Psychosocial and Situational Risk Factors of Suicidality among Young Adults amid and after the COVID-19 Pandemic: A Three-Wave Cross-Sectional Network Analysis

Abstract

Purpose: The COVID-19 pandemic has brought situational impacts and mental distress among young people. No studies have investigated and compared the risk factors of suicidality among young adults during and after the COVID-19 pandemic. The present study aimed to examine the risk factors of suicidality in this population via a network approach amid and after the COVID-19 pandemic. Methods: Repeated, cross-sectional telephone surveys recruited three samples of young adults in Hong Kongvia random sampling in autumns of 2021 (N=1472), 2022 (N=1238), and 2023 (N=1226). The respondents completed measures on situational impact, meaning in life, societal pessimism, Patient Health Questionnaire-4 (PHQ-4), social withdrawal, and suicidality. Mixed graphical modeling was conducted to identify the bridge linkages between suicidality and risk factors across the three waves. Results: The 2023 wave showed a substantial decline in COVD-19 distress but higher rates of suicidality than the 2021 and 2022 waves. The network models showed good stability. Financial impact, PHQ-4, and social withdrawal showed positive linkages with suicidality in the network. PHQ-4 consistently showed the greatest bridge strength across the three waves. Network comparison found no significant differences in the network structure and global strength across gender, age groups, and waves. Societal pessimism showed significantly greater bridge strength in the network model from 2021 to 2023. Conclusion: The results elucidated the network structure of risk factors of suicidality in population-based samples of young adults after the pandemic, highlighting meaning in life and societal pessimism as potential targets of interventions.