Cognitive Predictors of Suicidal Ideation in Ecuadorian Medical and Nursing Students: The Roles of Perceived Loneliness and Life Satisfaction
Predictores Cognitivos de la Ideación Suicida en Estudiantes de Medicina y Enfermería Ecuatorianos: El Papel de la Soledad Percibida y la Satisfacción Vital
DOI:
https://doi.org/10.15446/rcp.v35n1.117861Keywords:
loneliness, life satisfaction, suicidal ideation, medical students, nursing students (en)soledad, satisfacción vital, ideación suicida, estudiantes de medicina, estudiantes de enfermería (es)
Downloads
Background: This study investigates the relationships between perceived loneliness, life satisfaction, and suicide ideation (SI) in Ecuadorian medical and nursing students, aiming to identify cognitive predictors of si using structural equation modelling (SEM). Methods: A cross-sectional, quantitative, descriptive, correlational and explanatory study was conducted with 618 medical and nursing students from four universities in Tungurahua, Ecuador. Results: The results indicate that si is moderately and positively associated with perceived loneliness (r= .581; p < .001), and moderately and negatively associated with life satisfaction (r= -.408; p < .001). Additionally, perceived loneliness and life satisfaction are slightly and negatively related. sem analysis showed that perceived loneliness (R2= .252) is a stronger predictor of SI than life satisfaction (R2= .060), but their combined explanatory power is significant, accounting for 39.2% of the variance in SI. Conclusions: This study highlights the importance of perceived loneliness and life satisfaction as cognitive predictors of si among university students.
Objetivo: Este estudio investiga las relaciones entre la soledad percibida, la satisfacción vital y la ideación suicida (IS) en estudiantes de medicina y enfermería ecuatorianos, con el objetivo de identificar predictores cognitivos de la IS mediante modelos de ecuaciones estructurales (SEM). Métodos: Se realizó un estudio transversal, cuantitativo, descriptivo, correlacional y explicado con 618 estudiantes de medicina y enfermería de cuatro universidades de Tungurahua, Ecuador. Resultados: Los resultados indican que la IS está moderada y positivamente asociada con la soledad percibida (r= .581; p < .001) y moderada y negativamente asociada con la satisfacción vital (r= -.408; p < .001). Además, la soledad percibida y la satisfacción vital están ligera y negativamente relacionadas. El análisis sem mostró que la soledad percibida (R2= .252) es un predictor más fuerte de la IS que la satisfacción vital (R2= .060), pero su poder explicativo combinado es significativo, lo que representa el 39.2% de la varianza en la IS. Conclusiones: Este estudio destaca la importancia de la soledad percibida y la satisfacción vital como predictores cognitivos de la soledad entre estudiantes universitarios.
References
Antonelli-Salgado, T., Monteiro, G., Marcon, G., Roza, T., Zimerman, A., Hoffmann, M., . . . Passos, I. (2021). Loneliness, but not social distancing, is associated with the incidence of suicidal ideation during the COVID-19 outbreak: a a longitudinal study. Journal of Affective Disorders, 290, 52-60. https://doi.org/10.1016/j.jad.2021.04.044
Beck, A., Kovacs, M., & Wiessman, M. (1979). Assessment of suicidal intent: The scale for suicide ideation. Journal of Consulting and Clinical Psychology, 47(2), 343-352.
Bennardi, M. C., Miret, M., Ayuso‐Mateos, J., Haro, J., Lara, E., ..., & Cabello, M. (2019). Longitudinal relationships between positive affect, loneliness, and suicide ideation: Age‐specific factors in a general population. Suicide and Life‐Threatening Behavior, 49(1), 90-103. https://doi.org/10.1111/sltb.12424
Beutel, M., Klein, E., & Brähler, E. (2017). Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry, 17, 97. https://doi.org/10.1186/s12888-017-1262-x
Brown, T. A. (2015). Confirmatory factor analysis for applied research (Vol. 2nd). Guilford Publications.
Buecker, S., Mund, M., Chwastek, S., Sostmann, M., & Luhmann, M. (2021). Is loneliness in emerging adults increasing over time? A preregistered cross-temporal meta-analysis and systematic review. Psychological Bulletin, 147(8), 787–805. https://doi.org/10.1037/bul0000332
Cabañero, M., Martínez, M., Cabrero, J., Orts, M., Reig, A., & Tosal, B. (2004). Fiabilidad y validez de la Escala de Satisfacción con la Vida de Diener en una muestra de mujeres embarazadas. Psicothema, 16(3), 448-455.
Caycho-Rodríguez, T., Ventura-León, J., Valencia, P., Vilca, L., Carbajal-León, C., Reyes-Bossio, M. .., & Petzold, O. (2022). What is the support for conspiracy beliefs about COVID-19 vaccines in Latin America? a prospective exploratory study in 13 countries. Frontiers in Psychology, 13, 1885. https://doi.org/10.3389/fpsyg.2022.855713
de Jong Gierveld, J. (1987). Developing and testing a model of loneliness. Journal of Personality and Social Psychology, 53, 119–28. https://doi.org/10.1037//0022-3514.53.1.119
Diehl, K., Jansen, C., Ishchanova, K., & Hilger-Kolb, J. (2018). Loneliness at Universities: Determinants of Emotional and Social Loneliness among Students. International Journal of Environmental Research and Public Health, 15(9), 1865. https://doi.org/10.3390/ijerph15091865
Diener, E. (1984). Subjective well-being. Psychological bulletin, 95(3), 542.
Diener, E., Emmons, R., Larsen, R., & Griffin, S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49(1), 71-75. https://doi.org/10.1207/s15327752jpa4901_13
Ferguson, C. (2016). An effect size primer: A guide for clinicians and researchers. En A. Kazdin (Ed.), Methodological issues and strategies in clinical research (págs. 301–310). American Psychological Association. https://doi.org/10.1037/14805-020
Ferrando, P. J., & Anguiano-Carrasco, C. (2010). El Análisis Factorial como Técnica de Investigación en Psicología. Papeles del Psicólogo, 31(1), 18-33.
Fonseca-Pedrero, E., Inchaus, F., Pérez-Guérrez, L., Ario Solana, R., Ortuño-Sierra, J., Sánchez-García, M. A., . . . Pérez de Albéniz Iturriaga, A. (2018). Ideación suicida en una muestra representava de adolescentes españoles. Revista de psiquiatría y salud mental, 11(2), 76-85. https://doi.org/10.1016/j.rpsm.2017.07.004
Gonzalez-Bernal, J., Rodríguez-Fernández, P., Santamaría-Peláez, M., González-Santos, J., León-del-Barco, B., Minguez, L., & Soto-Cámara, R. (2021). Life satisfaction during forced social distancing and home confinement derived from the COVID-19 pandemic in Spain . International Journal of Environmental Research and Public Health, 18(4), 1474. https://doi.org/10.3390/ijerph18041474
Hamermesh, D. (2020). Life satisfaction, loneliness and togetherness, with an application to Covid-19 lock-downs. Review of Economics of the Household, 18(4), 983-1000. https://doi.org/10.1007/s11150-020-09495-x
Helm, P., Medrano, M., Allen, J., & Greenberg, J. (2020). Existential isolation, loneliness, depression, and suicide ideation in young adults. Journal of Social and Clinical Psychology, 39(8), 641-674. https://doi.org/10.1521/jscp.2020.39.8.641
Jovanović, V., Rudnev, M., Abdelrahman, M., Abdul Kadir, N., Adebayo, D., Akaliyski, P., . . . Pilkauskaite Valickiene, R. (2024). The Coronavirus Anxiety Scale: Cross-national measurement invariance and convergent validity evidence. Psychological Assessment, 36(1), 14-29. https://doi.org/10.1037/pas0001270
Keiner, C., Nestsiarovich, A., Celebi, J., & Zisook, S. (2023). Loneliness among medical students, physician trainees and faculty physicians. Academic Psychiatry, 1-7. https://doi.org/10.1007/s40596-023-01780-y
Klonsky, E., May, A., & Saffer, B. (2016). Suicide, suicide attempts, and suicidal ideation. Annual review of clinical psychology, 12, 307-330. https://doi.org/10.1146/annurev-clinpsy-021815-093204
Lapo-Talledo, G., Talledo-Delgado, J., Portalanza, D., Rodrigues, A., & Siteneski, A. (2023). Suicide rates in Ecuador: A nationwide study from 2011 until 2020. Journal of affective disorders, 320, 638-646. https://doi.org/10.1016/j.jad.2022.09.167
Li, C. H. (2016). Confirmatory factor analysis with ordinal data: Comparing robust maximum likelihood and diagonally weighted least squares. Behavior Research Methods, 48(3), 936-949. https://doi.org/10.3758/s1342
Liu, J., Wei, W., Peng, Q., Xue, C., & Yang, S. (2022). The roles of life satisfaction and community recreational facilities in the relationship between loneliness and depression in older adults. Clinical Gerontologist, 45(2), 376-389. https://doi.org/10.1080/07317115.2021.1901166
Macalli, M., Castel, L., Jacqmin-Gadda, H., Tournier, M., Galera, C., Pereira, E., & Tzourio, C. (2024). Frequency of Depressive Symptoms and Suicidal Ideation Among University Students Before and After the COVID-19 Pandemic. medRxiv 2024.03.14.24304160. https://doi.org/10.1101/2024.03.14.24304160
Mardia, K. (1970). Measures of Multivariate Skewness and Kurtosis with Applications Measures of Multivariate Skewness and Kurtosis with Applications. Biometrika(57), 519. https://doi.org/10.2307/2334770
Marttila, E., Koivula, A., & Räsänen, P. (2021). Does excessive social media use decrease subjective well-being? A longitudinal analysis of the relationship between problematic use, loneliness and life satisfaction. Telematics and Informatics, 59, 101556. https://doi.org/10.1016/j.tele.2020.101556
Mazereel, V., Van Assche, K., Detraux, J., & De Hert, M. (2021). COVID-19 vaccination for people with severe mental illness: why, what, and how? The Lancet Psychiatry, 8(5), 444-450. https://doi.org/10.1016/S2215-0366(20)30564-2
McClelland, H., Evans, J., Nowland, R., Ferguson, E., & O'Connor, R. (2020). Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies. Journal of affective disorders, 274, 880-896. https://doi.org/10.1016/j.jad.2020.05.004
McNeish, D., & Wolf, M. (2023). Dynamic fit index cutoffs for confirmatory factor analysis models. Psychological Methods, 28(1), 61. https://doi.org/10.1037/met0000425
Morales-Vives, F., & Dueñas, J. (2018). Predicting suicidal ideation in adolescent boys and girls: The role of psychological maturity, personality traits, depression and life satisfaction. The Spanish journal of psychology, 21, E10. https://doi.org/10.1017/sjp.2018.12
Moreta-Herrera, R., Caycho-Rodríguez, T., Salinas, A., Jiménez-Borja, M., Gavilanes-Gómez, D., & Jiménez-Mosquera, C. (2022). Factorial Validity, Reliability, Measurement Invariance and the Graded Response Model for the COVID-19 Anxiety Scale in a Sample of Ecuadorians. OMEGA - Journal of Death and Dying, Online first. https://doi.org/10.1177/00302228221116515
Moreta-Herrera, R., Núñez-Núñez, M., Lascano-Arías, G., & Mascialino, G. R.-L. (2024). Psychometric properties of the Escala de Gravedad de Síntomas Revisada del Trastorno de Estrés Postraumático (EGS-R) in adults in Ecuador after the Covid-19 pandemic. European Journal of Trauma & Dissociation, 8(2), 100400. https://doi.org/10.1016/j.ejtd.2024.100400
Moreta-Herrera, R., Perdomo-Pérez, M., Reyes-Valenzuela, C., Gavilanes-Gómez, D., Rodas, J., & Rodríguez-Lorenzana, A. (2023). Analysis from the classical test theory and item response theory of the Satisfaction with Life Scale (SWLS) in an Ecuadorian and Colombian sample. Journal of Human Behavior in the Social Environment, 1-13. https://doi.org/10.1080/10911359.2023.2187915
Moreta-Herrera, R., Rodas, J., & Lara-Salazar, M. (2021). Factor validity of Alcohol use Disorders Identification Test (AUDIT) using robust estimations in Ecuadorian adolescents. Alcohol & Alcoholism, 56(4), 482-489. https://doi.org/10.1093/alcalc/agaa126
Mortier, P., Cuijpers, P., Kiekens, G., Auerbach, R. P., Demyttenaere, K., Green, J., & Bruffaerts, R. (2018). The prevalence of suicidal thoughts and behaviours among college students: a meta-analysis. Psychological medicine, 48(4), 554-565. https://doi.org/10.1017/S0033291717002215
Naseem, S., & Munaf, S. (2017). Suicidal ideation, depression, anxiety, stress, and life satisfaction of medical, engineering, and social sciences students. Journal of Ayub Medical College Abbottabad, 29(3), 422-427.
O'Brien, E., Whitman, K., Buerke, M., Galfalvy, H., & Szanto, K. (2023). Life-satisfaction, engagement, mindfulness, flourishing, and social support: do they predict depression, suicide ideation, and history of suicide attempt in late life? The American Journal of Geriatric Psychiatry, 31(6), 415-424. https://doi.org/10.1016/j.jagp.2022.12.192
Pavot, W., & Diener, E. (2013). Happiness experienced: The science of subjective well-being. En S. David, I. Boniwell, & A. Conley Ayers (Edits.), The Oxford Handbook of Happiness (págs. 134-151). Oxford University Press.
Paykel, E., Myers, J., Lindenthal, J., & Tanner, J. (1974). Suicidal feel-ings in the general population: A prevalence study. British Journal of Psychiatry, 124(5), 460-469. https://doi.org/10.1192/bjp.124.5.460
R Core Team. (2019). R: A language and Environment for Statistical Computing. , R Foundation for Statistical Computing. R Foundation for Statistical Computing.
Raifman, J., Ettman, C., Dean, L., Abdalla, S., Skinner, A., Barry, C., & Galea, S. (2022). Economic precarity, loneliness, and suicidal ideation during the COVID-19 pandemic. PloS one, 17(11), e0275973. https://doi.org/10.1371/journal.pone.0275973
Rogowska, A., Ochnik, D., Kuśnierz, C., Jakubiak, M., Schütz, A., Held, M., . . . Cuero-Acosta, Y. (2021). Satisfaction with life among university students from nine countries: Cross-national study during the first wave of COVID-19 pandemic. BMC Public Health, 21(1), 2262. https://doi.org/10.1186/s12889-021-12288-1
Rosero-Ordóñez, S. R.-G.-B. (2023). Evaluación de riesgo suicida en estudiantes universitarios. Revista Arbitrada Interdisciplinaria de Ciencias de la Salud. Salud y Vida, 7(13), 15-27. https://doi.org/10.35381/s.v.v7i13.2297
Russell, D. (1996). UCLA Loneliness Scale (Version 3): Reliability, Validity, and Factor Structure. Journal of Personality Assessment, 66(1), 20–40. https://doi.org/10.1207/s15327752jpa6601_2
Sánchez-Vélez, H., & Moreta-Herrera, R. (2022). Miedo y Ansiedad al Covid-19, estrés y percepción de salud. Modelo de predicción en pacientes hospitalarios de atención primaria del Ecuador. Anales de Psicología, 38(3), 439-447. https://doi.org/10.6018/analesps.489761
Teixeira, S., Ferré-Grau, C., Canut, T., Pires, R., Carvalho, J., Ribeiro, I., . . . Sequeira, C. (2022). Positive mental health in university students and its relations with psychological vulnerability, mental health literacy, and sociodemographic characteristics: a descriptive correlational study. International journal of environmental research and public health, 19(6), 3185. https://doi.org/10.3390/ijerph19063185
Thompson, A., Dewa, C., & Phare, S. (2012). The suicidal process: age of onset and severity of suicidal behaviour. Social psychiatry and psychiatric epidemiology, 47(1263-1269), 1263-1269. https://doi.org/10.1007/s00127-011-0434-0
Torres, A., Campos, L., Lima, M., & Ramos-Cerqueira, A. (2018). Suicidal ideation among medical students: prevalence and predictors. The Journal of nervous and mental disease, 206(3), 160-168. https://doi.org/10.1097/NMD.0000000000000734
Turan, N., Durgun, H., Kaya, H., Aştı, T., Yilmaz, Y., Gündüz, G., . . . Ertaş, G. (2020). Relationship between nursing students' levels of internet addiction, loneliness, and life satisfaction. Perspectives in psychiatric care, 56(3), 598-604. https://doi.org/10.1111/ppc.12474
Velarde-Mayol, C., Fragua-Gil, S., & García-de-Cecilia, J. (2016). Validación de la escala de soledad de UCLA y perfil social en la población anciana que vive sola. SEMERGEN-Medicina de Familia, 42(3), 177-183. https://doi.org/10.1016/j.semerg.2015.05.017
Wolf, E. J., Harrington, K. M., Clark, S. L., & Miller, M. W. (2013). Sample size requirements for structural equation models: An evaluation of power, bias, and solution propriety. Educational and Psychological Measurement, 73(6), 913-934. https://doi.org/10.1177/0013164413495237
Woodward, S., Bari, S., Vike, N., Lalvani, S., Stetsiv, K., Kim, B., & Katsaggelos, A. (2022). Anxiety, post–COVID-19 syndrome-related depression, and suicidal thoughts and behaviors in COVID-19 survivors: cross-sectional study. JMIR Formative Research, 6(10), e36656. https://doi.org/10.2196/36656
World Health Organization [WHO]. (2021). Suicide worldwide in 2019: global health estimates. WHO.
Xiao, P., Chen, L., Dong, X., Zhao, Z., Yu, J., Wang, D., & Li, W. (2022). Anxiety, depression, and satisfaction with life among college students in China: nine months after initiation of the outbreak of COVID-19. Frontiers in psychiatry, 12, 777190. https://doi.org/10.3389/fpsyt.2021.777190
Yang, Y., Liu, Y., Jiang, Z., Mo, J., Wang, C., Yang, Y., . . . Lin, L. (2021). Negative affect and life satisfaction mediate the association between negative life events and suicidal ideation in college students. Psychology, Health & Medicine, 26(6), 692. https://doi.org/10.1080/13548506.2020.1861637
Yao, Y., Chang, W., Jin, Y., Chen, Y., He, L., & Zhang, L. (2014). Life satisfaction, coping, self‐esteem and suicide ideation in C hinese adolescents: a school‐based study. Child: care, health and development, 40(5), 747-752. https://doi.org/10.1111/cch.12142
How to Cite
APA
ACM
ACS
ABNT
Chicago
Harvard
IEEE
MLA
Turabian
Vancouver
Download Citation
License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The RCP is published under the Creative Commons license and can be copied and reproduced according to the conditions of this license (http://creativecommons.org/licenses/by-nc-nd/2.5). RCP articles are available online at https://revistas.unal.edu.co/index.php/psicologia/issue/archive. If you would like to subscribe to the RCP as reader, please go to https://revistas.unal.edu.co/index.php/psicologia/information/readers and follow the instructions mentioned in the webpage. Additionally, a limited number of print journals are available upon request. To request print copies, please email revpsico_fchbog@unal.edu.co.












