Adolescent Suicide Risk in China: A Multilevel Meta-Analysis and Multilayer Network Perspective.

Adolescent suicide is a major public health concern. Prior research has often examined risk factors within single systems, limiting understanding of how influences intersect across contexts. This study addressed this gap through a multilevel meta-analysis and multilayer network analysis of suicide-related risk factors among Chinese adolescents. A total of 134 studies with 355 effect sizes (N = 602,301) were synthesized, covering students in primary, junior high, senior high, and vocational schools, approximately 7–18 years of age. The meta-analysis indicated that negative cognitive-emotional states, such as hopelessness, were the strongest correlates of suicide. Childhood trauma and school ostracism also showed relatively strong associations. Stressful life events showed effects comparable to individual vulnerabilities, while risks in the virtual system were smaller but remained evident. Network analysis suggested that emotional states and cognitive processes acted as central bridges, linking factors into six communities of risk: Academic Frustration, Social Alienation, Identity Alienation, Affective Distress, Stress Reactivity, and Maladaptive Cognition. By combining multilevel meta-analysis with multilayer network modeling, this study tentatively explored how risk factors identified in existing research may configure across systems, providing an ecological view of adolescent suicide in China.