Life events, psychopathology, and suicidal behavior in Chinese adolescents

Background: Little is known about risk factors of suicidal behavior among Chinese adolescents. This study examined the associations between negative life events, psychopathology, and suicidal behavior in rural adolescents of China. Methods: A total of 1362 adolescent students in a rural prefecture of China completed a self-administered questionnaire concerning suicidal behavior, psychopathology, life events, and demographics. Data analyses were conducted using multivariate logistic regression modeling. Results: Females were more likely to report suicidal ideation than males (22.0% vs. 17.5%). While the rate of suicide attempt was slightly higher in younger males (12-15 years) than in females (4.7% vs. 3.1%), the rate was higher in older females (16-18 years) than in males (12.7% vs. 9.5%). Suicide attempters reported more negative life events during the past year than suicidal ideators and non-suicidal adolescents. Academic stress and family conflicts were the major stress domains of adolescents at risk for suicidal behavior. A significant dose-response relationship was observed between the number of life events and suicidal behavior. Negative life events were also associated with increased risk for internalizing and externalizing problems. Both internalizing and externalizing problems were significantly associated with elevated risk for suicidal behavior after negative life events were controlled. Limitations: This is a cross-sectional study. Longitudinal study is warranted to examine the roles of life stress in adolescent suicidal behavior. Conclusions: Adolescents who experienced more negative life events are at increased risk for suicidal behavior. Both internalizing and externalizing problems mediate the effect of life events on adolescent suicidal behavior.