ABSTRACT
There is a paucity of knowledge on the mechanism by which social support predicts suicidal ideation at emerging adulthood. The present study was aimed to examine the mediating role of self-efficacy in the relationship between social support and suicidal ideation in a sample of 251 emerging adults (116 females; mean age = 20.84, SD = 2.34). Data analyses were conducted using structural equation modelling. Results indicated that an increase in family support significantly predicts a decrease in suicidal ideation. However, friends and significant other supports were not predictive of suicidal ideation. The outcome of mediation analysis showed that self-efficacy partially mediated the association between family support and suicidal ideation. It was recommended that family support should persist through the period of emerging adulthood notwithstanding that this life stage is characterized by more independence in lifestyle. Such kind of support may bolster self-efficacy in overcoming life difficulties that may predispose vulnerability to suicidal ideation at emerging adulthood.
Introduction
Despite being a major public health concern, suicidal ideations and behaviours have not significantly declined in several decades (Franklin et al., Citation2017). Globally, one person dies of suicide every 40 seconds, cumulating to about 800,000 deaths annually (WHO, Citation2019a). Although the majority of research on suicide focus on adolescent age group, more recent data show that emerging adults (ages 18–29: Arnett et al., Citation2014) are becoming more prone to suicidal deaths (WHO, Citation2019b; Hooven et al., Citation2012). After road accidents, suicide accounts for the leading cause of death among young people aged 15–29 years with the highest rate and almost 79% of all cases found in high income and low-and-middle-income nations, respectively (WHO Citation2019b). The increasing suicide rate at emerging adulthood may be premised on the overwhelming burdens of instability, feeling in-between and identity explorations that distinguish this stage from other phases of human development (Arnett, Citation2013; Munsey, Citation2006). Earlier vulnerabilities and poor developmental transitions from adolescence characterized by reduced social supports and pervasive changes in social connections and contexts make emerging adults susceptible to suicide risks (Hooven et al., Citation2012). Further, the period of emerging adulthood poses a greater risk for the development of various psychological problems related to suicide such as mood disorders, schizophrenia, and substance use disorders (Wilcox et al., Citation2010).
Suicidal rates among emerging adults in Nigeria
Lately, there is a greater focus on the increasing suicide cases among emerging adults in Nigeria. More recent statistics show that the suicide rate in Nigeria is 9.5 per 100,000 people with an annual figure of 18,608 deaths (World Population Review, Citation2019). The Suicide Research and Prevention Initiative (SURPIN) reports that 20% of all suicide cases occur among young individuals aged 13–19 years in Nigeria but the casualties sharply increase to over 50% as the ages of victims tend towards 29 years, the later stage of emerging adulthood (Muanya et al., Citation2019; Offiah & Obiorah, Citation2014). Also, current trends suggest that students in Nigerian tertiary institutions within this age bracket are more susceptible to committing suicide compared to other groups in the general population (Mac-Leva et al., Citation2019; Muanya et al., Citation2019). Reports have indicated various factors that could be attributed to the common suicide incidence among higher education students in Nigeria. These include examination failure, notice of withdrawal from academic programme, being accused of plagiarism, problems encountered in romantic relationships, depression, dementia and other mental health problems (Agbedo, Citation2019; Okon, Citation2019).
Risk and protective factors of suicidal ideation
A plethora of research has been carried out to understand the risk and protective factors of suicidal ideation to prevent suicide occurrence. Suicidal ideation or thoughts are considered to precede suicidal act and thus, knowledge on the predicting factors of suicidal ideation may help mitigate suicidal risks (Kleiman & Riskind, Citation2012). Among the risk factors of suicidal ideation include burdensomeness, loneliness and hopelessness (Kleiman et al., Citation2017; Ribeiro et al., Citation2018), affective disorders (Gili et al., Citation2019; Opakunle et al., Citation2019), psychosis (Huang et al., Citation2018), anger (Bagalkot et al., Citation2014), alcohol use disorder (Darvishi et al., Citation2015; Igundunasse & Medubi, Citation2019), precarious employment (Min et al., Citation2015), stressful psychosocial school environment (Shang et al., Citation2014), broken home and childhood adversity (Angst et al., Citation2014; O’Neill et al., Citation2018), previous suicide by family member or friend (Teevale et al., Citation2016), having no close friend (Canbaz & Terzi, Citation2018) and media reports with headline that included the suicide method (Sinyor et al., Citation2018). Conversely, protective factors and buffers include religiosity (e.g. Assari, Citation2015; Cole-Lewis et al., Citation2016), survival, coping beliefs and hope (Goldston et al., Citation2016; Luo et al., Citation2016), physical activity, recreation and focusing on the positive (Armstrong & Manion, Citation2013; Breton et al., Citation2015; Vancampfort et al., Citation2018), hardiness and resilience (Abdollahi et al., Citation2015; Elbogen et al., Citation2020; Hourani et al., Citation2018; Min et al., Citation2015), mindfulness (Anastasiades et al., Citation2017), grit (Blalock et al., Citation2015), forgiveness (Quintana-Orts & Rey, Citation2018), fear of death and thinking about the family (Bazrafshan et al., Citation2017), self-esteem (Primananda et al., Citation2019; Yen et al., Citation2015) and social support (e.g. Bell et al., Citation2017; Mackin et al., Citation2017; Šedivy et al., Citation2017).
Social support, emotional wellbeing and suicidal ideation
Zimet et al. (Citation1988) conceptualized social support as the overall availability of family members, friends and significant other that provide material and emotional resources. As noted in Goldsmith (Citation2018) family support at emerging adulthood includes the contribution of energy, time and financial resources for continual development and ‘bailing out’ with same energy, time and financial resources for emerging adults vulnerable to poor decision-making. While friends’ support is characterized by the provision of emotional security, help, intimacy, reliable alliance, companionship, self-validation and companionship (Demir & Özdemir, Citation2010), significant other support consists in the availability of a special person in one’s life, who is always around during the time of need, and real source of care and comfort, with whom sorrows and joys can be shared (Adamczyk, Citation2016).
The role of social support in emotional wellbeing and suicidal ideation is underscored in the literature. For example, Pettit et al. (Citation2011) showed that an increase in perceived support from the family predicted a decrease in symptoms of depression. Szkody and McKinney (Citation2019) also indicated that both family and friends’ support impact psychological health among emerging adults through self-esteem. Further, lower levels of family and friend supports are shown to predict greater loneliness level at this life stage (Lee & Goldstein, Citation2015). Of the three social support dimensions, only family support was found to be inversely associated with both suicide history and depression (Bell et al., Citation2017). Similarly, Mackin et al. (Citation2017) demonstrated that family support in terms of parental support protected adolescent girls against developing suicidal symptoms following stressful life events. Moreover, general social support is demonstrated as a protective factor against suicide within the general population (Šedivy et al., Citation2017).
Given the importance of perceived support in predicting the low level of suicidal ideation and symptoms, researchers are beginning to investigate the mechanism by which social support impact suicidal ideation (Kleiman & Riskind, Citation2012). Outcomes of literature search showed that only two studies have delved into this area. Recently, Hollingsworth et al. (Citation2018) found that perceived burdensomeness mediated the association between social support and suicidal ideation. Similarly, Kleiman and Riskind (Citation2012) in a test of a multiple mediation model of suicidal ideation demonstrated that utilization of social support and self-esteem both have independent and successive mediating effects on the association between social support and suicidal ideation. That is, asides that the two variables have individual mediating effects, the study further suggests that perceived social support predicted the use of social support, which in turn led to increased self-esteem, and then decreased suicidal ideation.
Potential mediating role of self-efficacy on the relationship between social support and suicidal ideation
As a related but different concept from self-esteem, self-efficacy – ‘people’s beliefs in their capabilities to produce desired effects by their own actions’ (Bandura, Citation1997, p. 7) – may also mediate the relationship between social support and suicidal ideation. According to the self-efficacy theory, individuals’ belief about their capability to act determines the kind of behaviour they decide to engage in and the extent to which they persevere in their efforts to surmount life challenges and obstacles (Maddux, Citation2002). The theory further maintains that efficacy beliefs play a significant role in physical health, psychological maladjustments, and adjustments, as well as both professional and self-guided behavioural modification interventions (Maddux, Citation2002). Abdel-Khalek and Lester (Citation2017) found the strongest association between self-efficacy and mental health in both male and female emerging adults compared to associations of mental health with other relevant variables. Moreover, recent studies show that reduced self-efficacy is associated with severity in suicidal ideation and attempts among adolescents and patients with alcoholic disorder (Berent et al., Citation2017; Valois et al., Citation2015; Wu & Yaacob, Citation2017).
Further, the relationship between self-efficacy and social support has also been evidenced in the literature. For instance, Martínez-Martí and Ruch (Citation2017) found that social support and self-efficacy were positively related to the Swiss general population. Also, Zhang and Jin (Citation2014) showed that social support and self-efficacy were positively correlated in a sample of postpartum women. Besides, the study demonstrated that self-efficacy mediated the relationship between social support and postpartum depression. Other studies have found similar results (e.g. Tovar et al., Citation2015; L. Wang et al., Citation2018).
Aim and hypothesis
Given that social support is associated with suicidal ideation, and that self-efficacy is correlated with both social support and suicidal ideation, it is hypothesized in the current study that self-efficacy will mediate the relationship between social support and suicidal ideation. In other words, it is proposed that self-efficacy will explain the pathway by which social support influences suicidal ideation. Findings will fill the knowledge gap on the possible mediating role of self-efficacy in the relationship between social support and suicidal ideation, especially at emerging adulthood. Additionally, outcomes will help professionals manage suicidal ideation and intention from social support through self-efficacy.
Method
Sample and procedure
This was a cross-sectional survey consisting of 251 emerging adults (46% females) purposely selected from the population of two suburban universities located in South West, Nigeria. The sample comprised 70% and 30% of students from public and private universities, respectively, with the age range 18–29 years (M = 20.84, SD = 2.34). Based on class level, 37% of participants were in their first year, 22% (second year), 17% (third year) while 24% were in the fourth or final year. According to marital status, 97% were single while 3% were married.
An approval was granted to carry out the study by the Ethics and Research Committee of the two universities after complying with the necessary ethical standard. Sequel to obtaining written informed consent, participants were administered research instruments in various faculties while waiting to receive lectures. Specifically, we asked students whose ages were in the range of 18 to 29 to participate in the study. Completed instruments were collected immediately. A total number of 292 students participated in the study. However, we discarded the responses of 41 participants because they were not emerging adults.
Measures
Suicide ideation questionnaire
Suicide ideation was assessed using the 15-item Suicide Ideation Questionnaire (SIQ: Reynolds, Citation1987) measured on a 5-point Likert scale ranging from ‘I never had this thought’ (1) to ‘Almost every day’ (5). Sample items include ‘I thought it would be better if I was not alive’, ‘I thought about what to write in a suicide note’ and, ‘I thought that no one care if I live or die’. Reynolds (Citation1988) obtained convergent validity coefficients ranging between.56 and.66 by correlating the SIQ with associated affective constructs such as depression and anxiety. Similar to alpha coefficient value reported by the scale author, we obtained a Cronbach alpha value of.94 for the SIQ in the present study. Moreover, a confirmatory factor analysis (CFA) was carried out to assess the correctness of the unidimensional orientation of the SIQ. Outcomes showed that the SIQ unidimensionality fits the current study data after covarying error terms, χ2 (79 N = 251) = 179.11, p < .001; CFI = .97; RMSEA = .07 [90% CI = (.057,.085)], and SRMR = .04. Higher scores reflect increased severity of suicidal ideation.
Multidimensional scale of perceived social support (MSPSS)
The MSPPS (Zimet et al., Citation1988) is a 12-item inventory designed to measure the perception of social support from three subscales including support from family (Fam), friends (Fri) and significant other (SO). Participants’ responses were measured on a 5-point Likert scale ranging from ‘strongly disagreed (1)’ to ‘strongly agree (5)’. Sample items are: ‘There is a special person who is around when I am in need’ (SO), ‘I can talk about my problems with my friends’ (Fri), and ‘My family really tries to help me’ (Fam). The MSPPS is valid in measuring perceived social support using the Nigerian sample (Nwoke, Onuigbo & Odo, Citation2017). We further assessed the fitness of the MSPPS factorial structure in the current study. Result showed the three-factor structure of the scale adequately meets the criteria for model fit, χ2 (46 N = 251) = 91.03, p < .001; CFI = .967; RMSEA = .06 [90% CI = (.04,.08)], and SRMR = .05. The alpha coefficients obtained in the present study were SO (.85), Fam (.78) and Fri (.70). Higher scores indicate increased perception of social support across the subscales.
General self-efficacy scale (GSES)
Self-efficacy was assessed by the GSES (Schwarzer & Jerusalem, Citation1995). It is a 10-item inventory that assesses general self-efficacy using the unidimensional approach. Responses are measured on a 4-point Likert scale ranging from ‘Not at all true (1)’ to ‘Exactly true (4).’ Sample items included ‘I can always manage to solve difficult problems if I try hard enough’ and ‘I can solve most problems if I put in the necessary effort,’ and ‘When I am confronted with a problem, I can usually find several solutions’. The GSES is found to be highly psychometrically sound (Schwarzer & Jerusalem, Citation1995). After covarying error terms, CFA results indicated the unidimensional structure of the GSES absolutely fit current study data, χ2 (30 N = 251) = 39.32, p = .12; CFI = .99; RMSEA = .035 [90% CI = (.00,.06)], and SRMR = .03. We also obtained satisfactory alpha coefficient value of.87.
Statistical analyses
Descriptive statistics and correlations were performed with the aid of IBM SPSS Statistics version 24.0. Structural equation modelling (SEM) with maximum likelihood was used to estimate the direct effect of social support dimensions on suicidal ideation. Given that only the family support dimension was significant on suicidal ideation, we proceeded to mediation analysis by specifying only family support as the independent variable, self-efficacy as mediating variable and suicidal ideation as the dependent variable. IBM SPSS AMOS (version 25.0) was utilized to conduct SEM analysis. Distribution of scores on study variables met the criteria for normality except for the suicidal ideation scores having positive skewness and kurtosis values (see ) falling outside the range of −1 to +1 (Blanca et al., Citation2013). Log10 transformation was used to achieve data normality (Mertler & Vannatta, Citation2005). All z scores on study variables were in the range of −4 to +4, thereby showing that there were no outlier cases in data distribution (Stevens, Citation1992). Multicollinearity among subscales of social support was not a problem because tolerance value for each subscale was in the range of.38 and.58, which is above the cut-off value of.1 (Mertler & Vannatta, Citation2005). We used the comparative fit index (CFI), root-mean-square of approximation (RMSEA) and standardized root-mean-square residual (SRMR) to evaluate model fitness. A model fit is achieved if the CFI value is above.90, SRMR is below.06 while the RMSEA is below.08 (Kline, Citation2011).
Results
Descriptive statistics and correlations
displays descriptive statistics and bivariate relationships among study variables. All demographic variables were not significantly related with any of the continuous variables. Significant other support (r = .37, p < .001), family support (r = .44, p < .001) and friend support (r = .33, p < .001) were positively associated with self-efficacy. Conversely, significant other support (r = −.20, p = .002), family support (r = −.32, p < .001) and friend support (r = −.22, p < .001) were negatively related with suicidal ideation. In addition, self-efficacy and suicidal ideation were also negatively associated (r = −.43, p < .001).
Structural model
An initial model (see ) was tested to examine the predictive ability of dimensions of social support on suicidal ideation. Results indicated that family support was significant on suicidal ideation [β = −.35, p < .001] while significant other support [β = .002, p = .97] and friends support [β = .03, p = .59] were not. Given the pattern of results, we proceeded to conduct a mediation analysis with only family support as the only exogenous variable.
Mediation analysis: displays the standardized estimates of the mediation model. The model indicates an absolute fit for the data, χ2 (1) = 1.69, p = .19; CFI = .99; RMSEA = .05; SRMR = .02. The path from family support to suicidal ideation was significant [β = −.16, p = .01]. The path from family support to the self-efficacy [β = .44, p < .001] and the path from self-efficacy to suicidal ideation were also significant [β = −.36, p < .001].
According to Preacher and Hayes (Citation2004), establishing a mediating effect in the SEM framework is dependent on the significance of both total and indirect effects. In the present model, the total effect of family support on suicidal ideation (standardized total effect = −.32; p = .01) was significant. displays the 90% and 95% bias-corrected confidence intervals and standardized estimate for the indirect effect of family support on suicidal ideation.
The 95% confidence interval for the indirect effect from family support to suicidal ideation through self-efficacy did not all pass through zero, thus showing significant indirect effect. Given that the direct effect of family support on suicidal ideation still maintained significance, though, with a decrease from β = −.85 in the initial model to β = −.16 in the mediation model, it is concluded that self-efficacy partially mediates the relationship between family support and suicidal ideation.
Discussion
Previous studies (e.g. Bell et al., Citation2017; Mackin et al., Citation2017) have shown that perceived social support predicts low suicidal ideation especially among adolescents, psychiatric and medically ill patients. However, little is known about the nexus between social support and suicidal ideation during emerging adulthood, and the mechanism by which the two variables associate with each other. Only in two studies do we see that utilization of social support and self-esteem (Kleiman & Riskind, Citation2012) and perceived burdensomeness (Hollingsworth et al., Citation2018) mediated the relationship between social support and suicidal ideation. To add to existing knowledge we investigated the mediating ability of self-efficacy in the relationship between perceived social support and suicidal ideation in a sample of emerging adults.
All bivariate relationships among study variables were significant. Our findings showed that all dimensions of social support significantly correlated with suicidal ideation. Specifically, family, friend, and significant other supports were negatively associated with suicidal ideation, although the relationship was moderately stronger for perceived support from the family. These outcomes are consistent with previous works that demonstrated the relationship of family, friend and significant other supports with suicidal ideation (e.g. Ayub, Citation2015; Tabaac et al., Citation2016). The stronger association of family support with suicidal ideation compared to other social support types also agrees with findings in previous studies (Bell et al., Citation2018; Lamis & Lester, Citation2013; M. Wang et al., Citation2013). Also, results showed that all dimensions of social support were moderately and positively correlated with general self-efficacy. Again, results align with past findings that suggest a positive relationship between perceived social support and self-efficacy (e.g. Martínez-Martí & Ruch, Citation2017; Zhang & Jin, Citation2014). Finally, bivariate outcomes likewise confirmed previous findings (e.g. Berent et al., Citation2017; Wu & Yaacob, Citation2017) showing a negative association between self-efficacy and suicidal ideation.
Results of SEM model predicting suicidal ideation from social support dimensions indicated that only family support significantly predicted suicidal ideation while friends and significant other supports were not. This result emphasizes the greater importance of family support in protecting emerging adults from suicidal ideation compared to other forms of social support. This is because family support perhaps represents a more enduring and consistent construct of social support compared to friend and significant other supports which perhaps are more fleeting and short-lived in nature (Tabaac et al., Citation2016). In contrast to support provided by family members, supports from friends and significant others have a more distal and less longitudinal influence on individuals (Tabaac et al., Citation2016) which may account for why both do not predict suicidal ideation. No matter how worse life conditions may be for an individual, the family remains the constant and persistent source of help. This notion is supported by an African proverb which asserts that ‘there is no fool who is disowned by his family’ (HowAfrica, Citationn.d.). Results corroborate previous findings (Purcell et al., Citation2012; M. Wang et al., Citation2013) underscoring the importance of family connectedness and support in buffering the individual against suicidality. Current findings also fully support past literature with ethnically diverse sexual minority women (Tabaac et al., Citation2016) and adolescents (Shilubane et al., Citation2014) that found family support to be significant in lowering suicidal ideation while friends and significant other supports were not.
Our finding showing that self-efficacy partially mediates the relationship between family support and suicide ideation is a novel addition to the research literature. This outcome indicates that the protective influence of family support on suicidal ideation is partly explained by general self-efficacy. In other words, the perception of support from family members increases self-efficacy, which in turn predicts a decrease in the level of suicidal ideation among emerging adults. Findings imply that the role of family support in building individual self-efficacy during the period of emerging adulthood cannot be over-emphasized. Although emerging adulthood is a period when individuals become independent of parents and families (Arnett, Citation2000; Munsey, Citation2006); nonetheless, emerging adults still require significant support from family members for increased self-efficacy in overcoming life stressors, and be protected against suicidal ideation.
Despite the new knowledge provided in the current study, it may be necessary to exercise some caution in the interpretation of findings. Given that the study design is cross-sectional, drawing causal associations in the mediation paths between family support and suicidal ideation may be misleading. At best, findings could be considered exploratory, thus requiring future studies to use longitudinal data to draw cause–effect relationships among study variables. Additionally, sample of our emerging adults was only drawn from a population of university students. Generalizing findings to other groups of emerging adults such as those already married or in industrial settings may not be plausible. Although our findings show that self-efficacy mediates the relationship between family support and suicide ideation, it is also plausible that family support may moderate self-efficacy to predict lower suicide ideation. Further, our mediation model lacks some control variables such as differences in family compositions (functional versus dysfunctional families), specific roles of siblings, personality traits and engagement in social activities which may also influence suicidal ideation as family support. For example, it may be important to know whether support provided in dysfunctional families or families with serious social problems and abuse can mitigate or aggravate suicidal ideation among emerging adults. In addition, how do social engagement impact suicidal ideation in relation to social support? Prospective studies may take these variables into consideration in order to provide a holistic knowledge, and put into context the protective role of family support on suicidal ideation through self-efficacy as found in this study.
Conclusion
The outcomes of this study empirically demonstrate that family, friend and significant other supports negatively associate with suicidal ideation. However, of the three social support sources, the only perception of family support significantly predicts lower level of suicidal ideation. Results further showed that self-efficacy plays a partial mediating role in the relationship between family support and suicidal ideation. It is recommended that family support should persist through the period of emerging adulthood notwithstanding that this life stage is characterized by more independence in lifestyle, and autonomy in the making of enduring life choices. Such kind of support will bolster self-efficacy in overcoming challenges and instabilities that may predispose vulnerabilities to suicidal ideation and eventual suicide during emerging adulthood. Finally, future studies may investigate how family support can be strengthened given its importance in predicting lower suicidal ideation.
Disclosure statement
No potential conflict of interest was reported by the authors.
Additional information
Notes on contributors
Olabimpe Ajoke Olatunji
Olabimpe Ajoke Olatunji holds a PhD in Developmental Psychology and lectures in the Department of Psychology, Federal University Oye-Ekiti, Ekiti State, Nigeria. She is a postdoctoral research follow at the North West University, Mafikeng Campus, South Africa. Her area of research is on the socio-emotional and psychosocial factors influencing behavior during adolescence and emerging adulth.
Erhabor Sunday Idemudia
Erhabor Sunday Idemudia is a tenured full Professor of Research- Social Science Cluster in the faculty of Humanities/ Lifestyle & Diseases, Health Sciences, NWU, South Africa. He has a BSc (Honours) in Psychology, MSc and PhD in Clinical Psychology. He is an NRF Established Rated Scientist and a recipient of the Georg-Forster Life- Time Achievement Award in Research. A Humboldtian; Leventis Fellow, (UK; Salzburg Fellow, (Austria); a Phodiso-UCLA Fellow and Advisor, (USA) and currently the General Secretary and Registrar of Membership-WCP-African Chapter and Board member, WCP, Austria. He is a an Associate Editor (AE) of the Journal of Child and Adolescent Mental Health, South Africa and AE, Heliyon (Netherlands). Research interests include: applied research in psychotherapy and interventions with vulnerable populations such as migrants/refugees, IDPs and cultural aspects of African-oriented psychology and illness attributions. Prof. Idemudia has over 200 publications in peer reviewed journal and books of wide readership. He is a fellow of the WCP, NACP and NPA and author (with Klaus Boehnke) “I'm an alien in Deutschland: A quantitative mental health case study of African Immigrants in Germany
Babatola Dominic Olawa
Babatola Dominic Olawa, PhD, is lecturer and clinical psychologist in the Department of Psychology, Federal University Oye-Ekiti, Nigeria. He is a visiting postdoctoral fellow in Bremen International Graduate School of Social Sciences (BIGSSS), Jacobs University, Bremen, Germany and a postdoctoral fellow in Lifestyle Diseases, Mafikeng, North West University, South Africa. His research is on mental health and well being at adulthood and old age.
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