Revealing the Potential Causality of Suicidal Ideation and Psychopathic Symptoms Among Survivors 10 Years After the Wenchuan Earthquake Using Network Analysis

Objective: Little is known about the interactions and causal inference between psychopathic symptoms and suicidal ideation (SI) among earthquake survivors. Using a 10-year large cohort of Chinese adolescents exposed to the Wenchuan earthquake, this study aimed to structure networks of suicidal ideation and some specific symptoms of posttraumatic symptoms and depression among survivors of the Wenchuan earthquake to clarify the interactions and causality between these symptoms. Method: A total of 684 survivors who completed surveys at 6 months and 10 years postearthquake and had one or above psychopathic symptoms were included in the analyses. Sociodemographic, posttraumatic stress symptoms, depressive symptoms, and suicidal ideation were measured at 6 months and/or 10 years postearthquake. Network analyses were performed based on R Version 4.1.3. Results: The Gaussian graphical model network revealed that "depressed mood" had the highest expected influence value. In addition, the directed acyclic graph network revealed that anhedonia could affect "depressed mood," which further leads to "suicidal ideation." Conclusions: The pathway of "anhedonia -> depressed mood -> suicidal ideation" was a crucial psychopathic mechanism of suicidal ideation. It informs that intervening in anhedonia and depressed mood among earthquake-exposed survivors is necessary to potentially decrease the risk of future suicidal ideation.