Self-esteem, perceived social support, social capital, and risk-behavior among urban high school adolescents in Nepal.

Adolescence is not only characterized by a period of exploration and experimentation but also by vulnerability to risk-behaviors (substance-use, suicidal behavior, and sexual behavior) that can have many negative consequences. Given the lack of studies in Nepal and the variable results from international studies on the association of self-esteem, perceived social support (PSS), and social capital (SC) with risk behaviors, this study aimed to assess the role of these factors by specifying different sources of PSS (family, friends, and others) and SC (family, school, and neighbors), and controlling for demographic, socioeconomic-status (SES), family, and school related factors. A total of 943 adolescents (grades 9-11) in 8 schools from 3 provinces in Nepal participated in the study, and were selected by multi-stage, cluster, random sampling. Data were collected through a self-administered questionnaire (response rate; 91.9%). Multivariate logistic regression analysis (<0.05 significance) revealed that family SC (OR = 0.83) and PSS from family (OR = 0.95) were negatively associated with substance-use. Self-esteem (OR = 0.90), family and school SC (OR = 0.80 and 0.91, respectively), and PSS from family and friends (OR = 0.95 and 0.96, respectively) were protective against suicidal risk. None of the independent variables showed a preventive association with sexual behavior, but self-esteem was positively associated (OR = 1.11). Therefore, to improve the likelihood of adolescents becoming healthy adults, family and school level interventions to enhance self-esteem, PSS, and SC are helpful in protecting them against substance use and suicidal behavior. On the other hand, adolescents with high self-esteem are at greater risk for inappropriate sexual behavior and should therefore be monitored.