The Role of Social Comparison in Self-Esteem among Adolescents with Idiopathic Generalized Epilepsy: The Mediating Effect of Mentalization

Abstract

The present study aimed to investigate the role of social comparison in self-esteem among adolescents with idiopathic generalized epilepsy with an emphasis on the mediating role of mentalization. This study employed a descriptive-correlational design using structural equation modeling. The statistical population consisted of adolescents aged 12 to 18 years diagnosed with idiopathic generalized epilepsy who were referred to specialized epilepsy centers in Shiraz, Iran. A total of 351 participants were selected through purposive sampling. Research instruments included the Rosenberg Self-Esteem Scale, the Social Comparison Orientation Scale, and the Reflective Function Questionnaire. Data were analyzed using SPSS-27 and LISREL-8.8 software. Confirmatory factor analysis was conducted to evaluate the measurement model, and structural equation modeling was used to test the proposed hypotheses. The findings indicated that the structural model demonstrated acceptable fit indices. Social comparison had a significant direct effect on mentalization (β=0.72, t=5.12). Mentalization also showed a strong direct effect on self-esteem (β=0.83, t=7.38). In addition, the direct effect of social comparison on self-esteem was significant (β=0.35, t=2.27). Furthermore, Sobel test results confirmed the significant mediating role of mentalization in the relationship between social comparison and self-esteem (Z=4.23). The VAF value indicated partial mediation, suggesting that a substantial proportion of the effect of social comparison on self-esteem was transmitted through mentalization. The results demonstrated that mentalization plays a central role in explaining self-esteem among adolescents with idiopathic generalized epilepsy and can moderate the psychological impact of social comparison. Therefore, strengthening mentalization abilities may serve as an important target for psychological interventions aimed at improving mental health and self-esteem among adolescents with epilepsy.