Psychosocial and Mental Health Determinants of Suicidal Behavior Among Nursing Students: A Cross-Sectional Study in...

Background: Nursing students face emotional and psychological challenges stemming from early clinical exposure, intense academic pressure, and persistent social stigmas. These stressors can contribute to mental health deterioration and increase the risk of suicidal thoughts and behavior. Objective: To evaluate the psychosocial context and identify risk and protective factors contributing to suicidal behavior in undergraduate nursing students. Methods: This cross-sectional study included 433 undergraduate nursing students and utilized validated psychological instruments to assess suicidal behavior, emotional distress, impulsivity, anhedonia, mental health, and perceived social support. Data were analyzed using descriptive statistics, bivariate tests, exploratory factor analysis, and multivariate modeling to identify key predictors of suicidal behavior. Network visualization was used to integrate significant point-biserial correlations with factor loadings. Results: Among 433 nursing students (77.8% women, 93.8% cisgender, mean age 19), 15.2% showed clinically significant suicidal risk. Suicidal behavior was more frequent among women and students living away from home (p < 0.05). Higher levels of impulsivity, ADHD symptoms, and especially moderate-to-severe hopelessness (p < 0.001) were strongly associated. Hazardous alcohol use was also a significant risk factor (p < 0.01), while strong material and emotional support showed a protective effect (p < 0.05). Two psychological dimensions, emotional distress/impulsivity and hopelessness/low support, explained most of the variance. Conclusions: 1 in 7 nursing students show clinically relevant suicidal risk, particularly those with heightened hopelessness, emotional dysregulation or hazardous alcohol use. Protective social support plays a key mitigating role. These results underline the urgent need for tailored mental health interventions that specifically address emotional regulation and hopelessness, while reinforcing social support systems within nursing education contexts.