Associations Between Start or End of a Romance and Suicidal Behavior: A Longitudinal Study of Chinese Adolescents

Start or end of a romance is a major life event during adolescence. This study explored both cross-sectional and longitudinal associations between romantic involvement and suicidal behavior among Chinese adolescents.

Seven thousand seventy-two 7th-8th graders and 10th graders (mean age = 14.58 years, 50% male) were surveyed at baseline and 1 year later in Shandong, China. Starting a romantic relationship (SRR), romantic breakups, suicidal thought (ST), suicide plan (SP), suicide attempt (SA), and demographics were collected using a self-administered questionnaire.

Baseline data analysis showed that after controlling for covariates, SRR only, breakups only, and SRR+ breakups all significantly increased the risks of ST, SP, and SA (all ps < 0.001). The associations were stronger in female adolescents than in male adolescents, but the moderation effects of gender were not significant (all ps > 0.05). After controlling for covariates and baseline suicidal behavior, longitudinal data analysis indicated that SRR + breakups were significantly associated with 29%, 56%, and 67% increased odds of subsequent ST, SP, and SA at follow-up for 1-year. SRR only was significantly linked to a 75% higher chance of SA. Among adolescents who had no previous history of suicidal behavior at baseline, SRR only was significantly linked to a 54% higher chance of ST and twice the likelihood of SA. SRR and breakups were significantly linked to 43%, 83%, and 76% higher chance of incident ST, SP, and SA, respectively.

The findings suggest that romance education and romantic stress management should be explicitly integrated into suicide prevention programming.