Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jul 19, 2025; 15(7): 104373
Published online Jul 19, 2025. doi: 10.5498/wjp.v15.i7.104373
Effects of impulsive personality on suicide in adolescent depression: The chain mediating of perceived social adversity and security
Hua Zhang, Hua-Bin Li, Fu-Sheng Sun, Xue-Qiong Su, Chun-Bo Sun
Hua Zhang, Department of Clinical Psychology, Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital, Nanning 530003, Guangxi Zhuang Autonomous Region, China
Hua-Bin Li, No. 4 Ward, Department of Psychiatry, Guigang Medical District, 923 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army, Guigang 537100, Guangxi Zhuang Autonomous Region, China
Fu-Sheng Sun, Chun-Bo Sun, No. 2 Ward, Department of Psychiatry, Guigang Medical District, 923 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army, Guigang 537100, Guangxi Zhuang Autonomous Region, China
Xue-Qiong Su, Student Affairs Department, Guangxi Nanning Technician College, Nanning 530007, Guangxi Zhuang Autonomous Region, China
Co-first authors: Hua Zhang and Hua-Bin Li.
Author contributions: Zhang H and Li HB designed the research and wrote the first manuscript; Zhang H, Li HB, Sun FS and Su XQ contributed to conceiving the research and analyzing data; Sun CB conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript. Zhang H and Li HB contributed equally to this work as co-first authors.
Institutional review board statement: This study was approved by the Ethic Committee of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Bo Sun, No. 2 Ward, Department of Psychiatry, Guigang Medical District, 923 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army, No. 588 Yongjun 1st Road, Gangbei District, Guigang 537100, Guangxi Zhuang Autonomous Region, China. 17377587600@163.com
Received: April 8, 2025
Revised: May 13, 2025
Accepted: May 22, 2025
Published online: July 19, 2025
Processing time: 92 Days and 19 Hours
Abstract
BACKGROUND

Depression is a common mental disorder among adolescents, characterized by a high rate of suicide and self-harm, which not only is devastating to families but also has a negative impact on society. Psychological factors such as impulsive personality, perceived chronic social adversity (PCSA), and sense of security are closely associated with suicide risk in adolescents with depression. Few studies have been conducted on the relationship between these factors.

AIM

To explore the impact of impulsive personality on suicide risk in adolescents with depression and the chain mediating effect between PCSA and sense of security.

METHODS

This study is a retrospective study. A total of 200 adolescents with depression who visited the Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from January 2021 to December 2023 comprised the study cohort. The PCSA scale, Security Questionnaire, Barratt Impulsiveness Scale, and Beck Scale for Suicide Ideation were used to evaluate depression.

RESULTS

Suicide risk was positively correlated with impulsive personality and PCSA (P < 0.05), whereas sense of security was negatively correlated with suicide risk, impulsive personality, and PCSA (P < 0.05). The total indirect effect of PCSA and sense of security on impulsive personality and suicide risk was 35.43%, with the mediating effect of PCSA and sense of security contributing 16.53% and 15.75%, respectively. PCSA and sense of security exhibited a chain mediating effect between impulsive personality and suicide risk, accounting for 3.15%.

CONCLUSION

The suicide risk of adolescents with depression is significantly associated with impulsive personality, PCSA, and sense of security. Impulsive personality affects the suicide risk of adolescents with depression both directly and indirectly, with the latter occurring via PCSA and sense of security.

Keywords: Adolescents; Suicide risk; Impulsive personality; Perceived chronic social adversity; Sense of security

Core Tip: This study focuses on adolescent patients with depression and examines the relationship between impulsive personality, perceived chronic social adversity (PCSA), sense of security, and suicide risk. An analysis of 200 adolescent patients with depression revealed that their suicide risk was positively correlated with impulsive personality and PCSA and negatively correlated with sense of security. PCSA and sense of security play a chain mediating role between impulsive personality and suicide risk. Reducing the level of PCSA and enhancing the sense of security among adolescents with depression may reduce their suicide risk.