Effects of perceived stress and resilience on suicidal behaviors in early adolescents.

Suicidal behaviors are significant public health issues. The aim of the current study is to examine the effects of perceived stress and resilience on suicidal ideation (SI), plan (SP), and attempt (SA) among early adolescents. A longitudinal study was conducted with data collected from 1035 junior high-school students at baseline and 1-year follow-up. Participants were assessed for suicidal behaviors, resilience, and perceived stress. Logistic regression was performed to analyze for the associations between independent variables and suicidal behaviors. 210 (20.3%) of the participants reported to have SI, 59 (5.7%) had SP, and 49 (4.7%) had SA at baseline. Perceived stress was a strong risk factor (p < 0.001) for SI (OR 1.16-1.18), SP (OR 1.20-1.21), and SA (OR 1.12-1.16) while accounting for different dimensions of resilience. Students with persistent high stress during the 1-year follow-up period had significantly increased risk of SI (OR 7.14-9.64), SP (OR 3.92-6.37), and SA (OR 3.76-3.84) than the persistent low-stress group (p < 0.01). Increased perceived stress scale (PSS) (OR 2.89-3.15) and decreased PSS (OR 2.47) also had a higher risk for SI than persistent low PSS group. Moreover, students with high perceived stress who reported to have higher hope and optimism were less likely to show SI (OR 0.90, p = 0.001) and SP (OR 0.87, p = 0.002) at baseline, and the problem-solving and cognitive maturity mature dimension of resilience showed a significant protective effect on SP longitudinally (OR 0.25, p = 0.003). Perceived stress substantially increased the risk for suicidal behaviors, and moderates the protective effect of resilience on suicide. Considering both risk and protective factors of suicidal behaviors is essential in designing future suicide prevention and intervention programs.