Perceived Suicide Stigma and Associated Factors in Chinese College Students: Translation and Validation of the Stigma of Suicide Attempt Scale and the Stigma of Suicide and Suicide Survivors Scale

Abstract

This study aims to translate and validate two perceived suicide stigma scales, including the Stigma of Suicide Attempt Scale (STOSA) and the Stigma of Suicide and Suicide Survivor Scale (STOSASS) into Chinese language, examining the factor structure, and assessing the correlation between suicide stigma and a series of variables. After translating and back translating the STOSA and STOSASS, an online survey was administrated to 412 college students in China. These two scales were tested for their dimensionality in a series of confirmatory factor analyses. A series of regression analyses were conducted to examine the factors that are associated with perceived and public suicide stigma, including demographics, psychological distress, suicidality, suicide exposure, and perceived entitativity of suicide ideators, decedents, and survivors. The results showed that the two translated scales, STOSA and STOSASS, were reliable (Cronbach’s α = 0.79~0.83) and valid in Chinese contexts and it can be treated as unidimensional scales. Suicidality, exposure to suicide, and perceived entitativity of suicide-related persons were significantly associated with higher endorsement of public suicide stigma (SOSS Stigma, ps < 0.03), but not perceived stigma (STOSA, STOSASS). Higher levels of psychological distress were associated with both higher perceived and public suicide stigma (ps < 0.05).

The Roles of Endorsement and Stigma in Suicidal Ideation and Behavior among Chinese College Students

“…The results showed strong correlations among these variables and suggested that there was a lack of education on the topic of suicide in Chinese colleges. In a study assessing stigma toward suicide, suicide attempts, and suicide survival in a student sample, Wu and colleagues revealed positive correlations between suicidality, suicide exposure, and endorsement of suicide [66]. However, these studies mainly focused on scale development and translation and did not explore suicide attempts.…”

The Associated Factors of Self-Harm and Suicide Ideation Among Chinese Indonesians During the COVID-19 Pandemic

“…Moreover, in comparison to Chinese university students (Han et al, 2017(Han et al, , 2018Wu et al, 2021) who were surveyed with the same instrument, Chinese Indonesians in this study showed relatively lower levels of stigmatization. This result might be associated with their ethnic minority status in the country that enabled them to be more sympathetic toward adversity.…”

“…As the finding is in line with previous findings in Australia (Batterham et al, 2013) and China (Han et al, 2017), this indicates that there is a cross-cultural universal pattern between suicidal ideation and glorification of suicide. Another explanation might come from the role of specific Chinese cultural interpretation toward suicide, as it is historically interpreted as an effort to restore the person’s (or family’s) honor or advocate for justice in Chinese culture (Wu et al, 2021). Hence, those with suicidal ideation would have a cultural narrative that fits with their ideation as something heroic compared to those who do not have any suicidal ideation.…”

The prevalence and associated factors for self-harm and suicide ideation among Chinese Indonesians during the COVID-19 pandemic

“…Moreover, in comparison to Chinese university students (Han et al, 2018;Han et al, 2017;Wu et al, 2021) and Lao communities (Yang et al, 2018) who were surveyed with the same instrument, Chinese Indonesians in this study showed relatively lower levels of stigmatization. This result might be associated with their ethnic-minority status in the country that enabled them to be more sympathetic towards adversity.…”

“…This finding is in line with previous findings in Australia (Batterham et al, 2013) and China (Han et al, 2017) which might indicate that there is a cross-cultural universal pattern between suicidal ideation and glorification of suicide. However, there might also be a specific Chinese cultural role as suicide is historically interpreted as an effort to restore the person's (or family's) honor or advocate for justice in Chinese culture (Wu et al, 2021). Hence, those with suicidal ideation would have a cultural narrative that fits with their ideation as something heroic compared to those who do not have any suicidal ideation.…”