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Low Self-Esteem Predicts Persistent Suicidal Ideation Across Adolescence and Young Adulthood: A 14-year Longitudinal
Sean H Y Toh1, Aaron Corn2, Patrick Mair2
1Department of Psychology, Harvard University, Cambridge, MA, 02138, USA. sean_toh@g.harvard.edu.
Research on Child and Adolescent Psychopathology
|June 30, 2026
Summary
Low adolescent self-esteem predicts future suicidal ideation (SI) across young adulthood. However, suicide attempts (SA) are better predicted by concurrent risk factors, highlighting different pathways to suicidality.
Area of Science:
- Psychiatry
- Developmental Psychology
- Epidemiology
Background:
- Recurrent suicidal ideation (SI) and suicide attempts (SA) are significant predictors of suicide mortality.
- Identifying consistent predictors of SI and SA recurrence over time is crucial for effective suicide prevention.
Purpose of the Study:
- To investigate the predictive role of adolescent self-esteem in the development of SI and SA throughout adolescence and young adulthood.
- To differentiate the predictors of SI versus SA over a 14-year follow-up period.
Main Methods:
- Utilized data from the U.S. National Longitudinal Study of Adolescent to Adult Health (N = 6,504).
- Assessed self-esteem and demographics at baseline, with SI, SA, and other risk factors measured at four time points over 14 years.
- Employed time-lagged logistic regression models to analyze the longitudinal relationships.
Main Results:
- Adolescent self-esteem significantly predicted SI at all follow-up waves, independent of covariates.
- Suicide attempts (SA) were more consistently predicted by concurrent risk factors rather than baseline self-esteem.
- Established risk factors included depressive symptoms, substance use, violent victimization, childhood maltreatment, and recent exposure to suicide attempts.
Conclusions:
- Adolescent self-esteem emerges as a critical longitudinal predictor for suicidal ideation (SI).
- Suicide attempts (SA) appear to be more influenced by immediate, concurrent risk factors.
- Findings underscore the importance of addressing self-esteem in adolescent mental health and suicide prevention strategies.
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