The Role of Self-Esteem, Family Relationships, and Social Support With Mental Health Among High School Adolescents: A Cross-Sectional Study
DOI:
https://doi.org/10.55018/janh.v8i2.663Keywords:
Adolescents, Mental Health, Self-Esteem, Social Support, Family Relations, Psychological ResilienceAbstract
Background: Adolescent mental health has become a major public health concern worldwide. Although self-esteem, family relationships, and social support are recognized as important psychosocial protective factors, evidence regarding their combined contribution to adolescent mental health in the Indonesian context remains limited. This study aimed to examine the associations of self-esteem, family relationships, and social support with mental health among high school adolescents.
Methods: This cross-sectional study was conducted among 146 high school students aged 15–18 years in Padang, West Sumatra, Indonesia, and reported in accordance with the STROBE guidelines. Participants were selected using simple random sampling. Self-esteem, family relationships, social support, and mental health were assessed using the Rosenberg Self-Esteem Scale (RSES), Family Adaptability and Cohesion Evaluation Scale IV (FACES-IV), Multidimensional Scale of Perceived Social Support (MSPSS), and General Health Questionnaire-12 (GHQ-12). Data were analyzed using descriptive statistics, chi-square tests, and multivariable ordinal logistic regression, with adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) reported to identify factors associated with adolescent mental health.
Results: Bivariate analysis indicated that gender, self-esteem, family dynamics, and social support were significantly correlated with adolescent mental health (all p < 0.05). In the multivariable ordinal logistic regression model, adolescents with low self-esteem had significantly lower odds of being in a higher mental health category compared to those with high self-esteem (AOR = 0.00004; 95% CI: 0.000001–0.002; p < 0.001). Similarly, adolescents with weak family ties had reduced chances of improved mental health compared to those with strong family ties (AOR = 0.0002; 95% CI: 0.000005–0.007; p < 0.001). Gender continued to show a significant association with adolescent mental health (AOR = 82.43; 95% CI: 3.63–1877.76; p = 0.006), while social support lost its significance after adjustment.
Conclusion: Self-esteem, family relationships, and social support were significantly associated with adolescent mental health. Although they were not independent predictors in the multivariate model, these factors remain important psychosocial resources. Mental health promotion programs should target multiple psychosocial domains simultaneously, particularly within school and family environments.
Downloads
References
Bai, Y., Liu, X., Zhang, B., Fu, M., Huang, N., Hu, Q., & Guo, J. (2022). Associations of Youth Mental Health, Parental Psychological Distress, and Family Relationships During the COVID-19 Outbreak in China. BMC Psychiatry, 22(1), 1–11. https://doi.org/10.1186/s12888-022-03938-8
Bauer, A., Stevens, M., Purtscheller, D., Knapp, M., Fonagy, P., Evans-Lacko, S., & Paul, J. (2021). Mobilising Social Support to Improve Mental Health for Children and Adolescents: A Systematic Review Using Principles of Realist Synthesis. PLOS ONE, 16(5), e0251750. https://doi.org/10.1371/journal.pone.0251750
Cao, F., Li, J., Xin, W., & Cai, N. (2024). The impact of social support on adolescent resilience: The mediating effect of coping style. Frontiers in Public Health, 12, 1331813. https://doi.org/10.3389/fpubh.2024.1331813
Demetriou, C. (2025). Family Functioning and Adolescents’ Mental Health Problems: A Mixed-methods Analysis of Community and Clinical Samples. International Journal of Developmental Science, 19(1–2), 5–15. https://doi.org/10.1177/2192001X251326198
Erskine, H. E., Baxter, A. J., Patton, G., Moffitt, T. E., Patel, V., Whiteford, H. A., & Scott, J. G. (2024). Prevalence of adolescent mental disorders in Kenya, Indonesia, and Vietnam: A multi-country population-based study. The Lancet Regional Health - Western Pacific, 46, 101067. https://doi.org/10.1016/j.lanwpc.2024.101067
Han, X., & Cheung, M. (2025). The Relationship Between Dual Filial Piety and Mental Disorders and Symptoms Among Adolescents: A Systematic Review of Quantitative and Qualitative Studies. Adolescent Research Review, 10, 31–45. https://doi.org/10.1007/s40894-024-00234-2
Healy, C., Watt, D., Taylor, A., & Cannon, M. (2024). Social support and adolescent mental health outcomes: A systematic review. Child and Adolescent Mental Health, 29(2), 145–156. https://doi.org/10.1111/camh.12634
Herrmann, L., Reiss, F., Becker-Hebly, I., Baldus, C., Gilbert, M., Stadler, G., Kaman, A., Graumann, L., Otto, C., Devine, J., Hölling, H., & Ravens-Sieberer, U. (2024). Systematic Review of Gender-Specific Child and Adolescent Mental Health Care. Child Psychiatry and Human Development, 55, 1487–1501. https://doi.org/10.1007/s10578-023-01506-z
Huang, X., Zhang, H., & Wang, Y. (2022). Family Functioning and Adolescent Depression: A Moderated Mediation Model. Frontiers in Psychology, 13, 962147. https://doi.org/10.3389/fpsyg.2022.962147
Izzo, F., Baiocco, R., & Pistella, J. (2022). Children’s and Adolescents’ Happiness and Family Functioning: A Systematic Literature Review. International Journal of Environmental Research and Public Health, 19(24), 16593. https://doi.org/10.3390/ijerph192416593
Kurock, R., Gruchel, N., Bonanati, S., & Buhl, H. M. (2022). Family Climate and Social Adaptation of Adolescents in Community Samples: A Systematic Review. Adolescent Research Review, 7, 551–563. https://doi.org/10.1007/s40894-022-00189-2
Li, H., & Hao, F. (2025). The influence of physical activity on the mental health of high school students: the chain mediating effects of social support and self-esteem. Scientific Reports, 15, 27537. https://doi.org/10.1038/s41598-025-11952-5
Liu, Q., Jiang, M., Li, S., & Yang, Y. (2021). Social support, resilience, and self-esteem protect against common mental health problems in early adolescence: A nonrecursive analysis from a two-year longitudinal study. Medicine, 100(4), e24334. https://doi.org/10.1097/MD.0000000000024334
Lu, H., Yu, Y., Wang, D. B., Wu, A. M. S., Chen, J. H., Zhang, G., Wu, Y., & Lau, J. T. F. (2024). Association between interpersonal resources and mental health professional help-seeking among Chinese adolescents with probable depression: mediations via personal resources and active coping. BMC Psychiatry, 24(1). https://doi.org/10.1186/s12888-024-06271-4
Medina-Maldonado, V., Carrasco-Tenezaca, M., Frey, M., & Baus-Carrera, E. (2025). Understanding Family Functioning as a Protective Factor for Adolescents’ Mental Health from the Parental Perspective: Photovoice in Rural Communities of Ecuador. International Journal of Environmental Research and Public Health, 10(22), 1471. https://doi.org/doi.org/10.3390/ijerph22101471
Meland, E., Breidablik, H.-J., Thuen, F., & Samdal, G. B. (2021). How Body Concerns, Body Mass, Self-Rated Health and Self-Esteem Are Mutually Impacted in Early Adolescence: A Longitudinal Cohort Study. BMC Public Health, 21, 496. https://doi.org/10.1186/s12889-021-10553-x
Nivette, A., Ribeaud, D., Murray, A., Steinhoff, A., Bechtiger, L., Hepp, U., Shanahan, L., & Eisner, M. (2021). Non-compliance with COVID-19-related public health measures among young adults in Switzerland: Insights from a longitudinal cohort study. Social Science & Medicine, 268, 113370. https://doi.org/10.1016/j.socscimed.2020.113370
O’Neill, A., Humphrey, N., & Stapley, E. (2023). A Systematic Review of Qualitative Research Focusing on Emotional Distress Among Adolescents: Perceived Cause and Help-Seeking. Adolescent Research Review, 8, 387–402. https://doi.org/10.1007/s40894-022-00203-7
Oberle, E., Ji, X., Alkawaja, M., Molyneux, T. M., Kerai, S., Thomson, K. C., Guhn, M., Schonert-Reichl, K. A., & Gadermann, A. M. (2024). Connections Matter: Adolescent Social Connectedness Profiles and Mental Well-Being Over Time. Journal of Adolescence, 96(1), 31–48. https://doi.org/10.1002/jad.12250
Oropesa Ruiz, N. F. (2022). Assessment of the Family Context in Adolescence: A Systematic Review. Adolescents, 2(1), 53–72. https://doi.org/10.3390/adolescents2010007
Sakellariou, C. (2023). Estimating Bidirectional Effects Between Social Connectedness and Mental Health in Adolescent Students: Addressing Biases Due to Endogeneity. PLOS ONE, 18(12), e0294591. https://doi.org/10.1371/journal.pone.0294591
Santrock, J. W. (2021). Adolescence (17th ed.). McGraw-Hill Education.
Steare, T., Gutiérrez Muñoz, C., Sullivan, A., & Lewis, G. (2023). The Association Between Academic Pressure and Adolescent Mental Health Problems: A Systematic Review. Journal of Affective Disorders, 339, 302–317. https://doi.org/10.1016/j.jad.2023.07.028
Tietbohl-Santos, B., Shintani, A. O., Montezano, B. B., Biazin, P., Signori, G. M., Pulice, R., ... & Passos, I. C. (2024). Protective factors against depression in high-risk children and adolescents: a systematic review of longitudinal studies. Brazilian Journal of Psychiatry, 46. https://doi.org/https://doi.org/10.47626/1516-4446-2023-3363
UNICEF, I. (2024). Indonesia Adolescent Health Profile 2024. UNICEF Indonesia. https://www.unicef.org/indonesia/id/media/23811/file/adolescent-health-profile-2024.pdf
Wahdi, A. E., Wilopo, S. A., Erskine, H. E., & Team, I. N. A. M. H. S. (2023). The prevalence of adolescent mental disorders in Indonesia: An analysis of the Indonesia National Adolescent Mental Health Survey (I-NAMHS). Journal of Adolescent Health, 72(3), S70. https://doi.org/10.1016/j.jadohealth.2022.11.143
Wang, Y., & McLeroy, A. M. (2023). Poverty, Parenting Stress, and Adolescent Mental Health: The Protective Role of School Connectedness Reexamined. Children and Youth Services Review, 153, 107127. https://doi.org/10.1016/j.childyouth.2023.107127
World Health Organization. (2025). Mental health of adolescents. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
Yu, Y., Bai, W., Cai, H., & Xiang, Y. T. (2025). Family functioning and adolescent mental health: A cross-cultural study. BMC Psychiatry, 25(1), 118. https://doi.org/10.1186/s12888-025-06418-5
Zhang, J., Duan, X., Yan, Y., & Tan, Y. (2024). Family Functioning and Adolescent Mental Health: The Mediating Role of Bullying Victimization and Resilience. 14, 664. https://doi.org/doi: 10.3390/bs14080664
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Diana Arianti, Yuli Permata Sari, Ihsan Sanusi, Fadillah Ulva, Titin Ifayanti

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.














