The role of psychotic-like experiences, depressive symptoms, and anxiety symptoms in suicide ideation among college students with self-injurious behavior

Objective: Suicide is associated with a myriad of psychiatric symptoms, including psychotic-like experiences, depressive symptoms, and anxiety symptoms. However, few studies have simultaneously explored the specific role of these symptoms in different aspects of suicide behavior. This study aimed to reveal differential associations between various psychopathological symptoms and both the frequency of suicidal ideation and severity of suicidal ideation during self-injury through network analysis. Methods: Using logistic regression and network analysis approach, the present study examined the association between psychotic-like experiences (PLEs), anxiety symptoms, depressive symptoms, the frequency of suicidal ideation (SF), and the severity of suicidal ideation during self-injury (SS) in a sample of college students with selfinjurious behavior (n = 651, age 16-23, 65.1%female). Result: Logistic regression results showed that depressive symptoms were associated with the frequency of suicidal ideation (OR = 11.66, 95%CI:7.45-18.25), while psychotic-like experiences (OR = 1.57, 95%CI:1.15-2.72) and anxiety symptoms were associated with the severity of suicidal ideation during self-injury (OR = 1.77, 95% CI:1.01-2.43). The results of the network analysis further indicated that the item "persecutory ideation" of the PLEs community was the key bridge symptom linking SS, while self-reproach is the key bridge symptom linking SF. Conclusions: Although psychotic-like experiences, depressive symptoms, and anxiety symptoms were all predictors of suicide, they may play distinct roles in suicidal ideation and suicidal behavior, which require further research to verify their relationship as well as to explore the potential mechanisms.