Self-esteem and mental health among coastal adolescents in West Sumatra, Indonesia: A cross-sectional study

Background: Adolescents in West Sumatra's coastal regions face elevated mental health challenges, yet limited research examines self-esteem's protective role in these unique environments. Objective: This study examined the influence of self-esteem and related factors on adolescent mental health in coastal West Sumatra, Indonesia. Methods: This cross-sectional study involving 295 adolescents (mean age = 16.2 years) utilised the Rosenberg Self-Esteem Scale and the Self-Report Questionnaire 29 to assess self-esteem and mental health symptoms. Data were analysed using t-tests, ANOVAs, Pearson's correlations, and multiple regression. Results: Self-esteem was negatively correlated with neurosis (r = -0.452), psychosis (r = -0.205), and posttraumatic stress symptoms (PTSS) (r = -0.333). Females exhibited higher neurosis (p = 0.001) and PTSS (p = 0.022). Higher maternal education was associated with fewer psychotic symptoms (p = 0.006). Regression analyses confirmed self-esteem as a significant negative predictor of neurosis (β = -0.426, p < 0.001), psychosis (β = -0.177, p = 0.003), and PTSS (β = -0.375, p = 0.063). Sex was positively associated with neurosis (β = 0.169, p = 0.001) and PTSS (β = -0.139, p = 0.011), while it was negatively associated with psychoactive symptoms (β = -0.154, p = 0.009). No significant interaction between self-esteem and sex was found. Additionally, maternal education predicted psychosis (β = -0.156, p = 0.006), and school origin predicted PTSS (β = -0.139, p= 0.011). Conclusion: Self-esteem played a protective role in adolescent mental health in coastal areas. Sex-specific vulnerabilities and maternal education levels also contributed significantly. Interventions should focus on enhancing self-esteem and addressing sex and educational factors to promote better mental health outcomes among adolescents.