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Background <p>This study examined whether self-esteem mediates the association between perceived social support and youth mental health difficulties in a heterogeneous sample of school-recruited youths and clinically referred inpatient and outpatient youths.</p> Methods <p>The study included 312 children and adolescents (mean age = 14.36 years, SD = 2.19, range = 9–19; 37.5% boys, 62.5% girls). The primary analysis was a covariate-adjusted mediation model in the full sample, with perceived social support (MSPSS) as the predictor, self-esteem (RSE) as the mediator, and Strengths and Difficulties Questionnaire (SDQ) Total Difficulties as the outcome. Hierarchical clustering based on SDQ, RSE, and MSPSS item profiles was conducted as a secondary, exploratory analysis.</p> Results <p>Higher perceived social support was associated with higher self-esteem (B = 0.26, 95% CI [0.20, 0.31], bootstrapped <i>p</i> &lt; 0.001), and higher self-esteem was associated with fewer mental health difficulties (B = −0.43, 95% CI [−0.50, −0.35], bootstrapped <i>p</i> &lt; 0.001) in the covariate-adjusted full-sample model. The indirect effect via self-esteem was statistically detectable (B = −0.11, 95% CI [−0.14, −0.08], bootstrapped <i>p</i> &lt; 0.001), indicating partial mediation. Exploratory cluster-specific analyses indicated that the indirect effect was significant in the lower-difficulties/higher-resources cluster (B = −0.05, 95% CI [−0.09, −0.02], bootstrapped <i>p</i> = 0.003), but not in the higher-difficulties/lower-resources cluster (B = −0.01, 95% CI [−0.04, 0.00], bootstrapped <i>p</i> = 0.077).</p> Conclusion <p>Self-esteem appears to represent one pathway linking perceived social support to fewer mental health difficulties in youth. Cluster-specific findings should be interpreted as exploratory and suggest that the strength of this pathway may vary across psychosocial profiles.</p>

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The mediating role of self-esteem in the association between perceived social support and youth mental health difficulties

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月24日

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  • Tamás Földi,
  • Eszter Wittmann,
  • Olney Rodrigues de Oliveira,
  • Krisztina Kapornai,
  • Enikő Kiss

摘要

Background

This study examined whether self-esteem mediates the association between perceived social support and youth mental health difficulties in a heterogeneous sample of school-recruited youths and clinically referred inpatient and outpatient youths.

Methods

The study included 312 children and adolescents (mean age = 14.36 years, SD = 2.19, range = 9–19; 37.5% boys, 62.5% girls). The primary analysis was a covariate-adjusted mediation model in the full sample, with perceived social support (MSPSS) as the predictor, self-esteem (RSE) as the mediator, and Strengths and Difficulties Questionnaire (SDQ) Total Difficulties as the outcome. Hierarchical clustering based on SDQ, RSE, and MSPSS item profiles was conducted as a secondary, exploratory analysis.

Results

Higher perceived social support was associated with higher self-esteem (B = 0.26, 95% CI [0.20, 0.31], bootstrapped p < 0.001), and higher self-esteem was associated with fewer mental health difficulties (B = −0.43, 95% CI [−0.50, −0.35], bootstrapped p < 0.001) in the covariate-adjusted full-sample model. The indirect effect via self-esteem was statistically detectable (B = −0.11, 95% CI [−0.14, −0.08], bootstrapped p < 0.001), indicating partial mediation. Exploratory cluster-specific analyses indicated that the indirect effect was significant in the lower-difficulties/higher-resources cluster (B = −0.05, 95% CI [−0.09, −0.02], bootstrapped p = 0.003), but not in the higher-difficulties/lower-resources cluster (B = −0.01, 95% CI [−0.04, 0.00], bootstrapped p = 0.077).

Conclusion

Self-esteem appears to represent one pathway linking perceived social support to fewer mental health difficulties in youth. Cluster-specific findings should be interpreted as exploratory and suggest that the strength of this pathway may vary across psychosocial profiles.