The Roles of Attitudes Toward Suicide in Suicidal Ideation and Attempts among Chinese College Students: A Structural Equation Modeling Study

Abstract Attitudes toward suicide are complex and multifaceted, and their predictive roles in suicidal ideation and suicide attempts are not well understood. Elaborating on attitudes toward suicide can help contribute to suicide prevention. The current study examined whether and how attitudes toward suicide are involved in the ideation-to-action framework of suicide among college students. A cross-sectional survey was administered to 1427 Chinese college students (mean age, 22.42 years), of whom 570 reported suicidal ideation. Participants completed questionnaires to assess their endorsed attitude toward suicide, stigmatized attitude toward suicide, self-stigma toward suicide, depression, suicidal ideation, and suicide attempts. Structural equation modeling revealed that the associations between the three types of attitudes, i.e., endorsed attitude, stigmatized attitude, and self-stigma, and suicidal ideation and suicide attempts were fully or partially mediated by depression. The results suggested that attitudes towards suicide significantly influence suicidal behaviors and future suicide prevention efforts should consider these influences.