Summary

A medRxiv preprint based on 752 young adults in a North Indian city found that victimisation was indirectly associated with suicidal ideation and attempts through physical violence and depressive symptoms. The study used a structural equation model to examine these pathways.

A medRxiv preprint from researchers at the Postgraduate Institute of Medical Education and Research, Chandigarh, reports that victimisation among young adults was indirectly associated with suicidal ideation and attempts through physical violence and depressive symptoms. The finding comes from a survey of 752 students aged 18–22 in six colleges in a North Indian city and is based on statistical modelling rather than an intervention study.

Contents

What the survey measured

The participants had a median age of 19 years, and 64.4% were women. They were recruited by random sampling across six colleges. The researchers examined victimisation using indicators that included dating violence, campus bullying and cyberbullying. Physical violence, depressive symptoms and suicidal ideation or attempts were analysed as connected parts of the same model.

Among the respondents, 16.6% reported having been involved in a physical fight, 24.2% had depressive symptoms and 4.5% had seriously considered suicide during the previous 12 months. The researchers represented suicidal ideation and attempts as one five-level ordinal outcome, ranging from having not considered suicide to having had an attempt requiring medical treatment.

The study protocol was approved by the Institute Ethics Committee of PGIMER, Chandigarh, and participants provided informed written consent.

How the model connected victimisation and suicidal behaviour

The researchers used a theory-based structural equation model, or SEM, to estimate several related pathways at the same time. SEM is useful when a research question involves interconnected factors rather than a single exposure and outcome. In this study, the model tested whether victimisation was associated with suicidal ideation and attempts directly, or indirectly through physical violence and depressive symptoms.

The analysis found indirect associations between victimisation and the combined suicidal ideation-and-attempts outcome. Victimisation was associated with physical violence and depressive symptoms, which were in turn associated with suicidal ideation and attempts. The estimated direct effects of victimisation on the suicidal outcome were negligible. The researchers reported that the model had acceptable global fit, meaning the overall pattern specified in the analysis was reasonably consistent with the survey data under the study's fit measures.

These results describe statistical relationships within the surveyed group. They do not function as an individual prediction tool: the analysis was based on survey data, and the model estimates pathways among reported experiences and symptoms rather than testing a treatment or prevention programme.

Implications for prevention

The findings support a multi-level prevention approach, according to the authors. Measures to reduce bullying, dating violence and other forms of victimisation could be combined with life-skills education and access to treatment for depression. The model's structure suggests that prevention may need to address both the harmful experiences themselves and the physical aggression and depressive symptoms associated with them.

The study's interpretation is specific to young adults recruited from six colleges in one North Indian city. Its outcome also combines suicidal thoughts and attempts into a single ordered measure, so the results should not be read as separate estimates for each form of suicidal behaviour. As a medRxiv preprint, the work is preliminary pending peer review. The extent to which the estimated pathways apply to young people outside the participating colleges remains uncertain, and the survey-based design leaves the direction of causal relationships unresolved.

Sources