Psychological Distress and Suicidal Ideation among Emerging Adults of University of Gujrat

Abstract

Emerging adulthood represents a developmental window of heightened susceptibility to psychological distress and suicidal ideation. The present cross-sectional study examined the differential predictive utility of depression, anxiety, and stress in relation to suicidal ideation among 274 emerging adults (aged 18–25 years) enrolled at the University of Gujrat, Pakistan. Participants completed the Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Suicidal Behaviours Questionnaire-Revised (SBQ-R). Bivariate analyses revealed significant positive correlations between all three distress dimensions and suicidal ideation, with depression demonstrating the strongest association (r = .462, p < .01). However, multiple regression analysis identified depression as the sole significant unique predictor of suicidal ideation (β = [insert β], p < .001), with anxiety and stress failing to contribute independent predictive variance when depression was controlled. Additionally, individuals classified in the high suicidal ideation risk group (SBQ-R ≥ 7) exhibited significantly greater levels of depression, anxiety, and stress relative to the low-risk group. These findings highlight the primacy of depressive symptomatology in understanding and predicting suicidal ideation among Pakistani university students. Implications for campus-based mental health screening and targeted intervention are discussed.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Attia, M., Ibrahim, F. A., Elsady, M. A., Khorkhash, M. K., Rizk, M. A., Shah, J., & Amer, S. A. (2022). Cognitive, emotional, physical, and behavioral stress-related symptoms and coping strategies among university students during the third wave of COVID-19 pandemic. Frontiers in Psychiatry, 13, 933981. https://doi.org/10.3389/fpsyt.2022.933981

Bentley, K. H., Franklin, J. C., Ribeiro, J. D., Kleiman, E. M., Fox, K. R., & Nock, M. K. (2016). Anxiety and its disorders as risk factors for suicidal thoughts and behaviors: A meta-analytic review. Clinical Psychology Review, 43, 30–46. https://doi.org/10.1016/j.cpr.2015.11.008

Bibi, A., Blackwell, S. E., & Margraf, J. (2021). Mental health, suicidal ideation, and experience of bullying among university students in Pakistan. Journal of Health Psychology, 26(8), 1185–1196. https://doi.org/10.1177/1359105319869819

Brás, M., Martins, C., Nunes, C., Jesus, S. N., Madeira, A. R., & Carmo, C. (2025). Reasons for living and depressive symptomatology in young adults with and without suicide attempts: A moderated mediation approach. Frontiers in Psychiatry, 15, 1443894. https://doi.org/10.3389/fpsyt.2024.1443894

Fatima, S., & Raazia, A. U. (2025). Mood and anxiety symptoms, psychological distress, and life satisfaction: Differential associations between patients with anxiety and depression. Applied Psychology Review, 4(2), 67–87. https://doi.org/10.32350/apr.42.04

Han, K., Ji, L., Chen, C., Hou, B., Ren, D., Yuan, F., Liu, L., Bi, Y., Guo, Z., Wu, N., Feng, M., Su, K., Wang, C., Yang, F., Wu, X., Li, X., Liu, C., Zuo, Z., Zhang, R., Yi, Z., … He, G. (2022). College students' screening early warning factors in identification of suicide risk. Frontiers in Genetics, 13, 977007. https://doi.org/10.3389/fgene.2022.977007

Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS‑21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239. https://doi.org/10.1348/014466505X29657

Hochberg, Z. E., & Konner, M. (2020). Emerging adulthood, a pre-adult life-history stage. Frontiers in Endocrinology, 10, 918. https://doi.org/10.3389/fendo.2019.00918

Jiazhi, S., Caixia, C., Lamei, G., & Jian, Z. (2025). The relationship between physical activity and depression, anxiety, and stress in college students: A mediating effect of diet. Frontiers in Nutrition, 12, 1611906. https://doi.org/10.3389/fnut.2025.1611906

Kapfhammer, H.-P. (2006). Somatic symptoms in depression. Dialogues in Clinical Neuroscience, 8(2), 227–239. https://doi.org/10.31887/DCNS.2006.8.2/hpkapfhammer

Khan, M. N., Akhtar, P., Ijaz, S., & Waqas, A. (2021). Prevalence of depressive symptoms among university students in Pakistan: A systematic review and meta-analysis. Frontiers in Public Health, 8, 603357. https://doi.org/10.3389/fpubh.2020.603357

Kumar, S., Singh, G., Kumar, A., & Giri, S. K. (2025). Stress among research scholars: Causes, coping strategies and implications for policy reform. Annals of Neurosciences, 33(1), 123–130. https://doi.org/10.1177/09727531251315236

Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Psychology Foundation.

Mastorci, F., Lazzeri, M. F. L., Vassalle, C., & Pingitore, A. (2024). The transition from childhood to adolescence: Between health and vulnerability. Children, 11(8), 989. https://doi.org/10.3390/children11080989

Mayo Clinic. (2022). Depression (major depressive disorder). https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

McLafferty, M., Brown, N., McHugh, R., Ward, C., Stevenson, A., McBride, L., Brady, J., Bjourson, A. J., O'Neill, S. M., Walsh, C. P., & Murray, E. K. (2021). Depression, anxiety and suicidal behaviour among college students: Comparisons pre-COVID‑19 and during the pandemic. Psychiatry Research Communications, 1(2), 100012. https://doi.org/10.1016/j.psycom.2021.100012

Motillon-Toudic, C., Walter, M., Séguin, M., Carrier, J. D., Berrouiguet, S., & Lemey, C. (2022). Social isolation and suicide risk: Literature review and perspectives. European Psychiatry, 65(1), e65. https://doi.org/10.1192/j.eurpsy.2022.2320

Musfara, D. D., Widiyawati, W., & Fitrianur, W. L. (2024). Depression, anxiety, stress correlated with suicide idea on students of the faculty of health. Jurnal Ners dan Kebidanan, 11(1), 49–56.

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial Medicine, 15(1), 16. https://doi.org/10.1186/s13030-021-00219-w

National Institute of Mental Health. (2024). Depression. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimh.nih.gov/health/publications/depression

Naveed, S., Waqas, A., Aedma, K. K., Afzaal, T., & Majeed, M. H. (2019). Association of bullying experiences with depressive symptoms and psychosocial functioning among school-going children and adolescents. BMC Research Notes, 12(1), 198. https://doi.org/10.1186/s13104-019-4236-x

Ng, P. Y. N., Yang, S., & Chiu, R. (2024). Features of emerging adulthood, perceived stress and life satisfaction in Hong Kong emerging adults. Current Psychology, 43(23), 20394–20406. https://doi.org/10.1007/s12144-024-05811-1

Osman, A., Bagge, C. L., Gutierrez, P. M., Konick, L. C., Kopper, B. A., & Barrios, F. X. (2001). The Suicidal Behaviors Questionnaire‑Revised (SBQ‑R): Validation with clinical and nonclinical samples. Assessment, 8(4), 443–454. https://doi.org/10.1177/107319110100800409

Pradubkham, T., Klangpraphan, J., Tangtrakuladul, P., Taengthonglang, C., Saramunee, K., & Phimarn, W. (2026). Prevalence of depression, anxiety, stress, and suicidal ideation among pharmacy students: An updated systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 23(2), 155. https://doi.org/10.3390/ijerph23020155

Ribeiro, J. D., Huang, X., Fox, K. R., & Franklin, J. C. (2018). Depression and hopelessness as risk factors for suicide ideation, attempts and death: Meta-analysis of longitudinal studies. The British Journal of Psychiatry, 212(5), 279–286. https://doi.org/10.1192/bjp.2018.27

Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E., Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600. https://doi.org/10.1037/a0018697

Vidović, S., Kotromanović, S., & Pogorelić, Z. (2024). Depression, anxiety, and stress symptoms among students in Croatia during the COVID‑19 pandemic: A systematic review. Journal of Clinical Medicine, 13(20), 6240. https://doi.org/10.3390/jcm13206240

World Health Organization. (2025). Depressive disorder (depression). https://www.who.int/news-room/fact-sheets/detail/depression

Zhang, J., Liu, Y., & Sun, L. (2017). Psychological strain and suicidal ideation: A comparison between Chinese and US college students. Psychiatry Research, 255, 256–262. https://doi.org/10.1016/j.psychres.2017.05.046