title: The interplay of stressful life events and coping skills on risk for suicidal behavior among youth students in contemporary China: a large scale cross-sectional study.
abstract: BACKGROUND
  Stressful life events are common among youth students and may induce psychological problems and even suicidal behaviors in those with poor coping skills. This study aims to assess the influence of stressful life events and coping skills on risk for suicidal behavior and to elucidate the underlying mechanism using a large sample of university students in China.
  
  
  METHODS
  5972 students, randomly selected from 6 universities, completed the questionnaire survey. Logistic regression analysis was performed to estimate the effect of stressful life events and coping skills on risk for suicidal behavior. Bayesian network was further adopted to probe their probabilistic relationships.
  
  
  RESULTS
  Of the 5972 students, 7.64% reported the presence of suicidal behavior (attempt or ideation) within the past one year period. Stressful life events such as strong conflicts with classmates and a failure in study exam constituted strong risk factors for suicidal behavior. The influence of coping skills varied according to the strategies adapted toward problems with a high score of approach coping skills significantly associated with a reduced risk of suicidal behavior. The Bayesian network indicated that the probability of suicidal behavior associated with specific life events was to a large extent conditional on coping skills. For instance, a stressful experience of having strong conflicts with classmates could result in a probability of suicidal behavior of 21.25% and 15.36% respectively, for female and male students with the score of approach coping skills under the average.
  
  
  CONCLUSIONS
  Stressful life events and deficient coping skills are strong risk factors for suicidal behavior among youth students. The results underscore the importance of prevention efforts to improve coping skills towards stressful life events.
authors.affiliation: Department of Epidemiology and Biostatistics and Center for Suicide Prevention and Research, School of Public Health, Shandong University, Jinan, China. tangfangsdu@126.com.|Health Management Center, Qianfoshan Hospital Affiliated to Shandong University, Jinan, China. tangfangsdu@126.com.
authors.forename: Fang
authors.initials: F
authors.lastname: Tang
authors.affiliation: Department of Epidemiology and Biostatistics and Center for Suicide Prevention and Research, School of Public Health, Shandong University, Jinan, China. xuefzh@sdu.edu.cn.
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Xue
authors.affiliation: Department of Epidemiology and Biostatistics and Center for Suicide Prevention and Research, School of Public Health, Shandong University, Jinan, China. ping.qin@medisin.uio.no.|National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Sognsvannsveien 21, N-0372, Oslo, Norway. ping.qin@medisin.uio.no.
authors.forename: Ping
authors.initials: P
authors.lastname: Qin
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001499:Bayes Theorem; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D015995:Prevalence; D012306:Risk; D012307:Risk Factors; D013334:Students / Q000523:psychology; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult