Adolescents, Volume 5, Issue 2 (June 2025) – 12 articles

(1) Background: Adolescents living with HIV (ALHIVs) experience significant challenges in adhering to treatment and remaining engaged in care as they transition from pediatric to adult HIV care programs. The aim of this qualitative evidence synthesis (QES) was to review qualitative studies that describe how ALHIVs experience transition practices in low- and middle-income countries. (2) Methods: The following databases were searched: PubMed, Wiley Library Online, EbscoHost (PsychARTICLES, MEDLINE, Scopus, CINAHL), the WHO database, Google Scholar, and reference mining of the included studies. The inclusion criteria were as follows: ALHIV 10–19 years old, interventions on the transition period or studies describing transition practices, published between 2012 and 2023, conducted in low- and middle-income countries, English language, and qualitative and mixed-method studies. This review adheres to the PRISMA guidelines. CASP and MMAT were used for methodological quality assessment, and GRADE CERQual was used for the confidence in review findings. (3) Results: Seven articles were included in the final review. The five overarching themes described: (1) transition readiness during the pre-transition phase; (2) structural (health systems) barriers and treatment literacy as challenges during the transition period; and (3) provided accounts of successful post-transition experiences and recommendations for improving the transition process (when these were not experienced as positive), while also describing the individual and collective contexts in which transition took place, as they outlined (4) individual (psychological) barriers and the facilitative role that (5) a supportive environment played in the outcome of the transition process. There was a high level of confidence in transition readiness, while the other themes were assessed as having moderate confidence due to methodological limitations and minor concerns about adequacy or relevance. (4) Conclusions: There is a dearth of qualitative studies on the transition experiences of ALHIVs and on how the transition process impacts adherence, retention in care, and mental well-being. We recommend the development of interventions in the form of a guided transition protocol to improve the transition experiences of ALHIVs. Full article

Emotional exhaustion in children and adolescents has become a significant concern in post-pandemic educational settings, with increased risks of anxiety, depression, and academic disengagement. Despite the growing prevalence of burnout symptoms in school-aged populations, few psychometrically validated tools exist to assess this construct in younger cohorts. This study aimed to validate the factorial structure and psychometric properties of the Emotional Exhaustion Scale (EES-CA) for use in children and adolescents, focusing on reliability, internal structure, and convergent validity. An instrumental, cross-sectional study was conducted with a sample of 543 Chilean students aged 10 to 18 (M = 13.00, SD = 1.77). The EES-CA, adapted from the university-level Emotional Exhaustion Scale, was administered along with the Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed in the following four phases: descriptive analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and convergent validity. Reliability was estimated via Cronbach’s alpha and McDonald’s omega. EFA supported the following two-factor solution: Scholar Stress and Emotional Fatigue, explaining 58.49% of the total variance. CFA confirmed the superiority of the bifactorial model (χ² = 91.74, df = 34; CFI = 0.960; RMSEA = 0.072) over the unifactorial model (χ² = 133.20, df = 35; CFI = 0.932; RMSEA = 0.093). The internal consistency was strong (α = 0.888; ω = 0.883). The convergent validity for the EES-CA showed low correlations with wellbeing (PWI) and non-significant correlations with emotional intelligence (TMMS-24), supporting discriminant validity. The EES-CA exhibits a robust bifactorial structure with high reliability and valid associations with psychological distress measures. This scale is an appropriate and psychometrically sound instrument for assessing emotional exhaustion in school-aged populations, providing a valuable tool for early detection and intervention in educational and mental health contexts. Full article

Exclusionary discipline harms students, schools, and society at large. Students’ perceptions of prevention and countermeasures to this harm are imperative to improving equity in school discipline. This study examined eighth-grade students’ experiences in their middle school environments during implementation of the inclusive skill-building learning approach (ISLA). As part of ISLA implementation, school staff are supported in implementing preventative strategies and instructional responses in the face of behavior challenges. To inform future implementation efforts in these contexts, this paper examined how eighth-grade students experienced different aspects of the learning environment during the intervention year. A total of 22 students participated in focus groups and provided feedback on various elements of ISLA. Students’ experiences were analyzed using a theoretical thematic analysis, which revealed strong connections between teachers’ implementation of inclusive practices and relationship-building strategies and students’ sense of belonging and support in schools. Results are discussed in terms of the impact of student–teacher interactions, strategies to improve student outcomes, and considerations to improve ISLA implementation. Full article

This study examines the dynamics of information dissemination and opinion formation in Indonesian social media through a comprehensive analysis of a high-profile youth violence case. Using social network analysis (SNA), we analyzed 264,155 activities from 83,097 accounts on platform X (formerly Twitter) to understand the patterns of information flow, cluster formation, and inter-group interactions. The analysis revealed four distinct clusters with unique characteristics: a dominant support cluster (40.12%), a context-focused cluster (26.93%), a mainstream media cluster (14.14%), and a peripheral engagement cluster (6.05%). This study found significant patterns in information dissemination, with retweets dominating at 68% of total activities and strategic hashtag usage at 28%. Cross-cluster interactions comprised 20% of total activities, challenging assumptions about echo chambers in digital discourse. The network showed high resilience with 85% path reliability and demonstrated a consistent multiplier effect with a 1:5:15 ratio in message amplification. Bridge nodes (10–15% of accounts) played crucial roles in facilitating cross-cluster dialogue and maintaining network cohesion. The temporal evolution of discourse showed distinct phases, from initial factual reporting to later systemic analysis, with each phase characterized by different engagement patterns and narrative focuses. These findings extend existing theoretical frameworks while highlighting the need for more culturally nuanced approaches to understanding digital discourse in contexts of collectivist cultural dimensions. This study’s results have significant implications for digital literacy education, social media intervention strategies, and youth violence prevention efforts, suggesting the need for sophisticated, network-aware approaches that consider both structural dynamics and cultural contexts. Full article

Adolescent externalizing problems are commonly linked to maternal psychological distress and family functioning, but these associations remain underexplored in the Greek sociocultural context. This study examined how maternal symptoms of depression, anxiety, and stress, along with adolescent-perceived family functioning, predict externalizing behaviors in Greek adolescents. A total of 563 adolescent–mother dyads (63.4% girls; M_age = 15.03 and SD = 0.83) participated. Mothers completed the Child Behavior Checklist (CBCL), the Depression Anxiety Stress Scales (DASS-21), and the Family Assessment Device (FAD–GF), while adolescents completed the Youth Self-Report (YSR) and FAD–GF. Hierarchical regression analysis showed that adolescent-perceived family functioning was the strongest predictor of externalizing behavior (β = 0.24 and p < 0.001), even after accounting for demographic and maternal mental health variables. The final model explained 18% of the variance in adolescent externalizing problems. Mediation analysis confirmed that family functioning partially mediated the relationship between maternal depression and adolescent externalizing problems, with a significant indirect effect (a × b = 0.088, Sobel z = 2.90, and p = 0.004). Gender differences were found for self-reported aggressive behavior (t = −2.40, p = 0.017, and d = 0.20), with girls scoring higher than boys. These findings highlight the indirect impact of maternal depression through family dynamics and underscore the importance of culturally sensitive, family-centered interventions to reduce adolescent externalizing problems. Full article

Adolescence is a critical developmental stage marked by significant physical, emotional, and social changes that profoundly influence health behaviors. Public health plays a crucial role in promoting adolescent well-being, developing health education programs, community campaigns, and evidence-based prevention policies to mitigate risk factors associated with adolescent health, behavior, and lifestyle patterns. The aim of this study is to examine self-perceived health, mood, sleep patterns, substance use, dietary habits, and leisure activities among 120 adolescents aged 14 to 17 in a municipal school near Barcelona. The findings reveal that in the mood state distribution, boys are 2.34-times more likely to report a positive mood than girls. In the prevalence of addictive substance and alcohol use between male and female adolescents, 82.6% of girls reported an alcohol consumption that was significantly higher than the 56.9% of boys (p = 0.003). Similarly, 42.15% of girls had smoked at least once, compared to 19.83% of boys (p < 0.001). Physical inactivity was more prevalent among girls (17.4%) than boys (11.8%), indicating potential barriers to participation. The distribution of sleep hours between boys and girls shows notable differences in the 8.5 h sleep category (p = 0.0090). Skipping breakfast was more common among girls (33.3%) than boys (21.6%). Night-out frequency and return times have an identical proportion between boys and girls. This study underscores the necessity of implementing gender-sensitive public health strategies to address disparities in substance use, physical activity, and dietary habits, while promoting sleep hygiene and overall adolescent well-being through municipal and community-based initiatives. Full article

Adolescents’ health risk behavior may have a longstanding impact on their later adult life and health. The aim of this cross-sectional study is to report on health risk behaviors and sexual attitudes in a sample of Mongolian adolescents (N = 312) in light of their levels of social support and well-being. Measurements were derived from the Health Behavior in School-aged Children (HBSC), including substance use and sexual behavior, whereas social support from parents and peers was measured with the Multidimensional Scale of Perceived Social Support (MSPSS). Student well-being was evaluated using the WHO Well-Being Questionnaire (WBI-5). The frequency of current smokers was 13.1% (boys: 18.9%, girls: 10.2%; χ² = 4.61, Phi = −0.12, p = 0.032). The prevalence rate of current alcohol consumption was 11.2% (boys: 14.2%, girls: 9.7%; χ² = 1.38, Phi = −0.07, p > 0.05), similar to the nationwide results. The percentage of students who have ever had sexual intercourse was 6.4 (12.4% of boys and 3.4% of girls, χ² = 9.33, Phi = 0.17, p = 0.006), similar to Central Asian countries included in the HBSC survey. Boys were more likely to associate sexual activity with self-esteem, intimacy with a partner, and positive perceptions among peers. Conversely, girls expressed greater concern about the negative consequences of sexual activity, such as STDs and pregnancy. Social support from the family played a protective role in frequencies of smoking and drinking. However, levels of the social support subscales did not differ by the students’ relationship status or previous sexual intercourse. These results suggest that there is a need for a complex prevention program to avoid increases in Mongolian adolescents’ smoking and drinking and promote their healthy sexual attitudes and behavior. Full article

Body awareness consists of aesthetic body image, functional body image, and interoception. Previous studies indicated a link between these components of body awareness and mental health. This study aims to clarify the relationship among these variables during the period of pubertal body changes. As puberty progresses, individuals’ perceptions of their bodies shift, which has been associated with a decline in mental health, according to the existing literature. To investigate this issue, a sample of 294 post-pubertal adolescents assigned female at birth completed assessments related to body awareness, mental health, psychosomatic symptoms, gender congruence, and eating disorders. A network analysis was conducted to illustrate the intricate interactions among the observed variables, and a mediation model was utilised to explore how body image influences overall health, with interoception and functional body image acting as mediators. The study identifies three key variables—body image, mental health, and interoception—as central within the network. Additionally, functional body image was significantly associated with other variables in the study. Ultimately, both direct and indirect effects of body image on mental health were found, mediated through interoception and functional body image. The clinical implications emphasise the importance of enhancing awareness of bodily sensations and functions to support psychological well-being, particularly during a developmental stage characterised by challenges related to body image due to rapid changes in puberty. Full article

(1) Background: Adolescence is a critical period in human life, particularly in relation to the development of a healthy lifestyle. Physical activity, body composition and adherence to healthy dietary patterns are key indicators for preventing adolescent overweight and obesity. The aim of this study is to explore the associations between systematic engagement in physical activity, dietary habits and body composition in a sample of Greek adolescents. (2) Methods: In this cross-sectional study, 292 adolescent volunteers, aged 12 to 18 years, from high schools in the Attica region (169 boys [57.9%] and 123 girls [42.1%]) participated. The participants’ socio-demographic characteristics and physical activity levels were assessed through self-reported questionnaires. Their dietary habits were evaluated using the KIDMED questionnaire, and their body composition was determined via bioelectrical impedance analysis. (3) Results: The majority of the students (80.8%) was involved in organized exercise, either as part of a team or in individual sports activities. Physically active participants had significantly improved body composition profiles compared to their non-active peers. No significant differences were observed in the KIDMED scores between boys and girls. However, significantly higher KIDMED scores were found in the group of physically active adolescents compared to the non-active group, with this difference being more pronounced among boys. (4) Conclusions: Engagement in organized physical activity is associated with healthier dietary choices, contributing to a more favorable overall lifestyle profile among adolescents. Full article

This study employed Linguistic Inquiry and Word Count (LIWC-22) software, a language analysis tool, to examine Spanish-language pro-NSSI Tumblr posts. Pro-NSSI, or “pro non suicidal self-injury”, refers to online content that normalizes or supports self-harming behaviors. Given the strong associations between NSSI and conditions such as post-traumatic stress disorder (PTSD), anxiety, and depression, understanding how these behaviors are discussed online can help improve interventions. A year’s worth of public posts were collected, focusing on captions and hashtags that included NSSI-related terms. Using Linguistic Inquiry and Word Count (LIWC) software, we analyzed linguistic and psychological markers. Log-likelihood ratio tests revealed significantly higher frequencies of words related to negative emotions, sadness, health, and death compared to standard blog norms. Mixed-language posts showed notable code-switching, suggesting a possible emotional distancing mechanism when discussing self-harm. The findings indicate that Spanish-speaking adolescents engaging in pro-NSSI communities exhibit unique linguistic and psychological characteristics, with important implications for clinical assessment and intervention. Mental health counselors and educators can use these insights to develop culturally and linguistically responsive strategies for prevention and support. Full article

The coronavirus disease of 2019 (COVID-19) pandemic represented a significant global event that disrupted the typical social lives of adolescents. Studies show that the pandemic negatively impacted adolescent well-being. Very little is known about the social–cognitive implications of wide-scale social distancing, school closures, and the transition to digital modes of communication for adolescents. This study aims to compare affective Theory of Mind (ToM), self-esteem, and self-perceptions before and after the COVID-19 pandemic. Drawing on existing data, this study compared two distinct but comparable samples of adolescents. Data from the pre-COVID-19 sample were collected in the 2016/2017 school year (N = 145, 60.7% female and 39.3% male, mean age 13.38 years. Data from the post-COVID-19 sample were collected over the 2021/2022 school year (N = 107 participants, 51% female, 48% male, and 1% genderqueer, mean age of 13 years). Independent-sample t-tests and two-tailed correlational analysis were used to compare associations and changes in affective ToM, self-perceptions, and self-esteem between the pre-COVID-19 and post-COVID-19 samples. The main findings of this study includes declines in affective ToM post-COVID-19, specifically related to the perception of negative affect. Further, perceived self-worth and behavioural conduct declined after the COVID-19 pandemic. Implications for social–emotional learning and future research are discussed. Full article

Background: Globally, approximately 65% of adolescents undergoing antiretroviral therapy (ART) adhered to their treatment, whereas only 55% achieved viral suppression in 2023. The low rate of viral suppression is concerning, as elevated viral loads are associated with a heightened risk of opportunistic infections, progression to advanced HIV disease, increased mortality, and greater HIV transmission rates. We conducted this scoping review to identify the facilitators and barriers to ART adherence among adolescents and young adults (AYAs) in sub-Saharan Africa (SSA). Methods: We conducted this scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. We searched for peer-reviewed articles published in English from 2014 to 2024 across the SCOPUS, ScienceDirect, PubMed, Africa Journals Online, and Google Scholar databases. Two reviewers independently selected the articles and extracted the data. We used NVivo to develop codes and categories of facilitators and barriers. Results: We used 30 articles reporting on studies conducted in 13 countries in this review. The total number of participants in the studies was 12,250. Sixteen articles reported on qualitative studies, nine on quantitative studies, and five on mixed-methods studies. This scoping review identified various personal (14 articles), interpersonal and social (15 articles), healthcare system-related (9 articles), medication-related (7 articles), and economic (2 articles) factors that facilitate ART adherence among AYAs. Additionally, the scoping review also identified various personal (28 articles), interpersonal and social (13 articles), healthcare system-related (14 articles), medication-related (20 articles), school- or work-related (6 articles), and economic (14 articles) factors that hinder ART adherence among AYAs. Conclusions: Enhancing ART adherence in AYAs requires multiple strategies, including the reduction of internalized stigma, implementation of community awareness campaigns, harm reduction approaches for AYAs who misuse substances, comprehensive education on HIV, and the provision of support from school staff and leadership, alongside the adoption of differentiated service delivery (DSD), which encompasses home-based ART delivery, refills at private pharmacies, community ART distribution centers, and patient-led community ART refill groups, as well as multi-month dispensing practices. Full article