Implicit Health Beliefs and Suicidal Ideation in Chinese College Students: The Serial Mediating Roles of Lifestyle Behaviors and Anxiety Symptoms

The growing prevalence of mental health problems and suicidality among university students highlights the need to identify potentially modifiable psychological pathways that can inform preventive interventions. This study investigated the association between implicit health beliefs and suicidal ideation among Chinese college students and examined whether lifestyle behaviors and anxiety symptoms jointly explained this relationship. A cross-sectional survey was conducted among 1964 college students using the Lay Theories of Health Scale, 24-H Movement Behaviors Questionnaire, 7-item Generalized Anxiety Disorder, and Beck Suicide Ideation Scale. Serial mediation analyses were performed to test the indirect effects of lifestyle behaviors and anxiety symptoms. Implicit health beliefs were directly associated with lower suicidal ideation (direct effect: −0.0562, 95% CI: −0.0767 to −0.0357). In addition, lifestyle behaviors (indirect effect: −0.0049, 95% CI: −0.0086 to −0.0015), anxiety symptoms (indirect effect: −0.0644, 95% CI: −0.0770 to −0.0523), and their serial mediation pathway (indirect effect: −0.0018, 95% CI: −0.0035 to −0.0002) significantly mediated this association, accounting for 55.82% of the total effect. These findings suggest that implicit health beliefs may be associated with suicidal ideation, with lifestyle behaviors and anxiety symptoms statistically accounting for part of this association. Targeting these modifiable potential pathways may help inform the development of theory-driven psychological interventions to reduce suicidal ideation and promote mental health among higher education students.