Serial Multiple Mediation of Depressive Symptoms, Thwarted Belongingness, and Perceived Burdensomeness in the Relationship Between Personality Traits and Suicidal Ideation Among Nursing Students: A Cross-sectional Questionnaire Survey.

PURPOSE

Suicide is a global public health concern, significantly affecting young adults across the world. Studies have shown that nursing students exhibit a higher propensity for suicidal ideation in comparison to students from other academic disciplines. Personality traits have been recognized as a significant and comparatively consistent risk factor for suicidal ideation. However, the specific pathways through which personality traits influence suicidal ideation are not yet fully understood. Based on the Interpersonal-Psychological Theory of Suicide, this study aimed to examine the serial mediation effects of depressive symptoms, thwarted belongingness, and perceived burdensomeness in the relationship between the Big Five personality traits and suicidal ideation among nursing students.

METHODS

A descriptive cross-sectional survey was conducted. A sample of 435 nursing students participated in the online survey. Participants completed Chinese versions of questionnaires of the Suicidal Behaviors Questionnaire-Revised, Big Five Personality Inventory-15, Patient Health Questionnaire-9, and Interpersonal Needs Questionnaire. SPSS version 27.0 and the PROCESS 4.3 macro model 6 were used for statistical analyses.

RESULTS

The prevalence of suicidal ideation among nursing students was 17.5%. Neuroticism (β = 0.26, p < .001), conscientiousness (β = -0.10, p = .001), agreeableness (β = -0.14, p < .001), openness (β = -0.11, p < .001), and extraversion (β = -0.19, p < .001) had a statistically significant total effect on suicidal ideation. Furthermore, significant indirect effects were found between Big Five personality traits and suicidal ideation, serially mediated by depressive symptoms, thwarted belongingness, and perceived burdensomeness.

CONCLUSIONS

The findings indicate that nursing students exhibit high levels of suicidal ideation, which are influenced by their Big Five personality traits. This relationship appears to be serially mediated by depressive symptoms, thwarted belongingness, and perceived burdensomeness, aligning with the Interpersonal-Psychological Theory of Suicide. Therefore, interventions focused on reducing depressive symptoms in nursing students with vulnerable personality traits may help mitigate feelings of thwarted belongingness and perceived burdensomeness, ultimately reducing suicidal ideation.