Familial Resilience in Crisis: Navigating the Mediating Landscape of Depressive Symptoms Between Uncertainty Stress and Suicide Behavior Among Chinese University Students

Na Yan,1 Tong Zhou,1 Mingming Hu,1 Yuxuan Cai,1 Ling Qi,1 Blen Dereje Shiferaw,1 Wei Wang,1– 3 Chunxia Miao4 1School of Public Health, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of China; 2Research Center for Mental Crisis Prevention and Intervention of College Students in Jiangsu Province, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of China; 3Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of China; 4School of Management, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of ChinaCorrespondence: Wei Wang, School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu, 221004, People’s Republic of China, Email weiwang90@163.com Chunxia Miao, School of management, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu, 221004, People’s Republic of China, Email miaochunxia1978@163.comBackground: Previous findings indicate that stress has a profound influence on suicide behavior, but the potential mediating and moderating mechanisms are unknown between uncertainty stress and suicide behavior. The present study, therefore, examined the relationship between uncertainty stress and suicide behavior, the mediating effect of depressive symptoms, and the moderating effect of family relationship in a sample of university students in China.Methods: 1828 university students were assessed anonymously by using the Uncertainty Stress Scale, Center for Epidemiologic Studies Depression Scale, Brief Suicidal Scale, and Family Relationship Scale between May to June in 2021. SPSS 26.0 was used for descriptive statistics and Spearman correlation analysis. PROCESS 3.5 was used to calculate the significance of the mediating and moderating effects of the variables.Results: Moderated mediation model analyses showed that: (a) depressive symptoms partially mediated the link between uncertainty stress and suicide behavior (indirect effect = 0.14, 95%bootstrap CI = 0.10, 0.19). The indirect effect of the depressive symptoms accounted for 67.12% of the total variance in suicide behavior. (b) The indirect association between uncertainty stress and suicide behavior was moderated by family relationship. Specifically, the paths from uncertainty stress to depressive symptoms (interact effect = − 0.06, P< 0.001) and depressive symptoms to suicide behavior (interact effect = − 0.08, P< 0.01) were weakened in the context of higher family relationship.Conclusion: Depressive symptoms play a crucial role in bridging uncertainty stress and suicide behavior, while the family relationship can buffer the mediation impact of depressive symptoms. These findings significantly contribute to the prevention and intervention of suicide in Chinese university students.Keywords: uncertainty stress, depressive symptoms, suicide behavior, family relationship, university students