Cumulative interpersonal risk and suicide ideation/attempts among Chinese early adolescents: Does self-esteem play a moderating role?

Scope: Suicide among adolescents is a serious global health concern. Previous research has highlighted that interpersonal factors are vital determinants of suicidality. However, little is known about the cumulative effects of interpersonal risks and the protective factors that buffer individuals from developing suicidal tendencies. The present study examined whether linear or nonlinear models best account for the relationship between cumulative interpersonal risk and suicidal ideation and attempts among early adolescents and the protective value of self-esteem in these associations.

Methods: A sample of 605 seventh-grade students from in Hunan, China was tracked over a 6 month interval. Measures of interpersonal risk, suicidal ideation, suicide attempts, and self-esteem were obtained from adolescents' self-reports.

Results: The findings indicated both concurrent and longitudinal linear associations between cumulative interpersonal risk and adolescent suicidal ideation. Cumulative interpersonal risk was only associated with concurrent adolescent suicide attempts, showing a nonlinear relationship. Self-esteem moderates the association between cumulative interpersonal risk and subsequent suicidal ideation. The results also showed that identifying interpersonal risk early and simultaneously reducing multiple interpersonal risks would benefit high-suicide-risk youths.

Conclusions: Adolescents who face more than three interpersonal risks are particularly at risk for suicide attempts. Self-esteem is insufficient to counteract the cumulative impact of interpersonal risk completely. Study analyzing whether personal worth plays a moderating role in the suicidal ideation and attempts of early Chinese adolescents. While suicide among adolescents is a serious global health concern, little is known about the cumulative effects of interpersonal risks and the protective factors that buffer individuals from developing suicidal tendencies. As such, we followed 605 seventh graders over six months to investigate the combined influence of various interpersonal stressors such as low teacher support, limited classmates' support, ineffective communication with parents, and experiences of social ostracism on suicidality. In addition, we explored whether a good sense of personal worth (self-esteem) made a difference. Our findings showed that, as interpersonal risks accumulate, the likelihood of an adolescent experiencing suicidal thoughts increases. Although self-esteem offers some protection, it does not fully counteract the detrimental effects of combined interpersonal problems. In particular, when an adolescent faces three or more interpersonal stressors, the risk of suicide attempts increases. Based on our findings, we believe that interventions aimed at reducing these interpersonal risks and bolstering adolescent self-esteem could be pivotal for suicide prevention.