Adolescents doi: 10.3390/adolescents6050085

Authors: Maria Anna Donati Sofia Santisi Laura Di Leonardo Emilia Serra Marta Vecchiato Valentina Veronese Caterina Primi

Background: Self-control is crucial for promoting long-term goal-directed behaviors and avoiding involvement in risky behaviors. The Brief Self-Control Scale (BSCS) is one of the most used tools. As poor attention has been paid to its psychometric properties among adolescents, we aimed to investigate them in youth. Methods: In Study 1 (n = 504, 61% male; Mage = 15.67) we tested different BSCS versions. In Study 2 (n = 795, 53% male; Mage = 16.39), we tested the best-fitting solutions resulting from Study 1. We analyzed invariance across sex and age groups (middle and late adolescents), reliability and validity. Results: The 7-item two-dimensional (Impulse Control and Self-Discipline) solution proved to be the only one confirmed with an independent sample of adolescents and was invariant across sex and age groups. Internal consistency was questionable for the Impulse Control subscale and adequate for the Self-Discipline subscale. The subscale scores were negatively related to risk factors for addictive behaviors and problematic use of video games. Self-Discipline was related to problematic video gaming over and beyond the effects of other risk factors. Conclusions: The 7-item bidimensional BSCS is useful to measure self-control in Italian adolescents.

Adolescents doi: 10.3390/adolescents6050084

Authors: Feifei Shi Miao Jiang Jianguo Ding Huansheng Ning

Cyber-Syndrome denotes the physical, social, and thinking disorders arising from problematic cyberspace interactions, with its thinking dimension encompassing cognitive deficits (e.g., attentional impairment, executive dysfunction) and affective disturbances (e.g., mood disorders, emotional dysregulation). Conventional assessment approaches, relying primarily on self-report questionnaires and laboratory-based tasks, are unable to capture the rapid, context-dependent fluctuations of mental states in real-world digital environments. Leveraging advances in computational psychiatry, affective computing, and machine learning, this paper presents a scoping review that maps, rather than validates, the computational approaches available for inferring the cognitive and affective states of Cyber-Syndrome from digital behavior. Because the construct still lacks established diagnostic instruments, the review is positioned as an assembly of the evidence base that its future operationalization will require rather than as a validation of it. It situates Cyber-Syndrome within the Cyber–Physical–Social–Thinking (CPST) space framework, reviews the principal data sources, and covers the computational methods used to analyze them. It then synthesizes evidence from adolescent studies and examines the research institutions and open-source platforms that have driven methodological progress in the field. Finally, it discusses key challenges and outlines future directions essential for clinical translation and real-world deployment, particularly in adolescent mental health.

Adolescents doi: 10.3390/adolescents6050083

Authors: Julianna F. King Madeleine K. Mastin Sophia M. Huber Bailey K. Ortyl Kyle A. Kercher Vanessa M. Kercher

This study explored how rural youth cluster into physical activity (PA) profiles and whether psychological characteristics differ across these clusters. The primary objective was to identify PA-based profiles, and the secondary objective was to examine the differences in basic psychological needs across profiles. A 1-year exploratory prospective cohort study was conducted with 83 6th–8th grade students from an under-resourced rural middle school, with 48 participants having complete PA data for analyses. The sport-based PA intervention was implemented by college students in an undergraduate service-learning course. PA was assessed using Axivity AX3 accelerometers, and included light, moderate, vigorous, and total PA minutes/week. Psychological measures included the Basic Psychological Needs Satisfaction and Frustration. K-means cluster analysis identified PA profiles based on light, moderate, and vigorous PA levels (minutes/week). Analysis of variance (ANOVA) and Linear Mixed Models assessed profile differences based on (a) needs satisfaction, (b) needs frustration, (c) autonomy, (d) competence, (e) relatedness. Three PA profiles emerged: a low activity (n = 21), medium activity (n = 22), and high activity cluster (n = 5). These clusters differed significantly in PA levels (p < 0.001). Need satisfaction and frustration did not significantly differ across PA profiles; however, relatedness frustration differed significantly across timepoints (p = 0.036) and needs satisfaction showed descriptive trends across PA profiles. These findings demonstrate heterogeneity in PA engagement among rural youth and provide preliminary descriptive evidence of psychological patterns across these emerging PA profiles. Such differences may generate hypotheses for future research examining whether PA and psychological characteristics can meaningfully inform intervention tailoring.

Adolescents doi: 10.3390/adolescents6050082

Authors: Priscila-María Caballero-Rodríguez Héctor González-de la Torre Milagros de la Rosa-Hormiga Candelaria de la Merced Díaz-González Sergio Mies-Padilla Claudio-Alberto Rodríguez-Suárez

Energy drink consumption has increased among children and adolescents, raising concerns about its health effects and the factors that shape it. This review synthesised qualitative evidence on the experiences, perceptions and meanings that children and adolescents attribute to energy drink consumption. A qualitative metasynthesis was conducted following a systematic search of MEDLINE, Web of Science, Scopus, and CINAHL. Methodological quality was appraised with the Joanna Briggs Institute checklist, and confidence in the findings with GRADE-CERQual. Nine studies involving 637 participants aged 10–18 years were included. The synthesis generated eight descriptive themes and four analytical themes, concerning product appeal, the normalisation of consumption within social and environmental contexts, the negotiation of perceived benefits against health risks, and prevention. Marketing, brand recognition and easy retail access were consistently described as increasing product desirability. Although participants recognised adverse effects such as sleep disturbance and palpitations, these risks were commonly regarded as unlikely or manageable and outweighed by anticipated benefits. Confidence was high for three of the four review findings and moderate for the fourth, which was supported by fewer studies. An emergent interpretative conceptual framework highlighted the multidimensional nature of energy drink consumption and supported consideration of multilevel prevention combining educational, social, environmental, and regulatory approaches.

Adolescents doi: 10.3390/adolescents6050081

Authors: Nihaya Al-Sheyab Mohammad Sharif Alyahya Khulood Kayed Shattnawi Tariq N. Al-Dwaikat Heyam Al-Shhab Dima AlSharman

Adolescent girls may experience emotional distress within intersecting academic, familial, and social contexts, while anticipated judgment, concerns about confidentiality, and uncertainty about whom to trust may constrain disclosure and help-seeking. This study explored how Jordanian and Syrian adolescent girls understand emotional distress, negotiate disclosure and support, and evaluate the anticipated acceptability of digital mental health support. An exploratory qualitative design was used. Nine focus group discussions (FGDs) were conducted in Arabic with 39 girls aged 15–19 years who were purposively recruited through health, psychosocial, humanitarian, and community-service networks in Jordan. Each FGD included four to five participants. Data were analyzed using reflexive thematic analysis across the full dataset while retaining FGD and participant-group context. Three interrelated themes were developed: (1) distress under academic, familial, and social evaluation; (2) disclosure as calibrated risk management; and (3) anticipated digital support depends on demonstrable trustworthiness and retained control. Participants described disclosure as selective and shaped by the sensitivity of the concern, anticipated judgment, previous interpersonal experiences, confidentiality, and perceived control. Participants considered digital support more acceptable when it offered privacy, professional credibility, institutional legitimacy and accountability, and user control over the pace and extent of disclosure. We conceptualized trust as comprising interpersonal, professional, and institutional/platform dimensions, with privacy and control over disclosure operating as trust-enabling conditions. These findings describe anticipated acceptability rather than actual service uptake or effectiveness and identify empirically informed priorities for the co-design and evaluation of digital mental health services for adolescent girls.

Adolescents doi: 10.3390/adolescents6050080

Authors: Slavka Demuthova Andrej Demuth

Self-harm and depressive symptoms are important mental health concerns during adolescence, yet the factors shaping their association remain insufficiently understood. This exploratory cross-sectional study examined the association between depressive symptoms and self-harming behavior and tested whether age and gender moderated this relationship. A total of 1116 Slovak adolescents aged 11–19 years completed the Self-Harm Inventory and Children’s Depression Inventory. Spearman’s correlation, Mann–Whitney U test, linear regression, and moderation analyses using PROCESS were conducted. Depressive symptoms were moderately positively associated with self-harming behavior (ρ = 0.526, p < 0.001). Adolescents reporting repeated self-harm had significantly higher depressive symptom levels than the reference group, with a moderate-to-large group difference (r = 0.45). Depressive symptoms explained 32.3% of the variance in self-harm scores. Gender significantly moderated this association in the primary analysis, with stronger associations among women than men; however, the interaction explained only an additional 0.7% of variance (ΔR2 = 0.007). Age did not significantly moderate the association. These findings indicate that depressive symptoms are an important correlate of adolescent self-harm, while the modestly stronger association observed among women suggests that gender may add nuance to this relationship, although this difference was not consistently observed across sensitivity analyses.

Adolescents doi: 10.3390/adolescents6050079

Authors: Rapson Gomez Daniel Zarate Kaiden Hein Vasileios Stavropoulos

Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms show substantial developmental heterogeneity, yet less is known about how co-occurring psychopathology is associated with membership in different longitudinal symptom trajectories. This study examined developmental trajectories of parent-reported ADHD symptoms across seven annual assessment waves from late childhood through adolescence using data from the Adolescent Brain Cognitive Development (ABCD) Study. ADHD symptoms were assessed using the Child Behavior Checklist DSM-5-Oriented ADHD Problems scale and therefore represent dimensional symptom scores rather than clinical ADHD diagnoses. Growth mixture modelling was conducted in an analytic sample of 9718 participants and identified three trajectory classes: low/stable (79.87%), high/stable (10.77%), and remitting (9.36%). Baseline associations with class membership were subsequently examined using the R3STEP procedure in 9716 participants, preserving the identified class structure while accounting for classification uncertainty. Relative to the low/stable class, male sex and higher baseline affective, anxiety, conduct, and oppositional defiant problem scores were associated with greater odds of membership in both the remitting and high/stable classes, whereas age and somatic problems showed no clear associations. Comparisons between the remitting and high/stable classes were largely similar, although male sex was associated with greater odds of remitting-class membership. Overall, the findings demonstrate substantial heterogeneity in the developmental course of ADHD symptoms and suggest that baseline co-occurring psychopathology is associated primarily with differentiation between lower- and higher-symptom trajectories rather than clearly distinguishing persistent from remitting elevated-symptom pathways.

Adolescents doi: 10.3390/adolescents6050078

Authors: Neylan Kaya Aslıhan Ersoy Bozcuk Güray Tonguç Güler Ferhan Ünal Uyar

This study examined the indirect role of psychological resilience in the association between hope and life satisfaction among university students. University years involve substantial academic, social, and psychological change; therefore, identifying resources that support well-being during the transition to emerging adulthood is important. The sample comprised 500 undergraduate students from the Faculty of Economics and Administrative Sciences at Akdeniz University, selected through convenience sampling. Data were collected through face-to-face questionnaires. Hypotheses were tested with hierarchical regression, and indirect associations were examined using bootstrap analysis with 5000 resamples and 95% confidence intervals. Hope, psychological resilience, and life satisfaction were positively and significantly associated. Psychological resilience showed a significant indirect association between hope and life satisfaction, while the direct association remained significant. An alternative model with hope as the mediator also yielded a significant indirect association, indicating that temporal ordering cannot be established from these cross-sectional data. Additional analyses found no significant Hope × Psychological Resilience moderation effect. Overall, the findings highlight the interrelated roles of hope and psychological resilience in university students’ life satisfaction and underscore the need for longitudinal research to clarify their temporal relationships.

Adolescents doi: 10.3390/adolescents6050077

Authors: Paola Bully Joana Jaureguizar Elena Bernaras

Background: During adolescence, depression is a major concern due to its high prevalence and long-term impact on well-being. Effective intervention requires accurate assessment through culturally and linguistically adapted instruments with strong psychometric properties. Aims: This study aims to adapt and evaluate the metric properties of the Beck Depression Inventory (BDI-II) in the Moroccan context and to conduct a preliminary comparison of depressive symptomatology between the participating Spanish and Moroccan school samples, by gender and age. Method: A total of 1141 students (514 from Spain and 627 from Morocco), aged 14–19 years, completed the modified 19-item version of the BDI-II and the BASC-S3 questionnaires. Results: The Spanish and Moroccan modified 19-item versions of the BDI-II demonstrated adequate metric properties and gender- and age-invariance, both within and between countries. Intra-country comparisons revealed significant gender differences in both Spain and Morocco samples, with female adolescents reporting higher levels of depressive symptoms than their male counterparts. No differences were observed according to age. The cross-country comparison revealed a large difference in latent depression levels between the Spanish and Moroccan samples included in this study. Conclusions: This modified version of the BDI-II may provide a useful tool for assessing depressive symptoms in the Moroccan and Spanish school populations sampled in this study. The findings also highlight the importance of considering cultural and contextual factors when interpreting depressive symptomatology.

Adolescents doi: 10.3390/adolescents6050076

Authors: Alberto Horno Cristian Céspedes-Carreño Andrés Rubio Damarys Roy Sergio Fuentealba-Urra Fernanda Cancino-Norambuena Juan Carlos Oyanedel

This study examined the relative contribution of structural vulnerability and individual psychological resources in explaining subjective well-being among Chilean adolescents. From an ecological perspective, it assessed whether resilience and perseverance, or grit, mediate the relationship between school vulnerability and subjective well-being. A cross-sectional, non-experimental correlational design was used with a sample of 3774 secondary school students in Chile. Subjective well-being, resilience, and perseverance were measured using self-report instruments, whereas school vulnerability was operationalized through the School Vulnerability Index (SVI). Results indicated that school vulnerability was negatively associated with subjective well-being, although with a small effect size. In contrast, resilience and perseverance showed stronger positive associations, with resilience emerging as the strongest predictor in multivariate models. Hierarchical regression analyses showed that SVI and age explained only a small proportion of variance in well-being, whereas adding resilience and perseverance substantially increased explained variance. Bootstrapped mediation analyses indicated significant but small indirect effects, suggesting partial mediation. Resilience accounted for the largest indirect effect. Overall, findings suggest that adolescent subjective well-being is more strongly explained by psychological resources than structural vulnerability alone. These results challenge deterministic interpretations of school vulnerability and highlight the importance of strengthening socioemotional competencies in educational settings.

Adolescents doi: 10.3390/adolescents6050075

Authors: Esther Rodríguez-Jiménez Javier Martín-Ávila Selene Valero-Moreno Marián Pérez-Marín

Adolescence is marked by significant emotional changes, which may be intensified by the presence of a rare respiratory disease. The purpose of this study was to explore the psychological outcomes and challenges associated with these conditions during adolescence. Following the PRISMA guidelines, a systematic review was conducted in Web of Science, ProQuest and Scopus databases, identifying 677 articles. Following screening, 18 studies met the inclusion criteria and three additional eligible studies were identified through manual snowball searching, resulting in 21 studies included in the final synthesis. Most studies focused on symptoms of anxiety and depression as key psychological variables. Some also assessed health-related quality of life, psychological comorbidities, treatment adherence, disease knowledge and perceived self-efficacy. Most studies focused on adolescents with cystic fibrosis, whereas evidence concerning primary ciliary dyskinesia was considerably more limited (20 studies included participants with cystic fibrosis and 3 with primary ciliary dyskinesia; 1 study included both conditions). Findings regarding anxiety, depressive symptoms, and health-related quality of life were heterogeneous across studies. Despite the adequate methodological quality of these studies in general, the findings highlight inconsistent conclusions in the literature, with no clear consensus on the extent or nature of the psychological impact. There is a clear need for further high-quality research to better understand the psychological difficulties and consequences associated with rare respiratory diseases during adolescence. Regular psychological assessment may be considered part of multidisciplinary care to identify psychological difficulties and support the well-being of adolescents with CF and PCD. The main limitations were the heterogeneity of study populations and methodologies, the predominance of cross-sectional designs, and the restriction of the search to three databases.

Adolescents doi: 10.3390/adolescents6050074

Authors: Satyajit Kundu Mujibul Anam Jhantu Bakchi Azaz Bin Sharif Faruk Ahmed

In Bangladesh, adolescent girls face multiple challenges that negatively influence diet quality. Understanding the determinants of their diet quality is essential for informing effective nutrition interventions. This rapid review synthesised evidence on determinants of diet quality among Bangladeshi adolescent girls using the Socio-Ecological Model (SEM). We searched MEDLINE (Ovid), CINAHL Complete and Web of Science. Eligible studies examined determinants of diet quality-related indicators, such as dietary diversity, nutrient intake, or food choices among adolescent girls in Bangladesh. Fifteen studies met the inclusion criteria. We conducted a narrative synthesis. The studies reported the determinants across five SEM levels. At the individual level, adolescent girls’ diet quality was associated with their taste preferences, perceived body image, knowledge of nutrition and health, self-efficacy, food choice motives, dieting concerns, and misconceptions during menstruation. At the interpersonal level, family decision-making dynamics, gender-biased food allocation, household wealth and food security status, expenditure on food, low parental education, family and peer influence, and women’s empowerment were associated with diet quality. At the organisational level, lack of dedicated lunchrooms, availability of unhealthy food near schools, nutrition education by community organisations, and advice from healthcare providers were associated with diet quality. Community-level determinants included cultural norms, rural-urban disparities, and geographic variations. At the policy/macro level, food prices and seasonal food availability emerged as critical determinants. Diet quality among adolescent girls in Bangladesh is shaped by complex multi-level factors spanning individual to policy-level factors. These insights can guide context-appropriate interventions to improve diet quality in this population.

Adolescents doi: 10.3390/adolescents6050073

Authors: Aleksandria Perez Grabow Atika Khurana

Family conflict is a relational process that may shape adolescent aggression through disruptions to emotional security, reinforcement of coercive interactions, and the development of aggressive scripts and beliefs. Because adolescents are also exposed to violence in community and media contexts, these broader ecological experiences may independently contribute to aggression or alter the influence of family conflict. We analyzed two waves of data collected six months apart from 345 U.S. middle school students and examined whether exposure to family conflict was associated with an increase in adolescent aggression, and whether this association was stronger than effects of community and media violence exposure. We also examined interactive effects to test if violence exposure in community and media contexts operates independently or interacts with family conflict to alter its effect on adolescent aggression. Family conflict and community violence exposure independently predicted later aggression after accounting for baseline aggression. Family conflict made the largest relative contribution among the three contextual predictors. A significant interaction between family conflict and media violence exposure indicated that family conflict was associated with later aggression at low, but not high, levels of media violence exposure; no other interactions were significant. These findings position family conflict as a particularly salient relational context for adolescent aggression while showing that its influence may depend on violence exposure in other social contexts. Prevention efforts should prioritize reducing hostile and coercive family interactions while attending to media and other social contexts that may reinforce, normalize, or otherwise alter family conflict effects on adolescent aggression.

Adolescents doi: 10.3390/adolescents6050072

Authors: Sangmi Kim Seon-Kyeong Ahn Jeoung Min Lee Courtney Cronley Julie Cerel Ick-Joong Chung

Background: Cyberbullying victimization is associated with recent poor mental health among adolescents, but the roles of digital and offline contextual indicators require careful interpretation. Objective: Guided primarily by Stress Process Theory and secondarily by bounded routine activity concepts, this study examined cross-sectional associations among traditional school bullying, cyberbullying, social media use, physical activity frequency, and recent poor mental health among U.S. high school students. Methods: Complete-case 2023 Youth Risk Behavior Survey data for U.S. high school students (N = 10,295; 49.5% female; 42.7% White, 21.9% Hispanic/Latino, 11.2% Black or African American, and 24.2% all other races) were analyzed in two non-survey-weighted, model-based indirect-association specifications using PROCESS Model 6. Both models adjusted for sex, grade, sexual identity, race/ethnicity, and the alternate bullying indicator. Results: Traditional bullying and cyberbullying were each positively associated with more frequent recent poor mental health after mutual adjustment (β = 0.113 and β = 0.111, respectively). No indirect associations were statistically supported in the traditional bullying model. In the cyberbullying model, the indirect association through social media use was statistically supported but small, and the sequential indirect association through social media use and physical activity frequency was statistically supported but extremely small. Conclusions: Findings support a cautious, cross-sectional interpretation in which bullying victimization is treated as peer-related strain and social media use and physical activity frequency are contextual indicators rather than causal mediators.

Adolescents doi: 10.3390/adolescents6050071

Authors: Fatima Ipeleng Mmusi Ayanda Molema

Adolescence is a developmental stage characterised by identity formation, increasing independence, and a strong need for belonging. For adolescents in foster care, these developmental tasks are often complicated by unresolved trauma arising from abuse, neglect, abandonment, or the loss of primary caregivers. Frequent placement disruptions and difficulty establishing secure attachments with foster parents may further exacerbate emotional distress and risk behaviours. Despite these challenges, little research has examined foster parents’ experiences of caring for adolescents exhibiting risk behaviours. This qualitative study explores foster parents’ perspectives on the challenges they encounter, the coping strategies they employ, and the support systems they utilise while caring for adolescents exhibiting risk behaviours. Face-to-face semi-structured in-depth interviews were conducted in English and Setswana with eight purposively selected foster parents receiving services at the Joe Morolong Local Municipality in the Northern Cape Province, South Africa. Conducting the interviews in the participants’ home languages enhanced rapport and generated richer, more nuanced data. Data collection continued until saturation was reached. The participants described managing a range of behavioural challenges, including truancy, absconding, aggression, defiance, dishonesty, stealing, association with negative peer groups, and refusal to attend to household responsibilities. These behaviours contributed to considerable emotional strain and caregiving stress. Foster parents also reported inadequate professional and psychosocial support, leading to feelings of isolation, being overwhelmed, and burnout. Although compassion and cultural values strengthened resilience, caregiving capacity was constrained by poverty, unemployment, and limited support services. The findings underscore the need for strengthened supervision of foster care placements and sustained professional support, including counselling and caregiver support groups, to enhance foster parents’ well-being, improve coping capacity, and promote stable foster care placements for adolescents.

Adolescents doi: 10.3390/adolescents6050070

Authors: Valeria Giostra Martina Melis Rebecca Raggi Monia Vagni

The aim of this study was to examine the role of active and passive mechanisms of moral disengagement in adolescent difficulties through a new instrument with realistic scenarios: the Attitude to Moral Disengagement Scale (AMDS). A sample of 184 adolescents aged 14–16 years was recruited. All participants also completed the Moral Disengagement Scale (MDS) and the Strengths and Difficulties Questionnaire (SDQ). The AMDS showed satisfactory reliability and convergent validity with the MDS. The AMDS showed positive correlations with risk factors and negative correlations with protective factors of adolescent difficulties. Specifically, conduct problems, peer relationship problems, and hyperactivity/inattention were associated with higher levels of active moral disengagement, whereas prosocial behaviors were linked to lower levels. Conduct problems and emotional symptoms were uniquely linked to passive moral disengagement. The results highlighted how emotional and behavioral difficulties relate to different disengagement strategies, while prosocial behaviors play an important protective role. Practical insights and crucial information for targeted preventive interventions are discussed.

Adolescents doi: 10.3390/adolescents6050069

Authors: Dwi Nur Rachmah Wiwin Hendriani Primatia Yogi Wulandari

Future orientation is a central construct in adolescent development, shaping goal setting, decision-making, and long-term life planning. During the 2021–2025 publication period, research on adolescent future orientation expanded across multiple psychological domains, including psychological well-being, identity development, educational pathways, and COVID-19-related issues. However, the intellectual structure, collaboration patterns, and emerging directions of this research field have not been comprehensively synthesized. This study aimed to examine the global research landscape of adolescent future orientation by identifying publication trends, influential contributors, collaboration networks, thematic structures, and emerging research directions between 2021 and 2025. A bibliometric analysis of Scopus-indexed publications was conducted using Biblioshiny (RStudio) and VOSviewer. The findings indicate that research has increasingly focused on psychological well-being, identity development, educational transitions, and mental health, while COVID-19 emerged as one of several prominent research themes. Research output and international collaboration were predominantly led by authors and institutions from high-income countries, revealing disparities in global scientific contributions. This study provides a comprehensive overview of the evolving research landscape and identifies underexplored areas, including contextual and relational influences, developmental processes, and methodological innovations, offering directions for future research on adolescent development and future orientation.

Adolescents doi: 10.3390/adolescents6050068

Authors: Sitsofe Gbogbo Israel Wuresah Priscilla Klutse Nuworza Kugbey Victor Christian Korley Doku Julie Hennegan Frank E. Baiden Lydia Aziato Fred Newton Binka

Background: Adolescent boys often lack adequate menstrual education, leaving them susceptible to harmful sociocultural influences and reinforcing discriminatory attitudes. The purpose for this study was to explore adolescent boys’ knowledge, sociocultural beliefs, and attitudes toward menstruation. Methods: A descriptive-phenomenological qualitative study was conducted, involving 25 in-depth interviews with adolescent boys enrolled in senior high school (eligibility age range 14–19 years; achieved sample aged 15–19 years) from five districts in Ghana’s Volta Region. Participants were purposively sampled to ensure diverse perspectives. Semi-structured interviews explored knowledge sources, sociocultural influences, and attitudes toward menstruation. Data were analyzed thematically using Braun and Clarke’s six-phase framework with the aid of MAXQDA software. Results: Adolescent boys’ knowledge of menstruation was fragmented, stemming from family, school, and internet sources. Mothers were frequently cited as key informants, but misconceptions about menstruation persisted. Sociocultural and religious beliefs reinforced menstruation-related taboos, such as restrictions on cooking and entering sacred spaces, shaping discriminatory attitudes. Reactions to menstrual leaks varied from empathy to teasing. Conclusions: The findings highlight the need for inclusive menstrual education targeting boys and their families. Educational programs should include biological, emotional, and social aspects of menstruation to help reduce myths and nurture empathy.

Adolescents doi: 10.3390/adolescents6050067

Authors: Teodora Anghel Lavinia Hogea Iuliana Costea Amalia Marinca Raluca Dumache Laura Nussbaum Iuliana-Anamaria Trăilă

Background: Emotional intelligence (EI) is an important component of adolescents’ psychological adjustment and social functioning. Creativity-based experiential approaches may support EI development through active emotional processing, reflection, and interpersonal learning; however, empirical evidence in adolescents remains limited. Methods: This quasi-experimental controlled pretest–posttest study included 47 adolescents who self-selected into an experimental group (n = 24) or control group (n = 23) according to their preference regarding participation in the training program. EI was assessed using the Schutte Self-Report Emotional Intelligence Test (SSEIT). The experimental group completed a 12-week creativity-based experiential programme, while the control group continued usual activities. Results: At post-intervention, the experimental group had significantly higher overall EI (p < 0.001, d = 1.60), AES (p < 0.001, d = 1.34), and ERO (p < 0.001, d = 1.24) scores than the control group. Although post-intervention ERS scores were also higher in the experimental group, a large ERS difference was already present at baseline and the experimental group showed no favorable descriptive change in this dimension. Utilization of emotions in problem solving did not differ significantly between groups (p = 0.090, d = 0.50). Conclusions: Participation in creativity-based experiential training was associated with higher post-intervention overall EI, AES, and ERO scores, but demonstrated limited effectiveness for ERS and UEPS. The small sample and insufficient statistical power, together with the non-randomized design and baseline ERS imbalance, preclude firm or causal conclusions. Larger randomized controlled studies using multimethod assessments and long-term follow-up are needed to establish causality, durability, and the mechanisms underlying these associations.

Adolescents doi: 10.3390/adolescents6050066

Authors: Margarida Gaspar de Matos Marta Raimundo Ana Beito Cátia Branquinho Gina Tomé Marta Reis Tânia Gaspar

The mental health of young people has increasingly emerged as a public health priority due to the growing prevalence of mental health problems during adolescence and early adulthood. The literature has identified community-based programs as effective strategies for promoting well-being and preventing psychological symptomatology. In this context, the present study aimed to evaluate the impact of the interventions provided by junior psychologists working in the Youth Health Offices of the Cuida-te Program of the Portuguese Institute of Sports and Youth (IPDJ) on the quality of life, well-being, and mental health of Portuguese youth through a pre- and post-intervention analysis. A total of 1164 young people, aged between 12 and 29 years old, participated across three editions of the program. Self-report instruments were used to assess the quality of life, the well-being, and the psychological symptoms (stress, depression, and anxiety) of the participants. The results revealed statistically significant improvements between pre- and post-intervention assessments, including increased quality of life and well-being, as well as reduced levels of stress, depression, and anxiety. These findings were observed among both female and male participants and across different age groups. Non-binary participants showed less pronounced results, although with no statistically significant differences identified, suggesting the need for more research with larger samples and for inclusive interventions tailored to the specific needs of sexual and gender minorities. Overall, the work carried out appears to constitute an effective and cost-effective community-based response for the prevention of mental health symptoms and the promotion of mental health in adolescents and young adults, reinforcing the importance of permanent, accessible, and inclusive public policies.

Adolescents doi: 10.3390/adolescents6050065

Authors: Ashlee J. Saxon Edna C. Alfaro Eunjin Seo Yishan Shen

Adverse childhood experiences (ACEs) affect a third of all children in the United States. However, less is understood about how specific aspects of ACEs, such as household dysfunction, influence the behavioral development of children as they enter adolescence and whether collective efficacy can buffer this relationship. This study used longitudinal data from the Adolescent Brain Cognitive Development (ABCD) study (n = 11,868, baseline Mage = 9.9, SDage = 0.6, 52% male; 52% White, 20% Hispanic, 15% Black, 2% Asian, and 11% Other race/ethnicity). Multiple regression analyses suggested that baseline household dysfunction positively predicted externalizing behaviors two and three years later, and that these associations were attenuated by high levels of collective efficacy at the two-year follow-up. These findings suggest the joint roles of household- and neighborhood-level contexts in shaping adolescent behavioral health and indicate that collective efficacy can serve as a promotive and protective resilience factor in the trajectory of externalizing behaviors.

Adolescents doi: 10.3390/adolescents6050064

Authors: Kasetchai Laeheem Punya Tepsing

Promoting morality among youth is an important educational priority in Thailand’s Southern Border Provinces. However, few culturally grounded learning interventions based on the Sufficiency Economy Philosophy have been systematically developed and evaluated. This study aimed to develop and preliminarily evaluate the Digital Learning Innovation for Strengthening Society (DLISS), a culturally grounded learning intervention designed to promote self-reported morality among youth. A four-phase research and development design was employed, including needs assessment, intervention and instrument development, preliminary field implementation, and post-implementation expert appraisal. Self-reported morality was assessed using the Sufficiency Economy Moral Scale (SEMS), which underwent psychometric evaluation with 1640 youth. Preliminary implementation involved 22 youth leaders assessed at pretest, immediate posttest, and post-reinforcement assessment. The SEMS demonstrated satisfactory psychometric properties. Participants showed statistically significant within-participant changes in the five measured dimensions of self-reported morality across the three assessment occasions. Experts rated the DLISS model favorably for its appropriateness, feasibility, utility, and contextual relevance. The DLISS model represents a promising culturally grounded learning intervention for promoting self-reported morality among youth. The findings provide preliminary evidence supporting further evaluation using larger samples and controlled research designs.

Adolescents doi: 10.3390/adolescents6050063

Authors: Rutchadee Binwang Kasetchai Laeheem Punya Tepsing

This qualitative study explored the conditions that shape effective volunteer activity organisation by emerging adult university students (aged 18–25) in a religiously and ethnically diverse Thai setting. The study was conducted at Prince of Songkla University (PSU), Hat Yai Campus, where Buddhist and Muslim students form the two largest religious communities. Data were collected through in-depth interviews and focus group discussions with 30 purposively selected student volunteer leaders and analysed using a hybrid deductive-inductive content analysis approach. Four conditions emerged as foundational: (1) motivational readiness to engage across cultural boundaries; (2) substantive knowledge of cross-cultural communication, both verbal and non-verbal; (3) the capacity to examine and adjust one’s own cultural assumptions; and (4) active, structurally expressed respect for religious and cultural diversity. The findings reveal that family-transmitted stereotypes, knowledge gaps regarding Islamic practice, and the absence of institutional accommodation jointly constrain inclusive participation. Drawing on Cultural Intelligence (CQ) theory and Putnam’s social capital framework, the study advances two arguments: first, that intercultural competence among emerging adult volunteers cannot be reduced to individual skill and disposition; and second, that institutional programme design—schedules, catering arrangements, and physical infrastructure—constitutes an independent determinant of inclusion that CQ frameworks have not yet adequately theorised. The four-condition model offers a structured, trainable framework for volunteer leadership development and extends the literature on civic formation and intercultural learning during the formative years of emerging adulthood.

Adolescents doi: 10.3390/adolescents6040062

Authors: Burak Demirci Tuba Sürücü Alperen Bıkmazer Vahdet Görmez

Objective: Intolerance of uncertainty (IU) is a transdiagnostic cognitive construct associated with anxiety, emotional dysregulation, and psychopathology across multiple clinical conditions. This study aimed to adapt the Intolerance of Uncertainty Index A (IUI-A) into Turkish and evaluate its psychometric properties in a high-risk clinical adolescent sample. Methods: One hundred forty adolescents aged 12–17 years (Mage = 15.71, SD = 1.39; 84.3% female) were recruited from a Child and Adolescent Psychiatry Outpatient Clinic. The sample comprised adolescents presenting with suicidal ideation without a prior attempt (SI; n = 42, 30%) or a history of at least one suicide attempt (SA; n = 98, 70%). The majority met criteria for at least one psychiatric diagnosis, with depressive disorder (77.1%) and anxiety-spectrum conditions most prevalent. Analyses included exploratory and confirmatory factor analysis, internal consistency estimation, and assessments of convergent, discriminant, and known-groups validity. Results: EFA supported a two-factor model (Inhibitory IU and Prospective IU) explaining 61.04% of the variance. CFA indicated partially acceptable fit (χ2/df = 2.48, RMSEA = 0.102, CFI = 0.900, TLI = 0.882, SRMR = 0.054), with RMSEA and TLI falling outside conventional thresholds. Internal consistency was strong (α = 0.933, ω = 0.935). IUI-A scores correlated strongly with the IUS-12, and the SA group scored significantly higher on both IU subscales, with group differences persisting after adjustment for key covariates. Conclusion: The Turkish IUI-A provides preliminary, though methodologically provisional, evidence of validity and reliability for assessing IU in high-risk adolescent populations, with several limitations requiring further investigation.

Adolescents doi: 10.3390/adolescents6040061

Authors: Jana Krivec Tjaša Stepišnik Perdih

Perceived parental acceptance–rejection is associated with adolescent psychological adjustment, but evidence from Central Europe remains limited. Guided by IPARTheory, this cross-sectional study examined associations between perceived maternal and paternal acceptance–rejection and psychological maladjustment among 544 Slovenian secondary-school students (58% girls; M age = 16.5 years). Participants completed the Child Parental Acceptance–Rejection Questionnaire (PARQ) for mothers and fathers and the Adult Personality Assessment Questionnaire (PAQ). Maternal PARQ scores were modestly lower than paternal scores, indicating greater perceived maternal acceptance (Wilcoxon signed-rank test, p < 0.001, r = 0.27). In a regression model adjusted for gender, paternal PARQ (B = 0.161, SE = 0.048, β = 0.183, p < 0.001) and maternal PARQ (B = 0.273, SE = 0.055, β = 0.274, p < 0.001) were independently associated with higher PAQ maladjustment scores; female gender was also associated with higher PAQ scores (B = 15.47, SE = 1.98, β = 0.308, p < 0.001). The model explained 25.1% of PAQ variance. The results were similar after adjustment for programme type and year. Academic achievement was weakly associated with lower perceived parental rejection and lower psychological maladjustment, whereas parental employment status showed no significant associations. Exploratory family-status comparisons and interaction models were nonsignificant. Findings support the cross-cultural relevance of IPARTheory, but causal interpretation is limited by the cross-sectional, single-informant design and the absence of school identifiers.

Adolescents doi: 10.3390/adolescents6040060

Authors: B. J. Rye Aliyah S. d’Gama Rose

This study examined the sexual selfhood of transmasculine adolescents by assessing sexual identity development and sexual self-concept as complementary components of a broader psychosexual construct. Using cross-sectional data from a convenience sample, descriptive analyses indicated moderate levels of sexual identity development and a generally positive, though nuanced, sexual self-concept. Correlational analyses supported the internal coherence of both constructs, and canonical correlation analyses revealed two significant functions linking sexual identity development and sexual self-concept, suggesting an integrated higher-order construct of sexual selfhood. Comparisons with emerging adult and adult samples revealed minimal developmental differences, and no meaningful differences emerged between binary and non-binary youth. Findings suggest that transmasculine adolescents demonstrate developmentally appropriate patterns of sexual selfhood that are largely comparable across age and gender subgroups. The results support conceptualizing sexual selfhood as an integrated, multidimensional construct and underscore the value of examining normative psychosexual processes in trans populations.

Adolescents doi: 10.3390/adolescents6040059

Authors: Álvaro Farfán-Díaz Camila Fuentes-Hinojosa Marcelo Andrade-Oyarzun Exal Garcia-Carrillo Iván Molina-Márquez Rodrigo Yáñez-Sepúlveda Antonio Castillo-Paredes Dario Barrera-González Felipe Montalva-Valenzuela

Creatine monohydrate is well supported as an ergogenic aid in adults, but age-specific evidence in adolescent athletes remains limited. This critical narrative review examined performance, safety, dosing, and responsible-use considerations. PubMed/MEDLINE was the primary source; citation tracking, the Cochrane Library, ClinicalTrials.gov, Google Scholar, and Semantic Scholar were used through 19 June 2026. The core athletic synthesis included 17 primary studies: five Tier 1 studies with direct adolescent samples, eleven Tier 2 age-adjacent or mixed-age studies, and one Tier 4 adult study retained for contextual interpretation. Across soccer, swimming, basketball, rehabilitation, and resistance-training settings, controlled studies reported possible task-specific improvements in selected power, repeated-sprint, jumping, technical, and rehabilitation outcomes, whereas other outcomes were unchanged and some favorable findings were limited to within-group analyses. Short-term controlled studies and a 32-week mixed-age cohort did not identify a consistent clinically important safety signal within the protocols studied; however, safety monitoring was often secondary and the evidence remains underpowered for uncommon or long-term events. Creatine monohydrate should therefore be neither routinely recommended nor categorically prohibited in adolescent athletes. Any consideration represents a precautionary, individualized risk-management approach—not a validated adolescent protocol—and should be food-first, family-involved, professionally supervised, and accompanied by product-quality control and planned reassessment.

Adolescents doi: 10.3390/adolescents6040058

Authors: Tlangelani Noisy Mkhonto Dorah Ursula Ramathuba Tshepo Kabelo Mohale Takalani Ellen Mbedzi

Background: Adolescents in low- and middle-income countries (LMICs) continue to face substantial challenges related to sexual and reproductive health (SRH), including high rates of unintended pregnancy, sexually transmitted infections (STIs), and limited access to accurate reproductive health information and services. Rural provinces of South Africa, such as Limpopo, are no exception, with notably higher pregnancy rates. Aim: This study aimed to explore adolescent girls’ perceptions and experiences associated with school-based comprehensive sexuality education (CSE) programs and their perceived role in pregnancy prevention in Bolobedu, Limpopo province, South Africa. Methods: A qualitative, descriptive, and contextual design was employed. Data were collected through individual interviews and field notes from adolescent girls aged 14–19 years who were accessing contraceptives or had given birth. Content analysis was conducted using Tesch’s method. Findings: Results suggest that the quality and contents of CSE programs varied widely, leading to CSE intervention programs not being successfully implemented, leading to poor uptake and no behavior change. Implications: While research on CES programs shows that the CSE programming varies and can be vital to reducing adolescent pregnancy, its success depends on the quality of the implementation, which leads to behavior change. The research finds that the adoption of Comprehensive Sexual Education in schools and communities is vital to tackling the high incidence of adolescent pregnancy. However, its success depends on the quality of implementation, facilitator training, and resource availability.

Adolescents doi: 10.3390/adolescents6040057

Authors: Elif Sezgin Emine Kılıçaslan Ece Ezer

Objective: This study examined the relationships between father-related attachment and parenting variables and peer bullying among adolescent girls. Secure and insecure attachment styles, paternal caregiving styles, paternal autonomy support, and paternal involvement were investigated in relation to bullying victimization and bullying perpetration. Method: The study employed a correlational design with 200 adolescent girls aged 16–18 years attending vocational high schools in Bursa, Türkiye. Data were collected using the Adult Attachment to Father Scale, the Father Caregiving and Attachment Styles Scale, the Father Perception Scale, and the Peer Bullying Identification Scale. Pearson and Spearman correlation analyses, partial correlations, and Benjamini–Hochberg false discovery rate (FDR) corrections were conducted. Results: Secure attachment, paternal warmth/responsiveness, paternal involvement, and paternal autonomy support were negatively associated with bullying victimization and perpetration. In contrast, cold/rejecting and inconsistent/incongruent paternal attitudes were positively associated with bullying variables. Most findings remained significant after controlling for demographic variables and applying robustness and FDR correction analyses. However, some associations involving the Fearful Attachment subdimension appeared less robust. Conclusions: The findings suggest that supportive father–daughter relationships are consistently associated with lower levels of bullying involvement against peer bullying among adolescent girls. Interventions aimed at strengthening secure attachment and supportive parenting practices may contribute to reducing bullying behaviors and victimization.

Adolescents doi: 10.3390/adolescents6040056

Authors: Meghan J. Gangel Daniel Hamill Alleyne P. R. Broomell

Internalized weight stigma is related to psychological and physiological consequences independent of actual weight status. However, as peers assume an increasingly important role in early adolescence, peer support may protect adolescents from the related costs of weight stigma. The current study examines concurrent associations between internalized weight stigma and heart rate variability in response to an acute stressor in a non-clinical early adolescent sample using a novel peer-to-peer discussion task. We hypothesized that peer acceptance will moderate the effect of internalized weight stigma on changes in sympathetic and parasympathetic indices of HRV. The study included 31 adolescents (58.1% boys; Mage = 12.82, SDage = 1.00) from a charter middle school who completed self-report questionnaires to assess internalized weight stigma and perceived peer acceptance. Participants also completed a novel peer-to-peer discussion task to induce stress responses. Heart rate variability (HRV) was recorded during the baseline and the discussion task, and baseline-to-task change scores were used as an index of sympathetic and parasympathetic responses. Peer acceptance significantly moderated the association between internalized weight stigma and sympathetic reactivity (∆r2 = 0.07, B = −0.97 *, p < 0.05). Specifically, only for adolescents with low peer acceptance, increased internalized weight stigma predicted heightened sympathetic reactivity (B = 0.84, p = 0.03). The findings of this study support the development of a novel peer-to-peer discussion task as an acute stressor and suggest that peer acceptance may alter the association between internalized weight stigma and physiological stress reactivity.

Adolescents doi: 10.3390/adolescents6040055

Authors: Kaitlyn Swinney Sarah S. Bentley Leigh Ann Ganzar Niamh Tierny Brooklyn Baker Henry S. Brown Deborah Salvo Deanna M. Hoelscher

Purpose: The purpose of this study is to conduct a qualitative study of perceptions of active commuting to school (ACS) amongst middle school girls. Methods: Twelve adolescent girls (M = 13.1 ± 0.7 years old) who participated in the Safe TRavel Environment Evaluation of Texas Schools (STREETS) natural experiment were recruited to participate in semi-structured interviews. The semi-structured interview guide was grounded in Social Cognitive Theory, the Theory of Planned Behavior, and the existing literature. All interviews were transcribed by WebEx and thematic analysis was conducted via NVivo 12. Results: Participants had generally neutral to positive views of ACS. Main themes included social support of peers and the convenience of active commuting. Commonly reported barriers were distance to school, safety, and concerns about lack of sleep because of an early commuting time. Areas for future intervention included reducing perceived barriers of distance, time management, and safety, increasing girls’ motivation to actively commute, and improving skills and self-efficacy related to ACS through education, social support, guided practice, and incentives. Conclusions: This study provides evidence for schools and communities to include support programs for those who want to actively commute and suggestions for school policy changes to encourage active commuting to school (ACS). When developing ACS infrastructure or programs for middle school girls, concomitant programs that address strategies to address student perceptions and psychosocial barriers should be included.

Adolescents doi: 10.3390/adolescents6040054

Authors: Kadek Primadewi Haryono Irwan Budiono Dina Nur Anggraini Ningrum

Anemia among adolescent girls remains a persistent public health challenge in Indonesia, driven by limited nutritional knowledge, poor dietary practices, and suboptimal adherence to iron supplementation programs. This study is grounded in the Social–Ecological Model (SEM), which frames health behaviors as shaped by individual, interpersonal, institutional, and community-level factors. This study aimed to explore students’ knowledge and dietary behaviors related to anemia, assess perceptions of existing supplementation programs, and examine teachers’ and students’ perspectives on school-based digital education for anemia prevention in Denpasar, Bali. A qualitative descriptive design was employed across eight public junior high schools. Participants included eight teachers and 40 female students (aged 13–15 years) selected via purposive sampling. Data were collected through semi-structured in-depth interviews, non-participant observations, and document analysis. Thematic analysis was conducted using Atlas.ti version 23, with trustworthiness ensured through triangulation, member checking, peer debriefing, and iterative saturation assessment. Four inter-related themes emerged: (1) students held superficial, menstruation-centric conceptualizations of anemia with limited understanding of iron deficiency as an underlying cause; (2) dietary patterns were dominated by low-iron foods with poor vegetable consumption; (3) adherence to the Weekly Iron and Folic Acid Supplementation (WIFAS) program was inconsistent, hindered by side effects, forgetfulness, and low perceived benefit; and (4) both teachers and students expressed strong interest in digital education tools while identifying infrastructure and training gaps as barriers. Anemia prevention in school settings requires a multi-level approach integrating knowledge improvement, dietary behavior support, and institutional reinforcement. School-based digital education represents a contextually appropriate, youth-aligned innovation with strong potential to bridge the gap between health information and sustained behavioral change.

Adolescents doi: 10.3390/adolescents6040053

Authors: Esther Shuma Josephine Mudau Kingsley Amaechi Winter Mokhwelepa Olivia Sumbane

Growing up without parental care may negatively affect adolescents’ behavioral and emotional development, particularly among adolescents in conflict with the law. In a selected secure care center in the Vhembe District, limited research has explored the lived experiences and behavioral impact of growing up without parents. This study aimed to explore and describe the behavioral and emotional impact of growing up without parents among adolescents in conflict with the law in a child and adolescent secure care center in Limpopo Province. A qualitative, explorative, descriptive, and contextual research design was employed. Purposive sampling was used to recruit twelve (12) adolescents aged 15–17 years admitted to a secure care center in the Vhembe District. Data was collected through individual semi-structured interviews conducted in Xitsonga or Tshivenda, depending on participants’ preferred language. Interviews were audio-recorded, transcribed, translated into English, and analyzed using Tesch’s eight steps of data analysis. Ethical considerations and measures to ensure trustworthiness were observed throughout the study. The findings revealed that adolescents experienced low self-esteem, diminished self-confidence, early initiation of substance use, poor educational engagement, survival-oriented delinquent behavior, and feelings of neglect. These findings highlight the need for an integrated intervention approach to ensure coordinated psychosocial, educational, behavioral, and socio-economic support for this population.

Adolescents doi: 10.3390/adolescents6040052

Authors: Anastasios Karaoglou Tzortzis Nomikos Tonia Vassilakou Aikaterini Pontikaki Theodosia Chatzopoulou Athanasia Zourou Konstantinos Kotrokois

(1) Background: Adolescence is a critical period for the development of health-related behaviors, including dietary habits and physical activity. This cross-sectional study examined the associations between participation in organized sports, nutrient intake, and body composition in a sample of Greek adolescents. (2) Methods: A total of 224 adolescents aged 12–18 years from schools in the Attica region, Greece, participated in the study. Physical activity and organized sports participation were assessed using a validated questionnaire. Body composition was estimated using bioelectrical impedance analysis, and dietary intake was evaluated using three-day self-reported food records analyzed with Cronometer® nutrition analysis software. (3) Results: Boys had higher fat-free mass and basal metabolic rate and lower fat-mass percentage than girls. Organized sports participation was common and differed by sex, with boys reporting higher participation and greater adherence to physical activity recommendations than girls. Organized sports participation was associated with differences in selected nutrient intakes, particularly among late adolescents; however, several differences were attenuated when nutrient intake was standardized per 1000 kcal, suggesting that part of the observed pattern may reflect differences in total energy intake. (4) Conclusions: These cross-sectional findings suggest that age-defined adolescent stage and organized sports participation are associated with differences in sports involvement, body composition, and nutrient intake among Greek adolescents; however, causal relationships cannot be established, and the findings should be interpreted as associations.

Adolescents doi: 10.3390/adolescents6040051

Authors: Lainey E. Hunnicutt Scott R. Collier

Objective: In-season youth gymnastics is a sport that has maintained popularity, even though the youth are exposed to psychological and physiological injuries throughout their career. The absence of clearly demarcated competitive seasons complicates the distinction between in- and out-of-season, potentially masking cumulative health changes from chronically poor sleep and inadequate autonomic recovery. The present study investigated the differences in sleep architecture and health in- and out-of-season in young, in-season gymnasts. Methods: Nine in-season youth gymnasts between the ages of 12 and 16 years were recruited. Sleep data were collected for three consecutive nights during in-season and off-season using an ambulatory sleep monitor so the subjects could sleep in their own beds. Results: Mean nocturnal pulse was significantly higher during in-season versus off-season, reflecting higher sympatho-vagal outflow during the competition season. Sleep efficiency, wake after sleep onset (WASO), and spindle duration were similar during in-season and off-season, yet they had better values during off-season. Sleep latency, rapid eye movement (REM), and non-rapid eye movement (NREM) had greater sleep regularity during the off-season. Conclusion: These data demonstrate a significant decrease in mean nocturnal heart rate when an athlete transitions from in-season to off-season.

Adolescents doi: 10.3390/adolescents6040050

Authors: Agustin E. Fatmasari Hidayatun Nur’Aini Rahkman Ardi

(1) Background: Adolescents’ appraisals of family relationships play an important role in bridging family dynamics and maladaptive behavior in various contexts. However, the mechanism of adolescents’ appraisals remains unclear. This review aims to map the state of the art about adolescents’ appraisals of family relationships in intact family contexts from the existing global literature. (2) Methods: The article collection was performed in accordance with the PRISMA guideline and screening articles from 5 sources. Two reviewers independently screened to obtain 10 reported articles that met the inclusion criteria. (3) Results: Analyses identified that 90% of the previous study involved adolescents aged 8–19 years from the United States (USA) and predominantly White. The majority of the samples were also identified from middle to upper class socioeconomic status (n = 6), and relatively low conflict family structure (n = 5). The most commonly used variable term of adolescents’ appraisal was interparental conflict (IPC) appraisals (n = 7), and the Cognitive Contextual Framework (CCF) by Grych et al. was used as a theoretical framework. (4) Conclusions: Based on a global literature review, the findings of this review are limited, based on age, race, socioeconomic status, family structure, and certain geographical locations. The limited range of samples may affect the sensitivity of the theoretical framework and measurement tools in capturing variations in adolescents’ appraisals of family relationships in intact family contexts. Furthermore, the generalizability of these findings may be limited. Accordingly, future studies are encouraged to replicate the present research using larger samples from diverse ages, cultural and socioeconomic status, and family structure backgrounds. Future researchers could further advance this research area by incorporating a wider variety of theoretical perspectives, methodological approaches, and measurement instruments to promote the future health and well-being of adolescents.

Adolescents doi: 10.3390/adolescents6040049

Authors: Alessandro Messina Safae El Motarajji Livio Leo Alessandro Libretti Bianca Masturzo

Background: Contraceptive counseling is a critical component of reproductive healthcare, directly influencing method uptake, continuation, and user satisfaction. While global health guidelines increasingly emphasize person-centered, rights-based approaches to counseling, wide variations in practice persist, with significant implications for equity and autonomy. Objective: This narrative review aims to synthesize current evidence on the strengths, limitations, and future opportunities of contraceptive counseling within person-centered care frameworks, with particular attention to adolescents and other populations facing structural or sociocultural barriers to equitable care. Methods: A comprehensive literature search was conducted across six indexed databases (PubMed, Scopus, Embase, Web of Science, CINAHL, and PsycINFO) for peer-reviewed articles published between January 2010 and April 2025. Eligible studies included original quantitative, qualitative, and mixed-methods research examining contraceptive counseling practices, user experiences, provider–client communication, counseling interventions, or implementation strategies in reproductive healthcare settings. Results: Emerging strengths in the field include the increasing adoption of shared decision-making, motivational interviewing, and culturally tailored counseling approaches, all of which contribute to improved client satisfaction and method adherence. Digital tools and mHealth platforms have expanded the reach of counseling and show promise in supplementing in-person care. However, significant gaps remain. Provider bias, limited training, communication barriers, and a lack of socio-cultural tailoring frequently undermine the quality of care, especially for adolescents, migrants, women with disabilities, and socially vulnerable populations. Ethical challenges—such as coercion, inadequate informed consent, and structural inequities—persist in many healthcare settings. Moreover, contraceptive counseling is often treated as a one-time event rather than an ongoing, adaptive process. Conclusions: To maximize its impact, contraceptive counseling must be reframed as a longitudinal, relational, and ethically grounded practice. Future efforts should prioritize the development of structured training programs, integration into broader health services, and qualitative research that centers patient experiences. Embedding counseling within reproductive justice frameworks will be essential for advancing equity and autonomy. High-quality contraceptive counseling, when informed by evidence and empathy, is a strategic tool for reproductive empowerment and public health advancement.

Adolescents doi: 10.3390/adolescents6040048

Authors: Rapson Gomez Stephen Houghton Shane Langsford Shaun Watson Leila Karimi

Using the Hierarchical Taxonomy of Psychopathology (HiTOP) as our framework, the current study examines how 13 common psychological disorders can be grouped into different spectra in two groups of adolescents: a community sample (N = 951), and a clinic-referred sample (N = 173). Scores for the disorders were obtained using the parent version of the Child and Adolescent PsychProfiler. Taken together, the findings across the two samples for factor structure, reliability, and discriminant and concurrent validity indicate the most support for a three-factor CFA oblique model with primary factors for neurodevelopment disorders (that include Specific Learning Disorder, Autism Spectrum Disorder, Language Disorder, and Speech Sound Disorder), internalizing disorder problems (that include Generalized Anxiety Disorder, Persistent Depressive Disorder, Separation Anxiety Disorder, Obsessive–Compulsive Disorder, Posttraumatic Stress Disorder, Anorexia Nervosa, and Bulimia Nervosa), and externalizing disorder problems [(that include Attention Deficit/Hyperactivity Disorder (ADHD), and Oppositional Defiant Disorder/Conduct Disorder (ODD/CD)], with a covariance for the error variance for Anorexia Nervosa and Bulimia Nervosa. Additionally, the analysis for Sample 2 supports the concurrent validity of the factors in this model. A modification of this model, with ADHD cross-loading on the neurodevelopment disorders factor, did not produce an admissible solution. The findings indicate support for a neurodevelopmental spectrum in the HiTOP model, with ADHD and ODD/CD showing stronger statistical association with the externalizing factor than with the neurodevelopmental factor in the models tested. This finding pertains to dimensional structure and does not invalidate the neurodevelopmental classification of ADHD in DSM-5-TR.

Adolescents doi: 10.3390/adolescents6030047

Authors: Carolina Facci Paul J. Frick Andrea Baroncelli Enrica Ciucci

Relationships are a fundamental foundation of human development, shaping developmental trajectories, well-being, and health, yet their psychological assessment remains challenging. Youths’ perceived closeness to others has been linked to a range of prosocial outcomes but has been less extensively examined in research studying problematic developmental outcomes, such as conduct problems. Further, most studies have focused on a single relationship, which ignores the potential importance of determining the extent to which youth’s perceptions of closeness extend beyond immediate social groups. The present study addressed these gaps by examining the factor structure and construct validity of an expanded measure of perceived closeness that includes a broader range of relationships, labeled the Perceived Closeness to Others Questionnaire (PCtO). A sample of 426 middle school students (216 girls; M age = 12.90 (0.91) years) was recruited and completed a visual measure of perceived closeness that utilizes visual images of pairs of circles (i.e., one indicating “the Self” and one indicating “the Other”) at different distances (i.e., from very far away to almost completely overlapping) to indicate how close they feel to others. Participants also completed self-report measures assessing a range of prosocial and problematic outcomes. An exploratory factor analysis (EFA) suggested that, despite assessing a wide range of relationships, the measure seemed to be capturing a unidimensional construct. Further, scores from the measure showed adequate reliability and were positively correlated with all the measures of prosocial outcomes and with all but one measure of problematic outcomes (i.e., conduct problems). Overall, the findings provide initial support for a measure of psychological closeness suitable for use in research with youth. This tool may help advance theories of prosocial and antisocial development and guide interventions aimed at enhancing youths’ relationships with others.

Adolescents doi: 10.3390/adolescents6030045

Authors: Minh Hao D. Tran Kathan D. Shukla Xinye Xia Norma Olvera Margit Wiesner

Structural constraints arising from the family environment have been highlighted as a key predictor of deviant lifestyles that expose youths to criminogenic circumstances. Intervening processes are not well-understood. This study examined (a) whether family deviance is associated with students’ deviant lifestyles, (b) whether this association is mediated by low parental nurturance, and (c) whether this indirect effect is moderated by low parental education. Cross-sectional data from 233 African American, Hispanic, White, Asian American, and multiracial 11th grade students were used. The student deviant lifestyles construct was assessed using three composite indicators (student delinquent behavior, perceived peer deviance, student substance use). Using structural equation modeling, a latent moderated indirect effects model showed excellent fit (e.g., CFI = 0.986, RMSEA = 0.047, SRMR = 0.027). Parental nurturance significantly mediated the relation of family deviance with student deviant lifestyles, but only for students whose parents have low levels of education. Our results support the utility of an integrative criminogenic framework that includes structural constraints arising from the family environment and showed that high parental education can serve as a buffer against the adverse indirect effects of family deviance on adolescents’ deviant lifestyles via low parental nurturance.

Adolescents doi: 10.3390/adolescents6030046

Authors: Paula Segura-Daroca Vicente Gea-Caballero Raúl Juárez-Vela Elena Chover-Sierra Raquel María Martínez-Pascual Antonio Martínez-Sabater

Mental health disorders among adolescents have risen significantly in recent years, particularly following the COVID-19 pandemic, highlighting the need for effective preventive and supportive interventions. Nurses play a key role in the promotion, early detection, and management of mental health issues in adolescents, both in school and community settings. This study aimed to synthesize quantitative and qualitative evidence on the role, effectiveness, and implementation of nursing interventions for adolescent mental health. A systematic mixed-methods review was conducted in accordance with the PRISMA 2020 guidelines. It was registered in PROSPERO (CRD42024502076). Databases including PubMed, Scopus, SciELO, Dialnet, BVS, and Cuiden were searched for studies published between 2014 and 2024. Twelve studies met the inclusion criteria, comprising randomized and non-randomized quantitative studies, qualitative studies, and previous reviews. The interventions identified included cognitive-behavioral therapy programs, resilience and life skills training, physical activity initiatives, digital interventions, and mental health literacy strategies. Overall, the findings suggest improvements in symptoms of anxiety and depression, coping skills, resilience, and knowledge about mental health, particularly in structured school-based programs. Qualitative evidence highlighted the importance of accessibility, multidisciplinary collaboration, cultural sensitivity, and sustained commitment for successful implementation. However, considerable heterogeneity was observed in study designs, interventions, and outcome measures. In conclusion, nursing interventions can make a positive contribution to adolescents’ mental health, particularly in school and community settings. However, further rigorous, long-term studies are needed to strengthen the evidence base.

Adolescents doi: 10.3390/adolescents6030044

Authors: Nomava Siyasamkela Jinoyi Eugene Lee Davids

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.

Adolescents doi: 10.3390/adolescents6030043

Authors: Carla Viana de Sousa Anabela Pereira Paula Vagos

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.

Adolescents doi: 10.3390/adolescents6030042

Authors: Glykeria P. Reppa Christos Rentzios Iliana Tsoutsa Irini K. Zerva Aikaterini Voulgari Christiana Koundourou

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.

Adolescents doi: 10.3390/adolescents6030041

Authors: Chrysi Paradeisioti Gerasimos Kolaitis Konstantinos Siomos Georgios Giannakopoulos

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.

Adolescents doi: 10.3390/adolescents6030040

Authors: Nazerke Asemkhankyzy Bazargaliyeva Niyetbayeva Gulmira Bekenovna Ayapbergenova Almira Zhenisbekovna Aksakalova Zhanna Kenzhebekovna Dautkaliyeva Perizat Bolatovna

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.

Adolescents doi: 10.3390/adolescents6030039

Authors: Mesut Öztürk Kübra Ada Yildiz Garyfalia Charitaki

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.

Adolescents doi: 10.3390/adolescents6030038

Authors: Ibrahim A. Elshaer Chokri Kooli Tarik A. Jasim Alaa M. S. Azazz

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.

Adolescents doi: 10.3390/adolescents6030037

Authors: Efpraxia Kalapoda Chrysovalanto Staneloudi Ioannis Trigonis Evaggelia Manolaki Ioannis Tsartsapakis Aglaia Zafeiroudi

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.

Adolescents doi: 10.3390/adolescents6030036

Authors: Daniela Bager-Mariscal Francisco Molins Francisco González-Sala Florencia Talmón-Knuser Laura Lacomba-Trejo

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.

Adolescents doi: 10.3390/adolescents6020035

Authors: Nkiruka Eze Ally Memedovich Benedicta Asante Becky Skidmore Fiona Clement

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.

Adolescents doi: 10.3390/adolescents6020034

Authors: Štefan Adamčák Michal Marko Zora Kľocová Adamčáková

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.

Adolescents doi: 10.3390/adolescents6020033

Authors: Esther Richter Gabor Aranyi Sara Edraki Jutta Fiegl Elke Humer

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.

Adolescents doi: 10.3390/adolescents6020032

Authors: Shiamalan Thanaskanda Richard Whitehead Liza Hopkins Iain Macmillan Michelle Kehoe

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.

Adolescents doi: 10.3390/adolescents6020031

Authors: Holly Davies Monit Cheung Yu-Ju Huang

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.

Adolescents doi: 10.3390/adolescents6020030

Authors: Ana Simão Cristina Nunes

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.

Adolescents doi: 10.3390/adolescents6020029

Authors: Tomislav Pavlović Marina Maglić Marija Antić Igor Mikloušić

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.

Adolescents doi: 10.3390/adolescents6020028

Authors: Gloria Mittmann Beate Schrank Verena Steiner-Hofbauer Susanne Siegmann Sonja Zehetmayer

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.

Adolescents doi: 10.3390/adolescents6020027

Authors: Urooj Sadiq Ayesha Irfan Khawer Bilal Baig Luca Flesia

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.

Adolescents doi: 10.3390/adolescents6020026

Authors: Gregory M. Zimmerman

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.

Adolescents doi: 10.3390/adolescents6020025

Authors: David A. Sleet Lloyd Kolbe

In the original article [...]

Adolescents doi: 10.3390/adolescents6020024

Authors: Anaís Sánchez-Domínguez Leticia del Carmen Ríos-Rodríguez Jorge de la Torre y Ramos Francisco Eneldo López-Monteagudo José Berumen-Enríquez Angélica Colín-Mercado Adrián Gerardo Nevaréz-Esparza Leonel Ruvalcaba-Arredondo

Background: The relationship between selfie addiction and narcissism in students at the Universidad Autónoma de Zacatecas (UAZ, Autonomous University of Zacatecas), Mexico, was analysed. The aim of this study was to identify the narcissistic factors associated with students’ selfie taking addiction. Methods: To identify the relationship between narcissism and selfie addiction, the Narcissistic Personality Inventory (Adapted NPI-40) and the Psychometric Selfie Addiction Scale (PSAS) were used. A structural equation model (SEM) was employed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for structural validation. EFA and CFA confirmed adequate fit and reliability indicators regarding the robust unidimensional structure of the PSAS. Results: The SEM results indicated significant associations between the latent dimensions of the narcissistic traits of superiority, authority, need for admiration, exhibitionism, and exploitation and selfie addiction. This research provides structural and psychometric evidence for the relationship between narcissism and selfie addiction in the Mexican student population, integrating Adapted NPI-40 and PSAS, as well as a parsimonious explanatory structural equation model that demonstrates the relationship between different narcissistic traits and social media practices. Conclusions: The results provide a basis for developing digital literacy interventions for young people and future cross-validations.

Adolescents doi: 10.3390/adolescents6010023

Authors: Danielle M. Mitnick Amy M. S. Slep Stacey S. Tiberio Kelly A. Daly Richard E. Heyman Michael F. Lorber

Coercion theory posits that a vicious cycle of negative reinforcement traps both parents and children, shaping young children to become stably aggressive in conflicts with their parents. Research on intimate partner violence has found some evidence supporting the application of coercion theory in explaining aggressive escalation in adult conflicts as well. It is unclear whether the same processes are at play during teens’ early dating relationships. On the one hand, dating aggression emerges as soon as dating relationships do. On the other hand, we also know that if aggression presents extremely early in relationships, dissolution is the most likely path. We explored the role of coercion in 209 teen dating couples who were observed in a laboratory series of problem-solving discussions and analogue conflict tasks. All data were coded by trained coders blind to hypotheses. Analyses suggest that the negative reinforcement of hostility is indeed significantly associated with both psychological and physical aggression in an adolescent dating sample. Implications for prevention and intervention are discussed, as well as developmental processes that may contribute to dating aggression in light of our findings.

Adolescents doi: 10.3390/adolescents6010022

Authors: Virginia Pupi Gianluca Santoro Giorgia Varallo Antonio Albano Alessandro Guarnieri Giancarlo Condello Antonio Ozzimo Monica Pacetti Alessandro Musetti Christian Franceschini

Early adolescence is a critical developmental period marked by emotional, behavioral, and biological changes. The COVID-19 pandemic disrupted adolescents’ daily routines, potentially producing lasting effects on mental and physical health. This study investigated anxiety and depressive symptoms, risk of extreme social withdrawal, use of technological devices, physical activity, and sleep–wake functioning in 276 early adolescents (54% females; Mage = 12.28, SD = 0.81) living in a forested and geographically isolated area of Emilia-Romagna in Italy. Participants completed validated self-report questionnaires assessing internalizing symptoms, use of technological devices (including problematic online gaming and smartphone use), gaming motivations, physical activity, chronotype, sleep disturbances, and daytime sleepiness. Scores on the anxiety and depressive symptom scales were within the normative range, except for scores on certain scales suggesting a moderate degree of severity that was not clinically significant. Females reported higher levels of anxiety, depressive symptoms, and problematic smartphone use, whereas males showed greater involvement in problematic online gaming and stronger achievement-, social-, and immersion-related motives. A substantial proportion of participants reported excessive daytime sleepiness (42.4% of females; 26.1% of males). Significant patterns of association were found among internalizing symptoms, domains of sleep–wake functioning, use of technological devices, and risk of extreme social withdrawal. Overall, these findings support the relevance of predisposing preventive strategies aimed at improving different domains of physical and mental health among youth in underserved or geographically isolated communities.

Adolescents doi: 10.3390/adolescents6010021

Authors: Jodi Dworkin Ting Xu Elizabeth Hruska

It is undeniable that COVID-19 has impacted all aspects of college student and family life. However, the posttraumatic growth (PTG) framework suggests there are opportunities for growth after traumatic or highly stressful events. To explore PTG in college students during the COVID-19 pandemic, this study recruited parents of college students (N = 1655) from across the U.S. Hierarchical multiple regression analyses revealed that when parents reported that their student experienced more positive impacts of COVID-19 on their relationships and health, received more career support, and when parents reported that their own well-being improved, they were more likely to report that their student experienced PTG. Additionally, parent gender, student first-generation status, and student year in school were also associated with PTG. This is consistent with past research; when parents were well supported during the pandemic, their college students did better and were more likely to uphold academic and graduation plans. Findings underscore the important role of both university resources such as career support, and family resources such as parental well-being in buffering the negative effects of the pandemic and supporting PTG.

Adolescents doi: 10.3390/adolescents6010020

Authors: Joan García-Perales Isabel Martínez Elena Delgado

The availability of the Internet in current society has brought about the development of Internet addiction and participation in online gambling. This study aimed to examine the associations between Internet addiction and gambling craving with personality traits and psychological well-being (self-esteem and life satisfaction), controlling for gender differences. The sample consisted of 517 Spanish university students (28.6% males), aged 21–23 years (mean age = 21.53 years; SD = 3.76). Participants were administered the Internet Addiction Test (IAT), Gambling Craving Scale, Self-Esteem Scale, Mini-IPIP Scale, and Satisfaction with Life Scale (SWLS). The results show that Internet addiction is negatively related to self-esteem, satisfaction with life, and personality traits of agreeableness, conscientiousness, emotional stability, and openness to experience. In line with these findings, the results concerning gambling craving are particularly noteworthy, revealing significant negative associations with self-esteem, life satisfaction, and the personality traits of agreeableness and openness to experience. This pattern suggests that heightened craving may be linked to broader deficits in psychological well-being and adaptive personality functioning. Finally, the results indicate differences by gender when predicting Internet addiction and gambling craving through personality and psychological well-being.

Adolescents doi: 10.3390/adolescents6010019

Authors: Rodrigo Moya-Vergara Diego Portilla-Saavedra Jennifer Marín Medina Catalina Carvallo Parraguez Katherin Castillo-Morales Ricardo Espinoza-Tapia

Digital victimization has been increasingly linked to adverse mental health outcomes during adolescence; however, less is known about its association with depressive symptoms when accounting for other forms of peer victimization and underlying psychological mechanisms. This study examined the relationship between lifetime digital victimization and depressive symptoms in a nationally representative sample of Chilean adolescents (N = 11,439) and tested the mediating role of self-esteem. Lifetime exposure to digital victimization, emotional bullying, and harassment were assessed using dichotomous indicators. Depressive symptoms were measured with the Birleson Depression Self-Rating Scale, and self-esteem with the Rosenberg Self-Esteem Scale. Overall, 27.2% of Chilean adolescents reported lifetime digital victimization. The proposed model showed an adequate fit to the data (CFI = 0.992; TLI = 0.942; RMSEA = 0.065; SRMR = 0.012). Lifetime exposure to digital victimization was directly associated with higher depressive symptoms and lower self-esteem, and self-esteem significantly mediated this association after controlling for age and in-person peer victimization. These findings highlight the importance of self-esteem as a key mechanism linking digital victimization and depressive symptoms in adolescents.

Adolescents doi: 10.3390/adolescents6010018

Authors: Ryusuke Matsumoto Tomoka Oka Eishi Motomura Motohiro Okada

In Japan, national crude suicide mortality rates (CMR-suicides) consistently decreased during the 2010s, whereas adolescent CMR-suicides have increased from the mid-2010s. However, the high-risk groups and their causalities remain to be clarified. Temporal fluctuations of adolescent CMR-suicides disaggregated by gender, age, social standing, and suicide motive were analyzed with joinpoint regression and linear mixed-effect models using two government suicide databases. CMR-suicides among female elementary school students, middle school students, high school students, university students, and <20-year-old individuals with social withdrawal syndrome (SWS) increased from the mid-2010s. CMR-suicides among male elementary school, middle school, and high school students also increased from the mid-2010s, while those of university students were unchanged. In contrast, CMR-suicides of males aged <20 and 20–29 with SWS unexpectedly decreased. Surprisingly, the increasing trends of CMR-suicides of female students were greater than males; consequently, CMR-suicides of female students in middle school and high school became greater than those of male students in the 2020s. The highest suicide risk among those under 20 years of age was observed among part-time high school students. Among individuals 20–29 years of age, those with SWS were in the highest-risk group for suicide, while CMR-suicides of individuals with SWS aged under 20 years were almost equivalent to those of middle school students. The leading suicide motives for elementary school students were family-related, including family discord and parental reprimand (there was no difference in gender in terms of leading suicide motive). Among middle school female students and older, the leading suicide motives were mental issues followed by school-related problems. Among male middle school students and older, the leading suicide motives were underachievement followed by mental issues. CMR-suicides caused by mental issues (for both genders) and underachievement (in males) increased from the mid-2010s. These results suggest that increasing internalizing problems may be a fundamental factor contributing to the currently increasing suicides among adolescents (particularly females) in Japan. Although the recent promotion of inclusive education in Japan has successfully provided educational opportunities for individuals with internalizing problems, these statistics highlight the need for a further enhancement of psychosocial support for adolescents with internalizing problems who are at a high risk for suicide.

Adolescents doi: 10.3390/adolescents6010017

Authors: Rosa Dabinia Uribe-Madrigal Betzaida Salas-García María del Carmen Gogeascoechea-Trejo Xóchilt de San Jorge-Cárdenas Juan Manuel Gutiérrez-Méndez María Cristina Ortiz-León

Adolescent tobacco use remains a critical public health challenge, requiring innovative early prevention strategies. This study participatively evaluated a medium-fidelity prototype of the No le entres app, designed to prevent tobacco use among adolescents. The prototype was developed based on user-centered design and gamification frameworks, with the aim of ensuring cultural relevance and active user engagement. Qualitative design with content analysis was employed. Four focus groups were conducted in Xalapa, Veracruz: two with health professionals from Medical Specialty Units—Community Mental Health and Addiction Centers (UNEME CECOSAMA), and two with secondary school students. Nineteen professionals and twenty-two adolescents participated. Data were analyzed using MAXQDA 2022, applying both a priori and emergent categories. Professionals valued the app’s innovative approach but recommended improvements in navigation speed, visual design, message clarity, and cultural validation. Adolescents emphasized the need for more engaging features, such as music, rewards, team competitions, and updated graphics. Both groups highlighted the importance of interactivity, personalization, and contextualized content. Findings underscore the value of participatory methods in designing digital health interventions and confirm that involving end users enhances usability and acceptability. The app demonstrates potential for integration into school settings as a preventive tool, with implications for influencing adolescent knowledge, attitudes, and behaviors regarding tobacco use.

Adolescents doi: 10.3390/adolescents6010016

Authors: Cara Lucke Kristine Piescher Traci LaLiberte

The transition to adulthood is challenging for all youth, but this developmental period can present substantial difficulties for youth involved in child-serving systems due to a constellation of adversities and a lack of protective factors present in their lives. Notably, many system-involved youth are disconnected from important relationships and are tasked to navigate the increased demands of adulthood without sufficient support. There is a spectrum of services available for youth transitioning out of system-involvement, but the majority focus on independent living skills, which alone are often insufficient to facilitate a successful transition to adulthood. This paper provides details regarding the importance of building relational permanence—relationships with permanent-supportive individuals—among young adults transitioning out of system involvement. Authors review evidence-based approaches, used by community agencies, which build relational permanence for system-involved youth, while discussing future directions to improve the rigor of research on relational permanence, and action for necessary policy change.

Adolescents doi: 10.3390/adolescents6010015

Authors: Shaimaa Helal Saja Michael Colleen M. Davison Susan A. Bartels

The Syrian conflict has created one of the largest displacement crises of the twenty-first century, disproportionately affecting adolescent girls. Syrian girls have been primarily portrayed as victims of war or “the lost generation”, neglecting the plurality of their experiences. Building on Bandura’s social cognitive theory, Giddens’ structuration theory, Kabeer’s empowerment framework, and Mahmood’s modalities of agency, this study examines how Syrian refugee adolescent girls in Lebanon enact agency within contexts of forced displacement and how structural factors shape these processes. We conducted a secondary analysis of 293 first-person narratives from Syrian girls and mothers collected in 2016 using Cognitive Edge’s SenseMaker®. Thematic analysis revealed seven structural barriers—restricted access to education, economic insecurity, inadequate infrastructure/living conditions, limited healthcare, gender and social norms, xenophobia, and lack of legal status—as well as key enablers including community services, parental support, and peer networks. Girls expressed agency through seven interconnected processes: awareness/acknowledgement of barriers, emotional navigation, resource identification, decision-making, future planning, reflection, and action execution. These processes were adaptive and recursive, highlighting that agency during displacement is dynamic, relational, and conditioned by structural forces. These findings inform approaches that both reduce structural barriers and enable refugee girls’ agency.

Adolescents doi: 10.3390/adolescents6010014

Authors: Konstantina Arseniou Charalambos Gnardellis Areti Lagiou Venetia Notara

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.

Adolescents doi: 10.3390/adolescents6010013

Authors: Ifeyinwa Mbakogu Brad Richards

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.

Adolescents doi: 10.3390/adolescents6010012

Authors: Esther Fernández-García Sofía Buelga María-Jesús Cava

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.

Adolescents doi: 10.3390/adolescents6010011

Authors: Yvette Efevbera Anshu Banerjee Nuray Kanbur

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.

Adolescents doi: 10.3390/adolescents6010010

Authors: Francisco D. Fernández-Martín Patricia Ayllón-Salas

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.

Adolescents doi: 10.3390/adolescents6010009

Authors: Vinícius Tenório Moraes da Silva Rafael dos Santos Henrique José Ywgne Francisco Salviano Sales Nobre Paulo Henrique Guerra Leonardo Gomes de Oliveira Luz

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.

Adolescents doi: 10.3390/adolescents6010008

Authors: Garyfallia Daroglou Despoina Ourda Zoe Akoni Eirini Koidou Aikaterini Mouratidou Vassilis Barkoukis

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.

Adolescents doi: 10.3390/adolescents6010007

Authors: Omar Al kuraydis Awadh Mushabbab Alqahtani Mohammad Alqahtani Ali Saad Alshahrani Abdulaziz Saad Ali Muidh Alqarni Muhannad Alqahtani Rawan Alqahtani Abdulaziz Alqahtani Mashari Mohammed Ashwag Asiri Faris Alzahrani

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.

Adolescents doi: 10.3390/adolescents6010006

Authors: Matthew E. Lemberger-Truelove Dan Li Hyunhee Kim Dominique D. Hill Reagan Dickson ZiYoung Kang

(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.

Adolescents doi: 10.3390/adolescents6010005

Authors: Anna Na Na Hui Chi Kin Kwan Priscilla Sei Yah Ip

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.

Adolescents doi: 10.3390/adolescents6010004

Authors: Valeska Reichel Pape Susanna Wiegand Rebecca Mylius Antonia Hope Alexander Korte

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.

Adolescents doi: 10.3390/adolescents6010003

Authors: Jumana Jbara Ziad D. Baghdadi

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.

Adolescents doi: 10.3390/adolescents6010002

Authors: Lara Wippermann Alissa Schüürmann Viktoria Pöchmüller Naska Goagoses

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.

Adolescents doi: 10.3390/adolescents6010001

Authors: Nan Zhang Zhenzhen Su Zhongguo Li Yong Jiang

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.

Adolescents doi: 10.3390/adolescents5040082

Authors: Silvia Cimino Luca Cerniglia

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.

Adolescents doi: 10.3390/adolescents5040081

Authors: Ryan J. Lowhorn Mohammed Chowdhury Mithun K. Acharjee Nahida Akhter AKM Fazlur Rahman

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.

Adolescents doi: 10.3390/adolescents5040080

Authors: Deyanira A. Domínguez-Muñoz Carlos Alberto Jiménez-Zamarripa Refugio Cruz-Trujillo Elena Flores-Guillén Alfredo Pérez-Jácome Juan Gabriel Tejas-Juárez Alfredo Briones-Aranda Josselin Carolina Corzo-Gómez Josué Vidal Espinosa-Juárez Alejandro Pérez-Ortiz Adriana Amaya-Hernández

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.

Adolescents doi: 10.3390/adolescents5040079

Authors: Neelam Punjani Amber Hussain

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.

Adolescents doi: 10.3390/adolescents5040078

Authors: Marta Reis Catarina Noronha Gina Tomé Marina Carvalho Nuno Neto Rodrigues Margarida Gaspar de Matos

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.

Adolescents doi: 10.3390/adolescents5040077

Authors: Silvia Cimino Luca Cerniglia

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.

Adolescents doi: 10.3390/adolescents5040076

Authors: Tshikani Elsie Mabasa Mphedziseni Esther Rangwaneni Mary Maluleke Ndidzulafhi Selina Raliphaswa

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.

Adolescents doi: 10.3390/adolescents5040075

Authors: Ana María Carroza-Pacheco Carolina Bringas-Molleda Benito León-del-Barco

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.

Adolescents doi: 10.3390/adolescents5040074

Authors: Venkata Sushma Chamarthi Pallavi Shirsat Kunal Sonavane Sastry Chamarthi

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.

Adolescents doi: 10.3390/adolescents5040073

Authors: Emma Sterrett-Hong Lisa Merkel-Holguin Nikki Thornton Anita Barbee Glenda Wright Eltuan Dawson Cameron Galloway Chyna Angelini Tia Humphrey

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.

Adolescents doi: 10.3390/adolescents5040072

Authors: Bárbara Porter Cristian Oyanadel Ignacio Betancourt-Peters Wenceslao Peñate

(1) Background: Self-regulation of attention, emotions, and behavior constitutes a core set of skills essential for positive mental health in adolescence and adulthood. Mindfulness-based interventions (MBIs) have shown positive effects on these skills in early developmental stages. Yet it remains unclear whether dispositional mindfulness mediates these effects. This study examined whether dispositional mindfulness mediates the effects of attention and emotion-focused MBIs on attentional, emotional, and behavioral self-regulation. (2) Method: An experimental study was conducted with three conditions: (a) MBI focused on emotion regulation, (b) MBI focused on attentional regulation, and (c) control group. The sample consisted of boys and girls aged 8 to 12 years (n = 70, Mage = 9.60, SD = 1.01), randomly assigned to the three experimental conditions. Group differences in emotional, behavioral, and attentional regulation were analyzed, with mindfulness as a mediating variable. The mediation analysis was conducted using linear regressions and a nonparametric bootstrap technique with 5000 samples. Age and gender were included as control variables in all models. (3) Results: Both programs produced significant improvements in all three dimensions of self-regulation. However, mindfulness showed a mediating effect only on emotional self-regulation, not on attention and was inconclusive on behavioral self-regulation. (4) Conclusions: Mindfulness mediates emotional but not attentional self-regulation. The evidence for the mediating role of mindfulness in behavioral regulation was inconclusive. Incorporating mindfulness in educational settings could strengthen emotional self-regulation skills, thereby promoting mental health; however, further studies are needed.

Adolescents doi: 10.3390/adolescents5040071

Authors: Zuzana Rojková Zuzana Mičková Slávka Démuthová

Objective: This study focuses on selected potential determinants of self-harm in adolescents of two age groups. The considered factors are depression, sex, and parental cohabitation. The aim of the study is to reveal the association between the mentioned factors and self-harm in younger and older adolescents. A secondary goal is to identify the prevalence of self-harm in two age groups. Self-harm is defined as the repeated occurrence of its physical forms. Methods: In the non-experimental research study, the respondents (N = 1285) were primary and secondary school pupils from Slovakia and made up two age cohorts (12–15 and 16–18 y). A battery of questionnaires consisted of the CDI, Self-Harm Inventory and a demographic questionnaire. Procedures of statistical analysis including the logistic regression were applied for data processing. Results: Depression as a risk factor for physical forms of self-harm was recognised in both age cohorts. In terms of sex as a predictor (girls), it proved to be a strong determinant of development of self-harm in the younger group. Conclusions: The results demonstrate the relevance of the need for a separate study of self-harm in boys and girls, as well as in the context of developmental peculiarities in adolescence.

Adolescents doi: 10.3390/adolescents5040070

Authors: Bing-Kwan Chan Simon Tak-Mau Chan Esther Yin-Nei Cho Yee-May Chan

(1) Background: While Hong Kong is renowned for being a multicultural city, its South and Southeast Asian population has experienced disadvantages in various aspects of life, particularly career development. This study adopts the Systems Theory Framework (STF) to investigate the school-to-work transition of Pakistani, Nepalese, Filipino, and Indian youths in the Hong Kong Chinese context. (2) Methods: A qualitative approach using individual and focus group interviews was employed to uncover and critically examine educational and career aspirations and contextual factors in the transition pathways of educational and career advancement experienced by these ethnic groups. (3) Results: Findings show that career aspirations among South and Southeast Asian youths undergoing the school-to-work transition are comparatively lower than those of their counterparts who remain in secondary education. This disparity is attributed to a range of contextual factors, particularly shortcomings in education policy and limited cultural competence within Hong Kong Chinese society, both of which contribute to the erosion of occupational outlook among these underrepresented groups. (4) Conclusions: This study demonstrates the critical impact of contextual factors on the ethnic inequality of school-to-work transition, which are more overwhelming than can be overcome by personal and family efforts. If these issues are not addressed, achieving racial equality and equal opportunity in school-to-work transition will remain a persistent challenge.

Adolescents doi: 10.3390/adolescents5040069

Authors: Sarah Carter Narendorf Caitlyn Mytelka Jody Gardner Seonyeong Kim

Transition-age youth exiting foster care (TAY) are at high risk for housing instability, with nearly half experiencing homelessness before age 26. Multi-level factors are associated with greater risk, including individual, social, and geographic contexts. This study explored experiences of TAY in a large region of Texas to identify drivers of housing stability during the transition out of care. Youth aged 18–25 who were connected to the region’s foster care transition center were recruited to participate in a mixed-methods, semi-structured interview (n = 25). Youth were prompted to identify networks of up to 20 people who had provided support over the past year. Interview questions explored what happened when youth turned 18, including changes in their housing situations, and delved into relationships with the network members. An iterative coding process was used to create a matrix to examine housing transitions and social supports within and across cases, then identify themes and subthemes. Housing instability was common, with 13 of 25 participants reporting episodes of homelessness after turning 18. Abrupt transitions were driven by systemic factors related to placement settings, strict rules, and a lack of available housing options. Social network data illuminated the close link between housing and the social network, along with the importance of “housing-capable” adults who helped prevent homelessness. Findings call for the development of more youth-friendly housing options for TAY transitioning out of care and interventions that help to build enduring social supports.

Adolescents doi: 10.3390/adolescents5040068

Authors: Raquel Pascual Luque Mónica Luque Suárez María del Carmen Olmos Gómez

This bibliometric study analyses scientific output over the last 10 years on music using the following keywords “youth”, “culture” and “education”. Based on a sample of 904 documents extracted from the Web of Science database, the research analyses emerging trends in the United States, the United Kingdom and Australia, in patterns of collaboration between authors and countries, and the main topics related to music, culture, identity and young people. To this end, we have applied a quantitative bibliometric methodology, using the Biblioshiny tool from RStudio, generating frequency network maps, multiple correspondence analysis and thematic graphs showing the relationships between keywords and those used by authors. The results show that the United States is the leading scientific producer in this field. The two main terms obtained in the analysis are popular culture and popular music, in addition to related concepts such as identity, gender and education, among others. In conclusion, this study shows how globalisation alters popular culture by influencing the behaviour of adolescents. The research is limited in terms of contributions from the Global South, given the database used, but it is presented as an inclusion in future lines of research.