Abstract
The factors associated with suicidal ideation among adolescents have been extensively characterised, but the mechanisms underlying the complexities of the relationship between experiences of childhood trauma and suicidal ideation have been less studied. This study examined the direct effect of childhood trauma on suicidal ideation on the one hand and whether school bullying victimisation and Internet addiction mediate the association between childhood trauma and suicidal ideation on the other hand. This school-based mental health survey was carried out in Qinghai Province in Northwest China in December 2019. We employed standardised questionnaires to collect sociodemographic and target mental health outcomes. Hierarchical multiple logistic regression and structural equation modelling were performed for the data analyses. This study included 5864 university students. The prevalence of lifetime suicidal ideation and Internet addiction were 34.7% and 21.4%, respectively. Overall, 16.4% and 11.4% of participants reported experiences of childhood trauma and school bullying victimisation, respectively. There were direct effects of childhood trauma, school bullying victimisation and Internet addiction on suicidal ideation. The total effect of childhood trauma on suicidal ideation was 0.201 (p < 0.001). School bullying victimisation and Internet addiction mediated the relationship between childhood trauma and suicidal ideation. Internet addiction played a mediating role between school bullying and suicidal ideation. Childhood trauma had both direct and indirect effects on suicidal ideation; these effects were mediated by school bullying victimisation and Internet addiction in Chinese university students. Elucidating these relationships will therefore be useful in developing and implementing more targeted interventions and strategies to improve the mental well-being of Chinese university students.
Highlights
Suicide occurs across the lifespan and is the second-leading cause of death among 15- to 29-year-olds worldwide (World Health Organization (WHO), 2016)
Childhood trauma has been established as the principal predictor of lifetime DSM-IV disorders (Kessler et al, 2010; Kircaburun et al, 2019), and evidence has successively suggested that the likelihood of suicidal ideation among students increased as the probability of childhood trauma experienced increased (Jeon et al, 2009; Clements-Nolle et al, 2018)
16.4% (936/5718; 95% confidence intervals (CIs) 15.4–17.4%) and 11.4% (662/5832; 95% CI 10.5–12.2%) of university students reported experiences of childhood trauma and school bullying, respectively
Summary
Suicide occurs across the lifespan and is the second-leading cause of death among 15- to 29-year-olds worldwide (World Health Organization (WHO), 2016). Suicide-related issues among Chinese children and adolescents are repeatedly emphasised (Chen et al, 2018; Guo et al, 2018), such as suicidal ideation which is a significant risk factor for suicidal attempts and death (Barzilay et al, 2017; Kwok et al, 2019). The existing body of research has demonstrated that the prevalence of suicidal ideation among Chinese college students ranges from 1.24% to 26.00% (Li et al, 2014). Socioeconomic adversity, adverse childhood events, bullying victimisation, substance abuse and psychological problems are identifiable predictors that contribute to the development of adolescent suicidal ideation (Barzilay et al, 2017; Tang et al, 2018; Kwok et al, 2019; Kim and Chun, 2020; Wang et al, 2020). A longitudinal study in the USA found that the accumulation of adverse childhood
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