A Path Towards Identifying Suicide Risk Factors in College Students

College students are experiencing anxiety rates at an all-time high, with contributing factors that are beginning to be understood. The isolation and loneliness of the pandemic are only compounding the risk for students experiencing mental health challenges. Given all of this, it may not come as a surprise that suicide rates are also rising. Suicide should be a particular concern for universities, as suicide is the second leading cause of death in the college student population. Most research highlights the relationship between depression and suicide, however, not everyone who dies by suicide is depressed. As a field, we are lacking in our understanding of who is most at risk for suicide. Although the field continues to do research within this area, prediction models have historically lacked accuracy in identifying who is most at risk. As suicide rates continue to climb, it is crucial we continue to investigate risk factors and identify key warning signs that may predict one’s risk.

For instance, little is known about the association between suicide risk and anxiety. To address this gap, I am working with Sarah K. Lipson, Ph.D., Assistant Professor at Boston University School of Public Health and co-Principal Investigator of the Healthy Minds Study, using Healthy Minds Study (HMS) data, which collects information from a national sample of college students with the aim of understanding issues related to students’ mental health. We are studying the prevalence and correlates of suicidality and anxiety amongst college students, aiming to identify risk factors that may shed light on who is most at risk. Preliminary analyses of the data reveal that high rates of anxiety may be associated with increased risk, particularly for students who are also experiencing depression. In addition to anxiety, there are likely other important factors to identify as well, which could serve as indicators for early intervention. For instance, hopelessness is known to have a significant relationship with negative affect and suicidality. Similarly, I would speculate that loneliness may be a symptom linked to suicide risk. Future research of ours is aiming to delve more deeply into this topic.

Much of the field is shifting towards understanding psychopathology at the symptom level, rather than studying diagnoses. In the Boston University Psychotherapy and Emotions Research Laboratory (led by Dr. Stefan Hofmann), our research is focusing on process-based treatments, with the goal of understanding and targeting specific symptoms and processes of treatment change for individuals. Process-based therapy (PBT) emphasizes the importance of function over content and is based in identifying and testing key change processes that build upon each other in order to best treat the individual in a particular context at a given time.

College campuses may benefit from assessing for suicide risk in relation to anxiety, and as the research continues to focus on symptom identification and risk analysis, we can expect to learn about new indicators to effectively target and treat. From my experiences thus far working with college students in the therapy room as well as my work as a Teaching Fellow, it is clear that our students are struggling. I believe we need to pay attention not just to diagnoses, but to underlying symptoms and risk factors. Once we have identified more of these risk factors, we can disseminate this information more broadly, to help inform policy and practices across college campuses. I hope our research and findings from other researchers can continue to pave the way to find reliable and valid ways to assess for suicidality and effectively intervene and treat students in need.

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