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Open AccessArticle

Effects of Self-Esteem on the Association between Negative Life Events and Suicidal Ideation in Adolescents

1
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
2
Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei 230032, China
3
Centre for Health and Social Care Improvement (CHSCI), Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
4
Division of Primary Care, School of Medicine, University of Nottingham, Nottingham NG1 4BU, UK
5
Teaching Centre of Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(16), 2846; https://doi.org/10.3390/ijerph16162846
Received: 24 June 2019 / Revised: 4 August 2019 / Accepted: 7 August 2019 / Published: 9 August 2019
(This article belongs to the Special Issue Recent Advances of Adolescents and Children Health Research)
Negative life events (NLEs) increase the risk of suicidal ideation (SI) in adolescents. However, it is not known whether the association between NLEs and SI can be moderated by self-esteem and varies with gender. The aim of the current paper was to examine gender differences in the association of SI with NLEs in adolescents, and assess the effects of self-esteem on the association and their gender variations. We conducted a school-based health survey in 15 schools in China between November 2013 and January 2014. A total of 9704 participants aged 11–19 years had sociodemographic data reported and self-esteem (Rosenberg self-esteem scale), NLEs, and SI measured. Multivariate-adjusted logistic regression was used to calculate the odds ratio (OR) of having SI in relation to NLEs. Increased risk of SI was significantly associated with NLEs (adjusted OR 2.19, 95%CI 1.94–2.47), showing no gender differences (in females 2.38, 2.02–2.80, in males 1.96, 1.64–2.36, respectively). The association was stronger in adolescents with high esteem (2.93, 2.34–3.68) than those with low esteem (2.00, 1.65–2.42) (ORs ratio 1.47, p = 0.012). The matched figures in females were 3.66 (2.69–4.99) and 2.08 (1.61–2.70) (1.76, p = 0.006), while in males these figures were 2.27(1.62–3.19) and 1.89 (1.41–2.53) (1.20, p = 0.422), respectively. Self-esteem had moderate effects on the association between NLEs and SI in adolescents, mainly in females. NLEs, self-esteem, and gender need to be incorporated into future intervention programs to prevent SI in adolescents. View Full-Text
Keywords: negative life events; suicidal ideation; self-esteem; adolescents negative life events; suicidal ideation; self-esteem; adolescents
MDPI and ACS Style

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.

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