Study Confirms Self-Esteem as Key Predictor of Suicidality in College Students

Here’s a troubling statistic: Suicide has been the 2nd-leading cause of death among teens in the U.S. since 2016. According to a study published in Scientific Reports, self-esteem is predictive of suicide risk according to an algorithm created using artificial intelligence (AI).

Since young people have struggled with grief during the pandemic, research like this will be useful in addressing mental health concerns among this group.

As college students prepare for return to classes this fall, it will be crucial to ensure that mental health outreach efforts prioritize self-esteem building.

Understanding the Research

For this study, AI algorithms were used to analyze 70 potential suicide predictors based on data that had been collected for at least a year between 2013 and 2019 regarding over 5,000 university students in France.

Suicidal thoughts, anxiety, depressive symptoms, and self-esteem were found to predict about 80% of suicidal behaviors, which were reported by about 17% of students, based on surveys completed a year apart.

Despite the large sample and longitudinal design, a limitation of this study was its reliance on self-report of participants, which can reflect information and recall bias as well as under-reporting due to social desirability.

The Comparison Effect in College

Licensed clinical psychologist and co-founder and director of the Center for Cognitive Behavioral Therapy and Mindfulness, Suraji Wagage, PhD, JD, says, “There are myriad reasons why college students/young adults suffer from low self-esteem, including the incessant social comparisons inherent to social media use, where research shows the carefully curated images presented by others make us feel worse in comparison.”

In therapy, Wagage explains how she discusses this as comparing our insides to others’ outsides as we are privy to the messiness of our own private lives but viewing only the glossy facade of others’ public lives. “Living among a large community of peers in a college setting can intensify this comparison effect—there is always another student who is seemingly more successful, smart, social, popular, well-liked, athletic, etc,” she says.

Wagage says, “Low self-worth is both a contributor to and effect of depression and anxiety, which are prevalent in young adults (e.g., low self-worth lowers our mood, and when we are depressed we have a more difficult time being productive and completing daily tasks, which leads to impaired performance and relationships and furthers low self-worth).”

In this way, Wagage highlights that self-esteem can require this type of social comparison to feel that we are “good enough” or better than others, and thus “worthy” of feeling good about ourselves. “We feel good when we are doing well, and we feel inadequate when we are doing poorly,” she says. This is why Wagage recommends self-compassion, regardless of how well or poorly one is doing, aside from how anyone else is doing. “Self-compassion is stable and not linked to social comparison,” she says.

Wagage says, “People can begin to cultivate self-compassion by thinking about how we respond to friends who are struggling and how we respond to ourselves when we are struggling. We can practice noticing how we speak to ourselves and responding to ourselves as we would a friend.”

By this, Wagage highlights how individuals can challenge the ways they trick themselves into thinking self-criticism is helpful as motivation. “Extreme self-criticism actually tends to sap motivation and reduce confidence and can be paralyzing. My takeaway from the study is that low self-worth is linked to suicidal behavior, and instead of rushing to work on self-esteem as a result, we should focus on self-compassion,” she says.

Self-Doubt Among High Achievers

Licensed marriage and family therapist and certified art therapist at Guidance Teletherapy, Ariel Landrum, MA, LMFT, says, “Self-esteem is our self-assessment regarding our personal values and worth. It’s essentially the opinion we have of ourselves. There are a variety of factors for college students, as to why their self-esteem may be affected.”

From attending school away from home to new obstacles locally, Landrum highlights how individuals may feel unprepared, which can cause them to question their capabilities. “College students who are high performers may overly compare themselves to their peers, who were also high performers in their respected communities. This can cause self-doubt,” she says.
Landrum explains that college students are at a developmental age where they are focused on intimacy and isolation, as they are comparing their desire to understand themselves with their desire to connect with others. “If unable to develop formative support groups, college students may come to believe they do not deserve formative relationships,” she says.

In terms of how college students can improve self-esteem, Landrum says, “When students are aware of the situations that seem to regularly deflate their self-esteem, they can actively create solutions and prepare themselves for these environments. They can use affirming self-talk to help hype themselves up, have a self-care routine planned after the experience to decompress, or have an ally with them who is a positive motivator.”

Landrum says, “Self-esteem is fostered in moments of achievement-based outcomes. When students properly acknowledge the areas they are competent in and take time to hone those skills, they are more likely to evaluate themselves positively. Celebrating competencies will help with competency identity. Students can share their accomplishments with supportive peers and family members, obtain a mentor or coach who acknowledges their growth, or mentor and coach others.”

Self-compassion was recommended, as Landrum explains how that can address self-critical thoughts and increase intrinsic value for individuals. “Journaling these thoughts and then destroying the page is one way to externalize critical statements. Sticking to the routine of using phrases and words that we use with our children, our pets, our partner, or another loved one, is another way to build self-compassion,” she says.

When her clients do not have an affirming sense of self, Landrum explains that they may be unable to find and appreciate their own value, as they can start to question their purpose and belonging in this world. “They are questions formed to suggest that they do not have a purpose and will never belong. When my clients and I actively work on improving their opinion of themselves, suicidal thoughts tend to subside,” she says.

Landrum emphasized that this study was focused on French students, so it may not reflect a variety of cultural backgrounds. “Different cultures and communities understand and present self-esteem very differently. Some see it as being boastful and rude, especially in cultures that are collectivist in thinking. Learning how to discuss self-esteem in a way that doesn’t appear arrogant will help these individuals be more willing to open up about suicidal thoughts linked to how they feel about themselves,” she says.

Regarding self-esteem, Landrum notes that it can shift and change as individuals experience new environments and struggles, especially when facing a variety of unknowns. “Additionally, BIPOC individuals may experience new forms of systemic and explicit racism, such as roommates blaming them for missing items or professors ostracizing them during a lecture. Schools could have a freshmen class of newbies eager to learn at the beginning of the year, only to see the same group discouraged, disheartened, and disillusioned. Therefore schools need to foster programs that increase self-esteem and connection, especially for BIPOC students,” she says.

Landrum says, “For my clients who have survived sexual assault and sexual abuse, the trauma completely overtakes their sense of self. They no longer feel empowered, and even hate themselves and their bodies. Therefore the work we do is not immediate self-love. We first look at these critical feelings of hate, loathing, anger, disappointment, and embarrassment. I have the clients label the parts of themselves and their trauma narrative that these feelings are associated with. Once we have a better understanding of these strong adverse feelings, we shift to neutral.”

When clients can start to see they have neutral feelings about themselves and their trauma narrative, then Landrum slowly works towards building their self-esteem and self-love. “The journey towards high self-esteem for these clients starts with making room for the parts of themselves that they have lost and no longer desire and highlighting the parts of themselves they haven’t even considered or thought about,” she says.