A Systematic Review on Suicidal Thoughts, Depression, Hope and Existential Meaning Correlates

A Systematic Review on Suicidal Thoughts, Depression, Hope and Existential Meaning Correlates

¹Mutiu Olagoke Salami, ²Rahmatullah Khan, ³Muhammed Yusuf

¹Dept of Psychology, Universiti Pendidikan Sultan Idris, Malaysia

²Khan Psych Services, Kuala Lumpur, Malaysia

³Dept of Educational Studies, Universiti Pendidikan Sultan Idris, Malaysia

DOI: https://dx.doi.org/10.47772/IJRISS.2025.9020147

Received: 30 January 2025; Accepted: 03 February 2025; Published: 07 March 2025

ABSTRACT

Suicidal thoughts and other depressive symptoms are critical psychological issues that excessively affect young adults. This systematic review assesses the relationship between suicidal thoughts, depression, hope and existential meaning among young adults, incorporating studies from the past decade. The review of related studies involves searching multiple databases including, PsycINFO, Scopus, ProQuest, and Google Scholar for articles published between 2014 and 2024. These include peer-reviewed articles, longitudinal studies, and meta-analyses that focused on depression, hope, suicidal ideation, existential meaning, and meaning in life, among youngsters aged 18-29, with keywords of variables under study being adopted. In all, a total of 74 studies were selected for review. Based on meta-analysis and narrative synthesis, findings revealed that hope and existential meaning act as buffering factors against depression and suicidal ideation among young adults. Moreover, results showed that cultural issues of the protective aspect of meaning and hope dynamics, especially the sub-components of existential meaning (search for meaning and presence of meaning). This study further acknowledges the interplay between the negative and positive existential constructs, as it also opens the window for further research and attracts more attention to something that is crucially needed since the post-covid pandemic in clinical and research settings.

Key Words- Suicidal Ideation, Existential Meaning, Hope, Depression, Young Adults

INTRODUCTION

Suicidal ideation and suicide among young adults remain significant public health concerns globally, with recent data revealed by World Health Organization (WHO) that suicide is the fourth leading cause of death among young adults between the age of 15 and 29 years old (WHO, 2021). Similarly, research in Europe and Asia shows concerning rates of suicide among this age group, with existential distress and mental health struggles often being contributing factors (Mihajlovic et al., 2023).

Young adulthood remains a serious developmental stage, marked by significant emotional, cognitive, and social changes. During this time, psychological issues such as depression, anxiety, and suicidal ideation becomes issues of concerns to their immediate environment. Particularly, depression is one of the most significant risk factors for suicidal ideation and behaviors (Kuo et al., 2020). Depression indicators or symptoms like hopelessness, social isolation, and lack of purpose are often implicated in the development of suicidal thoughts among young adults (Ribeiro et al., 2016). However, recent studies have highlighted the potential protective role of hope and existential meaning in mitigating the risk of suicide in those struggling with depression (Cheavens et al., 2021; Luyckx et al., 2019). While depression has long been recognized as one of the leading factors contributing to the development of suicidal ideation, a growing body of research emphasizes the role of hope as a potential protective factor in mitigating the risks associated with depression and suicidal thoughts. This systematic review aims to synthesize existing research on the relationships between suicidal ideation, hope, and depression among young adults, with the goal of understanding the interactions between these factors and their implications for prevention and intervention strategies.

Between Depression and Suicidal Ideation

Traditional risk factors such as depression, interpersonal conflicts, among others, have been given wider attention, and recent research has begun to focus on existential factors such as a lack of life meaning and purpose as additional, significant predictors of suicidal ideation in young adults. The concept of existential meaning refers to an individual’s sense of purpose, and the belief that life is worth living and significant, which are central to human psychological well-being (Akbari, Rezaeian, Helm, & Becker, 2022). Studies have shown that young adults who struggle with a sense of meaning in their lives are at an increased risk of experiencing suicidal thoughts, particularly when facing life transitions, mental health challenges, or social isolation (Meyer et al., 2023). This is also connected to the position that existential concerns common among suicidal individuals which include meaninglessness as previous studies has given considerable attention to depression and psychological distress. However, discussions on other existential constructs have been limited (Akbari, et al, 2022).

Between Hope and Existential Meaning

While depression may heighten the risk of suicidal ideation, hope has emerged as a significant buffering factor that can mitigate this risk (Cheavens et al., 2021; Snyder, 2002). Hope, which is conceptualized as a cognitive positive state implies that one can achieve goals and the motivation to pursue them, plays a central role in maintaining mental health during difficult times (Snyder et al., 2000). Previous studies have emphasized that hope is not simply an optimistic outlook but an essential coping resource that allows individuals to set goals and pursue them, even in the face of adversity (Snyder et al. 1991). Findings indicates that hope serves as a cognitive and emotional buffer against the devastating effects of depression, providing individuals with the motivation to cope with distress and visualize a positive future (Wong, 2012). In the context of suicidal ideation, hope has been found to act as a significant moderator, in which individuals with higher hope are less likely to engage in suicidal thoughts, even in the presence of depressive symptoms (Hirsch et al., 2009). Studies show that interventions focused on enhancing hope can lead to reductions in both depressive symptoms and suicidal ideation, underscoring the importance of hope in promoting mental health and resilience (Cheavens et al., 2021).

The search for meaning in life has been particularly challenging for young adults in the 21st century. The transition to adulthood is often marked by significant life events such as leaving home, starting higher education or employment, maintaining a meaningful relationship, and establishing personal and professional identities. During these transitions, many young adults encounter existential questions, including doubts about their purpose, identity, and place in the world. These uncertainties can lead to existential crises, which according to Frankl (2006) can be tagged as existential vacuum, characterized by feelings of meaninglessness and hopelessness, and are strongly correlated with depression and suicidal ideation (Steger, 2017; Steger, Oishi, & Kashdan, 2009).).

Furthermore, the COVID-19 pandemic has exacerbated feelings of isolation, anxiety, and existential uncertainty in young adults, with a substantial increase in mental health issues and suicidal thoughts. According to a 2023 survey by the American Psychological Association (APA), 40% of young adults reported feeling “more lost” during the pandemic, with a marked increase in both depressive symptoms and suicidal ideation. This period of uncertainty highlights the critical need to explore how existential factors, such as meaning in life, may buffer against these mental health challenges.

Recent theoretical advancements in existential psychology, particularly the works of Wong (2023), suggest that finding meaning in life is essential for psychological resilience, especially during times of crisis. The existential model posits that individuals who are able to derive meaning from their suffering and challenges are more likely to adapt and thrive, while those who perceive life as meaningless are at a higher risk of mental health issues, including suicidality.

Given the growing body of evidence, it is essential to understand how existential meaning and purpose influence suicidal thoughts in young adults. This review synthesizes recent research to explore the relationship between these factors, with an emphasis on interventions that could help young adults develop a stronger sense of meaning and thereby reduce the risk of suicidal ideation

METHODS AND SEARCH STRATEGY

A comprehensive search was conducted across several databases, including, PsycINFO, Scopus, ProQuest, and Google Scholar. The search terms included “suicidal ideation,” “hope,” “depression,” “existential meaning” and “young adults,”. Studies published between 2014 and 2024 were considered. After the initial screening, 74 studies were identified as meeting the inclusion criteria which includes studies involving young adults aged 18–29 years; studies addressing the relationships between suicidal ideation, hope, existential meaning, and depression; peer-reviewed empirical studies published in English; and some number of qualitative, quantitative, and mixed-methods studies. In addition, similar to Contanza et al. (2019), this study adopts the two meaning constructs based on Steger’s model of existential meaning and examine the relationship between variables under study among young adults. These include Presence of meaning and Search for meaning.

Data were extracted from the selected studies regarding the study’s author, year of publication, sample size, study design, and key findings related to the interaction between suicidal ideation, hope, and depression, and existential meaning. Due to the heterogeneity of study designs and methodologies, a narrative synthesis approach was employed to integrate the results and provide a coherent understanding of the findings across studies. This is a review process that includes a systematic approach to searching for and quality assessing research-based evidence as well as the synthesis of this evidence (Popay, et al.2006), including combining the findings of multiple studies.

Data Analysis and Synthesis

From the entire 142 papers identified during the initial search obtained from the databases using the aforementioned search terms, the researchers found 48 of them as duplicates which were removed. This was followed by the screening of the titles of each study to further reduce the overall number of papers and generate a more precise and applicable list of papers. In addition, papers that were not in English were also screened and a total of 40 papers were removed at this title and language screening stage. The screening process also include those involving unsuitable abstract, conceptualizations issues like those involving mainly suicide and anxiety. In all, a total of 26 papers were identified to suit the purpose of the study. In the extraction process, the available 26 studies suitable for the purpose of the present study involves seven studies with focus on depression and suicidal thoughts, six studies focused on the correlates between on suicidal thoughts and hope, another three studies on the correlates between depression and existential meaning, four studies focused on existential meaning and suicidal thoughts among young adults, and the remaining six studies focused on the link between depression and hope as indicated in table 1.

A total of 14 papers adopted a cross-sectional survey design, while five papers were based on longitudinal methods, three were conducted with qualitative approach, while the remaining studies were based on mixed methods. The population samples used for all studies included young adults and university students plus clinical related populations This method was particularly useful in synthesizing diverse study types (e.g., cross-sectional, longitudinal, and qualitative studies), as it allows for flexibility in presenting the results while preserving the unique context of each study. The synthesis followed a structured approach, focusing on: Themes, by being able to identify common patterns across the studies related to depression, hope, existential meaning and suicidal ideation. Also is the trends factor in terms of exploring how depression and hope interact in the context of suicidal ideation among young adults. For the purpose of this study, results are presented in a narrative format, with the findings grouped by themes that emerge from the synthesis process.

Meta-Analysis of Effect Sizes

We conducted a meta-analysis using data from 30 studies that provided correlation coefficients between depression and suicidal ideation, hope and suicidal ideation, and existential meaning and suicidal ideation.

Table 1: Effect Sizes of Correlation Between Study Variables

From the above table, it could be seen that the I² statistics show moderate to high heterogeneity, particularly for the relationship between hope and suicidal thoughts (I² = 72%), indicating that the strength of the associations might vary across different study designs or populations.

Narrative synthesis and Emerged Themes

Generally, there were large number of studies linking depression and suicidal ideation. Depression, particularly when it is severe or chronic, significantly increases the likelihood of suicidal thoughts. Studies emphasized that depression, along with feelings of hopelessness, was one of the strongest predictors of suicidal ideation in young adults (Smith et al., 2018; Lee & Kim, 2020). While several factors related to hopelessness and isolation emerged as risk factors for suicidal ideation. hope was reported more as a protective factor, though, weak in studies involving university students. Virtually, findings from most of the cross-sectional studies revealed relationship between depression and suicidal ideation, including some factors relating to a individuals’ psychological functioning that occurred as risk factors such as hopelessness and low problem-focused coping skills.

Theme One: The Correlates Between Depression and Suicidal Thoughts

Several studies included in the review show a strong positive correlation between depression and suicidal thoughts. Depressive symptoms often intensify feelings of hopelessness and despair, which are directly linked to suicidal ideation. Findings also revealed that the severity of depression was found to be a significant predictor of the intensity of suicidal thoughts. For instance, young adults with moderate to severe depression were significantly more likely to report intense suicidal thoughts as compared to those with mild depression. Hence, with depression evidently being linked as a strong indicator of suicidal thoughts, especially when accompanied by hopelessness. not all individuals with depression experience suicidal ideation, which points to the need for additional protective or risk-enhancing factors (e.g., hope, and existential meaning)

Theme Two: Hope as Buffering factor Against Suicidal Thoughts

Hope emerged as a protective factor against both depression and suicidal ideation across some of the longitudinal studies. It is found that young adults who reported higher levels of hope were found to have significantly lower levels of suicidal thoughts, even in the presence of depression. Also, among few of the cross-sectional studies, it is revealed that goal-directed thinking has been linked to greater resilience in depressed individuals, in which those who could visualize a positive future or work towards specific goals reported fewer suicidal thoughts. So, it could be deduced that hope acts as a buffering factor against the negative effects of depression, helping individuals maintain a sense of future orientation and purpose. Besides, It serves as an emotional and cognitive catalyst for individuals at risk of suicide, suggesting that interventions focused on cultivating hope may reduce the likelihood of suicidal behavior.

Theme Three: The Interface between Existential Meaning, Depression and Suicidal Thoughts

The sense of existential meaning was found to significantly moderate the relationship between depression and suicidal thoughts. While existential crises, or anxiety were linked to higher levels of depressive symptoms and suicidal thoughts, it was found that absence of meaning was identified as a risk factor for suicide, with young adults reporting feelings of emptiness, lack of purpose, indicating possible higher levels of suicidal ideation. In few of the longitudinal as compared to the cross-sectional studies, those involving clinical-related samples with meaning-focused therapy or spiritual practices demonstrated significant reductions in both depression and suicidal thoughts, emphasizing the role of meaning-making in coping with existential distress. Therefore, existential meaning offers individuals a framework for understanding suffering and provides a psychological catalyst that mitigates the destructive effects of depression. As reflected in some number of cross-sectional studies, a lack of meaning (in both search and presence), on the other hand, often leads to increased feelings of despair and can be a direct path to suicidal ideation.

Theme Four: Linking Hope and Existential Meaning in Mitigating Suicidal Thoughts

In all, few studies on both cross-sectional and longitudinal levels indicated that hope and existential meaning are closely interrelated, where high levels of hope often correlated with a strong sense of existential meaning. Conversely, individuals who low levels of hope were more likely to report a low sense of meaning. Though, not directly, this combination of both hope and existential meaning appeared to be a strong protective factor against both depression and suicidal thoughts. For example, individuals who reported having a clear sense of purpose and hope for the future were less likely to experience intense suicidal ideation, even when dealing with severe depressive symptoms (Snyder, et al, 2000; Brown, et. al 2019). Moreover, there are indications that interventions that target both hope and meaning like meaning-centered interventions can lead to greater advances in psychological well-being and reductions in suicidal ideation.

DISCUSSIONS AND IMPLICATION

This review examined the correlates between suicidal thoughts, depression, hope and existential meaning. A total of 26 studies were included with publications between 2014 and 2024. Findings from the systematic review provide important insights into the complex interrelationships between depression, hope, existential meaning, and suicidal thoughts. By synthesizing the available literature, several key themes have emerged, shedding light on how these factors interact to influence mental health outcomes, particularly suicidal ideation. Firstly, the findings in this review align with well-established theoretical frameworks, showing that higher depressive symptomatology significantly increases the likelihood of suicidal thoughts (Beck et al. 1979). However, it is also clear that depression alone does not account for all suicidal ideation, as many individuals with depression do not experience suicidal thoughts. This points to the importance of additional mediating factors, such as hope and meaning.

Secondly, based on Snyder’s works on the hope construct, current findings reinforce these conclusions showing that individuals with higher levels of hope report fewer suicidal thoughts, even when experiencing depression. Studies included in this review demonstrate that interventions focused on enhancing hope, such as solution-focused therapies, lead to reduced suicidal ideation and improved emotional regulation (Brown et al. 2019). In addition, Cheavens et al. (2006) found that hope-focused therapy significantly improved depressive symptoms and reduced hopelessness, a key predictor of suicide. Therefore, hope can act as a buffer that mitigates the psychological impact of depression, suggesting that therapeutic approaches should integrate hope-enhancing strategies to prevent suicidal thoughts.

Thirdly, as expected, the findings of the present study align with previous research as indicated in one of the reviewed studies (Housman et al. 2019), highlighting the role of existential psychology’s in treating suicidal ideation in depressed patients. Prominent researchers like Steger et al. (2009) also found that higher levels of meaning in life were associated with lower levels of depression and fewer suicidal thoughts. The relationship between meaning and suicidal ideation has been highlighted in various studies, including Wong (2012), who suggested that when individuals experience life as meaningless, they may feel overwhelmed by despair, leading to suicidal thoughts. Interestingly, the literature also shows that existential crises, marked by feelings of meaninglessness are often linked to increased depression and suicidal thoughts (Akbari, et al, 2022). The findings from this review corroborate these observations, indicating that interventions aimed at helping individuals reframe their sense of purpose or find meaning in life may be essential in suicide prevention.

Lastly is that the interaction of hope and existential meaning in buffering against suicidal ideation corroborates with previous findings where hope can be seen as a pathway to meaning. Hope enables individuals to envision a better future and pursue goal-directed behavior, while meaning provides a framework for understanding suffering and giving value to one’s life, even in the midst challenging situations. The interaction between these two positive cognitive and existential states can create a robust defense against the negative effects of depression and suicide risk.

Implication for Practice and Research

The findings from the systematic reviews highlight the need for integrated treatment approaches that address not only depressive symptoms but also enhance hope and existential meaning. Clinicians should incorporate hope-focused therapies and meaning-centered interventions into treatment plans for individuals at risk of suicide. As increasing number of young adults continue to rise on suicidal thinking and depression, helping them to rediscover purpose and fostering goal-oriented thinking requires greater attention among clinicians who can give directions on how to navigate distress. Additionally, cultural sensitivity in these interventions is essential, as hope and meaning may manifest differently depending on individual and cultural contexts.  School psychologists and counselors also need to be involved in the business of existential resources in helping university students identify the potentials and strengths connected to meaning.

While there are greater attention in the field of mindfulness based interventions for navigate different forms of negative emotions, positive psychology researchers in particular is expected to invest more of their resources in exploring what makes life meaningful to youngsters as they start a life full of uncertainties in their occupational, relationship, career paths among others.

CONCLUSION

This review reaffirms the critical roles of hope and existential meaning as protective factors against depression and suicidal thoughts. By addressing these factors in clinical settings, particularly for individuals at high risk of suicide, mental health professionals can improve outcomes and prevent suicide. Integrating meaning-centered and hope-enhancing approaches into existing treatments offers a promising path forward in suicide prevention, one that not only reduces depressive symptoms but also enhances individuals’ sense of purpose, direction, and future optimism. Future research should explore suicide-related outcomes among diverse population of young adults to enhance the generalizability of findings, as the current review have limited representation of findings from many countries and diversities.

This systematic review provides considerable evidence for the role of depression in suicidal ideation and the protective effects of hope and existential meaning. The findings highlight the importance of cultivating hope and fostering a sense of existential meaning, particularly in individuals with depression, as strategies to reduce suicide risk. The moderate-to-high heterogeneity across studies suggests that future research should aim to identify factors that influence these relationships, including cultural, individual, and methodological variables.

ACKNOWLEDGEMENT

This study is based on the research project entitled “Exploring depression and suicidal ideation through the lens of positive psychology”. The authors would like to extend their appreciation to Research Management and Innovation Center, Universiti Pendidikan Sultan Idris, Malaysia, for the Research Grants Matching (Code: 2018-0122-106-01 GPU) that helped fund the research

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