{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:21:23Z","timestamp":1787062883740,"version":"build-2736575974"},"reference-count":87,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003093","name":"Ministry of Higher Education Malaysia","doi-asserted-by":"crossref","award":["(FRGS\/1\/2020\/SS0\/UMT\/02\/4)"],"award-info":[{"award-number":["(FRGS\/1\/2020\/SS0\/UMT\/02\/4)"]}],"id":[{"id":"10.13039\/501100003093","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Studies have documented a heightened risk of suicidal ideation in response to stressors, especially among people from socioeconomically disadvantaged backgrounds. However, the mechanisms of this association remain elusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>Drawing on the social deterioration and counteractive models, this study aims to elucidate the pathways linking stressors to suicidal ideation through serial mediation of social support and mental health symptoms in Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>Data were collected from 404 low-income adults (33.2% male and 66.8% female) receiving monthly financial assistance from Malaysia\u2019s social welfare department. We employed stressor measures (i.e. financial, family and work), the Oslo Social Support Scale, the Patient Health Questionnaire and the Suicidal Behaviour Questionnaire-Revised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 46.8% of participants reported mild-to-severe anxiety and depressive symptoms, with 11.1% classified as high risk for suicide. Direct and indirect effects were found. After controlling for age and gender, social support and mental health symptoms mediated the link between stressors and suicidal ideation. The serial mediation analysis indicates that stressors are connected to heightened suicidal ideation through a sequence involving insufficient social support, followed by elevated levels of mental health symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Understanding the multifaceted relationships among stressors, social support, mental health symptoms and suicide ideation expands the potential for developing targeted interventions and preventive strategies tailored for vulnerable populations. Clinical work with low-income individuals may include implementing early systematic efforts to develop accessible mental health and integrated care services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640241288686","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T09:34:49Z","timestamp":1729157689000},"page":"295-306","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Stressors and suicidal ideation in low-income adults in Malaysia: A serial mediation analysis of social support and mental health symptoms"],"prefix":"10.1177","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7817-5677","authenticated-orcid":false,"given":"Madihah","family":"Shukri","sequence":"first","affiliation":[{"name":"Faculty of Business Economics and Social Development, Universiti Malaysia Terengganu, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J","family":"Armitage","sequence":"additional","affiliation":[{"name":"Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, UK"},{"name":"NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong Siew","family":"Koon","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Mental Health, Kuala Lumpur Hospital, Wilayah Persekutuan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurul Nabila","family":"Tarmizi","sequence":"additional","affiliation":[{"name":"Faculty of Business Economics and Social Development, Universiti Malaysia Terengganu, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"bibr1-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-9125.1992.tb01093.x"},{"key":"bibr2-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2013.01.005"},{"key":"bibr3-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtumed.2021.04.010"},{"key":"bibr4-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2014.12.002"},{"key":"bibr5-00207640241288686","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.592467"},{"key":"bibr6-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1219-2"},{"key":"bibr7-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0257357"},{"key":"bibr8-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.09.077"},{"key":"bibr9-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018786228664"},{"key":"bibr10-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.12.086"},{"key":"bibr11-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2021.106047"},{"key":"bibr12-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/24705470211000338"},{"key":"bibr13-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.07.102"},{"key":"bibr14-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2008.10.008"},{"key":"bibr15-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.124.1.3"},{"key":"bibr16-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1023\/A:1022133228206"},{"key":"bibr17-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-006-0051-5"},{"key":"bibr18-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1080\/0144929X.2021.1877355"},{"key":"bibr19-00207640241288686","unstructured":"Department of Statistics Malaysia. (2019). Household income and basic amenities survey report 2019. https:\/\/www.dosm.gov.my\/v1\/index.php?r=column\/pdfPrev&id=TU00TmRhQ1N5TUxHVWN0T2VjbXJYZz09"},{"key":"bibr20-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.113998"},{"key":"bibr21-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-012-9611-1"},{"key":"bibr22-00207640241288686","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2021.11030"},{"key":"bibr23-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwaa146"},{"key":"bibr24-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/0020764013486777"},{"key":"bibr25-00207640241288686","doi-asserted-by":"publisher","DOI":"10.2307\/2137101"},{"key":"bibr26-00207640241288686","doi-asserted-by":"crossref","unstructured":"Ensel W. M., Lin N. (1996). Distal stressors and the life stress process. Journal of Community Psychology, 24(1), 66\u201382. https:\/\/doi.org\/10.1002\/(SICI)1520-6629(199601)24:1<66:AID-JCOP5>3.0.CO;2-1","DOI":"10.1002\/(SICI)1520-6629(199601)24:1<66::AID-JCOP5>3.0.CO;2-1"},{"key":"bibr27-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2020-215213"},{"key":"bibr28-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1080\/02673843.2022.2151715"},{"key":"bibr29-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.12.008"},{"key":"bibr30-00207640241288686","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.536188"},{"key":"bibr31-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2023.02.024"},{"key":"bibr32-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1007\/s11469-021-00604-0"},{"key":"bibr33-00207640241288686","doi-asserted-by":"publisher","DOI":"10.19082\/5212"},{"key":"bibr34-00207640241288686","unstructured":"Hayes A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. The Guilford Press. https:\/\/www.afhayes.com\/"},{"key":"bibr35-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-7358(01)00102-7"},{"key":"bibr36-00207640241288686","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.828379"},{"key":"bibr37-00207640241288686","volume":"24","author":"Ismail R. N. H. R.","year":"2021","journal-title":"Journal of Legal Ethical & Regulatory Issues"},{"key":"bibr38-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-022-03973-5"},{"key":"bibr39-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30248-8"},{"key":"bibr40-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/1077727X980272002"},{"key":"bibr41-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-1843-7_15"},{"key":"bibr42-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/0164027591133004"},{"key":"bibr43-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(09)70864-3"},{"key":"bibr44-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22295"},{"key":"bibr45-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1017\/S1138741600004273"},{"key":"bibr46-00207640241288686","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.770252"},{"key":"bibr47-00207640241288686","doi-asserted-by":"publisher","DOI":"10.2307\/2136667"},{"key":"bibr48-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.08.081"},{"key":"bibr49-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.05.093"},{"key":"bibr50-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2013.08.004"},{"key":"bibr51-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.09.005"},{"key":"bibr52-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/56.4.P214"},{"key":"bibr53-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2021.100868"},{"key":"bibr54-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.031809.130711"},{"key":"bibr55-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1111\/fare.12258"},{"key":"bibr56-00207640241288686","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.08m04986gry"},{"key":"bibr57-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/019251398019002004"},{"key":"bibr58-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.128405"},{"key":"bibr59-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2017-104531"},{"key":"bibr60-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1186\/1751-0759-5-8"},{"key":"bibr61-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdp093"},{"key":"bibr62-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/bs.irn.2019.11.006"},{"key":"bibr63-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2020.212"},{"key":"bibr64-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/107319110100800409"},{"key":"bibr65-00207640241288686","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.669106"},{"key":"bibr66-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.59.6.1266"},{"key":"bibr67-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.01.012"},{"key":"bibr68-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114475"},{"key":"bibr69-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000058"},{"key":"bibr70-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.11.1249"},{"key":"bibr71-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.27491"},{"key":"bibr72-00207640241288686","volume-title":"The stress of life","author":"Selye H.","year":"1956"},{"key":"bibr73-00207640241288686","doi-asserted-by":"crossref","unstructured":"Sheffler J. L., Joiner T. E., Sachs-Ericsson N. J. (2021). The interpersonal and psychological impacts of COVID-19 on risk for late-life suicide. The Gerontologist, 61(1), 23\u201329. https:\/\/doi.org\/10.1093\/geront\/gnaa1032","DOI":"10.1093\/geront\/gnaa103"},{"key":"bibr74-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordhb\/9780190681777.013.1"},{"key":"bibr75-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/13591053211014597"},{"key":"bibr76-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-019-00534-5"},{"key":"bibr77-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14127-3"},{"key":"bibr78-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1201\/b12215-7"},{"key":"bibr79-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1037\/a0018697"},{"key":"bibr80-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.01.051"},{"key":"bibr81-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2011.581622"},{"key":"bibr82-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.01.061"},{"key":"bibr83-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1736-5"},{"key":"bibr84-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.09.081"},{"key":"bibr85-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2020.05.006"},{"key":"bibr86-00207640241288686","doi-asserted-by":"publisher","DOI":"10.1177\/0044118X17700318"},{"key":"bibr87-00207640241288686","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.669833"}],"container-title":["International Journal of Social Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00207640241288686","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00207640241288686","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00207640241288686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:55:44Z","timestamp":1777463744000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00207640241288686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,16]]},"references-count":87,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1177\/00207640241288686"],"URL":"https:\/\/doi.org\/10.1177\/00207640241288686","relation":{},"ISSN":["0020-7640","1741-2854"],"issn-type":[{"value":"0020-7640","type":"print"},{"value":"1741-2854","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,16]]}}}