An explanatory model of loneliness and suicidal ideation in Peruvian adolescents: the mediating role of non-suicidal self-injury
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Abstract
The present study aimed to examine the mediating role of nonsuicidal self-injury in the relationship between loneliness (social and emotional) and suicidal ideation among Peruvian adolescents. A cross-sectional explanatory study was conducted with a sample of 434 adolescents aged 14 to 17 years from three public educational institutions. Validated instruments were used to assess loneliness, suicidal ideation, and nonsuicidal self-injury, and the proposed model was tested using structural equation modeling with the robust maximum likelihood (MLR) estimator. The results showed that both social and emotional loneliness were positively and significantly associated with suicidal ideation; furthermore, nonsuicidal self-injury mediated both relationships. Regarding gender differences, female adolescents reported higher levels of emotional loneliness, nonsuicidal self-injury, and suicidal ideation. It is concluded that adolescents who experience loneliness may engage in nonsuicidal self-injury as a maladaptive coping mechanism, which is associated with greater suicidal ideation.
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References
Ato, M., y Vallejo, G. (2015). Diseños de investigación en psicología. Pirámide.
Bahamón Muñetón, M. J., Alarcón Vásquez, Y., & Trejos Herrera, A. M. (2019). Manual de intervención: prevención del riesgo suicida en adolescentes. Editorial El Manual Moderno.
Baños-Chaparro, J., & Contreras-Nuñez, O. D. (2025). Ideación suicida e inteligencia emocional en adolescentes: un análisis de ecuaciones estructurales y factor Bayes. Revista de Investigación en Psicología, 28(1), Article e29538. https://doi.org/10.15381/rinvp.v28i1.29538
Baños-Chaparro, J., & Ramos-Vera, C. (2020). Validez e invarianza según sexo y edad de la Escala Paykel de Ideación Suicida en adolescentes peruanos. Interacciones: Revista de Avances en Psicología, 6(1), Article e225. https://doi.org/10.24016/2020.v6n1.225
Bao, X., Guo, T., Xu, L., Chen, W., Luan, L., Yang, H., & Zhang, X. (2024). Suicidal ideation in Chinese adolescents: Prevalence, risk factors, and partial mediation by family support, a cross-sectional study. Frontiers in Psychiatry, 15, Article 1427560. https://doi.org/10.3389/fpsyt.2024.1427560
Barreto, M., Victor, C., Hammond, C., Eccles, A., Richins, M. T., & Qualter, P. (2021). Loneliness around the world: Age, gender, and cultural differences in loneliness. Personality and Individual Differences, 169, Article 110066. https://doi.org/10.1016/j.paid.2020.110066
Barzilay, S., Feldman, D., Snir, A., Apter, A., Carli, V., Hoven, C. W., Wasserman, C., Sarchiapone, M., & Wasserman, D. (2015). The interpersonal theory of suicide and adolescent suicidal behavior. Journal of Affective Disorders, 183, 68-74. https://doi.org/10.1016/j.jad.2015.04.047
Bračič, M., Roškar, S., Zager Kocjan, G., & Jeriček Klanšček, H. (2019). The prevalence and predictors of suicidal ideation among Slovene adolescents. Community Mental Health Journal, 55(7), 1210-1217. https://doi.org/10.1007/s10597-019-00398-5
Brackman, E. H., Morris, B. W., & Andover, M. S. (2016). Predicting risk for suicide: A preliminary examination of non-suicidal self-injury and the acquired capability construct in a college sample. Archives of Suicide Research, 20(4), 663-676. https://doi.org/10.1080/13811118.2016.1162247
Bresin, K., & Schoenleber, M. (2015). Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55-64. https://doi.org/10.1016/j.cpr.2015.02.009
Campo-Arias, A., & Oviedo, H. C. (2008). Propiedades psicométricas de una escala: La consistencia interna. Revista de Salud Pública, 10(5), 831-839.
Centro Nacional de Epidemiología, Prevención y Control de Enfermedades [CDC]. (2025). Sala situacional de problemas de salud mental priorizados [Dataset]. Centro Nacional de Epidemiología, Prevención y Control de Enfermedades.
Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14(3), 464-504. https://doi.org/10.1080/10705510701301834
Dattani, S., Rodés-Guirao, L., Ritchie, H., Roser, M., & Ortiz-Ospina, E. (2023). Suicides. Our World in Data.
De Jong-Gierveld, J., & Kamphuls, F. (1985). The development of a Rasch-type loneliness scale. Applied Psychological Measurement, 9(3), 289-299. https://doi.org/10.1177/014662168500900307
Dominguez-Lara, S. (2018). Magnitud del efecto, una guía rápida. Educación Médica, 19(4), 251-254. https://doi.org/10.1016/j.edumed.2017.07.002
Espinosa-Salido, P., Perez, M. A., Baca-García, E., & Ortega, M. P. (2021). Systematic review of the indirect relationships of thwarted belongingness and perceived burdensomeness in suicide. Clínica y Salud, 32(1), 29-36. https://doi.org/10.5093/clysa2020a27
George, D., & Mallery, P. (2019). IBM SPSS statistics 26 step by step: a simple guide and reference (16th ed.). Routledge. https://doi.org/10.4324/9780429056765
Grandclerc, S., & Lachal, J. (2018). Liens entre conduites automutilatoires et suicidaires chez les adolescents. Soins Psychiatrie, 39(316), 14-16. https://doi.org/10.1016/j.spsy.2018.03.003
Have, M. T., De Graaf, R., Van Dorsselaer, S., Verdurmen, J., Van’T Land, H., Vollebergh, W., & Beekman, A. (2009). Incidence and course of suicidal ideation and suicide attempts in the general population. The Canadian Journal of Psychiatry, 54(12), 824-833. https://doi.org/10.1177/070674370905401205
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218-227. https://doi.org/10.1007/s12160-010-9210-8
Hernández-Vásquez, A., Vargas-Fernández, R., & Bendezu-Quispe, G. (2023). Binge drinking and suicidal ideation in peruvian adolescents: evidence from a pooled cross-sectional survey. Journal of Affective Disorders, 340, 321-326. https://doi.org/10.1016/j.jad.2023.08.008
Hu, W., Li, B., Li, X., Luo, S., Xu, Z., Li, J., Chen, W., & Guo, V. Y. (2025). The distribution of frequent perceived loneliness and its association with suicidal behaviors in adolescents: A school-based study across 93 countries/territories. European Child & Adolescent Psychiatry, 34(9), 2779-2789. https://doi.org/10.1007/s00787-025-02698-6
Joiner, T. E., Van Orden, K. A., & Witte, T. K. (2009). The interpersonal theory of suicide: guidance for working with suicidal clients. American Psychological Association.
Joiner, T. E., Van Orden, K. A., Witte, T. K., Selby, E. A., Ribeiro, J. D., Lewis, R., & Rudd, M. D. (2009). Main predictions of the interpersonal-psychological theory of suicidal behavior: Empirical tests in two samples of young adults. Journal of Abnormal Psychology, 118(3), 634-646. https://doi.org/10.1037/a0016500
Kline, R. (2016). Principles and practice of structural equation modeling (4ª ed). Guilford Press.
Lavelle, L., & Hawkley, L. C. (2010). Loneliness. En I. B. Weiner y W. E. Craighead (Eds.), The Corsini encyclopedia of psychology (pp. 1-3). Wiley. https://onlinelibrary.wiley.com/doi/10.1002/9780470479216.corpsy0513
Lee, G., & Ham, O. K. (2018). Behavioral and psychosocial factors associated with suicidal ideation among adolescents. Nursing & Health Sciences, 20(3), 394-401. https://doi.org/10.1111/nhs.12422
Lee, J., & Lee, M. A. (2026). Association between loneliness and suicidal behaviors among Korean adolescents: A Nationwide cross-sectional study. Journal of Child and Adolescent Psychiatric Nursing, 39(1), Article e70047. https://doi.org/10.1111/jcap.70047
Marín, M. I. (2013). Desarrollo y evaluación de una terapia cognitivo conductual para adolescentes que se autolesionan. Universidad Nacional Autónoma de México. https://doi.org/10.22201/dgpyfe.9786070253263e.2013
Matarazzo, B. B., Homaifar, B. Y., Farro, S. A., & Brenner, L. A. (2015). The language of suicide. In C. J. Bryan (coord.), Cognitive behavioral therapy for preventing suicide attempts: A guide to brief treatments across clinical settings (pp. 14-32). Routledge.
Morales-Perez, L., Palacios-Delgado, J. R., Castillo-Blanco, R., Livia-Segovia, J., & Peralta-Eugenio, G. (2025). Exposición a la violencia en casa y conductas autolesivas: el rol de la supresión emocional en adolescentes. Psychology, Society & Education, 17(2), 44-53. https://doi.org/10.21071/pse.v17i2.17600
Muthén, L., & Muthén, B. (2017). MPlus user’s guide (8ª ed.). Muthén & Muthén.
Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6(1), 339-363. https://doi.org/10.1146/annurev.clinpsy.121208.131258
Nock, M. K., & Favazza, A. R. (2009). Nonsuicidal self-injury: Definition and classification. In M. K. Nock (Ed.), Understanding nonsuicidal self-injury: Origins, assessment, and treatment (pp. 9-18). American Psychological Association. https://doi.org/10.1037/11875-001
Nock, M., Joinerjr, T., Gordon, K., Lloydrichardson, E., &y Prinstein, M. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144(1), 65-72. https://doi.org/10.1016/j.psychres.2006.05.010
Organización Mundial de la Salud [OMS]. (2025, marzo 25). Suicidio. Organización Mundial de la Salud.
Otto, A., Jarvers, I., Kandsperger, S., Reichl, C., Ando, A., Koenig, J., Kaess, M., & Brunner, R. (2023). Stress-induced alterations in resting-state functional connectivity among adolescents with non-suicidal self-injury. Journal of Affective Disorders, 339, 162-171. https://doi.org/10.1016/j.jad.2023.07.032
Our World in Data. (2024). Suicide rate, by age, 2000 to 2021. Our World in Data.
Pan American Health Organization [PAHO]. (2021). The burden of suicide in the Region of the Americas Pan American Health Organization.
Paykel, E. S., Myers, J. K., Lindenthal, J. J., & Tanner, J. (1974). Suicidal feelings in the general population: A prevalence study. British Journal of Psychiatry, 124(582), 460-469. https://doi.org/10.1192/bjp.124.5.460
Pollak, O. H., Frye, N. G., Nugiel, T., Cohen, J. R., Telzer, E. H., Lindquist, K. A., & Prinstein, M. J. (2025). Testing an interpersonal risk pathway to suicidal ideation in adolescence: Linking neural, psychological, and sociometric indices of socially relevant factors. Social Cognitive and Affective Neuroscience, 20(1), Article nsaf087. h https://doi.org/10.1093/scan/nsaf087
Poudel, A., Lamichhane, A., Magar, K. R., & Khanal, G. P. (2022). Non suicidal self injury and suicidal behavior among adolescents: Co-occurrence and associated risk factors. BMC Psychiatry, 22(1), Article 96. https://doi.org/10.1186/s12888-022-03763-z
Quevedo, J. K. C., García-García, E. E., Prado, R. Y. T., & Robles, N. E. C. (2021). Adaptación de la Cédula de Autolesión (CAL): propiedades psicométricas y resultados en una muestra de adolescentes. https://doi.org/10.5281/ZENODO.5459512
Ribeiro, C. N., & Guerra, A. M. C. (2020). Adolescência, atos e o risco de suicídio. Psicologia USP, 31, Article e190108. https://doi.org/10.1590/0103-6564e190108
Ribeiro, J. D., & Joiner, T. E. (2009). The interpersonal-psychological theory of suicidal behavior: Current status and future directions. Journal of Clinical Psychology, 65(12), 1291-1299. https://doi.org/10.1002/jclp.20621
Rosseel, Y. (2012). lavaan: An R Package for structural equation modeling. Journal of Statistical Software, 48(2), 1-36. https://doi.org/10.18637/jss.v048.i02
Soper, D. (2024). A-priori sample size calculator for structural equation models. Daniel Soper.
Ulutas, I., & Aksoy, A. B. (2014). The socio-emotional loneliness and communication skills of preschool teacher trainees. The International Journal of Interdisciplinary Studies in Communication, 8(1), 1-8. https://doi.org/10.18848/2324-7320/CGP/v08i01/53584
Vargas-Murga, H., Luna-Solis, Y., & Vargas-Suárez, K. (2025). Conducta suicida en la población adolescente de la ciudad de Ayacucho: Estudio comparativo entre 2003 y 2017. Revista de Neuro-Psiquiatría, 88(2), 130-146. https://doi.org/10.20453/rnp.v88i2.5875
Ventura-León, J., Caycho-Rodríguez, T., Barboza-Palomino, M., & Cáceres-Gonzales, G. (2017). Evidencia de validez y confiabilidad de una medida de soledad en adolescentes peruanos. Revista Evaluar, 17(2). https://doi.org/10.35670/1667-4545.v17.n2.18726
Wang, J., Yang, Y., Chen, Y., Lin, H., Wang, T., Wang, Z., Chen, X., & Fu, C. (2025). Loneliness, internalizing and externalizing problems, and suicidal ideation among Chinese adolescents: A longitudinal mediation analysis. Journal of Adolescent Health, 76(1), 96-104. https://doi.org/10.1016/j.jadohealth.2024.08.010
Wang, J., & Wang, X. (2019). Structural equation modeling: applications using mplus. Hoboken: John Wiley & Sons.
Weiss, R. S. (1973). Loneliness: the experience of emotional and social isolation. Massachusetts Institute of Technology Press.
World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), Article 2191. https://doi.org/10.1001/jama.2013.281053
Yang, X., Wang, J., Wang, T., Lin, H., Yang, Y., Chen, X., & Fu, C. (2023). Psychosocial problems and suicidal ideation in Chinese adolescents: Findings from a longitudinal study. Translational Pediatrics, 12(6), 1076-1087. https://doi.org/10.21037/tp-22-676
Yzerbyt, V., Muller, D., Batailler, C., & Judd, C. M. (2018). New recommendations for testing indirect effects in mediational models: The need to report and test component paths. Journal of Personality and Social Psychology, 115(6), 929-943. https://doi.org/10.1037/pspa0000132