A cross-cultural examination of suicide ideation in Southeast Asia: Insights from Malaysian and Indonesian populations

Childhood maltreatment is a well-documented risk factor for mental health disorders and suicidal behavior. While existing literature has extensively examined individual predictors of suicide ideation, limited research has investigated the mediating role of psychological factors such as depression, psychache, and self-harm in the context of childhood maltreatment, especially among young Southeast Asian populations. This study examines the indirect effects of childhood maltreatment on suicide ideation through depression, psychache, and self-harm among Malaysian and Indonesian university students. A total of 291 undergraduate students participated in a cross-sectional survey using standardized instruments: the Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory-II (BDI-II), Psychache Scale, Beck Suicide Ideation Scale (BSIS), and Self-Harm Inventory (SHI). Results from hierarchical regression revealed that depression, psychache, and self-harm were significant predictors of suicide ideation, with self-harm emerging as the strongest predictor. Mediation analysis using PROCESS Macro Model 4 further demonstrated that the relationship between childhood maltreatment and suicide ideation was fully mediated by these three variables, indicating that childhood maltreatment does not directly predict suicide ideation once psychological distress factors are accounted for. These findings highlight the importance of identifying and addressing self-harm, depression, and psychache in suicide prevention strategies. The study also underscores the need for culturally sensitive interventions tailored to the specific needs of Southeast Asian university students, where mental health stigma and sociocultural norms may influence help-seeking behaviors. Integrating early screening for childhood trauma and psychological distress into university counseling services may improve mental health outcomes. Future research should consider longitudinal designs and additional cultural and psychosocial mediators to further clarify causal pathways and enhance generalizability. This study contributes to the broader discourse on suicide prevention by offering region-specific insights into the complex psychological mechanisms underlying suicidal ideation.