Associations of Suicide Stigma Internalization With Risk Factors of Suicidal Thoughts and Behaviors Among Chinese College Students: A Multi‐Wave Longitudinal Study

Introduction Suicide stigma is a multifaceted social issue with far‐reaching consequences for mental health. While previous research has linked it to suicidal thoughts and behaviors (STBs), the roles of perceived and internalized forms of suicide stigma in influencing STBs remain unclear. Method This study investigated the potential causal relationships between perceived and internalized suicide stigma, hopelessness, unbearable pain, and thwarted connectedness in relation to STBs among 546 Chinese college students (mean age = 20.92 years). Three‐wave longitudinal data with a time gap of roughly 3 months were analyzed by using structural equation modeling. Results The results showed that the second‐wave internalized stigma mediated the relationship between baseline perceived stigma and the third‐wave unbearable pain, hopelessness, and thwarted connectedness, which are considered risk factors of STBs. Furthermore, the coexistence of unbearable pain and hopelessness, and the coexistence of unbearable pain and connectedness mediated the influences of perceived and internalized suicide stigma on STBs. Conclusion These findings demonstrated that the temporal evolution of perceived and internalized suicide stigma contributes to risk factors predicting STBs.