Understanding adolescent suicide risk through alexithymia and hikikomori behaviours: A three-wave study

Objective: Suicide risk (SR) has emerged as a critical issue among adolescents, with various factors potentially contributing to this complex problem. Among these, alexithymia and hikikomori behaviours (HB) are two key elements that warrant further investigation. This study examines their longitudinal relationships through the lens of a unified model of SR. Method: A total of 1814 adolescents from Italy (M = 15.43, SD = 1.09) participated in a three-wave longitudinal study, with surveys administered at baseline (T1), 6 months later (T2), and 12 months later (T3). Structural equation modelling (SEM) was utilized to analyse the bidirectional relationships and mediation effects between the variables. Results: The results revealed that alexithymia consistently predicted HB and SR, while HB also predicted SR. However, HB did not predict alexithymia, nor did SR predict either alexithymia or HB. Significant mediation effects were observed from alexithymia at T1 to SR at T3 through alexithymia at T2, HB at T2, and SR at T2, as well as from HB at T1 to SR at T3 through HB at T2 and SR at T2. No significant indirect effect was found from HB at T2 to SR at T3 through alexithymia at T2. Conclusions: These findings suggest that adolescents with higher levels of alexithymia are at greater risk for suicidal behaviours, with HB intensifying this risk. Effective interventions may include programmes aimed at enhancing emotional awareness and promoting social reintegration, which could ultimately improve mental health outcomes and reduce SR among adolescents.