Structural Modeling of Suicidal Ideation Based on Somatic Symptoms: The Mediating Role of Perceived Stress and Psychological Flexibility in Adolescents
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: This study aimed to test a structural model of suicidal ideation in adolescents based on somatic symptoms, with perceived stress and psychological flexibility as mediators. Methods and Materials: In a cross-sectional design, 432 students (51.2% girls; Mage = 15.74, SD = 1.42) were selected through multistage cluster sampling. Participants completed validated scales of Patient Health Questionnaire–15 (PHQ-15), Perceived Stress Scale (PSS-10), Connor–Davidson Resilience Scale (CD-RISC-10) and the Suicidal Ideation Questionnaire–Junior (SIQ-JR). Data were analyzed using structural equation modeling with maximum likelihood estimation and 5,000-bootstrap resampling. Findings: The proposed model showed good fit to the data. Somatic symptoms had a significant direct effect on suicidal ideation (β = .28, p < .001) and a significant indirect effect via perceived stress (β = .19, p< .001). Higher somatic complaints were associated with greater perceived stress (β = .52, p < .001), which, in turn, predicted more severe suicidal ideation (β = .37, p < .001). Psychological flexibility was negatively related to perceived stress (β = −.44, p < .001) and suicidal ideation (β = −.25, p < .001) and partially buffered the impact of somatic symptoms on suicidal ideation (indirect β = −.09, p < .001). Overall, the proposed model explained 63% of the variance in suicidal ideation, indicating substantial explanatory power of the study variables. Conclusion: Findings underscore somatic symptoms as accessible clinical markers of suicide risk and highlight perceived stress and resilience as key, modifiable mechanisms in adolescent suicide prevention.
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W7217480511