Harsh parenting and suicidal ideation of undergraduates: The mediating role of psychache and the moderating role of resilience

Abstract

BACKGROUND

Harsh parenting represents a significant risk factor for suicidal ideation among college students. However, the underlying psychological mechanisms through which harsh parenting contributes to suicidal ideation remain inadequately understood, particularly regarding potential mediating and moderating factors.

AIM

To examine the mediating role of psychache and the moderating role of resilience in the relationship between harsh parenting and suicidal ideation among Chinese college students.

METHODS

A total of 890 college students from four comprehensive universities in China completed cross-sectional assessments between September and November 2024 using the Harsh Parenting Scale, Beck Scale for Suicide Ideation, Psychache Scale, and Ego-Resiliency Scale. Structural equation modeling with bias-corrected bootstrap procedures was employed to test the moderated mediation model.

RESULTS

Harsh parenting was significantly and positively associated with suicidal ideation (β = 0.39, P < 0.01). Psychache significantly and partially mediated this relationship, accounting for 35.71% of the total effect (indirect effect = 0.10, 95% confidence interval: 0.05-0.15). Resilience significantly moderated the relationships between harsh parenting and psychache (β = -0.20, P < 0.01), harsh parenting and suicidal ideation (β = -0.19, P = 0.02), and psychache and suicidal ideation (β = -0.13, P = 0.01). Simple slope analyses indicated that these relationships were significant under low resilience conditions but became non-significant or substantially weakened under high resilience conditions.

CONCLUSION

Psychache serves as an accelerating mechanism and resilience functions as a protective mechanism in the process whereby harsh parenting is associated with suicidal ideation among college students. These findings provide empirical support for suicide prevention strategies centered on psychache intervention and resilience cultivation.

Key Words: Harsh parenting; Suicidal ideation; Psychache; Resilience; Moderated mediation

Core Tip: This study reveals a moderated mediation model linking harsh parenting to suicidal ideation among college students. Psychache partially mediates this relationship, accounting for approximately 36% of the total effect, while resilience moderates all three pathways (harsh parenting - psychache, harsh parenting - suicidal ideation, and psychache - suicidal ideation). Under high resilience conditions, the detrimental effects of harsh parenting are substantially attenuated. These findings highlight the importance of targeting psychache reduction and resilience enhancement in suicide prevention programs for college students from adverse family backgrounds.

INTRODUCTION

In recent years, the intensification of social competition and sustained escalation of psychological pressure have rendered mental health issues among college students a paramount global concern[1,2]. Suicide, as a severe public health problem, demonstrates an alarming prevalence trend within the college student population[3]. Suicidal ideation, serving as a critical warning signal preceding suicidal behavior, is conceptualized as an individual's thoughts, plans, or intentions to terminate their own life, constituting a pivotal stage in the trajectory toward suicidal behavior[4,5]. Epidemiological investigations indicate that the lifetime prevalence of suicidal ideation among college students worldwide approximates 10%-25%, underscoring the pressing need to comprehend its formative mechanisms[6,7].

From the perspective of developmental ecological systems theory, individual mental health development emerges from the interactive influences of multi-level environmental factors, with the family microsystem exerting foundational and determinative effects[8]. Harsh parenting, as a salient risk factor within the family environment, may be associated with profound and enduring deleterious impacts on individual psychological development[9]. Consequently, systematic exploration of the mechanisms through which harsh parenting relates to suicidal ideation among college students possesses not only substantial theoretical significance but also critical practical implications for formulating effective prevention and intervention strategies.

Harsh parenting and suicidal ideation

Harsh parenting denotes severe, punitive, and controlling child-rearing practices employed by parents, predominantly characterized by physical punishment, verbal aggression, emotional neglect, and excessive psychological control[10,11]. This parenting style encompasses not merely overt physical violence but also covert psychological trauma, including threats, intimidation, and humiliation. Developmental psychopathology theory posits that adverse early parenting experiences constitute significant risk factors for individual psychological development, with effects that are frequently long-term and cumulative, potentially persisting into adolescence and adulthood[12,13]. Substantial empirical evidence supports this theoretical perspective. In a large-scale meta-analysis encompassing over 124000 participants, Liu et al[14] discovered that individuals who experienced harsh parental treatment during childhood exhibited 2.5 times the risk of developing suicidal ideation in adulthood compared to those without such experiences. Miller et al[15] further confirmed through systematic review that various forms of childhood maltreatment demonstrate significant associations with adolescent suicidal behavior. Based on these theoretical perspectives and empirical evidence, this study proposes hypothesis H1: Harsh parenting significantly and positively predicts suicidal ideation among college students.

Mediating role of psychache

The concept of psychache was pioneered by Shneidman[16], referring to an unbearable suffering experience deep within an individual’s psyche, a composite negative emotional state encompassing despair, loneliness, shame, anger, fear, and other negative emotions. Shneidman[16] identified psychache as the core element of suicide, proposing the influential “psychache theory”, which postulates that the fundamental motivation for suicide is to escape intolerable psychache. The central tenet of psychache theory posits that suicidal behavior essentially constitutes an escape behavior, with the fundamental objective of terminating unbearable internal suffering[17,18]. When an individual’s psychache exceeds their tolerance threshold, suicide may be perceived as a “solution”. This theoretical perspective has garnered substantial empirical support[19]. The Psychache Scale developed by Holden et al[20] has demonstrated robust associations with suicidal ideation and behavior across multiple studies. Troister and Holden[21] found that psychache more effectively predicts suicidal ideation than traditional indicators of depression and hopelessness.

Examining the mechanisms of psychache generation, harsh parenting may serve as a critical source of sustained psychache. First, harsh parenting practices may inflict direct physical and psychological trauma on children, generating acute negative emotional experiences such as fear, helplessness, and anger[22]. Second, such parenting may systematically undermine children’s self-esteem and self-worth, producing profound feelings of rejection and worthlessness[23]. Finally, prolonged harsh parenting may be associated with the formation of rigid negative cognitive schemas, whereby individuals maintain pessimistic attitudes toward themselves, others, and the world, consequently experiencing persistent psychache[24]. Multiple studies have confirmed the mediating role of psychache between various risk factors and suicidal ideation. Campos et al[25] found that psychache significantly mediated the relationship between general psychological distress and suicidal ideation. Orbach et al[26] also identified psychache as an important mediating variable in research on childhood trauma and suicidal behavior. Based on the above theoretical analysis and empirical evidence, this study proposes hypothesis H2: Psychache mediates the relationship between harsh parenting and suicidal ideation among college students.

Moderating role of resilience

Resilience represents a core concept in positive psychology and developmental psychopathology, denoting the dynamic process and capacity through which individuals maintain adaptive functioning when confronting adversity, trauma, threats, or significant life stressors[27]. Resilience encompasses not only the capacity to recover from adversity but also the ability to sustain normal functioning and even achieve transformative growth amid adversity[28]. Connor and Davidson[29] conceptualized resilience as a multidimensional construct incorporating personal competence, tolerance and acceptance of change, sense of control, spiritual influences, and secure attachments. From a theoretical perspective, the stress-buffering model provides an essential framework for understanding the protective role of resilience[30]. This model posits that resilience, as a crucial protective factor, does not directly influence mental health outcomes but rather buffers against the effects of risk factors. Individuals with high resilience typically possess more positive cognitive patterns and more effective coping strategies[31].

Empirical research provides compelling evidence for the protective role of resilience. Roy et al[32] found that resilience significantly moderated the relationship between childhood trauma and suicide risk. Johnson et al[33] demonstrated that resilience moderated the relationship between adolescent life stress and subsequent development of suicidal ideation. Among college students, Wilcox et al[34] discovered that resilience served as a critical protective factor against suicidal ideation. Based on the aforementioned theoretical analysis and empirical evidence, this study proposes hypothesis H3: Resilience moderates the relationships between harsh parenting and psychache, harsh parenting and suicidal ideation, and psychache and suicidal ideation. Specifically, under low resilience conditions, these relationships are more pronounced; under high resilience conditions, these relationships are attenuated or become non-significant.

In summary, this study aimed to construct a moderated mediation model to systematically explore the mechanisms through which harsh parenting is associated with suicidal ideation among college students, examining the mediating role of psychache and the moderating role of resilience, thereby providing theoretical foundations and practical guidance for college student suicide prevention and mental health promotion.

MATERIALS AND METHODS

Participants

This study recruited 890 college students (380 males, 510 females) from four comprehensive universities in China through convenience sampling between September and November 2024. Data were collected via an online survey platform (Wenjuanxing), and questionnaires were distributed through class representatives. A total of 950 questionnaires were distributed; 60 were excluded due to incomplete responses or obvious response patterns (e.g., all identical answers), yielding a final valid sample of 890 (response rate: 93.7%). Inclusion criteria were: (1) Currently enrolled undergraduate students; (2) Aged 18-24 years; and (3) Voluntary participation with informed consent. Students with a reported diagnosis of a major psychiatric disorder were excluded. Participants ranged in age from 18 years to 24 years (mean = 20.32, SD = 1.47). The sample comprised 245 freshmen, 231 sophomores (i.e., second-year undergraduates), 223 juniors, and 191 seniors. All participants provided informed consent and voluntarily completed the questionnaires. The study protocol received approval from the institutional ethics committee.

Measures

Harsh parenting: This study utilized a culturally adapted harsh parenting scale based on prior research[35-38]. The scale comprises 4 items (e.g., “My parents often yell at me”). These items cover key dimensions of harsh parenting including verbal aggression (e.g., yelling and threatening), physical punishment, and psychological control (e.g., humiliation and intimidation), reflecting the most prevalent forms of harsh parenting documented in Chinese family contexts. While brief, this measure was chosen for its cultural validity and parsimonious fit for survey use in large student samples; its limitations as a brief instrument are acknowledged in the Limitations section. Responses were rated on a 5-point Likert scale (1 = never to 5 = always). Higher scores indicate more severe harsh parenting experiences. In this study, Cronbach’s α was 0.82.

Suicidal ideation: The Beck Scale for Suicide Ideation[39] was employed to assess suicidal ideation. This widely used scale consists of 19 items rated on a 3-point scale (0 to 2). Higher total scores indicate more severe suicidal ideation. The Beck Scale for Suicide Ideation has demonstrated good reliability and validity in Chinese college student populations[40]. In this study, Cronbach’s α was 0.89.

Psychache: The Psychache Scale[20] was utilized to measure psychological pain. This 13-item scale assesses the intensity of psychological suffering (e.g., “I feel psychological pain”). Responses were rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Higher scores reflect greater psychache. In this study, Cronbach’s α was 0.91.

Resilience: The Ego-Resiliency Scale[41] was employed to assess resilience. This 14-item scale measures adaptive flexibility in response to environmental demands (e.g., “I quickly get over and recover from being startled”). Responses were rated on a 4-point Likert scale (1 = does not apply at all to 4 = applies very strongly). Higher scores indicate greater resilience. In this study, Cronbach’s α was 0.84.

Statistical analysis

All statistical analyses were conducted using SPSS 26.0 and Mplus 8.3. First, descriptive statistics and correlation analyses were performed for all variables. Second, item parceling was employed to create indicators for latent variables[42]; specifically, the item-to-construct balance strategy was adopted, in which items were assigned to parcels in a manner that balanced the factor loadings across parcels, following the recommendations of Little et al[42]. Third, confirmatory factor analysis was conducted to examine the measurement model. Fourth, structural equation modeling was used to test the hypothesized moderated mediation model. Model fit was evaluated using multiple indices: χ²/df, root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis Index (TLI), and standardized root mean square residual (SRMR)[43,44]. Fifth, the bias-corrected percentile bootstrap method with 1000 resamples was employed to test mediation effects[45]. Finally, latent interaction terms were created using mean-centered indicators to test moderation effects[46], and simple slope analyses were conducted to interpret significant interactions.

RESULTS

Common method bias test

Harman’s single-factor test was conducted to examine common method bias. Unrotated principal component analysis extracted 11 factors with eigenvalues greater than 1. The first principal component explained 28.12% of the variance, below the 40% critical threshold, indicating no serious common method bias in this study. It should be noted that Harman’s single-factor test has well-documented limitations in sensitivity; more rigorous methods (e.g., the Unmeasured Latent Method Construct approach) are recommended for future studies. This limitation is further discussed in the Limitations section.

Correlation analysis among variables

Descriptive statistics and correlation analyses for the main variables are presented in Table 1. Results revealed that harsh parenting was significantly and positively correlated with suicidal ideation (r = 0.39, P < 0.01) and psychache (r = 0.35, P < 0.01). Psychache was significantly and positively correlated with suicidal ideation (r = 0.56, P < 0.01). The correlation patterns among variables were highly consistent with theoretical expectations.

Table 1 Descriptive statistics and correlations among variables (n = 890).

Variable	mean	SD	1	2	3
Harsh parenting	6.84	2.17	-	-	-
Psychache	20.98	5.77	0.35b	-	-
Resilience	39.01	7.21	-0.20b	-0.39b	-
Suicidal ideation	1.78	2.21	0.39b	0.56b	-0.41b

^bP < 0.01.

Measurement model

Confirmatory factor analysis was performed to evaluate whether the measurement model adequately fit the sample data. The measurement model incorporated four latent constructs (harsh parenting, psychache, resilience, and suicidal ideation) together with their corresponding indicators (item parcels for all variables). The measurement model exhibited excellent fit to the data: χ²/df = 2.77, P < 0.01; RMSEA = 0.02, 95% confidence interval (CI): 0.01-0.04; TLI = 0.99; SRMR = 0.03; CFI = 0.99. All factor loadings of indicators on latent variables reached significance (P < 0.01), confirming that all latent constructs were adequately represented by their indicators. Standardized factor loadings ranged from 0.60 to 0.89, demonstrating robust relationships between observed indicators and their respective latent constructs.

Structural model and mediation analysis

Structural equation modeling analysis was conducted to test the hypothesized moderated mediation model (Figure 1). The structural model demonstrated adequate fit: χ²/df = 3.93, P < 0.01; RMSEA = 0.06, 95%CI: 0.05-0.07; TLI = 0.97; SRMR = 0.05; CFI = 0.98. Results revealed that harsh parenting was significantly and positively associated with suicidal ideation (β = 0.39, P < 0.01), supporting hypothesis H1. Harsh parenting also significantly related to psychache (β = 0.28, P < 0.01), which in turn was significantly associated with suicidal ideation (β = 0.36, P < 0.01). Bootstrap analysis indicated that the indirect effect of harsh parenting on suicidal ideation through psychache was significant (indirect effect = 0.10, 95%CI: 0.05-0.15), accounting for 35.71% of the total effect. These results confirm hypothesis H2, establishing psychache as a significant partial mediator.

Figure 1 The structural model. ^bP < 0.01.

Moderation analysis

Resilience significantly predicted suicidal ideation (β = -0.39, P < 0.01, 95%CI: -0.30 to -0.48) and psychache (β = -0.36, P < 0.01, 95%CI: -0.29 to -0.46); the interaction between harsh parenting and resilience significantly predicted psychache (β = -0.20,P < 0.01, 95%CI: -0.12 to -0.28), as well as suicidal ideation (β = -0.19, P = 0.02, 95%CI: -0.11 to -0.29); the interaction between psychache and resilience significantly predicted suicidal ideation (β = -0.13, P = 0.01, 95%CI: -0.01 to -0.24). To further elucidate the moderating effects of resilience, participants were categorized into high resilience (mean + 1 SD) and low resilience (mean - 1 SD) groups, and mean difference tests were conducted across main variables. Results revealed significant differences between high and low resilience groups in harsh parenting (t = 3.88, P < 0.01), psychache (t = 7.74, P < 0.01), and suicidal ideation (t = 9.66, P < 0.01).

Simple slope analyses indicated that under low resilience conditions, harsh parenting significantly predicted psychache (β = 0.62, P < 0.01), whereas under high resilience conditions, this relationship was non-significant (β = 0.09, P = 0.26). Under low resilience conditions, harsh parenting significantly predicted suicidal ideation (β = 0.67, P < 0.01); under high resilience conditions, this relationship was non-significant (β = 0.03, P = 0.66). Under low resilience conditions, psychache significantly predicted suicidal ideation (β = 0.74, P < 0.01); under high resilience conditions, the predictive capacity of psychache on suicidal ideation was substantially reduced (β = 0.18, P = 0.03). These results confirm hypothesis H3.

DISCUSSION

The present study systematically examined the mechanisms through which harsh parenting relates to suicidal ideation among Chinese college students, revealing significant mediation by psychache and moderation by resilience. These findings make several important contributions to the existing literature.

First, consistent with hypothesis H1 and prior research[14,15,47], harsh parenting was significantly and positively associated with suicidal ideation. This finding extends the existing literature by demonstrating the persistent impact of early family adversity on college-age young adults. The developmental psychopathology perspective suggests that adverse early parenting experiences create cumulative risk through disrupted attachment, impaired emotion regulation, and negative cognitive schemas[12,13].

Second, the mediation analysis confirmed hypothesis H2, revealing that psychache significantly mediated the harsh parenting-suicidal ideation relationship, accounting for approximately 36% of the total effect. This finding is consistent with Shneidman’s psychache theory[16] and provides direct empirical support for the role of psychological pain as an intervening mechanism. Harsh parenting may generate persistent psychache through multiple pathways: Direct trauma and negative emotional experiences[22], undermined self-esteem and self-worth[23], and formation of rigid negative cognitive schemas[24]. The finding that psychache partially mediated this relationship suggests that harsh parenting also exerts direct effects on suicidal ideation through other mechanisms not examined in the present study. Specifically, approximately 64% of the total effect remained unexplained by the psychache pathway, indicating that additional psychological mechanisms likely contribute. Potential candidates include ruminative thinking, which may sustain and intensify distress following harsh parenting experiences; thwarted belongingness, whereby harsh parenting erodes feelings of social connection; and diminished self-esteem, which may independently heighten vulnerability to suicidal ideation. Future research should incorporate these variables to more fully elucidate the pathway from harsh parenting to suicidal ideation.

Third, the moderation analyses confirmed hypothesis H3, demonstrating that resilience buffered all three pathways in the model. Simple slope analyses indicated that these relationships were significant under low resilience conditions but became non-significant or substantially weakened under high resilience conditions. This pattern supports the stress-buffering model[30,31] and aligns with previous research on resilience as a protective factor[48-51]. High-resilience individuals may possess superior cognitive reframing abilities, enabling them to reinterpret harsh parenting experiences more adaptively rather than internalizing them as personal deficiencies[50]. They may also demonstrate more effective emotion regulation strategies, preventing the accumulation of psychache into unbearable levels[51]. Furthermore, resilient individuals typically maintain broader social support networks and more active help-seeking behaviors, providing alternative resources for coping with family adversity.

Implications

The findings of this study have several important practical implications for college student suicide prevention. First, universities should establish comprehensive screening systems to identify students who have experienced harsh parenting, providing early intervention and support. Second, mental health services should incorporate psychache assessment and intervention as core components, with particular focus on alleviating psychological pain stemming from adverse family experiences. Third, resilience-building programs should be integrated into student mental health promotion efforts, including cognitive restructuring training, emotion regulation skill development, and social support network enhancement. Fourth, family education and parent training programs should emphasize positive parenting practices and the long-term impacts of harsh parenting on children's mental health.

Limitations

Several limitations should be acknowledged. First, the cross-sectional design precludes causal inferences; future longitudinal studies are needed to establish temporal precedence and causal relationships. Second, the reliance on self-report measures may introduce common method bias, despite statistical checks suggesting this was not a serious concern. Moreover, Harman’s single-factor test, which was used to assess common method bias, is recognized as a relatively insensitive approach; future studies should employ more rigorous methods such as the Unmeasured Latent Method Construct approach. Future research should incorporate multi-method assessments (i.e., converging evidence from multiple sources or procedures, such as self-reports combined with behavioral observations and physiological indicators, to reduce reliance on a single measurement method) including behavioral observations and physiological indicators. Third, the sample was drawn from Chinese universities, limiting generalizability to other cultural contexts. Fourth, this study focused on overall harsh parenting without distinguishing between paternal and maternal harsh parenting, which may have differential effects[36]. Fifth, the 4-item harsh parenting measure, while culturally validated and psychometrically sound (α = 0.82), may not fully capture the multidimensional nature of harsh parenting, including its physical, verbal, and psychological control dimensions; future research should employ more comprehensive assessments. Sixth, other potential mediators and moderators were not examined; future research should explore additional mechanisms and protective factors, such as rumination, thwarted belongingness, and self-esteem, which may account for the remaining direct effects of harsh parenting on suicidal ideation. Seventh, important demographic variables such as socioeconomic status, family structure, and urban/rural background were not assessed in the present study; future research should include these variables as potential confounders or moderators.

CONCLUSION

This study systematically examined the mechanisms through which harsh parenting relates to suicidal ideation among college students, revealing that psychache serves as a significant mediator and resilience functions as an important moderator. The findings illuminate the critical roles of psychache as an accelerating mechanism and resilience as a protective mechanism, providing empirical support for suicide prevention strategies centered on psychache intervention and resilience cultivation. These results underscore the importance of addressing adverse family experiences in college student mental health promotion and highlight the potential of resilience-building approaches in mitigating suicide risk.