A Network and Mediation Analysis on the Associations Between Family Environment and Suicidal Ideation in Adolescents in a Psychiatric Clinical Setting

Xing-Yan Liu ¹ Cheng-Han Li ² Shuhui XU ³ Wen-Jing Yan ^4,5*

• ¹ Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
• ² Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
• ³ Wenzhou University, Wenzhou, Zhejiang Province, China
• ⁴ School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
• ⁵ Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China

Background: Family environmental factors are known to contribute to adolescent suicidal ideation (SI), but how these factors interact and relate to SI needs further investigation. Aims: To examine how family factors interact with each other and are associated with adolescent SI in a psychiatric clinical setting, using network analysis with regularization methods. Method: Utilizing a quantitative research design, this study analyzed data from 293 adolescents aged 12 to 18 years seeking care in a psychiatric hospital. Data collection involved standardized interviews and self-report measures to assess SI, anxiety, depression, and various family environmental factors. Network analysis with regularization methods, including LASSO regression, was employed to elucidate the relationships among these variables. Results: Over 40% of adolescents reported SI, with positive relationship quality(RQ) significantly reducing SI. Network analysis indicated that family economic status did not directly relate to SI but through RQ. Additionally, anxiety was found to mediate the relationship between RQ and SI significantly, with a mediation effect of 53.34%. Parental marital status directly related to SI, whereas parental education level, particularly mothers', was not directly associated with SI or other mental health outcomes. Conclusions: This study reveals the complex interplay between family environmental factors and psychiatric symptoms in adolescents, highlighting family relationship quality as a critical risk mechanism. These findings underscore the importance of family-centered interventions and public mental health policies to reduce suicidal ideation in adolescents.