Research Article: Associations between depression, anxiety, stress, hopelessness, subjective well-being, coping styles and suicide in Chinese university students

Date Published: July 1, 2019

Publisher: Public Library of Science

Author(s): Bob Lew, Jenny Huen, Pengpeng Yu, Lu Yuan, Dong-Fang Wang, Fan Ping, Mansor Abu Talib, David Lester, Cun-Xian Jia, Marco Innamorati.


Suicide is a major public health concern worldwide. This study aimed to predict the suicidal behavior of Chinese university students by studying psychological measures such as hopelessness, orientation to happiness, meaning in life, depression, anxiety, stress, and coping styles. In November 2016, a stratified-clustered-random sampling approach was utilized to select subjects from two large public medical-related universities in Shandong province, China. This sample consisted of 2,074 undergraduate students (706 males, 1,368 females; mean age = 19.79±1.39 years). The students’ major risk factors for suicide were depression, anxiety, stress, and hopelessness, and the students’ minor risk factors included orientation to happiness and coping styles (including self-distraction, self-blame and substance use). Notably, the presence of meaning in life had a positive effect on preventing suicide and acted as a protective factor, which suggests that it is important to identify risk factors as well as protective factors relevant to the target population group in order to increase the effectiveness of counseling and suicide prevention programs.

Partial Text

Globally, suicide has been recognized as a severe public health concern associated with significant disability, psychosocial impairment, and medical illness. Approximately 800,000 people take their own lives each year [1]. Furthermore, suicide rates among adolescents and young adults, especially on university campuses, have been increasing at an alarming rate [2]. Significant precursors to dying by suicide are nonlethal suicidal behaviors—such as suicide ideation and suicide attempts [3–5]. A report from the USA in 2014 claimed that an estimated 108,000 full-time college students had attempted suicide [6]. Statistics show the prevalence of suicide ideation or suicide plans among college students to range between 5.4–38% worldwide [7–11]. In China, suicide is the leading cause of death for young adults [12]. The suicide rate in China has been decreasing but remains the second leading cause of death for this age group [13].

The mean scores and standard deviations for each of the scales are shown in Table 1, along with Cronbach’s alphas for each scale. The high Cronbach’s alphas indicated satisfactory reliability for the instruments.

The main findings of the present study were the following: the major risk factors for suicidal behavior were shown to be hopelessness, depression, stress and negative coping styles; furthermore, perceiving meaning in life was shown to be a protective factor for suicidal behavior.