The relationship between PTSD and suicidality among Wenchuan earthquake survivors: The role of PTG and social support

Background: Previous studies have found that suicide rates are likely to increase after the occurrence of earthquakes. Most existing studies that examined the relationship between PTSD and suicidally focus on risk factors. It remains unclear whether protective factors, such as post-traumatic growth (PTG) and social support, play a role in this relationship. Objectives: The aim of this study was to investigate the role of PTG and social support in the association between PTSD and suicidally, using data from a cross-sectional study conducted in China. Methods: 1,369 participants were recruited from two study sites that were severely affected by the Wenchuan earthquake. Univariate and multivariate regression analyses were conducted to examine the relationship between PTSD, PTG, social support, and suicidally. Results: The results indicate that the prevalence of suicidal ideation, suicide plans, and suicide attempts among adult survivors were 9.06%, 2.97% and 3.31%, respectively, even after 8 years following the Wenchuan earthquake. Furthermore, the findings show that PTSD was significantly associated with suicidally (OR = 1.96; 95% CI = 1.53, 2.52). Additionally, individuals reporting lower levels of social support and the acquisition of PTSD (OR = 5.99; 95% CI = 1.66, 21.56) were significantly related to suicidally. Moreover, compared to individuals who reported no presence of PTSD and high PTG, those who lived with PTSD and lower levels of PTG (OR = 2.33; 95%CI = 1.00, 5.42) were more likely to report suicidally. Limitations: The cross-sectional design of this study limits our ability to determine causal relationships. Effects of other related factors, such as cultural and life events, were not examined in this study. Conclusions: Suicidally is a long-term health issue among survivors of the Wenchuan earthquake. PTG and social support play important roles on the association between PTSD and suicidally and are important contributing factors to understanding this relationship. These results contribute new knowledge of suicidal risk for a number of years after an earthquake and have implications for further mental health promotion following earthquakes.