, A. F., & Dear, K. B. G. (2004). Suicide and mental health status in rural, remote and metropolitan areas in Australia. Medical Journal of Australia, 181, S10–S14.

    PubMed  Google Scholar 

  • Calear, A. L., Christensen, H., Freeman, A., Fenton, K., Grant, J. B., Van Spijker, B., et al. (2016). A systematic review of psychosocial suicide prevention interventions for youth. European Child and Adolescent Psychiatry, 25(5), 467–482.

    Article  PubMed  Google Scholar 

  • Cerel, J., Jordan, J. R., & Duberstein, P. R. (2008). The impact of suicide on the family. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 29(1), 38–44.

    Article  Google Scholar 

  • Chamberlain, K., & Zika, S. (1988). Measuring meaning in life: An examination of three scales. Personality and Individual Differences, 9, 589–596.

    Article  Google Scholar 

  • Chen, C. (2002). A validation study of Mental health status Diagnose Test. Journal Ningbo university educational science, 24(3), 10–13.

    Google Scholar 

  • Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Crumbaugh, J. C. (1968). Cross validation of Purpose-in-Life test based on Frankl’s concepts. Journal of Individual Psychology, 24, 74–81.

    PubMed  Google Scholar 

  • Crumbaugh, J. C., & Maholick, L. T. (1964). An experimental study in existentialism: The psychometric approach to Frankl’s concept of noogenic neurosis. Journal of Clinical Psychology, 20(2), 200–207.

    Article  PubMed  Google Scholar 

  • Crumbaugh, J. C., & Maholick, L. T. (1969). Manual of instruction for the Purpose in Life test. Munster: Psychometric Affiliates.

    Google Scholar 

  • Debats, D. L., van der Lubbe, P. M., & Wezeman, F. R. A. (1993). On the psychometric properties of the Life Regard Index (LRI): A measure of meaningful life. An evaluation in three independent samples based on the Dutch version. Personality and Individual Differences, 14, 337–345.

    Article  Google Scholar 

  • Deng, Y., & Peng, X. (2015). Development of Adolescents’ meaning of life questionnaire. Science of Social Psychology, 30(170), 6–11.

    Google Scholar 

  • Dimidjian, S., Barrera, M., Jr., Martell, C., Munoz, R. F., & Lewinsohn, P. M. (2011). The origins and current status of behavioral activation treatments for depression. Annual Review of Clinical Psychology, 7, 1–38.

    Article  PubMed  Google Scholar 

  • Fiske, A., Wetherell, J. L., & Gatz, M. (2008). Depression in older adults. Annual Review of Clinical Psychology, 5, 363–389.

    Article  Google Scholar 

  • Garland, A. F., & Zigler, E. (1993). Adolescent suicide prevention: Current research and social policy information. American Psychologist, 48, 169–182.

    Article  PubMed  Google Scholar 

  • Garlow, S. J., Rosenberg, J., Moore, J. D., Haas, A. P., Koestner, B., Hendin, H., et al. (2008). Depression, desperation, and suicidal ideation in college students: Results from the American foundation for suicide prevention college screening project at Emory university. Depression and Anxiety, 25, 482–488.

    Article  PubMed  Google Scholar 

  • Harlow, L. L., Newcomb, M. D., & Bentley, P. M. (1986). Depression, self-derogation, substance use, and suicidal ideation: Lack of purpose in life as a meditational factor. Journal of Clinical Psychology, 42, 5–21.

    Article  PubMed  Google Scholar 

  • Harris, E. C., & Barraclough, B. (1997). Suicide as an outcome for mental disorders: A meta-analysis. British Journal of Psychiatry, 170, 205–228.

    Article  PubMed  Google Scholar 

  • Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis. New York: Guilford Press.

    Google Scholar 

  • Heisel, M. J., & Flett, G. L. (2006). The development and initial validation of the Geriatric Suicide Ideation Scale. American Journal of Geriatric Psychology, 14, 742–751.

    Article  Google Scholar 

  • Hintikka, J., Koivumaa-Honkanen, H., Lehto, S. M., Tolmunen, T., Honkalampi, K., & Haatainen, K. (2009). Are factors associated with suicidal ideation true risk factors? A 3-year prospective follow-up study in a general population. Social Psychiatry and Psychiatric Epidemiology, 44, 29–33.

    Article  PubMed  Google Scholar 

  • Joiner, T. E. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Kimberly, L., Henry, P. J., Lovegrove, M. F., Steger, P. Y., Chen, K. P., & Cigularov, R. G. T. (2014). The potential role of meaning in life in the relationship between bullying victimization and suicidal ideation. Journal of Youth and Adolescence, 43, 221–232.

    Article  Google Scholar 

  • King, L. A., Hicks, J. A., Krull, J. L., & Del Gaiso, A. K. (2006). Positive affect and the experience of meaning in life. Journal of Personality and Social Psychology, 90, 179–196.

    Article  PubMed  Google Scholar 

  • Kleiman, E. M., Adams, L. M., Kashdan, T. B., & Riskind, J. H. (2013). Gratitude and grit indirectly reduce risk of suicidal ideations by enhancing meaning in life: Evidence for a mediated moderation model. Journal of Research in Personality, 47, 539–546.

    Article  Google Scholar 

  • Kletter, H., Weems, C. F., & Carrion, V. G. (2009). Guilt and posttraumatic stress symptoms in child victims of interpersonal violence. Clinical Child Psychology and Psychiatry, 14, 71–83.

    Article  PubMed  Google Scholar 

  • Kwok, S. Y. C. L., Chai, W., & He, X. (2013). Child abuse and suicidal ideation among adolescents in China. Child Abuse and Neglect, 37, 986–996.

    Article  PubMed  Google Scholar 

  • Lei, X. L., Xu, S. J., Liu, X. Y., Zu, P., Zhang, S. C., Zhao, Y. Q., et al. (2012). Relationship of self-harm and suicidal behavior among middle school students. Chinese Journal of School Health, 33, 393–395.

    Google Scholar 

  • Li, X. Y., Phillips, M. R., Zhang, Y. L., Xu, D., Tong, Y. S., Yang, F. D., et al. (2011). Reliablity and validity of the Chinese version of Bech scale for suicidal ideation (BSI-CV). Chinese mental health status journal, 25(11), 822–866.

    Google Scholar 

  • Martz, E. (2004). Death anxiety as a predictor of posttraumatic stress levels among individuals with spinal cord injuries. Death Studies, 28, 1–17.

    Article  PubMed  Google Scholar 

  • Mascaro, N., & Rosen, D. H. (2008). Assessment of existential meaning and its longitudinal relations with depressive symptoms. Journal of Social and Clinical Psychology, 27, 576–599.

    Article  Google Scholar 

  • Mazza, J. J. (2006). Youth suicidal behavior: A crisis in need of attention. In F. A. Villarruel & T. Luster (Eds.), Adolescent mental health status (pp. 156–177). West port, CT: Greenwood Publishing Group.

    Google Scholar 

  • Mclean, K. C., Breen, A. V., & Fournier, M. A. (2010). Constructing the Self in early, middle, and late adolescent boys: Narrative identity, individuation, and well-being. Journal of Research on Adolescence, 20(1), 166–187.

    Article  Google Scholar 

  • Meier, B. P., Harlow, L. L., Newcomb, M. D., & Bentler, P. M. (1986). Depression, self-derogation, substance use, and suicidal ideation: Lack of purpose in life as a mediational factor. Journal of Clinical Psychology, 42, 5–21.

    Article  Google Scholar 

  • Milner, A., Page, A., & LaMontagne, A. D. (2014). Cause and effect in studies on unemployment, mental health status and suicide: A meta-analytic and conceptual review. Psychological Medicine, 44, 909–917.

    Article  PubMed  Google Scholar 

  • National Center for Health Statistics. (1990). National suicide statistics. Washington, DC: Department of Health and Human Services, Mortality Statistics Branch.

    Google Scholar 

  • Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiologic Reviews, 30, 133–154.

    Article  PubMed  PubMed Central  Google Scholar 

  • Phillips, M. R., Li, X. Y., & Zhang, Y. P. (2002). Suicide rates in China, 1995–99. The Lancet, 359, 835–840.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.

    Article  PubMed  Google Scholar 

  • Reker, G. T., & Fry, P. S. (2003). Factor structure and invariance of personal meaning measures in cohorts of younger and older adults. Personality and Individual Differences, 35(5), 977–993.

    Article  Google Scholar 

  • Reker, G. T., Peacock, E. J., & Wong, P. T. P. (1987). Meaning and purpose in life and well being: A life-span perspective. Journal of Gerontology, 42, 44–49.

    Article  PubMed  Google Scholar 

  • Ryff, C. D., & Singer, B. H. (1998). The role of purpose in life and personal growth in positive human health. In P. T. P. Wong & P. S. Fry (Eds.), The human quest for meaning: A handbook of psychological research and clinical applications (pp. 213–235). Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Scott, B. G., & Weems, C. F. (2013). Natural disasters and existential concerns: A test of Tillich’s theory of existential anxiety. Journal of Humanistic Psychology, 53, 114–128.

    Article  Google Scholar 

  • Shek, D. T. L. (2006). Effectiveness of the Tier 1 Program of the Project P.A.T.H.S.: Preliminary objective and subjective outcome evaluation findings. The Scientific World Journal, 6, 1466–1474.

    Article  PubMed  Google Scholar 

  • Shek, D. T. L. (2012a). Life meaning and purpose in life among Chinese adolescents: What can we learn from Chinese studies in Hong Kong? In P. T. P. Wong (Ed.), The human quest for meaning: Theories, research and applications (pp. 335–355). New York: Routledge.

    Google Scholar 

  • Shek, D. T. L. (2012b). Spirituality as a positive youth development construct: A conceptual review. The Scientific World Journal, 2012, 458953. https://doi.org/10.1100/2012/458953.

    PubMed  PubMed Central  Google Scholar 

  • Shek, D. T. L., & Yu, L. (2012). Self-harm and suicidal behaviors in Hong Kong adolescents: Prevalence and psychosocial correlates. The Scientific World Journal, 2012, 932540. https://doi.org/10.1100/2012/932540.

    PubMed  PubMed Central  Google Scholar 

  • Shneidman, E. S. (2004). Autopsy of a suicidal mind (pp. 3–21). New York: Oxford University Press.

    Google Scholar 

  • Sobowale, K. A., Zhou, N., Fan, J. Y., Liu, N., & Sherer, R. (2014). Depression and suicidal ideation in medical students in China: A call for wellness curricula. International Journal of Medical Education, 5, 31–36.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steger, M. F., Frazier, P., Oishi, S., & Kaler, M. (2006). The Meaning in Life Questionnaire: Assessing the presence of and search for meaning in life. Journal of Counseling Psychology, 53, 80–93.

    Article  Google Scholar 

  • Su, R. R. (2013). Psychometric properties of the Meaning in Life Questionnaire in a sample of Chinese adolescents. Journal of the Chinese Society of Education, 3, 1–2.

    Google Scholar 

  • Tavernier, R., & Willoughby, T. (2012). Adolescent turning points: The association between meaning-making and psychological well-being. Developmental Psychology, 48(4), 1058–1068.

    Article  PubMed  Google Scholar 

  • Tillich, P. (1952). Anxiety, religion, and medicine. Pastoral Psychology, 3, 11–17.

    Article  Google Scholar 

  • Tillich, P. (1961). Existentialism and psychotherapy. Review of Existential Psychology & Psychiatry, 1, 8–16.

    Google Scholar 

  • Van Orden, K. A., Bamonti, P. M., King, D. A., & Duberstein, P. R. (2012). Does perceived burdensomeness erode meaning in life among older adults? Aging & Mental Health, 16, 855–860.

    Article  Google Scholar 

  • Wang, L. M., Shen, Y. L., Liang, Z. Q., Luo, Z. Y., & Zhang, K. R. (2012). Reliability and validity of BSI-CV in evaluating the depression patients. Chinese Journal of Health Psychology, 20(1), 159–160.

    Google Scholar 

  • Wasserman, D., Cheng, Q., & Jiang, G. X. (2005). Global suicide rates among young people aged 1519. World Psychiatry, 4(2), 114–120.

    PubMed  PubMed Central  Google Scholar 

  • Weems, C. F., & Berman, S. L. (2012). Existential anxiety. In R. Levesque (Ed.), Encyclopedia of adolescence (Part 5 ed., pp. 890–895). New York, NY: Springer.

    Google Scholar 

  • Weems, C. F., Russell, J. D., Neill, E. L., Berman, S. L., & Scott, B. G. (2016). Existential anxiety among adolescents exposed to disaster: Linkage with level of exposure and psychological symptoms. Journal of Traumatic Stress, 29, 466–473.

    Article  PubMed  Google Scholar 

  • Weems, C. F., & Stickle, T. R. (2012). Mediation, incremental validity, and novel intervention development: Introduction to a special issue on youth anxiety and related problems. Child & Youth Care Forum, 41(6), 509–515.

    Article  Google Scholar 

  • Westenberg, P. M., Siebelink, B. M., & Treffers, P. D. (2001). Psychosocial developmental theory in relation to anxiety and its disorders. In W. K. Silverman & P. D. A. Treffers (Eds.), Anxiety disorders in children and adolescents: Research, assessment and intervention (pp. 72–89). Cambridge: Cambridge University Press.

    Google Scholar 

  • World Health Organization. (2009). Suicide: Global facts. Retrieved June 1, www.who.org.

  • Xu, M. J., Wan, P. Y., & Yang, X. G. (2017). Relationship between stressful life events and suicidal ideation of left-behind children and mediating effect of negative cognitive emotion regulation. Chinese General Practice, 20(4), 482–486.

    Google Scholar 

  • You, J., Jiang, Y., Zhang, M., Du, C., Lin, M., & Leung, F. (2016). Perceived parental control, self-criticism, and nonsuicidal self-injury among adolescents: Testing the reciprocal relationships by a three-wave cross-lag model. Archives of Suicide Research, 21(3), 1–13.

    Google Scholar 

  • Zhang, J., Ma, J., Jia, C., Sun, J., Guo, X., Xu, A., et al. (2010). Economic growth and suicide rate changes: A case in China from 1982 to 2005. European Psychiatry, 25, 159–163.

    Article  PubMed  Google Scholar 

  • Zhou, B. C. (1991). Mental health status test (MHT) manual. Shanghai: East China Normal University.

    Google Scholar 

Download references

Acknowledgements

We would like to thank all the participants for their contributions to this study. We also thank all of our research collaborators and local education authority for their assistances in data collection. This work was also supported by Humanity and Social Science Youth foundation of Ministry of Education of China (16YJC190022 to T.S.X).

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Tiansheng Xia or Jingchu Hu.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tan, L., Chen, J., Xia, T. et al. Predictors of Suicidal Ideation Among Children and Adolescents: Roles of Mental Health Status and Meaning in Life. Child Youth Care Forum 47, 219–231 (2018). https://doi.org/10.1007/s10566-017-9427-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10566-017-9427-9

Keywords

Navigation