The Effects of Stress on Suicide Risk: The Mediating Role of Self-Esteem and Depression

Objectives This study aimed to examine the structural relationships among variables influencing suicidal ideation in adolescents across different school levels. Methods The study utilized a subset of data from the “2021 Survey on the Mental Health Status of Teenagers,” targeting 405 middle and high school students categorized as high-risk for suicide. Analyses were conducted using SPSS 27.0 and SPSS Macro Process 4.2 with Model 4 and Model 6 to explore both direct and mediating effects among stress, self-esteem, depression, and suicide risk. Results Stress was negatively correlated with self-esteem and positively correlated with depression and suicide risk in both middle and high school groups. Self-esteem was negatively correlated with depression and suicide risk, while depression was positively correlated with suicide risk. In the middle school group, the mediating effect of self-esteem in the relationship between stress and suicide risk was not significant, whereas it was fully mediated in the high school group. Depression fully mediated the relationship between stress and suicide risk in the middle school group, while it partially mediated this relationship in the high school group. The sequential mediating effects of self-esteem and depression in the relationship between stress and suicide risk were significant in the high school group but not significant in the middle school group. Conclusions The findings highlight the developmental differences in the mechanisms underlying suicide risk among adolescents. While depression played a significant mediating role across school levels, the mediating effects of self-esteem and its interaction with depression varied between groups. These results underscore the necessity of tailored intervention strategies that address the unique developmental and psychological needs of middle and high school students to effectively reduce suicide risk.