Prolonged Exposure to Violence: Psychiatric Symptoms and Suicide Risk Among College Students in the Palestinian Territory

Objective: Little is known about the risk for suicide in those exposed to prolonged political and domestic violence. Thus, this study aims to explore suicidal ideation and attempts in a community sample of Palestinian students and identify the extent to which clinical variables are associated with suicidal ideation. Method: A cross-sectional design was utilized in this study, and 303 college and university students aged 18 to 23 from seven campuses in the Palestinian territory voluntarily and anonymously completed self-report questionnaires that assessed 12 months of suicidal ideation and attempts, posttraumatic stress symptoms (PTSS), depression, anxiety, and sleep problems. Results: The results showed high rates of suicidal ideation and attempts within the last 12 months. Severe symptoms of PTSS, depression, and sleep problems were reported compared with other college samples. An exploratory path analysis showed that PTSS is directly associated with suicidal ideation and indirectly by its association with sleep problems and depressive symptoms. Conclusion: The results highlight the elevated mental health difficulties of students living under prolonged exposure to violence and could be helpful to policy and decision-makers in health care and academic institutions in implementing and design interventions aim to reduce depression and PTSS. Screening for PTSS and depression is a vital first step in suicide prevention efforts in college students exposed to trauma. Future studies should assess the types of traumatic stress exposure and health risk behaviors to offer a more in-depth view. Clinical Impact StatementThis study offered initial insight into one of the most severe mental health issues, namely suicide behaviors among those who have been exposed to political and domestic violence for prolonged periods. The results highlighted the extent and effects of exposure to prolonged trauma on suicidal ideation and mental health, specifically among young adults living under prolonged exposure to violence. The study results could be helpful to policy and decision-makers in health care and academic institutions to implement and design interventions aim to reduce depression and PTSS.