Adolescents

Background: Adolescence is a critical period of rapid physical and psychological change, yet it is also when many health and well-being problems first emerge, often setting limits on lifelong opportunities and achievements as youth transition into adulthood. The ground-breaking adverse childhood experiences (ACEs) study has significantly shaped the development of programs and policies aimed at fostering adolescent health. Nonetheless, there has been limited exploration into the heterogeneity among individuals experiencing a high number of ACEs, such as four or more. This study employs Latent Profile Analysis (LPA) to examine the diverse outcome profiles of adolescents who have been exposed to a substantial number of ACEs. Method: The data were from participants who experienced at least four ACEs by age 9 in the Future of Families and Child Wellbeing Study (N = 1427; 54% male; 59% Black; 15.3% Hispanic; 2.4% other). We applied LPA using the manual three-step method within Mplus 8 to establish profiles based on six developmental indicators at age 15. These indicators included optimism, perseverance, academic performance, internalizing and externalizing behavioral competence, and social skills. The full information maximum likelihood method was used to handle missing data. Results: The study identified three distinct profile groups according to model fit indices and interpretability: Multidimensional Competence Group (61.0%), Low Personality and Social Competence Group (23.8%), and Low Behavioral Competence Group (15.2%). Racial and ethnic backgrounds were significant predictors of membership in these different profile groups. Conclusions: In a research landscape often focused on the cumulative harm of ACEs, our study underscores the heterogeneity of trauma profiles among adolescents with substantial ACE exposure. Given that adolescence is a critical stage when health and well-being challenges emerge, tailored early interventions are important to supporting a successful transition into adulthood. We advocate for the importance of comprehensive screening for social-cognitive and behavioral health difficulties in trauma-affected youth, enabling practitioners to implement timely prevention strategies and tailored interventions that foster resilience and long-term well-being. Full article

Background and Objective: The availability of money to purchase food within the school setting has been identified as a factor associated with children’s nutritional status. The aim of this study was to analyze the relationship between spending on snacks and the nutritional status of Chilean schoolchildren living in a region in the far south. Methods: This was a descriptive, correlational, cross-sectional study. A total of 596 schoolchildren and adolescents (12.1 ± 1.3 years) from three public schools in the Magallanes Region, Chile, participated. Nutritional status was assessed using body mass index (BMI) for age, and a validated questionnaire was applied to assess frequency and type of food purchases within the school environment. To determine associations, ANOVA and Chi-square tests were used, with statistical significance set at p < 0.05. Results: Among boys, 25.8% were overweight, 36.4% with obesity, and 8.6% severely with obesity; among girls, 34.9% were overweight, 30.5% with obesity, and 5.5% severely with obesity. The average snack expenditure was 642.7 ± 658 CLP (Approximately USD 0.67). Weekly purchase frequency was once in 29.5% and twice in 26.9% of cases (p < 0.001), with no differences across BMI categories (ANOVA p = 0.469). Food preferences were unhealthy snacks in 46.5% and healthy snacks in 24.0% of cases, with no association with nutritional status (χ² = 6.073; df = 10; p = 0.728). Conclusion: Although no direct association was found between snack spending and nutritional status, high consumption of unhealthy foods reflects a persistent risk. The results highlight the importance of strengthening public and educational policies regarding school meals. A comprehensive approach is needed that combines regulation, nutrition education, and family involvement. This study provides novel evidence for the design of interventions in southern and isolated regions. Full article

Background: Former foster youth frequently experience housing instability, which hinders their transition to adulthood and affects key life outcomes including education, employment, mental health, and social connections. Objective: This scoping review explores housing stability and identifies barriers to stable housing. Method: Following the Arksey and O’Malley framework and PRISMA guidelines, a comprehensive search of peer-reviewed literature was conducted using PubMed, PsycINFO, and Academic Search Complete. Studies published in English within the last ten years were screened and selected based on relevance to housing stability and former foster youth outcomes. Nine studies met the inclusion criteria and were thematically analyzed. Results: Findings reveal that a significant proportion of youth aging out of foster care lack adequate preparation, face systemic barriers such as unaffordable housing and limited services, and often experience repeated episodes of instability. Promising strategies include transitional planning, extended housing support, trauma-informed services, and youth engagement in program design. Flexible funding and targeted support for high-risk subgroups are also crucial. Conclusion: Housing stability is foundational to the well-being of former foster youth. Addressing systemic gaps through youth-centered, supportive housing interventions is essential for promoting resilience and successful transitions to independence. Full article

The contemporary world presents increasingly complex challenges for adolescents. In addition to normative developmental tasks, adolescents must now navigate epidemic health crises, armed conflicts, family dissolution, economic instability, and academic pressures. Consequently, adolescents experience diminished security and elevated levels of anxiety, loneliness, and depression. While the need for emotional support has intensified across all demographics, adolescents’ psychological needs remain particularly underserved. The American Psychological Association has recently advocated for the expansion of group therapy services, a format that aligns particularly well with adolescents’ socioemotional needs, serving as a developmental bridge from childhood to adulthood. Research on adolescents’ group legs much behind the adult literature. The aim of the current paper is to show the potential power of group therapy with adolescents based on a selective review of our empirical studies examining the impact of therapy groups on adolescents’ well-being. The reviewed papers encompass randomized controlled trials and process research identifying critical therapeutic factors, collectively establishing the intervention’s validity. Results demonstrate the superiority of these groups compared to non-treatment controls and equivalence to individual therapy in reducing stress, anxiety, and aggression while enhancing self-perception, self-control, and academic functioning. These findings support the conclusion that group psychotherapy significantly contributes to adolescent well-being. Considering adolescents’ high yet unmet need for emotional support, group therapy appears to be a valid alternative. Full article

Background: Climate change increasingly threatens global health, with adolescents among the most vulnerable. Hospitals are major emitters of greenhouse gases, making carbon reduction in healthcare a pressing challenge. Nurses play central roles in implementing sustainability, while adolescents can contribute to long-term resilience. Methods: A scoping review of peer-reviewed articles (1990–2023) and World Bank datasets was conducted. Comparative analysis focused on Norway and South Korea, with the United States and Australia reviewed narratively. Inclusion criteria targeted studies on hospital-based carbon reduction and youth/nurse engagement; unrelated studies were excluded. Results: Three domains emerged: (1) governance approaches—Norway applied top-down integrated monitoring, while Korea showed fragmented progress, especially in private hospitals; (2) roles of adolescents and nurses—nurses led quality improvement in energy efficiency and waste reduction, while adolescents contributed through school–hospital partnerships and youth initiatives; and (3) barriers and enablers—key barriers included limited youth decision-making and lack of councils, while enablers included certification frameworks and WHO guidelines. Conclusions: Nurses and adolescents are complementary partners in sustainable healthcare. Establishing hospital green teams, integrating climate literacy into curricula, and fostering government–healthcare–education partnerships can reduce emissions and strengthen climate-resilient health systems. Full article

Adolescents’ increasing screen time has been linked to poor sleep quality, which may, in turn, affect their academic performance. This study aimed to examine screen time patterns among Jordanian adolescents and assess their associations with sleep quality and academic achievement. A descriptive correlational study was conducted among 477 students aged 12–14 years from four randomly selected schools in northern Jordan. Participants completed the validated Questionnaire for Screen Time of Adolescents (QueST) and the Adolescent Sleep–Wake Scale–Short Version (ASWS-S), while academic performance was assessed using GPA from school records. Results showed that average screen time was 9.13 h per day. Weekend screen time emerged as a significant negative predictor of sleep quality (β = −0.27, p = 0.016). Gender and school type were also significant predictors. Adolescents with screen devices in their bedrooms and those with chronic medical conditions reported higher screen time. Although total screen time did not significantly predict academic achievement, it showed a moderate negative correlation with sleep quality (r = −0.18, p < 0.01). These findings suggest that excessive screen use, particularly on weekends, may impair sleep quality among adolescents. Interventions targeting screen habits could help enhance sleep and potentially benefit academic performance. Full article

Cannabidiol (CBD) is a chemical produced by the cannabis plant that acts as an allosteric modulator of cannabinoid receptors resulting in non-competitive receptor antagonism in the central nervous system. This mechanism of action leads to anti-convulsant, anti-anxiety, and analgesic properties with minimal psycho-activity, which has led to significant interest in the use of CBD as a medication. Legislation around cannabis has changed in recent years, with many states permitting the use of CBD-based products as “medication” without approval from the Federal Drug Administration. This has led to a proliferation of products with associated marketing claims that are often unsubstantiated. This review summarizes the evidence for cannabidiol as a medical treatment, focusing on epilepsy, mental health, behavioral and substance use disorders occurring in pediatric and adolescent populations for which information is available. CBD preparations have been approved by the FDA to treat epilepsy in childhood; no other indications currently exist, and the literature remains inconclusive. Few adverse effects related to CBD use have been reported. However, endogenous cannabinoids play an important role in guiding brain development, and the long-term impact of modulating the endocannabinoid system during periods of brain growth during childhood and adolescence is unknown. While there is excitement about the potential for the development of CBD medications, currently, there is very limited information about the long-term safety of CBD, especially in children and adolescents, and caution is recommended regarding the use of unregulated, unapproved CBD preparations that are currently available over the counter. Full article

Compared to studies in school settings, little attention has been paid to bullying in the child protection system (PS), even though these children, adolescents, and youth are one of the most vulnerable groups, with the highest prevalence of bullying. This study aims to analyze, according to gender and nationality, the perception of adolescents and youth in the Spanish PS of the bullying and gender-based bullying situations that take place in their protection facility, as well as their response to these situations and the relationship with the training they received in gender equality, sexual diversity and bullying. Two hundred forty-nine adolescents and youth from 58 centers/facilities of the PS in Spain, with an average age of 16.38 years, participated. Of these, 37.3% had Spanish nationality. A correlational study was conducted using a cross-sectional random sample survey. It was found that 30.9% of the participants identify bullying situations, which reached 34.9% for LGBTIQ-phobic bullying and 37.7% for sexist bullying. Girls identify situations of both bullying and sexist bullying more, and girls and both male and female Spanish adolescents and youth attribute greater severity to these problems and respond more positively in favor of the victims. Those who have received more training in gender equality, sexual diversity, and bullying support bully victims more significantly. According to our current knowledge, this study addresses for the first time the phenomenon of bullying and gender-based bullying in the context of the PS from a perspective of gender, nationality, and the formative dimension. It also highlights the need for mandatory training in gender-equality and sexual diversity for adolescents/youth and educational professionals of the PS, as well as the creation of specific anti-bullying protocols with an inclusive approach. Full article

This study investigated the validity of a new observational procedure for assessing mother–father–adolescent conflict interactions. Addressing key gaps in the field, this procedure moves beyond mother–adolescent dyads and self-report questionnaires by offering a standardized, observational family-level approach. The procedure combines the Lausanne Trilogue Play—Conflict Discussion Task (LTP–CDT) with a coding system, the Family Conflict and Alliance Assessment Scales with Adolescents (FCAAS). In a sample of 82 two-parent families with adolescents aged 10 to 13, the FCAAS demonstrated excellent inter-rater reliability and good validity. Confirmatory factor analysis supported a theoretically grounded two-factor structure. Criterion and construct validity were confirmed via self-reports of marital satisfaction and coparenting, respectively. Ecological validity was supported by family members’ self-reports. This tool offers promising research and clinical applications and may be extended to diverse populations to assess known-group validity. Full article

While loneliness is a known correlate of social withdrawal, the underlying mechanisms, particularly within college student populations, remain inadequately understood. This study addresses this gap by investigating the mediating role of internet addiction and the moderating role of sex in the relationship between loneliness and social withdrawal. A cross-sectional survey was conducted with 1978 Chinese college students. Analyses were performed using SEM (AMOS) and the PROCESS for SPSS to test a moderated mediation model. Results confirmed a significant positive association between loneliness and social withdrawal. Internet addiction was found to significantly mediate this relationship, explaining 50.7% of the total effect. Moreover, sex moderated the indirect pathway, suggesting that the strength of the mediating effect varied by sex. These findings provide empirical support for the Evolutionary Theory of Loneliness by elucidating the psychological processes linking loneliness to social withdrawal within a collectivist cultural context. The study also offers practical implications for developing targeted mental health interventions to reduce social withdrawal and promote social participation among college students. Full article

Musculoskeletal injuries are a growing concern among adolescent athletes, with significant physical and psychological consequences. This integrative literature review aimed to analyze the risk factors associated with musculoskeletal injuries in adolescents engaged in sports and to explore the role of nursing interventions in their prevention. A systematic search was conducted across four databases and one gray literature source, including studies published between 2014 and 2024. Three descriptive studies were included, with evidence levels ranging from 3 to 4, according to the Joanna Briggs Institute classification. The main findings highlight that risk factors for musculoskeletal injuries include excessive training loads, inadequate sports technique, lack of professional supervision, improper use of equipment, and failure to recognize early signs of discomfort. Preventive nursing interventions were shown to be effective, particularly those focused on health education, proprioceptive training, and continuous monitoring. Multidisciplinary collaboration between nurses, coaches, and other health professionals emerged as a key strategy in creating safe sporting environments. Despite limitations such as the scarcity of studies on nursing-specific interventions in diverse sports contexts, this review supports the potential of structured, evidence-based nursing actions to reduce musculoskeletal injuries incidence, promote safer sports practices, and enhance adolescent athletes’ health outcomes. Full article

Purpose: Adolescence is a period of increased vulnerability to addictive behaviors, and Primary Health Care (PHC) plays a crucial role in prevention and intervention (e.g., through Screening, Brief Intervention, and Referral to Treatment), but professionals often face barriers, such as inadequate training and systemic challenges, particularly within the Greek context. Given the lack of data on their needs, this study aimed to investigate the levels of self-perceived knowledge/skills, attitudes regarding communication and readiness, perceived barriers, and educational expectations among PHC professionals in Greece. Method: A cross-sectional descriptive survey was conducted using an anonymous questionnaire with a convenience sample of 331 PHC professionals from 5 Health Regions. Results: Professionals recognized the high importance of effective communication (M = 4.31/5) but reported low preparedness (M = 2.65/5) and moderate confidence in knowledge, especially in screening tools/motivational interviewing (M = 2.25/5). Lack of training was the main barrier (87.6%). A strong positive correlation was found between knowledge and preparedness (rho = 0.68, p < 0.001), but not between age/experience and readiness (p > 0.05). Discussion: The study highlights a significant readiness gap and a substantial need for specialized training for PHC professionals in Greece, regardless of experience. Targeted interventions are required to enhance skills (especially in SBIRT/MI) and self-efficacy, alongside action to address systemic barriers. Full article

Accurate assessment of cardiorespiratory fitness (CRF) in adolescents is critical. However, normalizing oxygen consumption (VO₂) to body mass (BM) may underestimate CRF in overweight (OW) youth by including metabolically inactive fat mass. This study examined differences in VO₂ normalized by BM and fat-free mass (FFM) between normal weight (NW) and OW adolescents. Thirty-eight participants (19 NW, 19 OW; 12–17 years) underwent anthropometric, body composition, and cardiorespiratory fitness assessments. VO₂ at the aerobic threshold (VO₂AerT), anaerobic threshold (VO₂AnT), and peak exercise (VO₂peak) were measured and expressed in absolute terms and relative to BM and FFM. Group differences in the main outcomes were analyzed using a one-way ANOVA, and Pearson correlation was used to examine associations between VO₂, BM and FFM. When normalized by BM, NW adolescents showed significantly higher VO₂AerT (18.7 ± 3.6 vs. 14.5 ± 2.3), VO₂AnT (28.8 ± 6.3 vs. 23.6 ± 4.7), and VO₂peak (37.7 ± 6.7 vs. 29.1 ± 7.0) compared to OW peers (p < 0.05). No significant differences were found when VO₂ values were normalized by FFM. A group difference was observed in the VO₂peak vs. BM slope (p = 0.03) but not in the VO₂peak vs. FFM slope. FFM normalization provides a more accurate assessment of CRF by accounting for differences in body composition, underscoring the importance of evaluating the aerobic capacity of metabolically active tissue rather than total body weight in youth populations. Full article

Underserved communities in South Africa face persistent inequalities that hinder the health and well-being of young people, particularly during the critical developmental phase of adolescence. This study explored perceptions of adolescent health and well-being among parents/guardians and community leaders of adolescent girls in two underserved communities in Gauteng, focusing on food insecurity, alcohol use, and transactional sex. The sample comprised 63 participants, including parents/guardians of adolescents and community leaders (such as individuals working for community-based organisations or regarded as trusted figures in the community). Two facilitators conducted 11 focus group discussions in English, Sepedi, and isiZulu. All sessions were audio-recorded, translated, and transcribed. The transcripts were analysed using reflexive thematic analysis. The findings reflect community and parental narratives of risk, showing how adolescents in Mamelodi and Soshanguve—two underserved communities in Gauteng—experience food insecurity that contributes to underage drinking and transactional sex, ultimately leading to teenage pregnancies and HIV infection. The results highlight the risks faced by adolescents, showing how social and structural factors create conditions that enable underage drinking and transactional sex, thereby increasing vulnerability to pregnancy and HIV infection. This study highlights the urgent need for interventions that can effectively address these narratives of risk. Full article

Children in sub-Saharan Africa remain vulnerable to contracting malaria. While chemoprophylaxis is effective in preventing disease, its impact on social well-being is less understood. In this cross-sectional follow-up study conducted in 2001, we examined the role of chemoprophylaxis on social well-being in rural Gambia. Participants were 141 adolescents (age: 14.8–19.5; 40% male) from five villages, drawn from a longitudinal cohort in which one group received chemoprophylaxis in infancy, while the other received a placebo and began prophylaxis 1–2 years post-trial. Using a walking interview methodology, participants guided researchers through five village locations. Their narrations were coded for emotional content and social themes, followed by network analyses examining the relationships between these themes across treatment groups and gender. Emotional response analysis revealed significant gender differences in valence, with females exhibiting higher positive emotional tone than males (X² = 5.85, p = 0.016). Treatment effects showed gender-specific patterns: among males, the placebo group exhibited higher positive valence compared to the chemoprophylaxis group (X² = 8.34, p = 0.004), while females showed no treatment differences (X² = 1.11, p = 0.291). Affect analysis revealed high positive responses across all groups with no significant differences. Network analysis revealed significant gender differences in how adolescents organize social themes within their communities. Females demonstrated higher centrality in eigenvector (global influence; p = 0.039) and degree centrality (number of direct edges; p < 0.001), indicating greater interconnectedness and influence within the networks. No significant treatment group differences were observed in the network structure across any centrality indicators (all p > 0.05). This study provides an example of how the social–ecological framework and ecologically valid assessment methods, such as the walking interview, can be applied to investigate the interplay between early childhood health interventions, social dynamics, and individual development in a rural African context. The findings revealed that gender exerts a stronger influence than early treatment on adolescent social–emotional development. Full article

The literature has consistently shown the link between parental depressive symptoms and adolescent depressive symptoms. Emotion regulation processes may explain this association, with self-compassion acting as a potential mediating mechanism. This study aimed to explore these developmental trajectories using a longitudinal design. The sample comprised dyads of parents and adolescents (N = 311), assessed across two assessment waves (T1 and T2) over 12 months. The adolescents’ mean age was 13.63 years (SD = 1.30; 173 males). Mediation analyses using structural equation modelling supported the role of self-compassion in mediating the relationship between parental and adolescent depressive symptoms over time (53% of outcome variance explained). The results suggest that fostering self-compassion early in adolescence may help prevent the later adverse effects of depressive symptoms. Full article

Background: Firearm-related injuries are the leading cause of death among children and adolescents (ages 1 to 19 years) in the United States. Access to and carrying firearms are key risk factors for violence and adolescent firearm use. This study examines the association between family conflict and adolescent gun carrying in Los Angeles County, and the extent to which household and neighborhood contexts contribute to adolescent gun carrying. Methods: We use cross-sectional multilevel data from adolescents ages 12–17 years in the Los Angeles Family and Neighborhood Study, conducted in 2002, to fit a series of generalized linear mixed models to examine the association between family conflict (scale range: 0–2) and adolescent gun carrying. Models include random effects to examine the contributions of household and neighborhood contexts on the outcome measure. Results: After controlling for demographic characteristics, gang involvement, substance use, and household and neighborhood contexts, adolescent experiences of family conflict remain positively associated with adolescent gun carrying behavior (OR = 3.45, p = 0.043). Random effects estimates indicate that a relatively large amount of variation in adolescent gun carrying is explained by household and neighborhood contexts: 23% and 24%, respectively. Conclusions: Multilevel family and community-level interventions, with an emphasis on family violence, are necessary components of prevention strategies to reduce high rates of firearm-related mortality among US adolescents. Full article

Psychiatric illness during childhood and adolescence is a serious public health concern. Caregivers are critical for their child’s enactment of psychiatric interventions, though caregiver distress can have serious impacts on caregivers and their child’s outcomes. The purpose of this study was to explore the associations of caregiver distress with child symptom severity, family functioning, and caregiver social support and self-care at the time of their child’s referral to outpatient psychiatry. Caregiver distress was most strongly associated with parent self-care (higher distress for parents associated with less self-care), child symptoms (higher distress associated with higher severity), and parent age (higher distress associated with younger caregivers). These findings shed light on important and evolving characteristics of caregivers, which could be considerations for child and family interventions in outpatient psychiatry, and the importance of a family approach for improving overall health. Full article

This study aimed to explore the relationship between the experience of abuse and depressive symptoms among children and adolescents in a post-conflict setting while controlling for perceived support and individual background factors. This cross-sectional study was conducted in the post-conflict setting of Borama, Somaliland. A total of 645 adolescents that attended upper primary and lower secondary schools were included. The exposure variables were (a) experience of physical abuse, (b) experience of psychological abuse, and (c) experience of either or both forms of abuse. The outcome was depressive symptoms as measured by the Patient Health Questionnaire-9. Physical and psychological abuse were associated with higher levels of depressive symptoms (B = 2.74, p < 0.001 and B = 1.62, p < 0.001, respectively). The girls had higher levels of depressive symptoms than the boys (B = 0.71, p = 0.004). Moreover, a greater age was associated with higher levels of symptoms (B = 0.17, p = 0.033). Higher social support levels were associated with lower levels of depressive symptoms (B = −0.08, p = 0.001). Our findings suggest that interventions providing social support to adolescents who experience abuse may be beneficial in reducing depressive symptoms. Full article