Suicide ranks as one of the primary causes contributing to morbidity and mortality among young adults globally. In China, specifically, it is estimated that approximately 10.7% of college students have experienced suicidal ideation (1) and 4.4% have formulated plans toward such ends (2). While there exists no precise national data regarding suicide rates among this population at the present time, suicide among college students presents a significant public health issue throughout China. Although contemplating suicide serves as an important indicator for predicting future attempts or completed acts thereof, many instances where individuals experience these thoughts are transient phenomena which do not necessarily culminate into concrete plans or actions; thus, identifying variables which contribute toward transitioning from mere contemplations toward actualized planning remains crucially important (3–6).

To date, numerous studies have been conducted to investigate the factors associated with suicidal ideation among Chinese college students. The presence of psychiatric symptoms has consistently emerged as the most reliable risk factor for suicidal ideation. For example, meta-analytic data revealed that depressive symptoms were associated with a 3.2-fold increase in the likelihood of suicidal ideation among Chinese college students (7). Similarly, a meta-analysis involving 66,752 participants reported a strong association between anxiety symptom and students’ suicidal ideation (8). Additionally, stress symptoms have been identified as predictors of suicidal ideation (9). It is estimated that approximately 20% of patients with schizophrenia attempt suicide at least once during their life (10). In addition, exposure to adverse childhood experiences strongly increases the probability of suicide behaviors in patients with schizophrenia (11). However, it remains unknown whether these psychiatric symptoms can predict the occurrence of suicidal plans among individuals experiencing suicidal thoughts.

On the contrary, in line with a positive psychology framework, numerous psychological variables have been proposed as potential protective factors against suicide. For instance, accumulating evidence suggests that gratitude is linked to reduced psychological distress (12) and decreased overall symptoms of psychopathology (13), thereby conferring resilience against suicide (14). Furthermore, a correlation has been found between the meaning of life and lower levels of suicidal ideation and attempts (15). Additionally, hope has consistently been reported to be associated with greater life satisfaction, reduced psychological distress, and enhanced psychological well-beings, thus acting as a buffer against suicide (16). Again, it remains unclear whether these positive psychological variables can effectively prevent the transition from ideation to an actual plan.

According to the ideation-to-action framework (3–6), it is crucial to identify variables that can effectively predict and elucidate the transition from suicidal ideation to a concrete suicidal plan. Given that virtually all students with a suicidal plan also experience suicidal ideation, it becomes imperative to control for this factor when attempting to identify predictors of a suicide plan. However, as far as our knowledge extends, no studies have thus far examined the factors that predict a suicide plan among Chinese college students who have experienced suicidal thoughts. This research gap is significant because gaining a better understanding of the progression from suicidal ideation to planning can greatly facilitate the development of targeted intervention programs for individuals at risk. Consequently, this study aims to investigate whether certain frequently cited factors can differentiate between those who have formulated a specific suicide plan and those who have only experienced suicidal thoughts without any planning, based on data obtained through a cross-sectional survey.

Suicide among college students remain a significant public health concern in China. In order to advance the prevention efforts, it is crucial to gain a deeper understanding of the factors that contribute to or deter the transition from suicidal ideation to actual plans. This study, aligned with an ideation-to-action framework (3–6), aimed to investigate whether certain frequently mentioned factors could differentiate individuals who had made specific plans for suicide from those who had experienced suicidal ideation without planning. Our primary findings indicate that, while most of these potential variables distinguished between students with and without suicidal ideation, only two factors (namely, presence of stress and lower scores of SHS-A) were able to distinguish individuals with concrete suicidal plans from those who had contemplated suicide but did not have a plan in place. These findings hold significant implications for the development of effective strategies for suicide prevention and intervention.

Regarding psychiatric symptoms, our findings suggest that depression and anxiety are significant predictors of suicidal ideation but do not differentiate between individuals with a suicidal plan and those without one. This pattern aligns with previous literature. Our previous study in college students demonstrated that screening positive for psychiatric disorders offered limited discriminatory value in distinguishing suicide attempters from suicidal ideators (25). Similarly, a meta-analysis of 27 studies revealed that while depression strongly predicted suicidal ideation, its effect was minimal to small when comparing attempters to ideators (4). Importantly, our results indicate a significant positive association between the presence of stress and the development of a suicidal plan among ideators. We cautiously speculate that stress symptoms may facilitate the transition from mere ideation to planning, as prior research has shown a correlation between perceived stress and increased likelihood of developing a specific suicidal plan one year later (26).

Our findings, in line with a positive psychology framework, revealed that individuals with suicidal ideation displayed significantly lower scores on GQ-6, MLQ-P, MLQ-S, SHS-P, and SHS-A compared with those without such thoughts. However, except for the scores of SHS-A, these positive psychological variables failed to distinguish between individuals with suicidal plans and those with ideation alone. These results suggest that hope agency may be the sole factor that provides protection against the transition from ideation to planning suicide. These findings are particularly intriguing and significant because hope agency could serve as a valuable target for interventions aimed at reducing suicide risk. Indeed, hope agency fosters a sense of connectedness to successful determination. According to the three-step theory (27), this connectedness can surpass their psychological pain or hopelessness, thereby impeding the progression from occasional suicidal desires to an actual plan.

Several limitations of the current study should be acknowledged. Firstly, a cross-sectional research design was employed instead of a longitudinal approach, thus warranting the need for future longitudinal and prospective studies to establish causal relationships among the variables. Secondly, the sample size of participants with suicidal plan was small, which limited statistical power in detecting differences. Thirdly, various confounding factors such as social support (28), perceived discrimination (29), gender identity, and sexual orientation may have influenced the results of this study. Therefore, future research design should incorporate additional relevant variables to enhance our understanding of the transition process from suicidal ideation to suicide planning. Lastly, potential issues like intentional non-reporting of suicidality and recall bias cannot be ruled out.

In conclusion, these findings suggest that the stress may contribute to vulnerability in transitioning from mere thoughts to actual planning regarding suicide; conversely, hope agency appears to offer protection against this transition process. Henceforth, special attention should be given by suicide prevention programs toward recognizing stress symptoms and implementing training programs for management of stress symptoms among students reporting suicidal ideation (30). Additionally, targeted interventions aimed at fostering hope among individuals who have experienced adverse and stressful life events are strongly advocated (31).