Suicide by Chinese rural young women is an urgent focus in suicide research, because of the high suicide rates and the large population in China. Society and culture play an enormous role in dictating how people respond to and view mental health and suicide, and studies are needed to systematically examine the role of cultural factors (e.g. the value systems) in determining risk for suicide. Psychological autopsy (PA) studies with suicides are usually limited by their indirect evaluation and understanding of the suicides'neurocognitive functions, psychiatric disorders, suicidal intent, and conflicting social values, etc. However, studying serious suicide attempters can provide direct and comparatively more reliable information on why the victims are at high risk of suicide. This project is designed to study a cultural model of suicide using serious attempters in China. Confucian values, which are considered to be the cultural foundation in Asian societies including China, are supposed to explain the high suicide risks for young women and the comparatively low risks for young men. The deep-rooted Confucian sexism coupled with the communist egalitarianism advocated in China creates frustration or strain in the daily life of some rural young women. The strain resulting from the traditional reality and modern aspiration, interacting with other risk factors, is hypothesized to increase suicide risks for Chinese rural young women. In a case-control design, 800 serious suicide attempters (400 males and 400 females) and 800 community controls (400 males and 400 females) all aged 15-34 years will be randomly sampled from 16 rural counties selected in Liaoning, Hunan, and Shandong provinces of China. The study has the following four major aims: 1. To evaluate the direct effect of risk factors from four domains (personal factors, social structure, negative life events, and psychological/psychiatric factor) on young suicide attempters in rural China. 2. To test the Strain Theory of Suicide among suicide attempters (SAs) and community controls (CCs), by examining the impact of cultural factors related to Confucian values and communist ideology on attempted suicide in rural China and the role of gender in the relationship. 3. To test the moderating or intervening effects of the risk factors on the relationship between strain and attempted suicide in rural China. 4. To examine the relationship between strain and suicide intent among the suicide attempters Findings regarding the independent role of culturally defined beliefs and values in determining suicide risk will be generalizable to other Chinese and Asian populations in the United States and elsewhere in the world.

Public Health Relevance

Suicide is a global public health problem and suicide by Chinese rural young women is an urgent focus of research. Complementary to the traditional approaches of suicide research and prevention, this study proposes and tests a cultural model in understanding and reducing suicide. Findings regarding the independent role of culturally defined beliefs and values in determining suicide risk will be generalizable to other Chinese and Asian populations in the United States and elsewhere in the world.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Community Influences on Health Behavior (CIHB)
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Rubio, Mercedes
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Buffalo State College
Social Sciences
Schools of Arts and Sciences
United States
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Lyu, Juncheng; Wang, Yingying; Shi, Hong et al. (2018) Early warnings for suicide attempt among Chinese rural population. J Affect Disord 238:353-358
Liu, Yanzheng; Zhang, Jie (2018) The Impact of Negative Life Events on Attempted Suicide in Rural China. J Nerv Ment Dis 206:187-194
Zhang, Jie; Wang, Youqing; Fang, Le (2018) How to integrate proxy data from two informants in life event assessment in psychological autopsy. BMC Psychiatry 18:115
Sun, Long; Zhang, Jie (2018) Suicide Acceptability and Suicide Attempt: A Case-Control Study With Medically Serious Suicide Attempters Aged 15 to 54 Years in Rural China. J Nerv Ment Dis 206:694-698
Zhang, Jie; Liu, Yanzheng; Sun, Long (2017) Life satisfaction and degree of suicide intent: A test of the strain theory of suicide. Compr Psychiatry 74:1-8
Liu, Yanzheng; Zhang, Jie; Sun, Long (2017) Who are likely to attempt suicide again? A comparative study between the first and multiple timers. Compr Psychiatry 78:54-60
Lin, Lin; Zhang, Jie (2017) Impulsivity, Mental Disorder, and Suicide in Rural China. Arch Suicide Res 21:73-82
Sun, Long; Zhang, Jie (2017) Gender differences among medically serious suicide attempters aged 15-54 years in rural China. Psychiatry Res 252:57-62
Sun, Long; Zhang, Jie (2016) Psychological Strains and Suicidal Intent: An Empirical Study to Relate the 2 Psychopathological Variables. J Nerv Ment Dis 204:855-860
Sun, Long; Zhang, Jie (2016) Medically Serious Suicide Attempters With or Without Plan in Rural China. J Nerv Ment Dis 204:851-854

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