Pressure, bullying and low social support predict depressive symptoms and self-directed violence

Abstract Background More in-depth evidence about the complex relationships between risk and protective factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing pressure, bullying, and low social support on depressive symptoms and self-directed violence in adolescence. Methods A cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13-19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts. Results Poor family economy and low parental education predicted high pressure, bullying, low parental support and depressive symptoms in males and females. Further, high pressure predicted depressive symptoms among males and females, and self-harm and suicide thoughts among females, but not males. Bullying predicted depressive symptoms, self-harm, and suicide thoughts among males and females. Low parental support predicted bullying, depressive symptoms, self-harm and suicide thoughts among males and females, and high pressure among females, but not males. Low teacher support predicted high pressure, depressive symptoms, whereas low friends support predicted bullying, depressive symptoms and suicide thoughts among males and females, and self-harm among males, but not females. Results also showed that depressive symptoms predicted self-harm and suicide thoughts among males and females. Finally, pressure, bullying and depressive symptoms were the main mediators by which family economy, parental education, friends support, teacher support and parental support predicted self-harm and suicide thoughts. Conclusions Low socioeconomic status, pressure, bullying and low social support were important predictors of depressive symptoms and self-directed violence among Norwegian adolescents through direct and indirect mechanisms. Key messages • These results also provide increased knowledge about how multiple risk and protective factors across domains impact both depressive symptoms, self-harm and suicide thoughts among adolescents. • This study highlights the importance of policies aiming at reducing economic and social inequalities, as they may also improve youth mental health.