Transition from adolescence to adulthood serves as the critical period that is often accompanied by the worsening of mental health (1). This might be of importance for university students who face with challenges associated with adjustment to novel social environments. A recent systematic review estimated the pooled prevalence of depression in university students at 25% (2). This systematic review also identified a number of risk factors related to depression in this population, including a current mental health problem, negative rumination, parent separation, a history of sexual harassment, and the presence of parental depression. There is evidence that poor mental health in university students is associated with lower program completion rates, worse educational performance, and a lower likelihood of graduation (3). Mental health crisis in university students might also be related to an increased risk of suicide. Although it has been shown that suicide rates are lower among university students compared to the general population, rates tend to increase over time (4, 5). Evidence from a recent meta-analysis shows that even 14% of university students might present with suicide-related outcomes (2). Consequently, there is an urgent need to recognize the mechanisms contributing to suicide risk in university students.
In general, there is evidence that suicide-related outcomes occur as the consequence of underlying psychopathology which is perceived as the strongest predictor of suicide (6). However, trait-dependent mechanisms related to personality characteristics also need to be considered. Among them several studies investigating suicide-related outcomes have focused on impulsiveness that can be characterized as a multidimensional construct giving rise to behaviors that manifest in poor self-regulation, impaired planning, the occurrence of responses before thinking about potential consequences, risky behaviors, poor inhibition of responses, and the dependence on immediate rewards (7). Some authors also posit the presence of a related construct, known as venturesomeness. As opposed to impulsiveness, this construct refers to engagement in risky behaviors having a full consciousness of potential consequences (8). There is evidence, supported by a meta-analysis, that impulsiveness, especially its affective facet, is associated with suicide-related factors (9). However, none of previous studies has dissected potential differences between impulsiveness and venturesomeness in shaping suicide-related outcomes. Both personality dimensions might also interact with empathy. It has been hypothesized that individuals with a low impulse control but a high level of empathy might be less likely to harm other people (10). It has been shown that individuals with a history of suicide attempts might be less likely to integrate emotions of other people into decision-making processes (11).
Personality traits are further related to the way individuals process emotional states. Emotion regulation is an umbrella term for awareness, acceptance, and understanding of individual emotions together with abilities and strategies to control impulsive responses (12). Cognitive reappraisal and expressive suppression serve as the most frequently used strategies approached to regulate emotions (13). Cognitive reappraisal occurs at early stages of emotional processing and leads to changes of experienced emotions through their reinterpretation. In turn, expressive suppression appears at late stages of emotional processing leading to suppression of experienced emotions and manifesting, e.g., in decreased facial expression (14, 15). Studies investigating the association between emotion regulation and suicidality have not provided consistent results. For instance, Forkmann et al. (16) found that expressive suppression, but not cognitive reappraisal, is associated with increased suicide ideation in an inpatient sample. In turn, another study, based on a daily diary approach, revealed that expressive suppression and cognitive reappraisal might be effective strategies among individuals with suicidal ideation (17). Moreover, a recent systematic review revealed that emotion dysregulation is not associated with suicidal ideation and behaviors after accounting for other psychological processes (18).
Suicide-related outcomes often occur in the context of stressful life events. In light of stressful life events, individuals approach a variety of behaviors, commonly referred to as coping styles, that aim to manage new situations. Traditionally, coping styles can be divided into three distinct subtypes, i.e., problem-focused, emotion-focused, and avoidance coping (19, 20, 21, 22). There is some evidence that lower odds of using active or problem-focused coping and/or higher odds of using avoidance coping might be associated with increased suicide risk (23, 24, 25).
Taken together, it needs to be pointed out that discussed psychological mechanisms are usually investigated as separate constructs or predefined models of causality. However, recent advances in research of clinical psychopathology have provided a useful approach to analyze complex datasets, i.e., a network analysis. It allows to analyze multiple variables in their full spectrum of potential associations without imposing a specific model of causality. Considering existing gaps in the field, the present study aimed to investigate the association of personality traits (i.e., impulsivity, venturesomeness, and empathy), emotion regulation strategies, and coping styles with suicide risk in university students.