Core self-evaluation as mediator between depressive symptoms and suicidal ideation in adolescents

Objectives: To explore the role of core self-evaluation in mediating between depressive symptoms and suicidal ideation in Chinese adolescents. Methods: We used the cluster sampling method to analyze 11,563 students from five primary and secondary schools in China for depressive symptoms, core self-evaluation, and suicidal ideation using the following scoring scales: Core Self-Evaluation Scale (CSES), Center for Epidemiologic Survey Depression Scale (CES-D), the Second Edition of the Beck Depression Inventory (BDI-II), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Adolescent Self-Rating Life Events Checklist (ASLEC). Results: The incidence of depression was 29.7%; anxiety, 34.2%; and suicidal ideation, 28.0%. Core self-evaluation was a protective factor for suicidal ideation [OR 0.947, 95% CI 0.937-0.959, p<0.001]. Conversely, depression as measured by the CSES score was a risk factor for suicidal ideation (OR 1.084, 95% CI 1.073-1.096, p<0.001), as were anxiety as measured by the SCARED score (OR 1.011, 95% CI 1.006-1.016, p<0.001) and adolescent life events according to ASLEC score groups (OR 1.524, 95% CI 1.434-1.621, p<0.001). Core self-evaluation mediated the relationship between depression and suicidal ideation with an effect size of 13.9%. Conclusions: Better core self-evaluation is a protective factor against suicidal ideation and mediates the rela-tionship between depression and suicidal ideation. We may be able to reduce the risk of suicidal ideation and therefore suicide among adolescents by improving their core self-evaluation.