There is a paucity of cross-national studies evaluating protective models for suicidal behaviors. Thus, using a behavioral framework, the purpose of this study was to examine whether higher levels of life-enhancing behaviors could mitigate or weaken the relation between depressive symptoms and suicidal behaviors in United States and Pakistani college students. A total of 811 students (449 Pakistani and 362 U.S. students) participated in the study. Results indicated that the strength of the relation between depressive symptoms and suicidal behaviors was stronger for U.S. students. In addition, the association between depressive symptoms and suicidal behaviors weakened in the presence of high engagement in life-enhancing behaviors. This effect was comparable in strength for American versus Pakistani students. The results offer preliminary evidence for life-enhancing behaviors as a protective factor for suicide across unique cultural settings and may serve as a valuable area of focus for secondary prevention programs.
AftabS.KlibertJ.HoltzmanN.QadeerK.AftabS. (2017).
Schemas mediate the link between procrastination and depression: Results from the United States and Pakistan. Journal of Rational-Emotive & Cognitive-Behavior Therapy,
35(4), 329–345.
2.
AzizK.AfridiH. K.KhichiZ. H. (2006).
Psychological autopsy study of suicide pattern and its relationship to depressive illness. Annals of King Edward Medical University,
12, 121–123.
3.
CardenS. W.HoltzmanN. S.StrubeM. J. (2017).
CAHOST: An excel workbook for facilitating the Johnson-Neyman technique for two-way interactions in multiple regression. Frontiers in Psychology,
8, 1293.
ChangE. C.MartosT.SallayV.ChangO. D.WrightK. M.NajarianA. S.-M.LeeJ. (2017).
Examining optimism and hope as protective factors of suicide risk in Hungarian college students: Is risk highest among those lacking positive psychological protection?Cognitive Therapy and Research,
41(2), 278–288.
6.
ChuJ. P.GoldblumP.FloydR.BongarB. (2010).
The cultural theory and model of suicide.Applied and Preventive Psychology,
14, 25–40.
7.
DarlingtonR. B.HayesA. F. (2016). Regression analysis and linear models: Concepts, applications, and implementation.
New York, NY:
Guilford Press.
DentonE. D.MusaG. J.HovenC. (2017).
Suicide behaviour among Guyanese orphans: Identification of suicide risk and protective factors in a low- to middle-income country.Journal of Child and Adolescent Mental Health,
29(3), 187–195.
10.
FerrariA. J.SomervilleA. J.BaxterA. J.NormanR.PattenS. B.VosT.WhitefordH. A. (2013).
Global variation in the prevalence and incidence of major depressive disorder: A systematic review of the epidemiological literature.Psychological Medicine,
43(3), 471–481.
11.
HoovenC.HertingJ. R.SnedkerK. A. (2010).
Long-term outcomes for the promoting CARE suicide prevention program.American Journal of Health Behavior,
34(6), 721–736.
12.
HusainN.AfsarS.AraJ.FayyazH.RahmanR. U.TomensonB., . . . ChaudhryI. B. (2014).
Brief psychological intervention after self-harm: Randomised controlled trial from Pakistan.The British Journal of Psychiatry,
204(6), 462–470.
13.
KhanM. M. (2007).
Suicide prevention in Pakistan: An impossible challenge?Journal of Pakistan Medical Association,
57(10), 478–480.
14.
KhanM. M.AhmedA.KhanS. R. (2009).
Female suicide rates in Ghizer, Pakistan.Suicide and Life-Threatening Behavior,
39(2), 227–230.
15.
KhanM. M.MahmudS.KarimM. S.ZamanM.PrinceM. (2008).
Case-control study of suicide in Karachi, Pakistan.The British Journal of Psychiatry,
193(5), 402–405.
16.
KhanM. M.RezaH. (1998).
Gender differences in nonfatal suicidal behavior in Pakistan: Significance of sociocultural factors. Suicide and Life-Threatening Behavior,
28(1), 62–68.
17.
KlibertJ.Langhinrichsen-RohlingJ.LunaA.RobichauxM. (2011).
Suicide proneness in college students: Relationships with gender, procrastination, and achievement motivation.Death Studies,
35(7), 625–645.
18.
KnorrA. C.TullM. T.AnestisM. D.Dixon-GordonK. L.BennettM. F.GratzK. L. (2016).
The interactive effect of major depression and nonsuicidal self-injury on current suicide risk and lifetime suicide attempts.Archives of Suicide Research,
20(4), 539–552.
19.
LamisD. A.LesterD. (2013).
Gender differences in risk and protective factors for suicidal ideation among college students.Journal of College Student Psychotherapy,
27(1), 62–77.
20.
LamisD. A.SaitoM.OsmanA.KlibertJ.MaloneP. S.Langhinrichsen-RohlingJ. (2014).
Hopelessness and suicide proneness in U.S. and Japanese college students: Depressive symptoms asa potential mediator. Journal of Cross-Cultural Psychology,
45, 805–820.
21.
LaneR.CherefS.MirandaR. (2016).
Ethnic differences in suicidal ideation and its correlates among South Asian American emerging adults.Asian American Journal of Psychology,
7(2), 120–128.
22.
Langhinrichsen-RohlingJ.HudsonK.LamisD. A.CarrN. (2012).
Psychometric properties of a suicide screen for adjudicated youth in residential care.Death Studies,
36(4), 323–339.
23.
Langhinrichsen-RohlingJ.LamisD. A. (2008).
Current suicide proneness and past suicidal behavior in adjudicated adolescents.Suicide and Life-Threatening Behavior,
38(4), 415–426.
24.
LewinsohnP. M.Langhinrichsen-RohlingJ.LangfordR.RohdeP.SeeleyJ. R.ChapmanJ. (1995).
The life attitudes schedule: A scale to assess adolescent life-enhancing and life-threatening behaviors. Suicide and Life-Threatening Behavior,
25(4), 458–474.
25.
LewinsohnP. M.Langhinrichsen-RohlingJ.RohdeP.LangfordR. A. (2004). life attitudes schedule: A risk assessment for suicidal and life-threatening behaviors (LAS) technical manual.
North Tonawanda, NY:
Multi-Health Systems.
26.
LuW.LindseyM. A.IrsheidS.NebbitV. E. (2017).
Psychometric properties of the CES-D among Black adolescents in public housing.Journal of the Society for Social Work and Research,
8(4), 595–615.
27.
McCabeC.KimD.KingK. (2018).
Improving present practices in the visual display of interactions.Advances in Methods and Practices in Psychological Science,
1(2), 147–165.
28.
MoodyC.SmithN. G. (2013).
Suicide protective factors among trans adults.Archives of Sexual Behavior,
42(5), 739–752.
29.
OsmanA.BaggeC. L.GutierrezP. M.KonickL. C.KopperB. A.BarriosF. X. (2001).
The Suicidal Behaviors Questionnaire-Revised (SBQR): Validation with clinical and nonclinical samples.Assessment,
8(4), 443–454.
30.
RadloffL. S. (1977).
The CES-D scale: A self-report depression scale for research in the general population.Applied Psychological Measurements,
1, 385–401.
31.
RizwanM.AftabS.ShahI.DharwarwalaR. (2012).
Psychometric properties of the Rosenberg Self-esteem Scale in Pakistani late adolescents. The International Journal of Educational and Psychological Assessment,
10(1), 125–138.
32.
Rohde, P., Lewinsohn, P. M., Seely, J. R., & Rohling-Langhinrichsen, J. (1996). The Life Attitudes Schedule short form: An abbreviated measure of life-enhancing and life-threatening behaviors in adolescents. Suicide and Life-Threatening Behavior, 26(3), 272–281.
33.
RohdeP.SeeleyJ.Langhinrichsen-RohlingJ.RohlingM. (2003).
The life attitudes schedule-short form: Psychometric properties and correlates of adolescent suicide proneness.Suicide and Life-Threatening Behavior,
33(3), 249–260.
34.
RoweC. A.WalkerK. L.BrittonP. C.HirschJ. K. (2012).
The relationship between negative life events and suicidal behavior: Moderating role of basic psychological needs.Crisis,
34(4), 233–241.
35.
SaitoM.KlibertJ.Langhinrichsen-RohlingJ. (2013).
Suicide proneness in American and Japanese college students: Associations with suicide acceptability and emotional expressivity.Death Studies,
37(9), 848–865.
36.
SheanG.BaldwinG. (2008).
Sensitivity and specificity of depression questionnaires in a college-age sample.The Journal of Genetic Psychology,
169(3), 281–288.
37.
ShekhaniS. S.PerveenS.HashmiD.AkbarK.BachaniS.KhanM. M. (2018).
Suicide and deliberate self-harm in Pakistan: A scoping review. BMC Psychiatry,
18, 44.
38.
SherL. (2004).
Preventing suicide.Quarterly Journal of Medicine,
97, 677–680.
39.
SilvermanM. M. (2011). Challenges to classifying suicidal ideations, communications, and behaviours. In O’ConnorR. C.PlattS.GordonJ. (Eds.), International handbook of suicide prevention: Research, policy and practice (pp. 9–25).
Hoboken, NJ:
Wiley-Blackwell.
40.
StephensonJ. H.BelesisM. P.BallietW. E. (2005).
Variability in college student suicide: Age, gender, and race.Journal of College Student Psychotherapy,
19(4), 5–33.
41.
SyedE. U.KhanM. M. (2008).
Pattern of deliberate self-harm in young people in Karachi, Pakistan.Crisis: The Journal of Crisis Intervention and Suicide Prevention,
29(3), 159–163.
42.
TaliaferroL. A.MuehlenkampJ. J. (2015).
Factors associated with current versus lifetime self‐injury among high school and college students.Suicide and Life-Threatening Behavior,
45(1), 84–97.
43.
TerryM. L.LearyM. R.MehtaS.HendersonK. (2013).
Self-compassionate reactions to health threats.Personality and Social Psychology Bulletin,
39(7), 911–926.
44.
TranK. K.WongY. J.CokleyK. O.BrownsonC.DrumD.AwadG.WangM.-C. (2015).
Suicidal Asian American college students’ perceptions of protective factors: A qualitative study.Death Studies,
39(8), 500–507.
45.
VagiK. J.RothmanE. F.LatzmanN. E.TharpA. T.HallD. M.BreidingM. J. (2013).
Beyond correlates: A review of risk and protective factors for adolescent dating violence perpetration.Journal of Youth and Adolescence,
42, 633–649.
46.
VeronaE.Sachs-EricssonN.JoinerT. J. (2004).
Suicide attempts associated with externalizing psychopathology in an epidemiological sample.The American Journal of Psychiatry, 161(3), 444–451.
47.
WhitlockJ.MuehlenkampJ.EckenrodeJ.PuringtonA.Baral AbramsG.BarreiraP.KressV. (2013).
Nonsuicidal self-injury as a gateway to suicide in young adults.Journal of Adolescent Health,
52(4), 486–492.
48.
WongP. P. (2013).
Suicide risks among college students from diverse cultural backgrounds. Directions in Psychiatry,
33(4), 237–247.
