Childhood trauma and suicidal ideation among Chinese adolescents: The mediating effects of character strengths and perceived stress

J Psychiatr Ment Health Nurs. 2023 Jun;30(3):526-536. doi: 10.1111/jpm.12892. Epub 2023 Jan 4.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Prior research has demonstrated that childhood trauma can increase adolescents' suicidal ideation, and perceived stress plays a mediating role in the relationship between childhood trauma and adolescents' suicidal ideation. Character strengths, which are trait-like positive personality characteristics, have also been found to be closely related to decreased stress and suicidal ideation. However, it is unclear whether character strengths act as a transfer mechanism that links childhood traumatic experiences with perceived stress and eventually suicidal ideation. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study found that character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation. Specifically, childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. This study provided important theoretical implications for preventing suicidal risk among adolescents who are exposed to traumatic events during childhood. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study highlighted the roles of character strengths and perceived stress in the relationship between childhood traumatic experiences and suicidal ideation, which provided suggestions for designing nursing interventions to reduce adolescents' suicidal ideation, especially for those with traumatic childhood experiences. In addition to family nursing, school-based regular monitoring and interventions of character strengths and perceived stress are necessary. ABSTRACT: Aim This study sought to examine the mediating effects of character strengths and perceived stress on the relationship between childhood trauma and suicidal ideation among adolescents. Methods A cross-sectional survey was conducted on a sample of 1069 Chinese adolescents. The Chinese versions of the Suicidal Ideation Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and Character Scale for Adolescents were used to assess adolescents' suicidal ideation, childhood trauma, perceived stress and character strengths. Results The findings showed that childhood trauma influenced suicidal ideation directly and indirectly via perceived stress. Moreover, character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation, implying that childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. Conclusions This study highlighted the joint contribution of childhood trauma, character strengths and perceived stress to suicidal ideation, providing theoretical and practical implications to guide mental health nurses to reduce the suicide risk among adolescents. Implications for Practice These findings highlighted the importance of developing character strengths and stress-coping strategies. Family nursing and school-based regular monitoring and interventions of character strengths and perceived stress are necessary among adolescents who exposed to a high level of childhood trauma experiences to reduce their suicidal ideation and foster mental health.

Keywords: character strengths; childhood trauma; perceived stress; suicidal ideation.

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences*
  • Cross-Sectional Studies
  • Humans
  • Stress, Psychological / epidemiology
  • Suicidal Ideation*
  • Surveys and Questionnaires