Adolescents

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

Background: Adolescents’ engagement with social media and emerging metaverse platforms has become nearly universal, creating environments rich in opportunities for learning, creativity, and social connection. However, these same spaces also enable a range of risky behaviors (RBs) with potential impacts on mental health, safety, and development. Recent research (2022–2025) has documented rising concerns over cyberbullying, online sexual exploitation, self-harm content, problematic use, and new risks specific to immersive VR. Aims: This Perspective uses a narrative synthesis of recent empirical and theoretical literature, including four key articles provided by the author and over 40 additional peer-reviewed and institutional sources, to (i) map the most prevalent and emergent RBs in adolescent social media and metaverse use, (ii) clarify the neurodevelopmental and socio-technical mechanisms that link these behaviors to individual and contextual factors, and (iii) propose a multi-level framework for intervention, policy, and future research aligned with adolescent development. Methods: A narrative synthesis approach was adopted, which is appropriate for integrating heterogeneous study designs and rapidly evolving evidence. The review emphasizes studies published from 2022 to 2025, with a focus on large-scale surveys, longitudinal cohorts, systematic reviews, and scoping reviews relevant to adolescent online risk. Results: Evidence indicates small but consistent associations between high-intensity platform use and internalizing symptoms, with gendered pathways and cultural moderators. Algorithmic amplification contributes to the spread of harmful content, while immersive environments increase the salience and emotional impact of interactions. Certain groups—those with prior trauma, low SES, or marginalized identities—face heightened vulnerability. Conclusions: RBs in digital spaces emerge from the interplay of adolescent neurodevelopment, platform affordances, and socio-cultural context. This Perspective synthesizes recent evidence via narrative review to articulate these mechanisms and to inform an integrated, multi-level framework for harm mitigation that aligns research, platform design, and policy with adolescent developmental needs, while preserving the benefits of digital engagement. Full article

Blood pressure prediction in adolescents continues to remain a major challenge for health practitioners. In classical regression, many factors are found to be statistically significant based on p-values due to large sample sizes, but they may not be equally important predictors for an outcome variable. Machine learning methods provide non-linear and non-parametric approaches with superior predictive performance and a lower chance of model misspecification. Therefore, we employed a leave-one-covariate-out (LOCO) method, a novel variable importance measure, in addition to linear mixed-effects models integrated within random forest for prediction of longitudinal blood pressure. We used health markers such as BMI and dietary habits of 2379 Black and White adolescent girls, tracked yearly from ages 9 and 10 until 19 in the National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study (NGHS, USA). Age, BMI, waist circumference, and dietary cholesterol were consistently the most quantitatively important variables for prediction of systolic blood pressure (SBP). However, age, BMI and waist circumference were consistently the most quantitatively important covariates for prediction of diastolic blood pressure (DBP). The study findings demonstrate the importance of understanding how dietary habits and health markers influence blood pressure. Full article

This study compared executive functions, anthropometric profile, and dietary habits in adolescent girls with and without eating disorder (ED) symptoms. The main objective was to determine the relationship between the presence of ED symptoms and the degree of executive function impairment. A case–control design was used with 209 Mexican adolescents who completed ED screening questionnaires. Of the total sample, 54 participants scored above the clinical cutoff, and 39 of them completed both the BANFE-2 assessment and the anthropometric measurements. These 39 adolescents with ED symptoms were matched with an equal number of adolescents without symptoms to form the control group. Additionally, 21 adolescents in the ED symptoms group and 25 in the control group completed the 24 h dietary recall and food frequency questionnaires. The main findings were as follows: the prevalence of ED symptoms was 25.8%. Adolescents with ED symptoms showed higher body mass index, waist circumference, body fat percentage, and neck circumference compared with those without symptoms. They also exhibited poorer inhibitory control, reflected in a greater number of errors, along with non-significant trends toward lower performance on the maze test, Card Sorting, and Card Game. Dietary inadequacy was also more pronounced in the ED symptoms group. Furthermore, the presence of ED symptoms significantly increased the likelihood of severe executive function impairment. In conclusion, adolescents with ED symptoms demonstrated an altered anthropometric profile, dietary deficiencies, and reduced inhibitory control. Full article

Across the globe, adolescents often grow up surrounded by cultural silence, taboo, or discomfort regarding conversations about sexuality, relationships, and power. The absence of timely, comprehensive, and honest conversations about sexuality, power dynamics, and sexual pleasure during adolescence can significantly impact young people’s mental health and well-being. This commentary paper examines the detrimental effects of the “unspoken curriculum” surrounding sexuality, characterized by silence, misinformation, and avoidance, on the psychological development of young individuals. It examines how the lack of open dialogue contributes to anxiety, shame, distorted perceptions of sexuality, and vulnerability to exploitation. Furthermore, this article underscores the critical need for parents, educators, and society at large to engage in transparent conversations that encompass not only the biological aspects of sexuality but also the essential elements of power, consent, sexual pleasure, healthy relationships, and emotional literacy. By drawing on global research, this paper reveals both common challenges and unique regional barriers, advocating for culturally responsive yet universally rights-based solutions. By fostering open communication and providing accurate, age-appropriate information, we can empower young people to navigate their sexual development with confidence, respect, and a positive sense of self, thereby safeguarding their mental health and fostering healthier societal attitudes towards sexuality. Full article

Introduction: School belonging is a key component of adolescent well-being, associated with academic success, mental health, and social inclusion. This study explores the levels of school belonging among Portuguese students and examines the psychosocial factors associated with this perception. Methods: Data from 3083 students (5th to 12th grade) obtained through the 2024 National Study by the Observatory of Psychological Health and Well-Being were analysed. Socio-emotional skills, well-being indicators, psychological symptoms, and school engagement variables were assessed using validated instruments. Statistical analyses included ANOVA and linear regression. Results: Overall, boys and younger students reported higher levels of school belonging. Sociability, resilience, confidence, school engagement, and and components of Positive Youth Development (PYD)—a strengths-based framework focusing on the internal and external assets that foster healthy youth development—such as competence and connection, were positively associated with school belonging. Conversely, depressive symptoms and experiences of bullying negatively predicted this outcome. Conclusions: This study’s findings highlight the need to reinforce inclusive educational practices, foster positive youth development, and promote protective relational dynamics within the school context. Full article

Background: Adolescence is marked by heightened reward sensitivity and incomplete maturation of cognitive control, creating conditions that favor engagement in risky behaviors. Traditional self-report methods often overlook the fast, automatic processes—such as attentional biases, approach–avoidance tendencies, and associative schemas—that shape adolescent decision-making in real time. Aims: This Perspective aims to synthesize recent (2018–2025) advances in the study of implicit measures relevant to adolescent risk behaviors, evaluate their predictive value beyond explicit measures, and identify translational pathways for prevention and early intervention. Methods: A narrative synthesis was conducted, integrating evidence from eye-tracking, drift-diffusion modeling, approach–avoidance tasks, single-category implicit association tests, ecological momentary assessment (EMA), and passive digital phenotyping. Emphasis was placed on multi-method phenotyping pipelines and on studies validating these tools in adolescent populations. Results: Implicit indices demonstrated incremental predictive validity for risky behaviors such as substance use, hazardous driving, and problematic digital engagement, outperforming self-reports in detecting context-dependent and state-specific risk patterns. Integrative protocols combining laboratory-based measures with EMA and passive sensing captured the influence of peer presence, affective state, and opportunity structures on decision-making. Mobile-based interventions, including approach bias modification and attention bias training, proved feasible, scalable, and sensitive to change in implicit outcomes. Acoustic biomarkers further enhanced low-burden state monitoring. Conclusions: Implicit measures provide a mechanistic, intervention-sensitive complement to explicit screening, enabling targeted, context-aware prevention strategies in adolescents. Future priorities include multi-site validations, school-based implementation trials, and the use of implicit parameter change as a primary endpoint in prevention research. Full article

Substance use remains a global public health concern with adverse effects on health, education, and community safety. In South Africa, in rural areas like substance use among secondary school students compromises teaching quality and school safety. This study aims to develop and validate community-based strategies to mitigate substance use among secondary school students using a Participatory Action Research approach. A qualitative, participatory design will be implemented in three phases: (1) situational analysis through interviews with parents and focus groups with students; (2) co-development of strategies guided by the strengths, weaknesses, opportunities, threats, building, overcoming, exploring, and minimizing framework and Dickoff’s practice-oriented theory; and (3) validation using Chinn and Kramer’s evaluation criteria. Twenty students (aged 13–18 years) and twenty parents will be purposively and conveniently sampled. Data will be analyzed thematically using Tesch’s eight-step method, with trustworthiness ensured using Guba’s criteria. This study is expected to strengthen collaboration among schools, parents, and community stakeholders. The co-developed strategies will inform future interventions, guide school health policy, and promote sustainable, community-driven approaches to adolescent health promotion, ultimately enhancing secondary school students’ well-being and academic performance in rural educational settings. Full article

Parenting style plays a key role in adolescent development and well-being. This study set out to examine how different dimensions of perceived parenting styles influence resilience levels among a sample of 609 Spanish secondary school students aged 11 to 17 years. Data were collected using the School Resilience Scale (SRS) and the Parenting Style Assessment Scale (PSAS). Spearman correlations showed strong and significant associations, particularly between Affection and Communication and External Resources (ρ = 0.637, p < 0.001) and Internal Resources (ρ = 0.489, p < 0.001). Linear regression models explained 31.7% (Internal Resources) and 44.3% (External Resources) of the variance, with Affection and Communication and Revelation emerging as the most consistent predictors (p < 0.001). Multinomial logistic regressions showed good model fit (Nagelkerke R² = 0.398 and 0.561) and indicated that these dimensions increased the likelihood of belonging to the high-resilience groups (odds ratios ranging from 1.07 to 1.21). The findings highlight the importance of warm and emotionally expressive parenting practices in promoting adolescent resilience and suggest potential directions for school-based and family-focused intervention programs. Full article

Background: Kawasaki disease (KD) is an acute vasculitis of childhood that usually affects children under five but can also present in adolescence. Although less common, adolescent cases pose unique diagnostic and therapeutic challenges due to atypical features and increased cardiovascular risk. Methods: A targeted PubMed search, supplemented by a Google Scholar screening, was conducted to identify studies on KD in adolescents published between 2000 and 2024. Nine studies were included in the synthesis, along with one national surveillance study. This scoping review was conducted in accordance with the PRISMA-Scr guidelines. Results: Adolescents with KD often do not meet full diagnostic criteria, leading to delays or missed diagnoses. Presentations frequently involve symptoms that mimic those of mucocutaneous, gastrointestinal, musculoskeletal, and neurological conditions. These delays are linked with higher rates of coronary artery abnormalities compared with younger children. Intravenous immunoglobulin (IVIG) remains the primary treatment, though resistance occurs more frequently in this group. Beyond the acute illness, adolescent KD impacts school participation, physical activity, and independence, underscoring the importance of addressing developmental and psychosocial outcomes. Conclusions: While KD is primarily a disease of younger children, adolescent cases require greater clinical awareness, prompt intervention, and developmentally informed follow-up to reduce complications and support effective transition to adult care. Full article

Truth-telling, a community intervention to increase reconciliation after systemic injustices, has been employed recently to increase public awareness of harms perpetuated by the child welfare industry in the U.S. Guided by participatory action research principles, we examined a public truth telling initiative over two years which was co-designed by a trans-experiential team of emerging adults with lived expertise and child welfare system professionals in Kentucky. The aims of the truth-telling events were to raise awareness about the experiences of Black American youth in the Kentucky child welfare system and generate ideas for improvements. We conducted a longitudinal collaborative autoethnography (n = 9, 2 time points) to examine our collective experience of developing and hosting the truth-telling circles and supporting activities. Key themes included the transformative impact on the alumni of receiving validation and acknowledgement, as well as forming social and professional connections. Some concerns related to timing of activities and group dynamics also were reported. In addition, the four lived expert truth-tellers engaged in a systematic consensus workgroup process to select a list of 10 priority practice and policy recommendations, such as child welfare system alumni being hired to provide emotion regulation and self-advocacy skills training directly to youth. Full article