Longitudinal Associations of Suicide Risk and Protective Factors Among Secondary School Students in Hong Kong: A Network Perspective

Purpose As they transition from childhood to adolescence, Hong Kong secondary school students may experience deteriorating mental health and are at increased risk of suicide. However, there have been insufficient systematic studies of the longitudinal relationship between suicide risk and protective factors. This study adopted a network perspective to investigate the longitudinal associations between suicide risk and protective factors among Hong Kong secondary school students. Methods Suicide risk (i.e., anxious-impulsive depression, suicidal ideation or acts, and family distress) and protective factors (i.e., self-appraisal of emotion, emotion regulation, subjective happiness, self-efficacy, social problem-solving, and resilience) were measured. The participants were 834 Hong Kong secondary school students (mean age = 11.97, SD = 0.58, and range = 11–15). The network analysis was performed using two waves of data collected in 2020 and 2021. Results The results identified the central role of anxious-impulsive depression in the suicidal system. Anxious-impulsive depression, emotion regulation, and subjective happiness were identified as the bridging nodes between the suicide risk community and the protective factors community. The critical protective effects of emotion regulation and subjective happiness on suicide risk were found in both undirected and directed networks. Discussion This study identified the influence of anxious-impulsive depression and the protective role of emotion regulation and subjective happiness in the suicide risk network of Hong Kong secondary school students. These results suggest the importance of including anxious-impulsive depression and protective factors, especially emotion regulation, in suicide theories and suicide prevention practice.