Religious affiliation and suicidality among college students in China: A cross-sectional study across six provinces

Bob Lew; Kairi Kõlves; Jie Zhang; Wang Zhizhong; Harold G Koenig; Paul S F Yip; Mansor Abu Talib; Augustine Osman; Ching Sin Siau; Caryn Mei Hsien Chan

doi:10.1371/journal.pone.0251698

Religious affiliation and suicidality among college students in China: A cross-sectional study across six provinces

PLoS One. 2021 May 19;16(5):e0251698. doi: 10.1371/journal.pone.0251698. eCollection 2021.

Authors

Bob Lew¹, Kairi Kõlves^{2

3

4}, Jie Zhang^{5

6}, Wang Zhizhong⁷, Harold G Koenig^{8

9}, Paul S F Yip^{10

11}, Mansor Abu Talib¹², Augustine Osman¹³, Ching Sin Siau¹⁴, Caryn Mei Hsien Chan¹⁴

Affiliations

¹ Australian Institute for Suicide Research and Prevention, Griffith University, Queensland, Australia.
² Australian Institute for Suicide Research and Prevention, Queensland, Australia.
³ WHO Collaborating Centre for Research and Training in Suicide Prevention, Stockholm, Sweden.
⁴ School of Applied Psychology, Griffith University, Queensland, Australia.
⁵ Shandong University Centre for Suicide Prevention Research, Jinan, Shandong, China.
⁶ Department of Sociology, State University of New York College at Buffalo, Buffalo, New York, United States of America.
⁷ Department of Epidemiology and Statistics, School of Public Health at Guangdong Medical University, Dongguan, Guangdong, China.
⁸ Duke University Medical Center, Durham, North Carolina, United States of America.
⁹ King Abdulaziz University, Jeddah, Saudi Arabia.
¹⁰ Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, People's Republic of China.
¹¹ HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, People's Republic of China.
¹² Department of Human Development and Family Studies, Putra University of Malaysia, Serdang, Selangor, Malaysia.
¹³ Department of Psychology, University of Texas at San Antonio, San Antonio, Texas, United States of America.
¹⁴ Center for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Abstract

Background: Several past studies indicated that religious beliefs, orientation, and practice are protective of suicide. Findings from recent studies in China suggest that religiosity may contribute to increased suicidality. However, few studies have examined the associations between religious affiliation across different faiths and suicidality in China.

Objective: The current study examines the association between religious affiliation and suicidality among college students in six provinces in China.

Methods: We conducted a cross-sectional study involving 11,407 college students from six universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, and Shaanxi. We collected the data between October 2017 and March 2018 using self-report questionnaires. They included self-report measures of depression, psychache, hopelessness, self-esteem, social support, and life purpose.

Results: Participants with a Christian affiliation had 1.5 times (95% CI: 1.14, 1.99, p = 0.004) higher odds of indicating an elevated suicide risk, 3.1 times (95% CI: 1.90, 5.04, p<0.001) higher odds of indicating a previous suicide attempt, and increased overall suicidality (B = 0.105, p < 0.001) after accounting for demographic and risk/protective factors. Christians also scored the highest in depression, psychache, hopelessness, and the lowest social support, self-esteem, and purpose in life. Muslims reported decreased suicidality (B = -0.034, p = 0.031). Buddhism/Daoism yielded non-significant results in the multivariate analyses.

Conclusions: Christian college students reported increased suicidality levels, perhaps due to public policies on religion. The decreased suicidality levels among Muslims may be attributed to higher perceived social support. The associations between religious affiliation and suicidality, depression, and hopelessness contrast sharply with US samples. This finding may be influenced by interactions between the religious denomination, individual, and social/political factors. This conclusion includes the possibility of anti-religious discrimination, which this paper did not investigate as a possible mediator and therefore remains a conjecture worthy of future investigation.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
China
Cross-Sectional Studies
Female
Humans
Male
Religion and Psychology*
Religion*
Risk Factors
Self Concept*
Students / psychology*
Suicidal Ideation*
Suicide, Attempted / psychology*
Surveys and Questionnaires*
Universities

Grants and funding

CCMH acknowledges support from the Universiti Kebangsaan Malaysia grant (DIP-2018-035). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.