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Loneliness and Suicidal Risk in Young Adults: Does Believing in a

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THE JOURNAL OF PSYCHOLOGY
2017, VOL. 151, NO. 5, 453–463
https://doi.org/10.1080/00223980.2017.1314928

Loneliness and Suicidal Risk in Young Adults: Does Believing

in a Changeable Future Help Minimize Suicidal Risk Among
the Lonely?
Edward C. Changa, Liangqiu Wana, Pengzi Lib, Yuncheng Guoc, Jiaying Hed, Yu Gue,
Yingjie Wangf, Xiaoqing Lig, Zhan Zhangh, Yingrui Sung, Casey N.-H. Batterbeea,
Olivia D. Changi, Abigael G. Lucasa, and Jameson K. Hirschj
a
University of Michigan; bUniversity of Toronto; cGettysburg College; dUniversity of International Business and
Economics; eThe University of British Columbia; fCoventry University; gBoston University; hMount Holyoke
College; iResearch in Action AcademyTM ; jEast Tennessee State University

ABSTRACT ARTICLE HISTORY

This study examined loneliness and future orientation as predictors of Received 28 September 2016
suicidal risk, namely, depressive symptoms and suicide ideation, in a Accepted 8 March 2017
sample of 228 college students (54 males and 174 females). Results of KEYWORDS
regression analyses indicated that loneliness was a significant College students; depression;
predictor of both indices of suicidal risk. The inclusion of future future orientation; loneliness;
orientation was found to significantly augment the prediction model suicide ideation
of both depressive symptoms and suicide ideation, even after
accounting for loneliness. Noteworthy, beyond loneliness and future
orientation, the Loneliness £ Future Orientation interaction term was
found to further augment both prediction models of suicidal risk.
Consistent with the notion that future orientation is an important
buffer of suicidal risk, among lonely students, those with high future
orientation, compared to low future orientation, were found to report
significantly lower levels of depressive symptoms and suicide ideation.
Some implications of the present findings for studying both risk and
protective factors associated with suicidal risk in young adults are
discussed.

Mental health concerns are a serious and growing problem in adult populations around the
world (World Health Organization [WHO], 2013), including in young adult populations
(e.g., college students; Zivin, Eisenberg, Gollust, & Golberstein, 2009). Among young adults,
suicide has been found to be the second leading cause of death behind unintentional injury
(e.g., fatal traffic accidents, accidental poisoning; Centers for Disease Control & Prevention,
2014). According to the model proposed by Bonner and Rich (1987), both distal (viz.,
depressive symptoms) and proximal (viz., suicidal behaviors) variables are believed to
increase the risk of committing suicide in young adult college students. Indeed, consistent
with their framework, findings from numerous studies over the past several decades have
consistently implicated depression and suicidal behaviors (e.g., suicide ideation) as

CONTACT Edward C. Chang changec@umich.edu Department of Psychology, University of Michigan, 530 Church
Street, Ann Arbor, MI 48109, USA.
© 2017 Taylor & Francis Group, LLC
454 E. C. CHANG ET AL.

important risk factors associated with suicide in college students (e.g., Furr, Westefeld,
McConnell, & Jenkins, 2001; Smith et al., 2015; Westefeld & Furr, 1987). Thus, it is not sur-
prising that researchers have been eager to identify variables that predict suicidal risk in
young adult populations, including in college student populations.

Loneliness as an Important Predictor of Suicidal Risk in College Students

One variable that has been strongly linked to suicidal risk in college students is loneliness. Lone-
liness is defined by feelings and thoughts of being isolated and disconnected from others
(Russell, Peplau, & Cutrona, 1980). According to Baumeister and Leary (1995), all humans have
a fundamental need to achieve a sense of belongingness or social connectedness with others.
Thus, it is not surprising that findings from studies on loneliness over the past three decades
have indicated that it is a robust correlate and predictor of a wide range of negative outcomes
(e.g., anxiety, stress, mortality; Blai, 1989; Hawkley & Cacioppo, 2010; Heinrich & Gullone,
2006). Indeed, according to Joiner’s (2005) interpersonal theory of suicide, social disconnected-
ness represents a critical factor involved in the development of suicidal risk. Consistent with this
view, findings from studies on loneliness have also implicated it as a reliable predictor of suicidal
risk in college student populations (e.g., Chang et al., 2015; Hirsch, Chang, & Jeglic, 2012; Lamis,
Ballard, & Patel, 2014; Muyan & Chang, 2015; Weber, Metha, & Nelsen, 1997). For example, in
a recent study, Chang, Muyan, and Hirsch (2015) found that loneliness was significantly associ-
ated with greater depressive symptoms and suicidal behaviors in college students. Indeed,
Westefeld and Furr (1987) found that in 47% of the college students who indicated a history of
suicide ideation, loneliness was the most frequently cited cause of suicide ideation. However,
what is less clear is the extent to which other variables might add to, or even moderate, the
hypothesized negative impact of loneliness on suicidal risk in college students.

Future Orientation as a Protective Factor?: Does Belief in a Changeable Future Make

a Difference?
According to Wingate et al. (2006), positive future cognitions represent an important category
of protective variables for understanding suicidal risk in adults. Among positive future cogni-
tions, future orientation, that is, the belief that one’s future can and will change for the better
(Hirsch et al., 2006), may be a particularly important variable to examine. First, future orienta-
tion is predicated on thoughts about realizing specific outcomes that are associated with posi-
tive adjustment within the individual (e.g., feeling good, reaching desired goals, being able to
engage in effective action; Hirsch et al., 2006). In that regard, future orientation is conceptually
different from more general positive future cognitions that tend to focus more on a general
disposition toward a positive expectation for future outcomes (Scheier & Carver, 1985) or a
positive expectation of reaching a desired goal in the future (Snyder, 2002). Accordingly,
believing that one will soon feel better should serve to broaden an individual’s range of per-
ceived options for dealing with painful or stressful situations in their life, and in turn reduce
the development of suicidal risk. Second, findings examining future orientation as a predictor
of suicidal risk in adults have shown that it significantly augments the prediction model, above
and beyond more general positive future cognition variables. For example, Chang et al. (2013)
found that the inclusion of future orientation added significant incremental validity in
accounting for depressive symptoms and suicidal behaviors in a sample of adult primary care
 THE JOURNAL OF PSYCHOLOGY 455

patients. Third, findings from a recent study of emotional victimization point to future orien-
tation as both an important predictor and buffer of suicidal risk in early adolescents aged 12–
13 years (Hamilton et al., 2015). Nonetheless, the extent to which future orientation might
augment a prediction model involving loneliness as a predictor of suicidal risk in young adults
has yet to be clarified. Moreover, beyond an additive role, it would be useful to examine if
future orientation might also moderate, or buffer, the extent to which loneliness is associated
with suicidal risk in young adults (e.g., Hamilton et al., 2015).

Purpose of the Present Study

Given these concerns and possibilities, we conducted the present study to: (a) determine if
future orientation adds to the prediction of suicidal risk, namely, depressive symptoms and
suicide ideation in college students; and (b) determine if the Loneliness £ Future Orienta-
tion interaction would add further incremental validity to these predictions beyond the
main effects of loneliness and future orientation.
Consistent with past research findings (e.g., Hirsch et al., 2012; Muyan & Chang, 2015),
we expect loneliness to be an important predictor of both depressive symptoms and suicide
ideation in college students. However, consistent with the notion that positive future cogni-
tions represent important variables for understanding suicidal risk (Wingate et al., 2006),
and past research findings specifically pointing to the value of future orientation in under-
standing suicidal risk in adults (Chang et al., 2013), we hypothesize that future orientation
would significantly augment the prediction model of both indices of suicidal risk, even after
accounting for the variance associated with loneliness. Finally, consistent with recent find-
ings indicating that the association between loneliness and suicidal risk in adults partly
depends on other factors (e.g., positive life experiences, sexual assault history; Chang et al.,
2015; Chang et al., 2015), we tested a moderation model in which future orientation was
hypothesized to weaken, or buffer (e.g., Hamilton et al., 2015), the relationship between
loneliness and suicidal risk. That is, we expect to find evidence for a significant Loneliness £
Future Orientation interaction effect in predicting suicidal risk. Thus, we hypothesize that
among lonely individuals, those who do believe that their future will change for the better
should report lower levels of suicidal risk compared to those who do not believe that their
future will change for the better.

Method
Participants
This study consisted of 228 college students (54 males and 174 females) from a large public
university in the Midwest. The sample was predominantly white (68%). Ages ranged from
18 to 28 years, with a mean age of 19.69 years (SD D 1.38).

Measures
Loneliness
Loneliness was assessed by the revised UCLA Loneliness Scale (R-UCLA; Russell et al.,
1980). The scale consists of 20 items, half of which describe non-lonely thoughts (e.g., “There
456 E. C. CHANG ET AL.

are people I feel close to”), while the other half describes feelings of loneliness (e.g., “I feel
isolated from others”). Respondents are asked to rate the statements on the frequency with
which they experience these feelings using a 4-point Likert-type scale, ranging from 1 (never)
to 4 (often). In support of construct validity, scores on the R-UCLA have been found to be
positively associated with other measures of social disconnectedness (Russell et al., 1980).
Higher scores on the R-UCLA indicate greater levels of loneliness.

Future Orientation
Future orientation was assessed by the Future Orientation Scale (FOS; Hirsch et al., 2006).
The FOS is a 6-item self-report measure that was developed to assess for an individual’s
belief and appreciation that the future will be changed even when experiencing stressful cir-
cumstances or negative events (e.g., “No matter how badly I feel, I know it will not last”).
Respondents are asked to indicate “how important each reason is to you for dealing with
stressors” using a 6-point Likert-type scale, ranging from 1 (extremely unimportant) to 5
(extremely important). In support of construct validity, scores on the FOS have been found
to be positively associated with other measures of positive future cognitions (Yu & Chang,
2016). In general, higher scores on the FOS indicate a greater belief that one’s future can be
changed for the better.

Suicidal Risk
Suicidal risk was assessed by the Beck Depression Inventory (BDI; Beck, Ward, Mendelson,
Mock, & Erbaugh, 1961) and the Frequency of Suicidal Ideation Inventory (FSII; Chang &
Chang, 2016). The BDI is a commonly used 21-item self-report measure of depressive symp-
tomatology. Respondents are asked to rate the extent to which they have experienced specific
depressive symptoms in the past week, across a 4-point Likert-type scale (e.g., “0 D I do not
feel sad” to “3 D I am so sad or unhappy that I can’t stand it”). In support of construct valid-
ity, scores on the BDI have been found to be positively associated with other measures of
depressive symptoms (Beck et al., 1961). Higher scores on the BDI indicate greater depres-
sive symptoms.
The FSII is a 5-item scale that assesses for the frequency of suicide ideation (e.g., “Over
the past 12 months, how often have you thought about killing yourself?”). Respondents are
asked to indicate how frequently they have entertained suicidal thoughts over the past twelve
months using a 5-point Likert-type scale, ranging from 1 (never) to 5 (almost every day). In
support of construct validity, scores on the FSII have been found to be positively associated
with other measures of suicide risk and negatively associated with measures of suicide pro-
tection (Chang & Chang, 2016). In general, higher scores on the FSII are indicative of greater
suicide ideation.

Procedure
Approval for the study was obtained from the Institutional Review Board at the univer-
sity where the study was conducted. All participants were enrolled in a psychology
course and completed the present survey in partial fulfillment of course requirements.
Participants were not made aware of the purpose of the study until after they had com-
pleted all measures.
 THE JOURNAL OF PSYCHOLOGY 457

Table 1. Correlations between Measures of Loneliness, Future Orientation, Depressive Symptoms, and Sui-
cide Ideation.
Measures 1 2 3 4

1. Loneliness —
2. Future orientation ¡.52 —
3. Depressive symptoms .69 ¡.49 —
4. Suicide ideation .52 ¡.39 .61 —
M 34.78 29.82 7.73 7.35
SD 11.68 5.989 8.25 3.96
Score range 20–73 6–36 0–40 5–24
a .89 .88 .92 .95

Note. N D 228.

p < .001.

Results
Correlations, means, standard deviations, and reliability estimates for all study measures are
presented in Table 1. Consistent with past findings, both loneliness and future orientation
were found to be correlated in the expected manner with the two indices of suicidal risk
examined in the present study.

Loneliness and Future Orientation as Predictors of Suicidal Risk in College Students

To examine for loneliness and future orientation as predictors of suicidal risk in college stu-
dents, we conducted a set of hierarchical regression analyses. Given our primary focus,
namely, determining if future orientation augments the prediction model of suicidal risk,
above and beyond loneliness, we entered loneliness in Step 1. Future orientation was entered
in Step 2. Finally, to determine if there was any evidence for an interaction effect, we entered
the multiplicative Loneliness £ Future Orientation term in Step 3. To determine whether
any of the predictors accounted for a small, medium, or large amount of the variance in sui-
cidal risk, we used Cohen’s (1977) convention for small (f2 D .02), medium (f2 D .15), and
large effects (f2 D .35) as a general guide.
Results for predicting depressive symptoms and suicide ideation are presented in Table 2.
As the table shows, loneliness was found to account for a large (f2 D .89) 47.0% of the vari-
ance in depressive symptoms. When future orientation was entered, it was found to account

Table 2. Results of Hierarchical Regression Analyses Showing Amount of Variance in Depressive Symp-
toms and Suicide Ideation Accounted for by Loneliness and Future Orientation.
Outcome b R2 DR2 F p

Depressive symptoms
Step 1: Loneliness .69 .47 — 200.42 <.001
Step 2: Future orientation ¡.19 .50 .03 11.92 .001
Step 3: Loneliness £ Future orientation ¡.59 .52 .02 9.62 <.01
Suicide ideation
Step 1: Loneliness .52 .27 — 83.26 <.001
Step 2: Future orientation ¡.16 .29 .02 5.99 <.05
Step 3: Loneliness £ Future orientation ¡.99 .35 .06 19.94 <.001

Note. N D 228.

p < .05. p < .01. p  .001.
458 E. C. CHANG ET AL.

for a small (f2 D .03), but significant (p  .001) 2.7% of additional unique variance in depres-
sive symptoms. Noteworthy, after including future orientation (moderator variable), the
strength of the effect of loneliness on depressive symptoms decreased (Db D .10). Finally,
when the Loneliness £ Future Orientation term was entered, it was found to account for a
small (f2 D .02), but significant 2.1% of additional unique variance in depressive symptoms.
Thus, evidence for a significant, albeit partial moderation effect was found (Aiken & West,
1991). The total model was found to account for a large (f2 D 1.07) 51.7% of the variance in
depressive symptoms, F(3, 224) D 80.05, p < .001.
To visually inspect the manner in which loneliness and future orientation interacted with
each other in predicting depressive symptoms, we plotted the regression of depressive symp-
toms on loneliness at low and high levels (§1/2 SD below and above the mean [26.87 and
32.77], respectively) of low versus high future orientation (§1/2 SD below and above the
mean [28.93 and 40.62], respectively), based on our initial regression results (see Figure 1).
As this interaction shows, among lonely students, those with high future orientation, com-
pared to low future orientation, reported significantly lower levels of depressive symptoms,
Ms D 9.30 vs. 20.41, respectively, t(42) D 3.31, p < .01.
In predicting suicide ideation, loneliness was found to account for a large (f2 D .37) 26.9%
of the variance in suicide ideation. When future orientation was entered, it was found to
account for a small (f2 D .02), but significant (p < .05) 1.9% of additional unique variance in
suicide ideation. Noteworthy, after including future orientation (moderator variable), the
strength of the effect of loneliness on suicide ideation decreased (Db D .08). Finally, when
the Loneliness £ Future Orientation term was entered, it was found to account for a small-
medium (f2 D .06) 5.8% of additional unique variance in suicide ideation. Again, evidence
for a significant, albeit partial moderation effect was found. The total model was found to
account for a large (f2 D .53) 34.6% of the variance in suicide ideation, F(3, 224) D 39.56,
p < .001.
Again, to visually inspect the manner in which loneliness and future orientation inter-
acted with each other in predicting suicide ideation, we plotted the regression of suicide idea-
tion on loneliness at low and high levels (§1/2 SD below and above the mean, respectively) of
negative and positive future orientation (§1/2 SD below and above the mean, respectively)

Figure 1. Depressive symptoms at low vs. high future orientation for lonely and non-lonely students.
 THE JOURNAL OF PSYCHOLOGY 459

Figure 2. Suicide ideation at low vs. high future orientation for lonely and non-lonely students.

based on our initial regression results (Figure 2). As this interaction also shows, among
lonely students, those with high future orientation, compared to low future orientation,
reported significantly lower levels of suicide ideation, Ms D 6.10 vs. 11.47, respectively,
t(42) D 2.90, p < .01. Interestingly, among students with a positive future orientation, there
was no significant difference in levels of suicide ideation between lonely and non-lonely stu-
dents, Ms D 6.10 vs. 5.78, respectively, t(53) D .49, n.s.

Discussion
Consistent with past research findings pointing to the importance of loneliness as an impor-
tant predictor of suicidal risk in young adults (e.g., Hirsch et al., 2012; Muyan & Chang,
2015), we found that loneliness was a positive predictor of depressive symptoms and suicide
ideation in college students. Indeed, loneliness was found to account for a large amount of
variance in both of the indices of suicidal risk examined in the present study. In keeping
with various theories that have often posited that interpersonal disconnectedness from
others is a critical component of adult suicide (e.g., Baumeister & Leary, 1995; Joiner, 2005;
Van Orden et al., 2010), young emerging adults who feel alone and socially disconnected
from others during a critical, if not stressful (Dunkel-Schetter & Lobel, 1990), period in their
development into adulthood may come to believe that their existence is of little concern to
others, thus heightening their general risk for suicide. Overall, the present findings for loneli-
ness join those from other studies to highlight the central role that it plays in predicting sui-
cidal risk in young adults.
Additionally, we found evidence supporting the contention that positive future cogni-
tions, specifically, future orientation (Hirsch et al., 2006; Yu & Chang, 2016), might also rep-
resent important predictors of suicidal risk in young adults (Wingate et al., 2006). Indeed,
we found believing that one’s future can and will change for the better, added significant
incremental validity, above and beyond loneliness, to the prediction of both depressive
symptoms and suicide ideation in college students. Thus, although feeling socially isolated
or disconnected from others might play a strong role in elevating suicidal risk in young
adults, our findings clearly indicate that protective factors, such as future orientation, also
need to be considered in order to develop comprehensive models of suicide in adults. This
460 E. C. CHANG ET AL.

view is consistent with the emerging notion that efforts associated with the study and pre-
vention of suicide need to balance an appreciation of processes associated with both risk and
protection (WHO, 2014). Given that some studies have pointed to cultural differences in
future orientation (Gao, 2016), it would be useful to determine if the present findings might
be generalizable to other young adult populations (e.g., East Asians).
Importantly, beyond the main effects of loneliness and future orientation, we also found
evidence for a significant Loneliness £ Future Orientation interaction effect in predicting
both depressive symptoms and suicide ideation. For both indices of suicidal risk, the pattern
obtained indicated that among lonely students, those who believed, compared to those who
did not believe, that their future would change for the better reported significantly less risk
for suicide. Indeed, we found that for those with high future orientation, levels of suicide ide-
ation were not negatively affected by the presence of loneliness. Thus, these findings are
important. They not only add to growing evidence for contextualizing our understanding of
the potential negative effects of loneliness on suicidal risk (e.g., Chang et al., 2015), but they
also highlight how the presence of protective factors, or positive conditions (e.g., positive life
events; Chang et al., 2015), might help minimize (e.g., depressive symptoms), and even help
resolve (e.g., suicide ideation), the deleterious effects of loneliness on suicidal risk in young
adults. Furthermore, our findings build on Hamilton et al.’s (2015) study to indicate that the
positive role of future orientation as an important predictor and buffer of suicidal risk is not
limited to early adolescents, but remains an important protective factor into young adult-
hood. Thus, our findings indicate that believing one’s future will change for the better makes
a positive difference when it comes to determining suicidal risk.
Taken together, the present findings point to at least two practical implications for poten-
tially reducing or lowering suicidal risk in young adults. First, it would be important to iden-
tify those who may lack important suicide protective factors. Thus, for example, within a
comprehensive suicide prevention program, mental health professionals should routinely
not only assess for the presence of suicidal risk and vulnerability factors (e.g., loneliness),
but also assess for the absence of specific protective factors like future orientation. Second,
and relatedly, it would be important for mental health professionals to consider applying
interventions that help decrease experiences of loneliness (e.g., treatments targeting mal-
adaptive social cognitions; Cacioppo, Grippo, London, Goossens, & Cacioppo, 2015), on the
one hand, but help increase the belief that one’s future will get better (Hirsch et al., 2006),
on the other hand, for those at heightened risk for suicide. For example, within cognitive-
behavioral models, mental health professionals may consider applying techniques such as
cognitive restructuring (Leahy & Rego, 2012) to help promote greater future orientation in
adults at risk for suicide (e.g., identifying maladaptive or distorting thoughts about the
future, challenging the accuracy of such thoughts, and evaluating the evidence for or against
such thoughts).
Despite the importance of the present findings, it is worth noting a few limitations. First,
unlike the numerous studies that have examined the construct of loneliness, fewer studies
have examined for the construct of future orientation. Thus, it would be important in future
research to continue conducting studies that examine the form and function of future orien-
tation in adults. Second, and relatedly, insofar as future orientation represents a positive
future cognition, it would be important to determine if similar buffering effects would
emerge when examining constructs like optimism and hope as moderators. Third, given that
the present sample was predominantly White, it would be important to examine the
 THE JOURNAL OF PSYCHOLOGY 461

generalizability of the present findings when studying different cultural or ethnoracial

groups. Lastly, although we tested a model examining loneliness and future orientation as
predictors of suicide risk, our cross-sectional design precludes drawing any causal inferences.
Thus, it would be useful in future studies to apply a prospective design that examines for
loneliness and future orientation as predictors of changes in suicide risk across time.

Concluding Thoughts
In summary, we examined and found support for a prediction model involving loneliness
and future orientation as predictors of depressive symptoms and suicide ideation in young
adults. Importantly, we also found support for a significant Loneliness £ Future Orientation
interaction effect. Specifically, findings from this study showed that believing that the future
will change for the better was associated with lower suicidal risk among lonely adults. Over-
all, the present findings are important for highlighting the potential power of positive future
cognitions like future orientation in minimizing, and possibly resolving, the negative effects
of loneliness on suicidal risk in young adults.

Acknowledgments
The first author would like to acknowledge Tae Myung-Sook and Chang Suk-Choon for their encour-
agement and support throughout this project. The second to ninth coauthors all contributed equally
to the present work and, therefore, their authorship order was determined randomly.

Author Notes
Edward C. Chang is a Professor of Psychology and Social Work at the University of Michigan,
United States of America.

Liangqiu Wan is a student of psychology at the University of Michigan, United States of America.

Pengzi Li is a student of psychology at the University of Toronto, Canada.

Yuncheng Guo is a student of psychology at Gettysburg College, United States of America.

Jiaying He is a student of psychology at the University of International Business and Economics,

China.

Yu Gu is a student of psychology at The University of British Columbia, Canada.

Yingjie Wan is a student of psychology at Coventry University, United Kingdom.

Xiaoqing Li is a student of psychology at Boston University, United States of America.

Zhan Zhang is a student of psychology at Mount Holyoke College, United States of America.

Yingrui Sun is a student of psychology at Boston College, United States of America.

Casey N.-H. Batterbee is a student of psychology at the University of Michigan, United States of
America.
462 E. C. CHANG ET AL.

Olivia D. Chang is a student at the Research in Action AcademyTM , United States of America.

Abigael G. Lucas is is a student of psychology at the University of Michigan, United States of America.

Jameson K. Hirsch is an Associate Professor of Psychology at East Tennessee State University, United
States of America.

References
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury
Park, CA: Sage.
Baumeister, R. F., & Leary, M. R. (1995). The need to belong: Desire for interpersonal attachments as a
fundamental human motive. Psychological Bulletin, 117, 497–529.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring
depression. Archives of General Psychiatry, 4, 561–571.
Blai, B., Jr. (1989). Health consequences of loneliness: Review of the literature. Journal of American
College Health, 27, 162–167.
Bonner, R. L., & Rich, A. R. (1987). Toward a predictive model of suicidal ideation and behavior: Some
preliminary data in college students. Suicide and Life-Threatening Behavior, 17, 50–63.
Cacioppo, S., Grippo, A. J., London, S., Goossens, L., & Cacioppo, J. T. (2015). Loneliness: Clinical
import and interventions. Perspectives on Psychological Science, 10, 238–249.
Centers for Disease Control and Prevention [CDC]. (2014). [Graphic representation of 10 leading
causes of death in the United States in 2014, for both sexes]. Leading causes of death reports,
National and regional, 1999–2014. Retrieved from http://webappa.cdc.gov/sasweb/ncipc/leadcau
s10_us.html
Chang, E. C., & Chang, O. D. (2016). Development of the frequency of suicidal ideation inventory:
Evidence for validity and reliability of a brief measure of suicidal ideation frequency in a college
student population. Cognitive Therapy and Research, 40, 549–556.
Chang, E. C., Lian, X., Yu, T., Qu, J., Zhang, B., Jia, W., Hu, Q., Li, J., Wu, J., & Hirsch, J. K. (2015).
Loneliness under assault: Understanding the impact of sexual assault on the relation between lone-
liness and suicidal risk in college students. Personality and Individual Differences, 72, 155–159.
Chang, E. C., Muyan, M., & Hirsch, J. K. (2015). Loneliness, positive life events, and psychological
maladjustment: When good things happen, even lonely people feel better! Personality and Individ-
ual Differences, 86, 150–155.
Chang, E. C., Yu, E. A., Lee, J. Y., Hirsch, J. K., Kupfermann, Y., & Kahle, E. R. (2013). An examination
of optimism/pessimism and suicide risk in primary care patients: Does belief in a changeable future
make a difference? Cognitive Therapy and Research, 37, 796–804.
Cohen, J. (1977). Statistical power analysis for the behavioral sciences (Rev. ed.). New York: Academic
Press.
Dunkel-Schetter, C., & Lobel, M. (1990). Stress among students. New Directions for Student Services,
49, 17–34.
Furr, S. R., Westefeld, J. S., McConnell, G. N., & Jenkins, J. M. (2001). Suicide and depression
among college students: A decade later. Professional Psychology: Research and Practice, 32,
97–100.
Gao, X. (2016). Cultural differences between East Asian and North American in temporal orientation.
Review of General Psychology, 20, 118–127.
Hamilton, J. L., Connolly, S. L., Liu, R. T., Stange, J. P., Abramson, L. Y., & Alloy, L. B. (2015). It gets
better: Future orientation buffers the development of hopelessness and depressive symptoms fol-
lowing emotional victimization during early adolescence. Journal of Abnormal Child Psychology,
43, 465–474.
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of the
consequences and mechanisms. Annals of Behavioral Medicine, 40, 218–227.
 THE JOURNAL OF PSYCHOLOGY 463

Heinrich, L. M., & Gullone, E. (2006). The clinical significance of loneliness: A literature review. Clini-
cal Psychology Review, 26, 695–718.
Hirsch, J. K., Chang, E. C., & Jeglic, E. L. (2012). Social problem solving and suicide ideation and
attempts: Ethnic differences in moderating effects of loneliness and life stress. Archives of Suicide
Research, 16, 303–315.
Hirsch, J. K., Duberstein, P. R., Conner, K. R., Heisel, M. J., Beckman, A., Franus, N., & Conwell, Y.
(2006). Future orientation and suicide ideation and attempts in depressed adults ages 50 and over.
The American Journal of Geriatric Psychiatry, 14, 752–757.
Joiner, T. E., Jr. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.
Lamis, D. A., Ballard, E. D., & Patel, A. B. (2014). Loneliness and suicidal ideation in drug-using col-
lege students. Suicide and Life-Threatening Behavior, 44, 629–640.
Leahy, R. L., & Rego, S. A. (2012). Cognitive restructuring. In W. T. O’Donohue & J. E. Fisher (Eds.),
Cognitive behavior therapy: Core principles for practice (pp. 133–158). Hoboken, NJ: John Wiley &
Sons Inc.
Muyan, M., & Chang, E. C. (2015). Perfectionism as a predictor of suicidal risk in Turkish col-
lege students: Does loneliness contribute to further risk? Cognitive Therapy and Research, 39,
776–784
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: Concur-
rent and discriminant validity evidence. Journal of Personality and Social Psychology, 39, 472–
480.
Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health: Assessment and implications of
generalized outcome expectancies. Health Psychology, 4, 219–247.
Smith, S. S., Carter, J. S., Karczewski, S., Pivarunas, B., Suffoletto, S., & Munin, A. (2015). Mediating
effects of stress, weight-related issues, and depression on suicidality in college students. Journal of
American College Health, 63, 1–12.
Snyder, C. R. (2002). Hope theory: Rainbows in the mind. Psychological Inquiry, 13, 249–275.
Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E., Jr.
(2010). The interpersonal theory of suicide. Psychological Review, 117, 575–600.
Weber, B., Metha, A., & Nelsen, E. (1997). Relationships among multiple suicide ideation risk factors
in college students. Journal of College Student Psychotherapy, 11, 49–64.
Westefeld, J. S., & Furr, S. R. (1987). Suicide and depression among college students. Professional Psy-
chology: Research and Practice, 18, 119–123.
Wingate, L. R., Burns, A. B., Gordon, K. H., Perez, M., Walker, R. L., Williams, F. M., &
Joiner, T. (2006). Suicide and positive cognitions: Positive psychology applied to the under-
standing and treatment of suicidal behavior. In T. E. Ellis (Ed.), Cognition and suicide: The-
ory, research, and therapy (pp. 261–283). Washington, DC: American Psychological
Association.
World Health Organization [WHO]. (2013). Mental health action plan 2013–2020. Geneva, Switzer-
land: Author.
World Health Organization [WHO]. (2014). Preventing suicide: A global imperative. Geneva, Switzer-
land: Author.
Yu, E. A., & Chang, E. C. (2016). Optimism/pessimism and future orientation as predictors of suicidal
ideation: Are there ethnic differences? Cultural Diversity and Ethnic Minority Psychology, 22, 572–
579.
Zivin, K., Eisenberg, D., Gollust, S. E., & Golberstein, E. (2009). Persistence of mental health problems
and needs in a college student population. Journal of Affective Disorders, 117, 180–185.

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