Background: Research suggests that Chinese religious believers are more likely to commit suicide than those identifying as non-religious among rural young adults, contrary to findings in Western countries. However, one cannot conclude that religiosity is associated with elevated suicide risk without examining the effect of political and religious beliefs in a generally atheist country like China where political belief plays a dominant role in the belief system of young adults. The present study investigated the effects of political and religious belief on suicidality with meaningfulness and psychopathology as potential mediators in a large representative sample of Chinese college students.Methods: A cross-sectional survey was conducted among 1390 first-year college students randomly sampled from 10 colleges and universities in mainland China.Results: A total of 1168 respondents (84.0%) provided complete data on all variables. Lifetime prevalence of suicidal ideation, plan, and attempt were 45.1%, 6.8%, and 1.9% respectively, with one-year suicidal ideation showing at 19.3%. Female gender was associated with elevated risk of suicidality. Political belief but not religious belief was associated with decreased suicide risk. A significant interactive effect of political belief and religious belief was found, indicating that for political believers, being religious was associated with decreased suicide risk; for non-political believers, being religious was associated with increased suicide risk. Multi-group structural equation modeling showed that meaningfulness completely mediated and psychopathology partially mediated the effect of belief system on suicidality. Gender differences were found in pathways of political belief by religious beliefs to suicidality and political belief to psychopathology. The coefficients were significant for males but not for females.Conclusions: In less religious societies, political belief may serve as a means of integration as does religious affiliation in religious societies. Males were more likely to benefit from the protective effect of a belief system on suicidality than females.

Background: Adolescent non-suicidal self-injury (NSSI) is becoming a serious public health concern worldwide. In recent years, there has seen a significant increase in both the growth rate and cases of NSSI in Eastern countries, such as Japan, India, and China. In China, most schools have a mental health office that comprises mental health professionals (MHPs), who are the first to respond to student mental health problems, which include NSSI. MHPs possess comprehensive knowledge as well as unique insight into adolescent NSSI. However, very few studies on NSSI have incorporated their perspectives. In this work, we seek to add novel insight by conducting a study focusing on adolescent NSSI from the perspective of MHPs.Methods: We recruited a total of 24 MHPs from different schools using purposive sampling and conducted a semi-structured interview on NSSI-related issues. Each interview was voice recorded and lasted ~30 min. A thematic analysis was performed for the responses to study the most common and concerning issues underlying NSSI.Results: We extracted three major themes and eight sub-themes from the interview records, which included (1) the impact of Chinese culture on NSSI (sex-bias discrimination, overly high expectations, and inappropriate parenting style); (2) life events in school (internet use, academic pressure, and romantic relationships); and (3) opinions on the status quo of NSSI in China (ignorance and stigma).Conclusion: Results showed that culturally sensitive influential factors, such as sex-bias discrimination, the imposing of unrealistic expectations for personal achievement, and inappropriate parenting style, should be given more attention to prevent, assess, and intervene in NSSI. Emerging factors of modern society and adolescent lifestyles, such as academic pressure, internet use, and romantic relationships, should also be considered for treatments.

Background: Childhood abuse and neglect are typically considered as two different forms of maltreatment. Previous international studies have found differential effects of abuse and neglect on prosocial behavior, but this and the mediating pathway underlying these associations have not been examined in a Chinese sample. Our study aims to examine the effects of childhood abuse and neglect on prosocial behavior in Chinese participants and test the unique mediating roles of different empathic components in these associations.Methods: A total of 1,569 young adults (average age = 18.17 years) were recruited from a college that enrolls students from all provinces of China. Participants completed a series of questionnaires, including the Childhood Trauma Questionnaire, Interpersonal Reactivity Index, and Prosocial Tendencies Measure. Path analysis was conducted to determine the mediational relationships.Results: Emotional neglect had significant direct effect on prosocial behavior (β = −0.108, p < 0.001), and could also impact prosocial behavior through the mediating roles of perspective-taking and empathic concern (effect size = −0.091 and −0.097 respectively, p < 0.001). Emotional abuse affected prosocial behavior only through personal distress (effect size = −0.072, p < 0.001). Physical abuse, sexual abuse and physical neglect have little effect on prosocial behavior and empathy.Conclusion: Childhood abuse and neglect have distinct influences on prosocial behavior. Emotional abuse and emotional neglect affect prosocial behavior through distinct pathways. This conclusion could help to establish precise interventions for improving prosocial behavior in maltreated individuals.

Background: Dialectical behavior therapy (DBT) is a first‐line treatment for the prevention of suicide. Zhong‐Yong thinking could be viewed as a Chinese way of dialectical thinking, has long been a culturally dictating thinking style in China. To enhance cultural adaptability, we integrated Zhong‐Yong thinking into DBT group skills training and examined its efficacy in suicidal prevention compared with a supportive group therapy and a wait‐list group in high‐risk suicidal Chinese college students.Methods: A total of 97 suicidal participants were randomized to either Zhong‐Yong thinking based DBT group skills training (DBT_ZYT, n = 33), or supportive group therapy (SGT; n = 32), or wait‐list group (WL; n = 32). DBT_ZYT was a 12‐week program based on Zhong‐Yong thinking instead of dialectical thinking, coaching participants mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. Supportive group therapy was a 12‐week program aiming at improving interpersonal effectiveness and emotion regulation skills. Outcome measures were assessed at pre‐ and post‐treatment and 6‐month follow‐up.Results: At post‐treatment measures, the levels of suicidal ideation, hopelessness, psychache symptoms, and general psychopathology had significantly decreased in both intervention groups; at the 6‐month follow‐up measures, the intervention effects were better maintained in the DBT_ZYT group rather than in the SGT group. Specifically, DBT_ZYT was more effective in relieving participants’ long‐term obsessive‐compulsive, anxiety, hostility, phobic, psychotic, and additional symptoms.Conclusions: Zhong‐Yong thinking not only could integrate with DBT skills training in Chinese young adult population, but also has special strength in enhancing DBT’s efficacy.

Background: Suicide is the fourth leading cause of death among young people aged 15–29 years. A large number of studies have found that mental disorder in adulthood is closely related to childhood trauma, and the relationship between childhood trauma and suicide risk is influenced by resilience and mental distress. This study aimed to explore the effects of childhood trauma on suicide risk among young people and the potential roles of resilience and mental distress in the relationship between childhood trauma on suicide risk. Methods: A cross-sectional survey was conducted among 742 young adults who were in graduate school stage from multiple provinces and cities in China. The Childhood Trauma Questionnaire (CTQ-Short Form), Connor-Davison Resilience Scale (CD-RISC) and Suicide Behavior Questionnaire-Revised (SBQ-R) were used to measure young adults’ childhood trauma, resilience and suicide risk, respectively. 9-items Patient Health Questionnaire (PHQ-9) and 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) were used together to measure mental distress. Correlation analysis was performed to explore the initial relationships among the main variables. Structural equation modeling (SEM) was conducted to examine the chain mediating effects of resilience and mental distress in the relationship between childhood trauma and suicide risk. Results: The structural equation modeling produced goodness of fit indices (χ² /df = 3.668, p < 0.001, RMSEA = 0.060, NFI = 0.959, CFI = 0.969, GFI = 0.969, TLI = 0.955). Childhood trauma significantly predicted suicide risk (β = 0.232, p < 0.001) and mental distress (β = 0.181, p < 0.001), which had negative effect on resilience (β = -0.233, p < 0.001). Resilience negatively affected mental distress (β = -0.483, p < 0.001) and suicide risk (β = -0.142, p = 0.001), while mental distress positively associated with suicide risk (β = 0.219, p < 0.001). Conclusion: The current study revealed that resilience and mental distress played chain-mediating roles in the relationship between childhood trauma and suicide risk. This suggests that we should view the suicide risk of graduate students from a comprehensive perspective.