The effect of stressful life events on adolescents with depression: the chain mediating role of basic psychological needs and self-esteem

Adolescent depression has emerged as a critical global public health concern, with stressful life events identified as key environmental risk factors. However, the underlying psychological mechanisms in clinically diagnosed adolescents remain insufficiently explored. This study aims to examine whether basic psychological needs and self-esteem serve as sequential mediators in the relationship between stressful life events and depressive symptoms. A total of 312 adolescents (aged 12–19 years; 68.8% female) diagnosed with depressive disorder were recruited from a psychiatric hospital in Northwest China. Participants completed validated self-report measures including the Adolescent Self-Rating Life Events Checklist (ASLEC), the Basic Psychological Needs Scale (BPNS), the Rosenberg Self-Esteem Scale (SES), and the Self-Rating Depression Scale (SDS). A serial mediation model was tested using SPSS PROCESS (Model 6), controlling for gender. Stressful life events positively correlated with adolescent depressive symptoms (B=0.305, p<0.001). In the chain mediation model, basic psychological needs and self-esteem acted as sequential mediators, explaining 47.25% of total variance (indirect B=0.144, 95% CI [0.088, 0.202]). Decomposition showed basic needs alone mediated 20.62% (B=0.063, CI[0.027,0.107]), self-esteem 19.57% (B=0.060, CI[0.027,0.096]), and the chain pathway (needs→self-esteem) 7.05% (B=0.022, CI[0.009,0.038]). Findings support a theoretically grounded chain mediation model in which stressful life events are associated with lower levels of adolescents’ basic psychological needs satisfaction, which in turn relates to reduced self-esteem and more severe depressive symptoms. These results integrate Self-Determination Theory and Maslow’s hierarchy of needs, offering evidence-based insight into the process through which environmental stress is associated with. Clinically, this suggests that interventions targeting need satisfaction and self-esteem restoration may may be associated with reduced depression in adolescent patients.