Adolescents

Child and adolescent mental health (CAMH) is a global concern that is increasingly recognized and prioritized. Worldwide, mental health conditions affect a significant number of children and adolescents; however, access to CAMH services remains limited. This study sought to explore the implementation of child and adolescent mental health services in the rural Chris Hani District of the Eastern Cape province, South Africa, from the perspectives of health professionals and teachers, focusing on strengths, weaknesses, opportunities, and threats. Using a qualitative approach, a sample of 36 participants (12 health professionals and 24 teachers) was purposively recruited. Data were collected through face-to-face, semi-structured individual interviews and focus group discussions. Thematic analysis identified several strengths, including effective screening and identification of CAMH problems, training in psychiatry and psychology, teacher support, collaboration with stakeholders, and the availability of policy and guidelines. Key weaknesses included inadequate CAMH training, a limited CAMH workforce, personal barriers, guidelines primarily oriented toward physical health, and insufficient basic infrastructure. Opportunities for improvement include enhancing the skills of the existing workforce, increasing engagement in extramural activities, and empowering parents with knowledge of available CAMH services. Identified threats included the normalization of CAMH symptoms, challenges involving parents and feeder schools, stigma, poor stakeholder collaboration, and inadequate guidelines. Overall, the analysis of strengths, weaknesses, opportunities, and threats reflects the broader challenges present in low-resource settings that hinder the implementation of CAMH services. It also highlights the need for integrative approaches to implementing CAMH services in rural contexts, while identifying opportunities to improve service delivery. Full article

This pilot clinical trial evaluated the feasibility and changes following the BeBuddies, which is a school-based program designed to promote mental health Literacy (MHL) among adolescents, based on MHL being a key protective factor for well-being in adolescence. Twenty-eight adolescents (57% girls; Mage = 16.46) were randomly assigned to either an intervention (n = 14) or a control group (n = 14). Participants were asked both qualitatively and quantitatively about their perception of acceptability, usability and satisfaction regarding each intervention session; they were also asked to fill in self-report questionnaires at pre-intervention, post-intervention, and follow-up. Program satisfaction and acceptability were consistently high, highlighting its potential to bind participants due to its experiential and dynamic nature. About changes over time, preliminary findings suggest that the BeBuddies yielded improvements primarily in symptom recognition and problem-solving, with more favorable change patterns in the intervention group. A slight reduction in stigma was also observed in the intervention group, in contrast with a small increase in the control group. These results are consistent with the existing literature and point to the feasibility and potential benefits of structured, school-based interventions focused on promoting MHL programs in adolescence. Full article

The present study investigated the relationship between resilience, self-esteem, and academic performance in primary school students. The sample comprised 124 pupils (59 males and 65 females) enrolled in the 5th and 6th grades. Psychometric assessment was conducted using the Resilience Scale and the Rosenberg Self-Esteem Scale, while academic achievement was evaluated based on students’ grades in Language, Mathematics, Science, English, and Physical Education. Data analysis was performed using ANOVAs and Pearson correlation coefficients. The results indicated that higher academic performance was positively correlated with both increased resilience and self-esteem. Furthermore, a strong positive correlation was observed between self-esteem and resilience. Regarding gender, no significant differences were found in resilience or self-esteem levels. However, academic performance variations were identified exclusively in English language proficiency; specifically, for male students, higher performance in English was significantly associated with greater resilience. In conclusion, these findings suggest that integrating self-esteem and resilience-building activities into the educational curriculum is essential. Such interventions may enhance students’ capacity to manage adversity and facilitate the attainment of their academic goals. Full article

Excessive internet use among adolescents is a growing public health concern, yet data from Cyprus are scarce. This cross-sectional study used parent reports for 248 adolescents (12–17 years; 54.4% boys) to describe problematic internet use and examine associations with emotional–behavioral difficulties and family functioning. Based on published Parent–Child Internet Addiction Test (PCIAT) cut-offs, used descriptively rather than as clinically validated Cypriot thresholds, 74.2% of adolescents in this parent-reported convenience sample fell within the broader problematic internet use range. This sample-specific proportion comprised 38.3% in the mild, 33.9% in the moderate, and 2.0% in the severe PCIAT category. Adolescents using the internet >3 h/day (n = 112) had significantly higher PCIAT scores than those using it <3 h/day (n = 136; U = 3100.00, Z = −4.72, p < 0.001). PCIAT scores correlated with conduct problems (r = 0.449), hyperactivity/inattention (r = 0.441), and total difficulties (r = 0.475), and inversely with prosocial behavior (r = −0.471; p < 0.001). Family functioning worsened across PCIAT severity categories (GF-12 means: 18.83 in the PCIAT 20–30 range vs. 29.00 in the severe range; H(3) = 28.30, p < 0.001). In multivariable regression, daily use (B = 8.02), poorer family functioning (B = 0.42), conduct problems (B = 5.28), and hyperactivity/inattention (B = 6.81) independently predicted higher PCIAT scores (R² = 0.24), whereas emotional symptoms were not significant (p = 0.637). Findings from this convenience sample highlight the potential importance of prevention efforts targeting screen-time regulation and family relationships; longitudinal, representative, multi-informant studies are warranted. Full article

Psychological readiness for career choice represents a critical developmental task during adolescence, shaping subsequent educational paths and vocational self-determination. This study investigates the formation of such readiness among grade nine students in a public secondary school in Almaty, Kazakhstan, using an integrated psychological assessment approach. Grounded in Holland’s RIASEC theory and temperament-based perspectives, the study examines how vocational interests, temperament characteristics, and educational decision status interact in early career planning. Data were collected from 185 students during structured school-based diagnostic sessions employing a RIASEC vocational interest inventory, a temperament assessment, and a brief educational decision questionnaire. The findings reveal a differentiated structure of vocational interests, with social and investigative orientations most prevalent. While a majority of students reported preliminary career or educational choices, a substantial proportion remained undecided, indicating heterogeneous levels of psychological readiness. Temperament distributions suggest that emotional regulation plays an important role in translating vocational interests into concrete decisions. Overall, the results support conceptualizing psychological readiness as a multidimensional construct encompassing interest clarity, personality-related regulation, and decision commitment. The study highlights the importance of sustained, psychologically informed career guidance during key educational transitions and offers practical implications for school-based career counseling. Full article

In this quantitative study, we investigated the conditional mediating role of students’ mathematical language self-efficacy in the relationship between self-regulation and mathematics anxiety. The study employed a relational research design and included survey data from 706 middle school students attending public schools in Turkey. Findings indicated that both self-regulation and perceived self-efficacy in mathematical language use were significantly associated with mathematics anxiety. Moreover, the effect of self-regulation on mathematics anxiety was significantly mediated by students’ perceptions of their ability to understand and use mathematical language self-efficacy. The indirect effect was negative while the direct effect was positive, indicating a suppression (competitive mediation) effect, whereby self-regulation exerts both anxiety-reducing and potentially anxiety-inducing influences through different pathways. Conditional mediation analysis further revealed that this mediating effect varied as a function of students’ perceived academic support, with the indirect effect being non-significant for students who did not receive support. Measurement invariance across gender and grade level was examined to ensure that the constructs were measured equivalently across groups. These findings highlight the importance of fostering both self-regulation skills and mathematical language proficiency, particularly in contexts where students may lack sufficient support. These findings provide a theoretically grounded and practically relevant framework for understanding mathematics anxiety within inclusive mathematics education contexts. Full article

Internet Gaming Disorder (IGD) has emerged as an increasingly prevalent behavioral health concern among late adolescent university students, a vulnerable population with emotional distress due to the developmental changes and academic pressures. This research explored the direct correlations between IGD and Mental Health Disorder (MHD), such as depression, anxiety, and stress in Saudi Arabia (SA) with study discipline as a moderator. A total of 480 students participated in the developed self-structured questionnaire, and Partial Least Squares Structural Equation Modeling (PLS-SEM) was employed to analyze the obtained data. The results showed that IGD can exert a positive and significant association with all three aspects of MHD. Moreover, the PLS-SEM slope analysis indicated that study discipline can significantly moderate the link from IGD to both anxiety and depression, with university students in health, science, and engineering fields displaying higher symptoms of depression and anxiety as compared to their peers in humanities and social sciences. However, study discipline failed to moderate the link from IGD to stress. These findings can be interpreted through maladaptive coping mechanisms and behavioral addiction, whereby extreme IG can contribute to social withdrawal, reduce sleep quality, and worsen stress regulation, specifically during the late adolescence period. The results extend current research on IGD by emphasizing the disciplinary differences in mental health vulnerability and offering more empirical evidence from a Middle Eastern context. The study highlighted the urgent need for discipline-oriented mental health screening and targeted proactive interventions to deal with unsettled IG attitude within a higher education context. Full article

Bullying and victimization are prevalent in school and sport settings, yet they are rarely examined concurrently. This study explored the relationships between school and sport bullying among youth athletes, assessing whether demographic and sport-related factors are associated with these behaviors across contexts. Participants included 189 youth athletes (aged 8–15 years) from Central Macedonia, Northern Greece. They completed a demographic survey and the Bullying and Victimization Questionnaire twice, assessing both school and sport environments. A multivariate analysis of variance (MANOVA) evaluated the effects of gender, educational level, sport type, and contact classification, followed by regression analyses. Results showed that educational level yielded a significant multivariate effect, with secondary school students reporting higher involvement in school bullying, sport bullying, and sport victimization. Crucially, regression analyses revealed that school-context bullying and victimization were the strongest factors associated with corresponding behaviors in sports. Additionally, team sport participation was associated with sport victimization, while demographic factors were related to school bullying perpetration. These findings demonstrate the interconnected nature of bullying between school and sport environments, emphasizing the critical need for coordinated, multi-contextual prevention strategies among educators and coaches. Full article

Background: Foster adolescents face elevated socioemotional risk, yet the joint and differential contributions of family adversity, attachment insecurity, and relational trauma to distinct adjustment domains remain poorly understood. The present study aimed to examine their joint, incremental, and differential contribution to emotional regulation difficulties and social competence. Methods: Forty-six adolescents (12–17 years; 63% female) in residential care in Uruguay completed self-report measures of family problems, attachment dimensions (anxiety, avoidance, socioemotional functioning), and relational trauma (SENA, CAA-R, CaMir-R). Hierarchical multiple regression examined their sequential prediction of emotional regulation difficulties and social competence. Results: Emotional regulation difficulties were explained by family problems, avoidant attachment, and relational trauma, whereas social competence was explained by anxious attachment and socioemotional attachment functioning. Final models explained 49% and 47% of variance, respectively. Discussion: This differential predictive pattern aligns with theoretical distinctions between deactivating and hyperactivating attachment strategies. Relational trauma’s specific contribution to regulatory, but not social, functioning supports neurobiologically grounded models of complex trauma. Conclusions: Findings suggest that emotional regulation difficulties were more closely associated with family problems, avoidant attachment, and relational trauma, whereas social competence was more strongly linked to anxious attachment and socioemotional attachment functioning. These results support differentiated, attachment-informed, and trauma-sensitive approaches in residential care settings. Full article

Emerging adults who are students (EAS) face challenges balancing academic demands with early career development in a competitive labour market. Career and vocational interventions (CVIs) aim to support this transition by improving employability, academic outcomes, career self-efficacy, and mental health protective factors. This systematic review assesses the effectiveness of CVIs compared with standard approaches in improving employment-related outcomes for EAS, following Cochrane and PRISMA guidelines. Multiple databases were searched for studies published between 2018 and May 2025. Three independent reviewers screened abstracts and full texts in duplicate. Eligible studies were primary research evaluating CVIs for students aged 12–25 yrs and reporting employment-related outcomes. Thirty-one moderate- to low-quality studies examining middle school, high school, and university students were included from an initial 5765 records. CVIs were typically multi-component, combining training, school- or work-based learning, and additional supports. Overall, CVIs were associated with improved career readiness, academic outcomes, employment, resilience, and career adaptability. However, some studies reported lower employment rates and income for women and students with disabilities compared with men and peers without disabilities. These findings suggest that CVIs can support school-to-work transitions but underscore the need for tailored, integrated approaches, and higher-quality longitudinal research to guide policy and practice. Full article

This study aims to provide insights into how physical activity is associated with sleep patterns in youth populations, in particular, Slovak adolescents, and how gender (boys vs. girls) and age (≤16 vs. ≥18) moderate this relationship, using an extreme-group comparison approach that excludes 17-year-olds to enhance contrast between developmental stages. Using a cross-sectional design, self-reported data were collected from 2504 (100%) high school students (aged 15–19; 45.6% boys, 54.4% girls) using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Pittsburgh Sleep Quality Index (PSQI). Participants aged 17 years were excluded from age-stratified analysis to create clearer separation between early/mid and late adolescence. The primary outcome was global sleep quality (PSQI > 5). Secondary outcomes included sleep duration and PSQI component scores. All other analyses (age- and gender-stratified comparisons and interaction models) were predefined as exploratory and hypothesis-generating to examine potential effect modification. Age-stratified analyses among girls showed that, within the low PA group, good sleep was reported by 37.7% of younger girls (≤16) and 28.6% of older girls (≥18). Among older girls, the proportion reporting good sleep increased to 49.8% in the high PA group (χ² = 29.16, p < 0.001). No consistent associations between PA and sleep quality were observed among boys; however, significant association was identified among younger boys (≤16 years), which was not observed in older boys. Logistic regression revealed a modest interaction between age and PA level in predicting sleep quality among girls (β = 0.346, p = 0.049), suggesting small age-dependent variation in the association. This effect should be interpreted cautiously given its borderline statistical significance. Component-level PSQI analyses showed that girls experienced higher rates of sleep disturbances (χ² = 91.40, p < 0.001), longer sleep latency (χ² = 26.71, p < 0.001), and greater daytime dysfunction (χ² = 79.90, p < 0.001). These findings provide region-specific evidence from Central and Eastern Europe and underscore the need for age- and gender-sensitive public health strategies targeting both physical activity promotion and better sleep outcomes, given their observed associations. Full article

We examined how sociodemographic, parental, and temporal factors are associated with parent-reported reasons for seeking consultation in a child and adolescent psychotherapeutic clinic. Data were derived from a large retrospective sample of more than 3000 cases collected between 2011 and 2023. Multivariable binary logistic regression analyses assessed the independent effects of age, gender, living arrangements, migration background, parental education, parental age at childbirth, parental separation or bereavement, and pandemic-related periods. School-aged children and adolescents were more likely than younger children to present with learning difficulties, depression, anxiety, mobbing and media addiction. Female patients showed lower odds of consultations related to learning difficulties, aggression, behavioral addiction, attention deficit/hyperactivity, but higher odds of depression, psychosomatic symptoms, anxiety, eating disorders and sleeping disorders. Parental separation increased the likelihood of consultations related to problematic social behavior within the family, delinquency and trauma and grief. Consultations for attention deficit/hyperactivity concerns were more frequent in the post-pandemic period compared to pre-pandemic. The findings highlight that sociodemographic, familial, and temporal factors are systematically associated with distinct patterns of parent-reported help-seeking patterns in child and adolescent psychotherapeutic care. Full article

Introduction: Increasing rates of youth suicide are a growing concern worldwide. The single highest risk factor for suicide is a prior suicide attempt; however, knowledge around the broader factors that may increase the likelihood of the initial suicide attempt is limited. Understanding these risk factors is critical for clinicians to inform the development of early intervention strategies. This study examines the characteristics of a specific cohort of young people attending a tertiary mental health service in Melbourne, Victoria, following a suicide attempt or with persistent suicidal ideation. Method: A file audit of all young people attending the service was conducted from the commencement of the new service in 2022 through to the end of 2024. One hundred and seventy-one files were examined for specific data, including items such as age, gender, gender diversity, socio-economic factors and neurodivergence. Results: One-sample z proportion tests showed significantly higher proportions of young people who were LGBTIQIA+, transgender, gender diverse or non-binary (TGDNB), neurodivergent, not engaged in employment, education or training (NEET), and international students in the clinical cohort compared with the Australian population. Almost one-fifth of the cohort reported a history of trauma. Discussion: The study provides insight into characteristics observed among a cohort of suicidal young people. Findings highlight that young people from several marginalised groups were more frequently observed in this clinical cohort. The findings have implications for youth mental health services, supporting earlier identification of potential factors associated with suicidality so that prevention strategies can be implemented in a timely manner. Full article

Although sexuality education is delivered in schools, Chinese adolescents’ preferred sources may still be inconsistent with where they currently receive sex education. Based on two theories (Objectivism and Sex-Positivity) that emphasize the use of information and rational choice in seeking information with a desire to learn more, this explanatory study analyses survey data on sexual health topics, the sources Chinese adolescents used and preferred, and the gender differences in how they seek information on sexual topics. From 17 secondary schools, Chinese adolescents in Hong Kong, aged 14–18 (n = 4869), took a 51-question survey on sexual risks and sex education sources conducted by a local agency. Using the secondary dataset, a discrepancy score was computed by matching 15 actually used and 15 preferred sources for getting sexual knowledge listed in the survey. The discrepancy scores were shifted along the X-axis to eliminate negative values and create the dependent variable, ‘Discrepancy-S’, which ranged from 1 to 11, where 1 = no discrepancy, and 11 = wide discrepancy (Cronbach Alpha = 0.750). The higher the score, the higher the discrepancy. Regression results indicated that the youth’s prior coitus and different information sources (except school) could explain the “use–prefer” discrepancy. Although these adolescents regarded parents as the primary sex educators, most did not consult with their families. They preferred electronic media and peers as their top “go-to” choices. Sex education should come from sources that teenagers rely on and choose to access. Personal responsibility must be explicitly discussed in various sexual health sources as teens prepare for transitions to adulthood. Full article

Scientific evidence shows that perception of adolescents’ psychological adjustment in residential care varies depending on the informant. This study examined discrepancies between adolescents’ self-reports and caregiver reports of psychological adjustment in 46 residential care institutions across Portugal. Data were collected from a sample of 511 adolescents (aged 12–24) and their institutional caregivers using the Strengths and Difficulties Questionnaire and the Socially Desirable Response Set-5. Descriptive statistics and paired-samples t-tests were conducted to compare mean scores between informants. Intraclass correlation coefficients and Cohen’s Kappa were calculated to assess agreement. Results revealed significant differences across all subscales and the total difficulties score, with adolescents consistently reporting more emotional, behavioral, and peer-related problems than caregivers, regardless of sex or age. Agreement ranged from poor to moderate, with the lowest concordance for internalizing symptoms. These discrepancies underscore the role of developmental factors in shaping self- and caregiver perceptions and highlight the importance of multi-informant, developmentally sensitive assessments in residential care. Practical implications include incorporating adolescents’ perspectives into evaluation and intervention, enhancing caregiver training to recognize internalizing issues, and implementing age- and gender-tailored mental health programs. Full article

Social identity approaches suggest that people favour ingroup members, yet ingroup favouritism does not necessarily translate into outgroup derogation. Using a sample of Croatian majority-group youth from a nationally and religiously homogeneous pre-COVID context, we examined whether personal values moderate the relationship between national identification and attitudes towards minorities. We conducted a latent profile analysis (LPA) on higher-order values among young Croatian Catholics who did not belong to minority groups (N = 994) and identified five value profiles that varied primarily in the prioritisation of openness to change versus conservation. Profiles differed in minority attitudes and national identification. Crucially, the association between national identification and minority attitudes varied across profiles: it was unrelated in the profile prioritising openness over conservation, whereas in the remaining profiles it tended to be negative and was most consistently negative in the profile prioritising conservation over openness. Taken together, the findings highlight the role of values in the relationship between group identification and attitudes towards outgroups, confirming their relevance for social cohesion and potential for the development of deradicalisation interventions. Full article

Background: Interpersonal emotion regulation (iER) is the process of managing others’ emotions and is critical during early adolescence, when social awareness and peer dependence increase. Little is known about how sex and gender role orientation shape adolescents’ iER. This study examined whether early adolescents differ in their use of person-focused (acceptance) versus problem-focused (positive engagement) strategies and whether these differences depend on context and measurement method. Methods: Data were collected from 322 adolescents (141 girls, 181 boys; aged 10–14 years, M = 12.47, SD = 1.55). The cross-sectional online study used a multi-method design comprising open-ended visual vignettes, a standardised questionnaire, and a serious game task. Participants also completed a validated gender-role self-concept measure assessing femininity and masculinity. Analyses were conducted using Poisson and logistic regressions with sex, femininity, and masculinity as predictors. Results: Across tasks, adolescents preferred problem-focused over person-focused strategies. Girls and those higher in femininity reported or generated more acceptance-based strategies, whereas boys and those higher in masculinity favoured positive engagement. These effects were evident in reflective measures (vignettes and questionnaire) but not in the interactive game, where sex and gender differences were absent. Conclusions: Findings suggest that gendered socialisation processes shape how adolescents regulate others’ emotions, particularly when behaviour is consciously reported. However, in ecologically valid contexts, these differences diminish, indicating shared capacities for adaptive interpersonal regulation across genders. Full article

Background: Self-awareness is a core psychosocial competence supporting emotional regulation, adaptive coping, and psychological well-being during late adolescence and emerging adulthood—a developmental period marked by identity exploration and heightened vulnerability to stress. Life skills education programs, such as UNICEF’s Basic Life Skills Training Program (BLSTP), aim to strengthen these competencies; however, empirical evidence on the effectiveness of structured self-awareness interventions remains limited in low- and middle-income countries, leaving a significant gap in culturally grounded preventive research. Methods: A randomized controlled trial was conducted with 60 Pakistani university students aged 18–24 years, randomly assigned to an experimental group or a waitlist control group. The experimental group received the self-awareness module of the BLSTP, targeting self-esteem, stress management, emotional regulation, and positive thinking through structured group sessions. Standardized self-report measures were administered at pre-test, post-test, and follow-up. Data were analyzed using repeated-measures ANOVA. Results: Compared to the control group, participants in the experimental group showed significant improvements across all self-awareness subdomains, with large effect sizes (partial η² = 0.46–0.84). Gains were maintained at follow-up, indicating sustained intervention effects. Conclusions: The BLSTP self-awareness module appears to be an effective and culturally appropriate preventive intervention for enhancing key psychosocial competencies in late adolescents and emerging adults. Full article

Firearm homicide is a leading cause of death among children and adolescents. This study examined variability in the correlates of firearm homicide across child and adolescent firearm homicide victims. U.S. firearm homicide victims comprising three developmental groups were identified in the National Violent Death Reporting System (2003–2021): infant and early child victims aged 0–5 years (N = 3992); middle and late child victims aged 6–12 years (N = 996); and adolescent victims aged 13–19 years (N = 8350). Descriptive statistics and multivariate regression analysis demonstrated strong support for the study hypotheses. First, firearm homicide victimization peaked among young children (0–5) and adolescents (13–19). Second, older victims were disproportionately male and overwhelmingly had male perpetrators. Third, younger victims were more likely to be killed by their caregivers, family members, and in the home. Finally, situational characteristics were more relevant for adolescent victims. The results suggest that the correlates of child and adolescent firearm homicide are developmentally patterned and reflect age-graded differences in familial reliance, autonomy, and social involvement. Full article