JMIR Publications

ABSTRACT

Background:

Increasing suicidal thoughts and behaviors (STB) among adolescents raise social concerns and have a well-recognized association with abuse-specifically, sexual abuse (SA). However, research regarding the mechanisms explaining the association between SA and STB remains limited.

Objective:

This study explored the serial mediating effects of negative life events (NLE) and Internet addiction (IA) in this association among Chinese adolescents.

Methods:

This study selected 9,325 adolescents from the Science Database of the People Mental Health survey conducted between March 2013 and December 2022 by the National Population Health Data Center of the National Research Institute for Family Planning. Pearson’s Chi-squared (χ2) test was conducted to analyze the associations between independent and outcome variables, and multivariate linear regression analysis was performed to identify independent predictors of STB. To formally test the hypothesized mediation pathways, structural equation modeling (SEM) was applied to quantify the direct and indirect effects.

Results:

Notably, SA was significantly associated with STB (β = 0.109, P<0.001, 95% CI = 0.089–0.127); the direct effect accounted for 70.32% of the total effect. Importantly, SA indirectly predicted STB via the following three significant mediating pathways: NLE accounted for 14.19% (β = 0.022, P<0.001, 95% CI = 0.015–0.021), IA accounted for 11.62% (β = 0.018, P<0.001, 95% CI = 0.012–0.024), and NLE and IA accounted for 3.87% (β = 0.006, P<0.001, 95% CI = 0.004–0.007) of the overall effect. The total mediating effect was 29.68%.

Conclusions:

Among Chinese adolescents, SA not only directly affects adolescents’ STB but also has indirect effects through NLE and IA, which have chain-mediating effects on this relationship. This study’s findings can be used to guide interventions targeting STB.