Adolescents, Volume 6, Issue 1 (February 2026) – 14 articles

This systematic review explores the role of family cohesion and health literacy in shaping the physical, mental, and behavioral health of parents and adolescents. Family cohesion and health literacy are recognized social determinants that influence communication, shared decision-making, and engagement in preventive health behaviors. Following PRISMA 2021 guidelines, a comprehensive search across major databases identified 16 eligible studies meeting the inclusion criteria between 2010 and 2025. The findings indicate that higher levels of family cohesion promote healthier behaviors, strengthen emotional regulation, and enhance adolescents’ perceived well-being, while also increasing parental involvement in health-related decisions. Health literacy emerged as a key explanatory and contextual factor in the association between family cohesion and health outcomes. However, socioeconomic disadvantages—such as low income, limited access to healthcare, and lower parental education—were shown to weaken these protective pathways, creating disparities in health outcomes. Cultural and contextual factors also influenced the effectiveness of health literacy interventions. Overall, the review underscores the relevance of family-centered, culturally tailored public health strategies that simultaneously strengthen family cohesion and health literacy to support equitable health outcomes for parents and adolescents. Full article

Spirituality and religion are underrecognized components of mental health and substance use (MHSU) care for youth of African descent. This study explores the dual role of spirituality and religion in influencing the help-seeking behaviors, recovery journeys, and care outcomes of youth of African descent aged 18 to 25 residing in Nova Scotia, Canada. Drawing on findings from a Canadian Institutes of Health Research (CIHR) funded community-based study using mixed methods, including interviews, focus groups, and arts-based approaches, the research highlights both the supportive and ambivalent roles spirituality plays in MHSU care. Participants shared themes such as spiritual reflection as a turning point, the assurance of a higher power, the culturally responsive support of faith-informed providers, and the significance of meditation and unseen connection as healing tools. While the narratives of research participants attested to the role of spiritual and religious practices in offering a sense of belonging, hope, and culturally aligned care, they may also reinforce stigma or act as a barrier to accessing formal MHSU services. These themes were derived from qualitative analysis of in-depth interviews with 60 youth participants. Through the lens of Ubuntu and Afrocentric paradigms, this paper calls for a more holistic and culturally inclusive approach to care, one that respects or honors the spiritual and communal lives of youth of African descent. It also reinforces the importance of training MHSU care providers to recognize, respect, and integrate spirituality as a legitimate component of wellness and recovery for help-seeking youth of African descent. Full article

Problematic Internet use is a major health issue among adolescents, underscoring the need for further research on the variables related to this dysfunctional usage pattern. This study examined the predictive capacity of four indicators of psychosocial adjustment (depressed mood, perceived stress, loneliness, and life satisfaction) for different dimensions of problematic Internet use (preference for online social interaction, Internet use for mood regulation, deficient self-regulation of Internet use, and negative consequences) in male and female adolescents. A sample of 628 adolescents, aged 12 to 18 years (M age = 14.11; SD = 1.52), participated. The results indicated that all dimensions of problematic Internet use were positively correlated with depressive mood, perceived stress, and loneliness, and negatively correlated with life satisfaction. However, notable differences emerged in how these psychosocial variables related to the four PIU dimensions. Loneliness and life satisfaction showed the strongest and most consistent associations. Loneliness predicted Internet use for mood regulation in both males and females and, additionally, predicted preference for online social interaction and negative consequences among males. Life satisfaction was a significant negative predictor of three PIU dimensions among females. Perceived stress stood out as the only predictor of deficient self-regulation in males and females. Finally, depressive mood predicted only the Internet-use-for-mood-regulation dimension among males. These findings may be useful for developing intervention programs aimed at reducing problematic Internet use among adolescents. Full article

Child marriage remains a major threat to adolescent girls’ health, development, and rights worldwide. Despite decades of progress, recent policy backsliding and sociopolitical instability have created new risks, with examples from Iraq, Afghanistan, and The Gambia illustrating how legal and political shifts are reshaping vulnerabilities for girls. This paper presents an integrated framework linking developmental science with legal and policy advocacy, emphasizing how evolving capacities and psychosocial maturity should inform marriage laws and protection mechanisms. It reframes advocacy and rights-based action as essential components of adolescent health systems, drawing on recent policy analyses and country examples to identify actionable, multisectoral strategies. The paper highlights an urgent need for collective, evidence-informed advocacy to protect adolescent girls and advance gender equality, an issue of growing importance amid renewed global attention to legal reforms on child marriage. Full article

Service-learning has emerged as a promising pedagogical approach to address social challenges while fostering students’ academic, socioemotional, and civic development. Despite the growing body of literature, there is a lack of systematic reviews evaluating its effectiveness in secondary education beyond the United States. Therefore, this systematic review aimed to synthesize the available empirical research on service-learning interventions implemented with secondary education students (grades 7–10) outside United States. Following The Campbell Collaboration guidelines, a comprehensive search was conducted across Web of Science and ProQuest, supplemented by other resources (general web search, hand searches, ongoing research, open access and relevant institutions and networks). Inclusion criteria required quantitative empirical studies (randomized controlled trials, quasi-experimental designs, or pretest–posttest designs) published from 2008 to June 2025 that measured academic, cognitive, socio-emotional, civic, and community outcomes using quantitative procedures. After screening, 10 studies met the inclusion criteria. The findings indicate that service-learning programs can generate positive outcomes on academic performance and non-cognitive skills. Nevertheless, methodological weaknesses and heterogeneity across studies prevent drawing robust conclusions. The review highlights the need for more rigorous research to strengthen the evidence base for service-learning among adolescents in systems worldwide. Full article

The present study proposes to identify information from health, educational and sports science studies that used Bronfenbrenner’s theory of human development to verify the complex relationship between factors associated with physical activity (PA) and sedentary behavior (SB) in children and adolescents. The scoping review will be developed across seven databases (PubMed, Scopus, SPORTDiscus, Web of Science, PsycINFO, ERIC, and Scielo). The inclusion criteria were formulated based on the PCC (Population, Concept, Context) framework: (a) children and adolescents (5–17 years); (b) studies on PA and/or SB that used Bronfenbrenner’s theory; (c) any context. Only peer-reviewed journal articles published in English, Spanish, or Portuguese will be included; grey literature will not be included. Finally, two reviewers will screen studies using Rayyan. A standardized charting form will be used to extract data on study characteristics and the factors mapped considering Bronfenbrenner’s theory components. This study is expected to show how Bronfenbrenner’s theory has been applied to explain PA and SB in children and adolescents, as well as to map the methodological tools used in this area, identifying gaps and providing a clear framework for future research on the complex and multilevel determinants of PA and SB in children and adolescents. Full article

Cooperative learning, a pedagogical approach emphasizing structured collaboration and mutual responsibility, has been associated with academic and social benefits, yet its influence on adolescents’ prosocial and antisocial behaviors remains underexplored. This study examined the relationships between cooperative learning, affective experiences, and social behavior in adolescent students. A total of 261 adolescent students (M = 13.06 years, SD = 0.86) from Greece participated in this cross-sectional study. Data were collected via questionnaires assessing perceptions of cooperative learning, enjoyment, vitality, and prosocial/antisocial behaviors toward teammates and opponents. Factor analyses confirmed the validity of the Greek versions of the instruments. Path analysis revealed that contextual elements of cooperative learning explained a significant proportion of variance in enjoyment and vitality, which in turn predicted prosocial behavior toward both teammates and opponents. Specifically, enjoyment and vitality were positively associated with prosocial orientations, whereas vitality negatively predicted antisocial behavior toward teammates. Unexpectedly, group reflection and heterogeneity emerged as negative predictors of enjoyment and vitality, while interaction showed marginal positive effects. Indirect effects indicated that cooperative learning dimensions influenced social behavior primarily through enjoyment and vitality. These findings suggest that positive affective states mediate the impact of cooperative learning on students’ social conduct in PE. Implications for practice highlight the importance of carefully designing cooperative structures to enhance enjoyment and vitality while fostering prosocial interactions during adolescence. Full article

Social media addiction (SMA) and social phobia (SP) are significant adolescent mental health concerns. In Saudi Arabia, despite high social media penetration, the association between these two constructs remains under-researched, particularly in the Aseer region. This cross-sectional study, conducted from January to March 2025, recruited 384 Saudi adolescents aged 11–19 from schools in the Aseer region using multistage cluster sampling. Participants completed validated self-report measures, including the Social Phobia Inventory (SPIN) and the Al-Menayes Social Media Addiction Scale. A refined “Core SMA” subscale was created based on expert consensus criteria to enhance measurement precision. The prevalence of moderate-to-severe social phobia was 15.6%. A significant, moderate positive correlation emerged between SP and SMA (Spearman’s ρ = 0.294, p < 0.001). After adjusting for age, gender, and family income, adolescents with moderate social phobia had 2.15 times the odds of probable SMA compared to those with no SP (adjusted odds ratio [AOR] = 2.15, 95% CI: 1.15–4.04, p < 0.05), and this effect was more pronounced for those with severe social phobia (AOR = 2.56, 95% CI: 1.04–6.30, p < 0.05). This study demonstrates a clear relationship between social phobia severity and social media addiction among Saudi adolescents in the Aseer region. These findings support the urgent need for integrated mental health and digital literacy interventions that proactively screen for both conditions. Full article

(1) Background: School-based mental health interventions represent a promising approach to address the substantial treatment gap affecting adolescents, with only 20% of youth with diagnosable mental health conditions receiving adequate care. (2) Methods: This meta-analysis synthesized evidence from 18 randomized controlled trials to examine the effectiveness of school-based mental health interventions and potential moderators of outcomes. (3) Results: Using Hedges’ g as the effect size index and a random-effects model, the analysis revealed a statistically significant overall effect size of 0.068 (95% CI [0.019, 0.117], p = 0.006), indicating small but reliable improvements in adolescent academic, social, emotional, behavioral, and mental health outcomes. Heterogeneity across studies was minimal (I² = 15%), suggesting consistent effects across diverse intervention types and contexts. Meta-regression analyses examining eight potential moderators including intervention focus, grade level, provider type, delivery format, duration, study design, geographic location, and theoretical foundation did not reveal statistically significant moderation effects, likely due to limited statistical power. However, descriptive patterns suggested that targeted interventions, small-group formats, and interventions delivered by mental health professionals may produce larger effects than universal programs, classroom-based approaches, and teacher-delivered interventions. (4) Conclusions: These findings support continued investment in school-based mental health programming while highlighting the need for specialized focus to optimize outcomes for all adolescents. Full article

The transition from secondary to post-secondary levels has been seen as challenging and significant among adolescents, in particular adolescents with disabilities (ADWs). Given the increasing trend of students with disabilities pursuing higher education under the integrated education policy, it is unclear whether these students can receive appropriate support to enhance their learning and career exploration. This study investigated the experiences of ADWs during this transition. A group of 40 adolescents took part individually in a 1 h semi-structured interview. The interview data was analyzed with reference to five levels using an ecological model from microsystem, mesosystem, exosystem, macrosystem and chronosystem. Facilitating factors at each level were extracted, e.g., adequate use of assistive technologies helping them overcome their perceived limitations caused by disabilities, and accommodation in learning and assessments also helped unleash their potentials. However, difficulties were also identified, e.g., poor interaction with academic peers, issues with disability disclosure, and schools’ rigid arrangements. The results from this study corroborate the different systems as suggested by the ecological model and also align with the different components of the taxonomy of transition: (a) student-focused development and planning; (b) family involvement and support; and (c) the importance of interagency collaboration. It was recommended that a supporting network should be established between secondary schools and post-secondary institutions to enhance a smooth transition across different education sectors. Full article

Problematic weight control behaviors during adolescence are associated with an increased risk of chronic obesity. Understanding how adolescents with obesity respond to body-related visual cues may offer insights into underlying motivational deficits. This experimental pilot study employed a peripherally measured startle reflex paradigm to assess the involuntary emotional responses to images of underweight, normal-weight, and overweight bodies. Twenty female adolescents with obesity and 21 normal-sized control subjects between 14 and 21 years of age were presented with photos of female bodies. Images from the International Affective Picture System served as reference material. The Self-Assessment Manikin was used as the subjective measure, while startle reflex magnitude and skin conductance response served as objective measures. A significant interaction emerged for body-related stimuli. In the normal-weight group, underweight and overweight body images elicited increased skin conductance responses (indicative of heightened attention) and potentiated startle reflexes (indicative of behavioral avoidance). In contrast, adolescents with obesity exhibited a general physiological down-regulation and a subjective vs. objective dissociation across all body image categories, suggesting a dysfunction in motivational processing. Our findings suggest diminished physiological salience of body-related cues in obese adolescents, which may undermine intrinsic motivation for weight loss. The limited sample size restricts generalizability. Full article

Background: Temporomandibular disorders (TMDs) are the most common source of non-dental orofacial pain, with peak prevalence during adolescence and young adulthood—the same age group when orthodontic treatment is typically initiated. Although orthodontics is not a proven cause of TMD, pre-existing dysfunction may be aggravated during treatment, creating clinical and medico-legal risks. Objective: This paper proposes a structured diagnostic questionnaire and scoring framework for pre-orthodontic TMD assessment. The protocol aims to enhance the early recognition of high-risk patients, facilitate interdisciplinary communication, and lay a foundation for systematic validation. Methods: The framework was developed through synthesis of international diagnostic criteria (DC/TMD), a targeted narrative review of the literature, and expert clinical input. Diagnostic categories were selected based on prevalence, impact on orthodontic outcomes, and medico-legal significance. Weighted scoring stratifies patients into three pathways: (1) proceed with orthodontics without concern, (2) proceed with monitoring, or (3) defer orthodontics until TMD is managed. Results: The proposed questionnaire is designed to address inconsistencies in the literature by applying standardized diagnostic items and objective thresholds (e.g., jaw opening < 38 mm) and structured follow-up intervals. Case scenarios illustrate how risk stratification guides decision-making. The questionnaire includes intra-articular and pain-related TMD entities such as disk displacement, degenerative joint disease, myalgia, myofascial pain, arthralgia, headache, and trismus. The framework provides orthodontists with defensible baseline documentation while supporting safe and individualized patient care. Conclusions: Inconsistent diagnostic frameworks, malocclusion classifications, and outcome measures have fragmented the evidence base in orthodontics and TMD. The framework aims to provide orthodontists with structured baseline documentation that may support clinical decision-making and medico-legal risk management. Validation studies are required to establish psychometric reliability and international applicability. Full article

The current investigation examines pathways linking individual risk factors, namely maladaptive emotion regulation, behavior problems, and drinking motives, with adolescents’ alcohol consumption. In a cross-sectional design, 243 adolescents attending secondary school in Germany completed questionnaires. The Cognitive Emotion Regulation Questionnaire was used to assess maladaptive emotion regulation, the Strengths and Difficulties Questionnaire for assessing internalizing and externalizing behaviors, and the Drinking Motives Questionnaire Revised for assessing the four drinking motives, namely social, enhancement, coping, and conformity motives. Adolescents also reported their daily and problematic alcohol consumption. The path analysis revealed that maladaptive emotion regulation was positively associated with both internalizing and externalizing problems, and all four drinking motives. Externalizing problems were positively associated with adolescents’ enhancement and coping motives, and their alcohol consumption. Internalizing problems were only negatively associated with enhancement motives. Only coping motives were positively associated with alcohol consumption. Moreover, maladaptive emotion regulation had an indirect effect on alcohol consumption, via externalizing problems and coping motives. The findings emphasize the interactions between the risk factors in contributing to adolescent alcohol consumption, underscoring the importance of targeting emotion regulation and coping motives in substance use prevention efforts prior and during adolescence. Full article

Background: Sedentary behavior is prevalent among female college students and may negatively affect motor competence—a key component of physical literacy and lifelong health. However, limited research has compared motor proficiency across distinct physical activity patterns in this population. This study aimed to examine differences in motor proficiency between sedentary and regularly active female college students. Methods: A cross-sectional study was conducted with 292 female undergraduates (aged 18–21 years). Participants were retrospectively classified into a sedentary behavior group (SBG; n = 124) and a regular exercise group (REG; n = 168) according to the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Motor proficiency was evaluated using the Bruininks–Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Group differences were analyzed using multivariate analysis of variance (MANOVA) and independent-samples t-tests. Results: The REG demonstrated significantly higher scores in manual coordination, body coordination, and strength and agility (all p < 0.01), whereas no significant difference was observed in fine motor control. The REG also exhibited a higher total BOT-2 score (p < 0.01; Cohen’s d = 0.56). Conclusions: Regular physical activity was associated with higher motor proficiency among female college students. As this study used a cross-sectional design, causal relationships cannot be inferred. Nonetheless, these findings highlight the potential importance of promoting active lifestyles in higher education to enhance motor competence and contribute to long-term public health. Full article