Understanding Suicidal Thoughts and Behaviors Among University Students: The Roles of Psychological Distress and Social Support Dynamics

Suicidal thoughts and behaviors (STB) constitute a major mental health challenge among university students worldwide, particularly in contexts of intense academic pressure and social transitions. This study investigated the risk factors for STB among Chinese university students, with a primary focus on the roles of psychological distress (PD) and social support dynamics. Using a random sample of 5,617 undergraduate students from a university in Southwest China, data were collected via standardized instruments: the Mini International Neuropsychiatric Interview (MINI 5.0) for STB, the Kessler‐10 (K10) for PD, and the Social Support Rating Scale (SSRS) for perceived social support. Binary logistic regression and moderation analyses were performed to examine associations and interactive effects. Results indicated that 11% of participants reported STB in recent months. Significant risk factors included female gender (OR = 1.64, 95% CI [1.36, 1.98]), poor family relationships (OR = 1.43, 95% CI [1.12, 1.83]), and left‐behind childhood experiences (OR = 1.22, 95% CI [1.02, 1.47]). Higher levels of PD were significantly associated with increased STB risk (OR = 1.05 per point increase, 95% CI [1.04, 1.07]), while greater social support emerged as a significant protective correlate (OR = 0.94 per point increase, 95% CI [0.93, 0.95]). Moderation analysis indicated that social support significantly buffered the positive association between PD and STB, although this interaction effect was small in magnitude. The co‐occurrence rate of moderate to severe PD and STB was 6%, with higher rates observed among females. These findings highlight the critical need for early PD screening and the development of comprehensive social support enhancement programs in university settings to effectively prevent STB, especially among vulnerable subgroups.