{
  "abstract": "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.\n\nMethods: 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.\n\nResults: 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).\n\nConclusion: 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.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13034-026-01141-1.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatrics and Pediatric Health Center, Department of Child and Adolescent Psychiatry, University of Szeged, Korányi fasor 14-15, Szeged, 6720 Hungary",
    "Universidade Aberta do Brasil, Fortaleza, Brazil",
    "Universidade Estadual do Ceará, Fortaleza, Brazil"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tamás Földi"
    },
    {
      "affs": [
        0
      ],
      "name": "Eszter Wittmann"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Olney Rodrigues de Oliveira"
    },
    {
      "affs": [
        0
      ],
      "name": "Krisztina Kapornai"
    },
    {
      "affs": [
        0
      ],
      "name": "Enikő Kiss"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0fa9360dwvntz.bib",
  "cited_by": 0,
  "doi": "10.1186/s13034-026-01141-1",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13715225/",
  "id": "0fa9360dwvntz",
  "issns": [
    "1753-2000"
  ],
  "landing_url": "https://doi.org/10.1186/s13034-026-01141-1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "3203|Child and Adolescent Psychosocial and Emotional Development"
    ]
  ],
  "openalex": "W7170460076",
  "pdf_url": null,
  "pmcid": "PMC13715225",
  "pmid": "42947129",
  "published": "2026-07-24",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/0fa9360dwvntz.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:22:34Z",
      "native_id": "PMC13715225",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s13034-026-01141-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Child and Adolescent Psychosocial and Emotional Development",
      "subfield": "psychiatry"
    }
  ],
  "title": "The mediating role of self-esteem in the association between perceived social support and youth mental health difficulties",
  "title_text": "The mediating role of self-esteem in the association between perceived social support and youth mental health difficulties",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:22:34Z",
  "url": "https://research.draconitic.com/paper/0fa9360dwvntz",
  "venue": "Child and Adolescent Psychiatry and Mental Health",
  "versions": []
}