Distinct trajectories of suicidal behaviors throughout the university stage and associated risk and protective factors: A large-scale prospective study

Background: Suicide is a major public health concern, especially among adolescents and young adults. Although research has begun to explore the developmental trajectories of suicide-related outcomes, most have thus far focused on children and adolescents. The current study extends existing literature by identifying subgroup tra-jectories and related factors of college students over a two-year period.Methods: The data used in this study was obtained from an ongoing longitudinal study in Guangdong, China. A total of 3871 students participated in assessments performed at three time points at one-year assessment in-tervals. Growth mixture modeling (GMM) was used to estimate trajectory classes for suicidal behaviors, followed by multivariable logistic regression to explore the association between predictive factors and classes.Results: GMM analyses extracted two distinct trajectories of suicidal behaviors: a low-decreasing group (n symbolscript 3669, 94.8 %) and a high-increasing group (n symbolscript 202, 5.2 %). Multivariate logistic regression analyses revealed that depressive symptoms, non-suicidal self-injury, hopelessness, and childhood emotional abuse served as risk factors for the high-increasing group, while reasons for living served as protective factors.Conclusions: Psychological interventions aimed at reducing the influence of risk factors and bolstering reasons to live may help to decrease the risk of suicide behaviors in college students.