Stress sensitivity makes suicidal thoughts more extreme and persistent among the university population

Stress sensitivity increases the frequency, intensity, and variability of suicidal thoughts among the university community. These are the findings of a longitudinal study coordinated by the Hospital del Mar Research Institute and Pompeu Fabra University, which analyses survey data from more than 700 university students. The study defines, for the first time, three degrees of passive suicidal ideation according to their frequency, intensity and increasing variability. Taking stress sensitivity into account could have an impact on suicide prevention. 

Suicide is the first cause of death among young people aged between 15 and 29 in Spain and the third globally. It is a complex clinical phenomenon –due to its etiology and stigma– that is not yet known in detail. Thus it is hard to predict and prevent. Although since 2017 there has been speculation that stress modulates the variability and persistence of suicidal thoughts, so far this relationship has not been defined. 

A study published in Journal of Affective Disorders, which analysed data taken from surveys conducted on university students, determines that stress sensitivity –a condition in which more sensitive people experience greater discomfort and adverse feelings such as fear, anxiety, guilt or hostility in the face of a stressful situation - renders suicidal thoughts more frequent, intense and persistent. 

To carry out the study, they analysed the data collected from surveys carried out every evening for 14 consecutive days on more than 700 university students to assess their degree of passive suicidal ideation and daily negative affect. That is, their tendency to experience unpleasant emotions. In addition, the students –who joined the study through the PROMES-U project, which seeks to improve the mental health of this population– included a follow-up session 12 months later. 

Suicidal thoughts at least every two days 

The study defines, for the first time, three degrees of suicidal ideation according to their frequency, intensity and increasing variability. The students with a higher degree of passive suicidal ideation (groups 2 and 3), have thoughts or desires to die with no specific plan at least one in every two days. 

Stress sensitivity is a growing factor among the groups and is higher among students with greater suicidal ideation (groups 2 and 3). In the most pronounced cases –high frequency and intensity of suicidal thoughts– “we see that people who are more stress sensitive have more constant ideation on consecutive days”, states Ana Portillo-Van Diest, a researcher in the Health Services Research Group who is doing her thesis at Pompeu Fabra University.

“To date, all people with suicidal ideation were grouped together, so it was difficult to find causal relationships with other factors that disrupt our health”, explains Jordi Alonso, coordinator of the Health Services Research Group at the Hospital del Mar Research Institute and a full professor of Public Health at Pompeu Fabra University. 

“Being able to distinguish students who have sporadic and less intense suicidal ideation from those who think about it at least once every two days more intensely has allowed us to see that stress sensitivity intensifies the frequency and variability of suicidal thoughts”, adds Ana Portillo-Van Diest, who is the first author of the article. 

Philippe Mortier, a researcher with the Health Services Research Group, says that, as it is a study on a non-clinical population, “we have not managed to distinguish as an independent group the profile of people who present a high intensity and low variability of suicidal ideation, on consecutive days”. This profile, according to other studies, is particularly dangerous because more suicide attempts are observed.  

Persistent suicidal thoughts and behaviours for at least one year

Thanks to follow-up visits held a year after conducting the surveys, the study determines that the severity of suicidal ideation in everyday life predicts this behaviour –as well as suicide attempts– in the future. For students with a more intense and frequent pattern of passive suicidal ideation, suicidal thoughts and behaviours persist more over time, for at least a year. Such behaviour increases the risk of attempting suicide. 

“Our data shatters the traditional view that passive is less serious than active ideation”, Mortier comments. The study shows that a more intense, frequent and persistent pattern of ideation predicts active ideation –with planning and intent–, until at least one year later. 

Among people with intense, frequent, and persistent ideation, stress sensitivity makes suicidal thoughts more extreme and sustained. Hence, the authors point out that taking stress sensitivity into account, applying measures such as the practice of mindfulness, or others, could be an effective measure to prevent suicide among the university community.

About Promes-U

PROMES-U is a research project that aims to improve the mental health of university students by studying the factors that can influence the onset of mental health problems, as well as the implementation and evaluation of online interventions to promote mental health and prevent depression and anxiety. 

The project, coordinated by the Health Services Research Group of the Hospital del Mar Medical Research Institute, analyses data obtained from students at the six participating universities: Pompeu Fabra University, University of the Balearic Islands, Jaume I University, University of Málaga, Miguel Hernández University of Elche, and University of Zaragoza.