Effects of Self-Esteem on the Association between Negative Life Events and Suicidal Ideation in Adolescents
Abstract
:1. Introduction
2. Methods
2.1. Sample and Procedures
2.2. Data Collection
2.2.1. Demographic and Control Variables
2.2.2. Suicidal Ideation
2.2.3. Negative Life Events
2.2.4. Self-Esteem
2.3. Statistical Analysis
3. Results
4. Discussion
Strength and Limitation
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Chang, W.W.; Yao, Y.S.; Yuan, H.; Chen, B.F.; Liang, Y.L.; Chen, Y.; Song, J.G.; Li, J.; Zhu, Y. Prevalence of suicide ideation among middle school students in China: A systematic analysis of studies between 2000 and 2012. Chin. J. Epidemiol. 2013, 34, 515–518. [Google Scholar]
- Witt, K.; Boland, A.; Lamblin, M.; McGorry, P.D.; Veness, B.; Cipriani, A.; Hawton, K.; Harvey, S.; Christensen, H.; Robinson, J. Effectiveness of universal programmes for the prevention of suicidal ideation, behaviour and mental ill health in medical students: A systematic review and meta-analysis. Evid. Based Ment. Health 2019, 22, 84–90. [Google Scholar] [CrossRef] [PubMed]
- Baiden, P.; Graaf, G.; Zaami, M.; Acolatse, C.K.; Adeku, Y. Examining the association between prescription opioid misuse and suicidal behaviors among adolescent high school students in the United States. J. Psychiatr. Res. 2019, 112, 44–51. [Google Scholar] [CrossRef] [PubMed]
- Victor, S.E.; Klonsky, E.D. Correlates of suicide attempts among self-injurers: A meta-analysis. Clin. Psychol. Rev. 2014, 34, 282–297. [Google Scholar] [CrossRef] [PubMed]
- Büscher, R.; Torok, M.; Sander, L. The effectiveness of internet-based self-help interventions to reduce suicidal ideation: Protocol for a systematic review and meta-analysis. JMIR Res. Protoc. 2019, 8, e14174. [Google Scholar] [CrossRef] [PubMed]
- Saeedzadeh Sardahaee, F.; Holmen, T.L.; Micali, N.; Sund, E.R.; Bjerkeset Kvaløy, K. Suicidal ideation in relation to disordered eating, body size and weight perception: A cross-sectional study of a Norwegian adolescent population: The HUNT Study. BMJ Open 2019, 9, e029809. [Google Scholar] [CrossRef] [PubMed]
- Lehmann, M.; Hilimire, M.R.; Yang, L.H.; Link, B.G.; DeVylder, J.E. Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults with History of Suicide Attempts. Crisis 2016, 37, 265–270. [Google Scholar] [CrossRef]
- Creemers, D.H.; Scholte, R.H.; Engels, R.C.; Prinstein, M.J.; Wiers, R.W. Damaged self-esteem is associated with internalizing problems. Front. Psychol. 2013, 4, 152. [Google Scholar] [CrossRef] [PubMed]
- Liu, R.T.; Miller, I. Life events and suicidal ideation and behavior: A systematic review. Clin. Psychol. Rev. 2014, 34, 181–192. [Google Scholar] [CrossRef] [PubMed]
- Macrynikola, N.; Miranda, R.; Soffer, A. Social connectedness, stressful life events, and self-injurious thoughts and behaviors among young adults. Compr. Psychiatry 2018, 80, 140–149. [Google Scholar] [CrossRef]
- Serafini, G.; Muzio, C.; Piccinini, G.; Flouri, E.; Ferrigno, G.; Pompili, M.; Girardi, P.; Amore, M. Life adversities and suicidal behavior in young individuals: A systematic review. Eur. Child Adolesc. Psychiatry 2015, 24, 1423–1446. [Google Scholar] [CrossRef] [PubMed]
- Perrot, C.; Vera, L.; Gorwood, P. Poor self-esteem is correlated with suicide intent, independently from the severity of depression. Encephale 2018, 44, 122–127. [Google Scholar] [CrossRef] [PubMed]
- Fiorilli, C.; Grimaldi Capitello, T.; Barni, D.; Buonomo, I.; Gentile, S. Predicting adolescent depression: The interrelated roles of self-esteem and interpersonal stressors. Front. Psychol. 2019, 10, 565. [Google Scholar] [CrossRef] [PubMed]
- Orth, U.; Luciano, E.C. Self-esteem, narcissism, and stressful life events: Testing for selection and socialization. J. Personal. Soc. Psychol. 2015, 109, 707–721. [Google Scholar] [CrossRef] [PubMed]
- Soman, S.; Bhat, S.M.; Latha, K.S.; Praharaj, S.K. Gender differences in perceived social support and stressful life events in depressed patients. East Asian Arch. Psychiatry 2016, 26, 22–29. [Google Scholar]
- Van Damme, L.; Colins, O.F.; Vanderplasschen, W. Gender differences in psychiatric disorders and clusters of self-esteem among detained adolescents. Psychiatry Res. 2014, 220, 991–997. [Google Scholar] [CrossRef] [PubMed]
- Hawton, K.; Saunders, K.E.; O’Connor, R.C. Self-harm and suicide in adolescents. Lancet 2012, 379, 2373–2382. [Google Scholar] [CrossRef]
- Tao, F.B.; Hu, C.L.; Sun, Y.; Hao, J.H. The development and application of multidimensional sub-health questionnaire of adolescents (MSQA). Chin. J. Dis. Cont. Prev. 2008, 12, 309–314. [Google Scholar]
- Zhao, X.; Zhang, Y.; Li, L.; Zhou, Y.; Li, H.; Yang, S. Reliability and validity of the Chinese version of childhood trauma questionnaire. Chin. J. Clin. Rehabil. 2005, 9, 105–107. [Google Scholar]
- Rose, S.M.S.-F.; Xie, D.; Stineman, M. Adverse childhood experiences and disability in US adults. PM R 2014, 6, 670–680. [Google Scholar] [CrossRef]
- Giovanelli, A.; Reynolds, A.J.; Mondi, C.F.; Ou, S.R. Adverse childhood experiences and adult well-being in a low-income, urban cohort. Pediatrics 2016, 137, e20154016. [Google Scholar] [CrossRef] [PubMed]
- Centers for Disease Control and Prevention. Adolescent and School Health. YRBSS Questionnaire; 2013. Available online: https://www.cdc.gov/healthyyouth/data/yrbs/questionnaires.htm (accessed on 20 July 2013).
- Hu, Y.; Su, P.Y.; Tao, F.B.; Qi, X.Y.; Xing, C.; Huang, Z.H. Compilation and reliability and validity assessment of multidimensional life events rating questionnaire for middle school students. Chin. J. Sch. Health 2010, 31, 146–149. [Google Scholar]
- Rosenberg, M. Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy. Meas. Package 1965, 61, 52. [Google Scholar]
- Chen, R.; Hu, Z.; Wei, L.; Wilson, K. Socioeconomic status and survival among older adults with dementia and depression. Br. J. Psychiatry 2014, 204, 436–440. [Google Scholar] [CrossRef] [PubMed]
- Daniel, S.S.; Goldston, D.B.; Erkanli, A.; Heilbron, N.; Franklin, J.C. Prospective study of major loss life events and risk for suicidal thoughts and behaviors among adolescents and young adults. Suicide Life Threat Behav. 2017, 47, 436–449. [Google Scholar] [CrossRef] [PubMed]
- Mackin, D.M.; Perlman, G.; Davila, J.; Kotov, R.; Klein, D.N. Social support buffers the effect of interpersonal life stress on suicidal ideation and self-injury during adolescence. Psychol. Med. 2017, 47, 1149–1161. [Google Scholar] [CrossRef] [PubMed]
- Liu, X.; Tein, J.Y. Life events, psychopathology, and suicidal behavior in Chinese adolescents. J. Affect. Disord. 2005, 86, 195–203. [Google Scholar] [CrossRef]
- Park, S. Predictors of suicidal ideation in late childhood and adolescence: A 5-year follow-up of two nationally representative cohorts in the Republic of Korea. Suicide Life Threat Behav. 2013, 43, 81–96. [Google Scholar] [CrossRef]
- Lee, D.; Jung, S.; Park, S.; Hong, H.J. The impact of psychological problems and adverse life events on suicidal ideation among adolescents using nationwide data of a school-based mental health screening test in Korea. Eur. Child Adolesc. Psychiatry 2018, 27, 1361–1372. [Google Scholar] [CrossRef]
- Sandin, B.; Chorot, P.; Santed, M.A.; Valiente, R.M.; Joiner, T.E., Jr. Negative life events and adolescent suicidal behavior: A critical analysis from the stress process perspective. J. Adolesc. 1998, 21, 415–426. [Google Scholar] [CrossRef]
- Wilburn, V.R.; Smith, D.E. Stress, self-esteem, and suicidal ideation in late adolescents. Adolescence 2005, 40, 33–45. [Google Scholar] [CrossRef] [PubMed]
- Wang, R.H.; Lai, H.J.; Hsu, H.Y.; Hsu, M.T. Risk and protective factors for suicidal ideation among Taiwanese adolescents. Nurs. Res. 2011, 60, 413–421. [Google Scholar] [CrossRef] [PubMed]
- Rowe, C.A.; Walker, K.L.; Britton, P.C.; Hirsch, J.K. The relationship between negative life events and suicidal behavior: Moderating role of basic psychological needs. Crisis 2013, 34, 233–241. [Google Scholar] [CrossRef] [PubMed]
- O’Connor, R. The relations between perfectionism and suicidality: A systematic review. Suicide Life Threat Behav. 2007, 37, 698–714. [Google Scholar] [CrossRef] [PubMed]
- Schrijvers, D.L.; Bollen, J.; Sabbe, B.G. The gender paradox in suicidal behavior and its impact on the suicidal process. J. Affect. Disord. 2012, 138, 19–26. [Google Scholar] [CrossRef] [PubMed]
- Zhang, Y.; Deng, G.; Zhang, Z.; Zhou, Q.; Gao, X.; Di, L.; Che, Q.; Du, X.; Cai, Y.; Han, X.; et al. A cross sectional study between the prevalence of chronic pain and academic pressure in adolescents in China (Shanghai). BMC Musculoskelet. Disord. 2015, 16, 219. [Google Scholar] [CrossRef] [PubMed]
- Cui, N.; Xue, J.; Connolly, C.A.; Liu, J. Does the gender of parent or child matter in child maltreatment in China? Child Abuse Negl. 2016, 54, 1–9. [Google Scholar] [CrossRef]
- Law, B.M.; Shek, D.T. A 6-year longitudinal study of self-harm and suicidal Behaviors among Chinese adolescents in Hong Kong. J. Pediatr. Adolesc. Gynecol. 2016, 29, S38–S48. [Google Scholar] [CrossRef]
- Xu, Z.; Müller, M.; Lay, B.; Oexle, N.; Drack, T.; Bleiker, M.; Lengler, S.; Blank, C.; Vetter, S.; Rössler, W.; et al. Involuntary hospitalization, stigma stress and suicidality: A longitudinal study. Soc. Psychiatry Psychiatr. Epidemiol. 2018, 53, 309–312. [Google Scholar] [CrossRef]
- Lu, R.; Zhou, Y.; Wu, Q.; Peng, X.; Dong, J.; Zhu, Z.; Xu, W. The effects of mindfulness training on suicide ideation among left-behind children in China: A randomized controlled trial. Child 2019, 45, 371–379. [Google Scholar] [CrossRef]
- Griffiths, S.; Allison, C.; Kenny, R.; Holt, R.; Smith, P.; Baron-Cohen, S. The Vulnerability Experiences Quotient (VEQ): A study of vulnerability, mental health and life satisfaction in autistic adults. Autism Res. 2019. [Google Scholar] [CrossRef] [PubMed]
Variables | Total n = 9704 | No SI n = 7913 | SI n = 1791 | p-Value |
---|---|---|---|---|
Age (mean, SD) | 15.6 (1.8) | 15.6 (1.8) | 15.4 (1.7) | <0.001 |
Gender | ||||
Female | 5104 (52.6) | 4057 (79.5) | 1047 (20.5) | <0.001 |
Male | 4600 (47.4) | 3856 (83.8) | 744 (16.2) | |
Urban/rurality | ||||
urban | 4049 (41.7) | 3160 (78.0) | 889 (22.0) | <0.001 |
rural | 5655 (58.3) | 4753 (84.0) | 902 (16.0) | |
Only child | ||||
yes | 2999 (30.9) | 2385 (79.5) | 614 (20.5) | 0.001 |
no | 6705 (69.1) | 5528 (82.4) | 1177 (17.6) | |
Father’s education level | ||||
less than junior middle school | 2256 (23.2) | 1889 (83.7) | 367 (16.3) | <0.001 |
junior middle school | 3802 (39.2) | 3150 (82.9) | 652 (17.1) | |
senior middle school | 2107 (21.7) | 1652 (78.4) | 455 (21.6) | |
college or more | 1539 (15.9) | 1222 (79.4) | 317 (20.6) | |
Mother’s education level | ||||
less than junior middle school | 3096 (31.9) | 2574 (83.1) | 522 (16.9) | <0.001 |
junior middle school | 3478 (35.8) | 2863 (82.3) | 615 (17.7) | |
senior middle school | 1888 (19.5) | 1501 (79.5) | 387 (20.5) | |
college or more | 1242 (12.8) | 975 (78.5) | 267 (21.5) | |
Economic status of family | ||||
good | 1289 (13.3) | 1022 (79.3) | 267 (20.7) | 0.031 |
moderate | 6638 (68.4) | 5456 (82.8) | 1182 (17.8) | |
poor | 1777 (18.3) | 1435 (80.8) | 342 (19.2) | |
Psychological symptoms | ||||
no | 7414 (76.4) | 6472 (87.3) | 942 (12.7) | <0.001 |
yes | 2290 (23.6) | 1441 (62.9) | 849 (37.1) | |
ACEs | ||||
0 | 1243 (12.8) | 1140 (91.7) | 103 (8.3) | <0.001 |
1–2 | 4385 (45.2) | 3755 (85.6) | 630 (14.4) | |
≥3 | 4076 (42.0) | 3018 (74.0) | 1058 (26.0) | |
Self-esteem | ||||
high | 3513 (36.2) | 3062 (87.2) | 451 (12.8) | <0.001 |
moderate | 3261 (33.6) | 2755 (84.5) | 506 (15.5) | |
low | 2930 (30.2) | 2096 (71.5) | 834 (28.3) |
NLEs | SI, n (%) | Adjusted Analysis a | Adjusted Analysis b | Adjusted Analysis c | |||||
---|---|---|---|---|---|---|---|---|---|
No | Yes | p-Value | OR (95%CI) | p-Value | OR (95%CI) | p-Value | OR (95%CI) | p-Value | |
Total | |||||||||
low | 5186 (88.7) | 659 (11.3) | <0.001 | 1.0 | 1.0 | 1.0 | |||
high | 2727 (70.7) | 1132 (29.3) | 3.39 (3.04–3.78) | <0.001 | 2.29 (2.03–2.58) | <0.001 | 2.19 (1.94–2.47) | <0.001 | |
Female | |||||||||
low | 2659 (87.8) | 369 (12.2) | <0.001 | 1.0 | 1.0 | 1.0 | |||
high | 1398 (67.3) | 678 (32.7) | 3.64 (3.16–4.21) | <0.001 | 2.49 (2.12–2.92) | <0.001 | 2.38 (2.02–2.80) | <0.001 | |
Male | |||||||||
low | 2527 (89.7) | 290 (10.3) | <0.001 | 1.0 | 1.0 | 1.0 | |||
high | 1329 (74.5) | 454 (25.5) | 3.09 (2.62–3.63) | <0.001 | 2.05 (1.71–2.46) | <0.001 | 1.96 (1.64–2.36) | <0.001 |
Self-Esteem | NLEs | n (%) | Adjusted Analysis a | Adjusted Analysis b | ||
---|---|---|---|---|---|---|
OR (95%CI) | p-Value | OR (95%CI) | p-Value | |||
high | low | 205 (8.1) | 1.0 | 1.0 a | ||
high | 246 (25.4) | 4.09 (3.33–5.02) | <0.001 | 2.93 (2.34–3.68) | <0.001 | |
moderate | low | 212 (10.8) | 1.0 | 1.0 a | ||
high | 294 (22.8) | 2.55 (2.10–3.11) | <0.001 | 1.94 (1.56–2.40) | <0.001 | |
low | low | 242 (18.2) | 1.0 | 1.0 a | ||
high | 592 (37.0) | 2.72 (2.28–3.23) | <0.001 | 2.00 (1.65–2.42) | <0.001 | |
Ratio of two adjusted b ORs in high vs. moderate self-esteem | 1.51 (1.10–2.06) | 0.010 | ||||
Ratio of two adjusted b ORs in high vs. low self-esteem | 1.47 (1.09–1.97) | 0.012 |
Self-Esteem | NLEs | n (%) | Adjusted Analysis a | Adjusted Analysis b | ||
---|---|---|---|---|---|---|
OR (95%CI) | p-Value | OR (95%CI) | p-Value | |||
high | low | 109 (8.8) | 1.0 | 1.0 | ||
high | 149 (31.5) | 4.91 (3.72–6.49) | <0.001 | 3.66 (2.69–4.99) | <0.001 | |
moderate | low | 127 (11.6) | 1.0 | 1.0 | ||
high | 172 (24.8) | 2.63 (2.03–3.39) | <0.001 | 1.97 (1.49–2.61) | <0.001 | |
low | low | 133 (19.1) | 1.0 | 1.0 | ||
high | 357 (39.3) | 2.86 (2.26–3.62) | <0.001 | 2.08 (1.61–2.70) | <0.001 | |
Ratio of two adjusted b ORs in high vs. moderate self-esteem | 1.86 (1.22–2.82) | 0.004 | ||||
Ratio of two adjusted b ORs in high vs. low self-esteem | 1.76 (1.18–2.63) | 0.006 |
Self-Esteem | NLEs | n (%) | Adjusted Analysis a | Adjusted Analysis b | ||
---|---|---|---|---|---|---|
OR (95%CI) | p-Value | OR (95%CI) | p-Value | |||
high | low | 96 (7.3) | 1.0 | 1.0 | ||
high | 97 (19.6) | 3.27 (2.40–4.45) | <0.001 | 2.27 (1.62–3.19) | <0.001 | |
moderate | low | 85 (9.7) | 1.0 | 1.0 | ||
high | 122 (20.4) | 2.46 (1.82–3.33) | <0.001 | 1.83 (1.32–2.55) | <0.001 | |
low | low | 109 (17.2) | 1.0 | 1.0 | ||
high | 235 (34.0) | 2.56 (1.97–3.32) | <0.001 | 1.89 (1.41–2.53) | <0.001 | |
Ratio of two adjusted b ORs in high vs. moderate self-esteem | 1.24 (0.77–1.99) | 0.371 | ||||
Ratio of two adjusted b ORs in high vs. low self-esteem | 1.20 (0.77–1.88) | 0.422 |
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Wan, Y.; Chen, R.; Wang, S.; Orton, S.; Wang, D.; Zhang, S.; Sun, Y.; Tao, F. Effects of Self-Esteem on the Association between Negative Life Events and Suicidal Ideation in Adolescents. Int. J. Environ. Res. Public Health 2019, 16, 2846. https://doi.org/10.3390/ijerph16162846
Wan Y, Chen R, Wang S, Orton S, Wang D, Zhang S, Sun Y, Tao F. Effects of Self-Esteem on the Association between Negative Life Events and Suicidal Ideation in Adolescents. International Journal of Environmental Research and Public Health. 2019; 16(16):2846. https://doi.org/10.3390/ijerph16162846
Chicago/Turabian StyleWan, Yuhui, Ruoling Chen, Shanshan Wang, Sophie Orton, Danni Wang, Shichen Zhang, Ying Sun, and Fangbiao Tao. 2019. "Effects of Self-Esteem on the Association between Negative Life Events and Suicidal Ideation in Adolescents" International Journal of Environmental Research and Public Health 16, no. 16: 2846. https://doi.org/10.3390/ijerph16162846