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The Impact of Negative Life Events on Attempted Suicide in Rural China

Liu, Yanzheng MA*; Zhang, Jie PhD*†

The Journal of Nervous and Mental Disease: March 2018 - Volume 206 - Issue 3 - p 187–194
doi: 10.1097/NMD.0000000000000727
Original Articles

This study aims to explore the impact of negative life events (NLEs) on attempted suicide in a Chinese cultural setting. The sample comprised 791 suicide attempters and an equal number of controls matched on age, sex, and location from selected rural counties in China. Conditional logistic regression model was used to examine the association between NLEs and suicide risk. The impact of NLEs on attempted suicide was further examined using regression-based method to explore its mediation effect. The types of NLEs that were most likely to precede a suicide attempt in rural sample included the events in marriage/love, family/home, and friend/relationship. Rural women were more likely to experience more interpersonal conflicts than rural men. Approximately 75.6% of suicide attempters had experienced at least one NLE, and NLEs were strongly associated with attempted suicide. Total effect (0.676), direct effect (0.501), and the total indirect effect (0.301) of NLEs on suicide attempts were significantly mediated by hopelessness and depression. NLEs play a crucial role in predicting suicidal attempt in rural China, and they are mediated by depression and hopelessness.

*Shandong University School of Public Health Center for Suicide Prevention Research, Jinan, Shandong Province, China; and †Department of Sociology, State University of New York College at Buffalo, Buffalo, New York.

Send reprint requests to Jie Zhang, PhD, Department of Sociology, State University of New York College at Buffalo, 1300 Elmwood Ave, Buffalo, NY 14222. E-mail:

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