Mental Health Difficulties Related to Suicidal Behavior in Adolescents: The Moderating Role of Self-Esteem

Abstract

Objective

The objective was to analyze the moderating effect of self-esteem on the relationship between mental health difficulties and suicidal behavior in adolescence.

Method

The sample was composed of 1,790 Spanish adolescents (M = 15.70 years; SD = 1.26; 53.7% girls) through a stratified random sampling by cluster at classroom level. The participants completed questionnaires about emotional symptoms, behavioral problems, peer relationship difficulties, hyperactivity, suicidal behavior, and self-esteem.

Results

The results evidenced gender differences, showing that girls tend to have more emotional symptoms (t = −15.27; p ≤ .001; d = −0.71), more difficulties in peer relationship (t=−2.49; p = .013; d = −0.12) and less self-esteem (t = 12.15; p ≤ .001; d = 0.57), as well as more suicidal behaviors (t = −5.36; p ≤ .001; d = −0.25) than boys. It is also noted that emotional and behavioral difficulties influence suicidal behavior (R² = 0.35; ΔF = 197.42; p ≤ .001). In addition, self-esteem appeared to act as a protective factor, buffering the relationship between emotional and behavioral problems and suicidal behavior (R² = 0.39; F = 376.92; p ≤ .001).

Conclusions

Adolescents who present mental health difficulties might commit suicidal behavior if they have an unfavorable attitude toward themselves. However, the risk of committing suicidal behavior decreases if their attitude toward themselves is favorable. Thus, the development of self-esteem may be included in intervention programs for the prevention of suicidal behavior.

HIGHLIGHTS

• Girls present more suicidal behaviors and less self-esteem than boys.

• Mental health difficulties influence the appearance of suicidal behavior.

• Self-esteem moderates the relationship between emotional problems and suicidal behavior.

Keywords:

• Adolescence
• mental health difficulties
• self-esteem
• suicidal behavior

ACKNOWLEDGMENTS

The authors would like to express their gratitude to the participating schools for their cooperation.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the “Ayudas Fundación BBVA a Equipos de Investigación Científica 2017,” FEDER in the PO FEDER of La Rioja 2014-2020 [SRS 6FRSABC026], and a research fellowship granted by the Regional Government of Valencia and the European Social Fund [ACIF/2018/033].

Notes on contributors

Usue de la Barrera

Usue de la Barrera and Inmaculada Montoya-Castilla, Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.

Inmaculada Montoya-Castilla

Usue de la Barrera and Inmaculada Montoya-Castilla, Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain.

Alicia Pérez-Albéniz

Alicia Pérez-Albéniz Department of Educational Sciences, University of La Rioja, Logroño, Spain.

Beatriz Lucas-Molina

Beatriz Lucas-Molina, Departament of Developmental and Educational Psychology, University of Valencia, Valencia, Spain.

Eduardo Fonseca-Pedrero

Eduardo Fonseca-Pedrero, Department of Educational Sciences, University of La Rioja, Logroño, Spain.