Relationships among self-esteem, depression and self-injury in adolescents: a longitudinal study

Front Public Health. 2024 May 15:12:1406283. doi: 10.3389/fpubh.2024.1406283. eCollection 2024.

Abstract

Objective: Non-suicidal self-injury is a widespread mental health concern among adolescents. This study aimed to examine the relationship between self-esteem, depression, and self-injury among adolescents using a longitudinal research design.

Methods: The Self-Esteem Scale (SES), Child Depression Inventory (CDI), and Adolescent Self-Injury Scale (ASIS) were used to follow up 1,265 junior middle school students on three occasions with six-month intervals.

Results: At all three time points, there were significant gender differences in self-esteem, depression, and self-injury. Self-esteem was negatively correlated with depression and self-injury at all three time points, while depression and self-injury were significantly positively correlated. Cross-lagged analysis revealed that self-esteem at Time 1 (T1) did not significantly predict self-injury at Time 2 (T2), but self-esteem (T2) significantly predicted self-injury at Time 3 (T3; β = -0.079, p < 0.05). Similarly, self-injury (T1) significantly predicted self-esteem (T2; β = -0.140, p < 0.001), and self-injury (T2) significantly predicted self-esteem (T3; β = -0.071, p < 0.01). Horizontal and longitudinal mediating analysis showed that depression served as a complete mediator in both the pathway from self-esteem to self-injury and from self-injury to self-esteem. Cross-lagged analysis showed that self-esteem (T1) significantly predicts depression (T2; β = -0.070, p < 0.05), which in turn predict self-injury (T3; β = 0.126, p < 0.001). Similarly, self-injury (T1) predicted depression (T2; β = 0.055, p < 0.05), which further predicted self-esteem (T3; β = -0.218, p < 0.001).

Conclusion: The self-esteem, depression, and self-injury of adolescents are closely related; self-esteem and self-injury predict each other; self-esteem indirectly affects self-injury through depression; and self-injury indirectly affects self-esteem through depression. Based on the relationship of bi-directional prediction of self-esteem and self-injury mediated by depression, this study proposes a theoretical model of depression-mediated self-esteem and self-injury cycle.

Keywords: NSSI; adolescent; cross-lagged analysis; depression; longitudinal study; self-esteem.

MeSH terms

  • Adolescent
  • Child
  • Depression* / epidemiology
  • Depression* / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Self Concept*
  • Self-Injurious Behavior* / psychology
  • Sex Factors
  • Students / psychology
  • Students / statistics & numerical data
  • Surveys and Questionnaires

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from the National Natural Science Foundation of China, China (grant number 82371537) and the Hunan Province Education Science Planning Projects, China (ND227507).