Search Results (2,045)

This study examined dynamic associations among stress, anxiety, and depressive symptoms during the first year of junior high school, a developmental period in early adolescence characterized by heightened vulnerability to psychological problems. A total of 503 students who had recently entered junior high school completed the Depression Anxiety Stress Scales-21 (DASS-21) at three time points, six months apart. Random-intercept cross-lagged panel modeling and network analysis were used to examine longitudinal symptom associations. Results revealed that, at the between-person level, symptoms of stress, anxiety, and depression were highly correlated (rs = 0.86–0.94), with their shared variance largely captured by a general factor. At the within-person level, anxiety showed significant autoregressive effects, and higher-than-usual anxiety at one time point was prospectively associated with higher-than-usual stress at the subsequent time point (ps ≤ 0.001). Among boys, breathing difficulty and worry about panic or embarrassment showed the highest out-expected influence values, whereas scared without any good reason and over-reacting to situations showed the highest values among girls. These findings suggest that, in the current study sample, anxiety may represent a potentially important focus for future intervention research and that the exploratory sex-stratified symptom patterns warrant further investigation. Full article

In recent years, concerns about youth mental health, school disengagement and territorial inequalities have renewed interest in arts-based, participatory educational practices, including participatory video (PV) and youth-led filmmaking. This scoping review, conducted and reported in accordance with the PRISMA-ScR guidelines, maps empirical studies employing PV or youth-led filmmaking with adolescents and young people (approximately 9–24 years) in school, after-school and community-based programmes, focusing on engagement, belonging, psychological well-being, agency, empowerment and socio-emotional skills. A structured search was conducted in four electronic databases (Scopus, Web of Science, PubMed, PsycInfo) and complemented by manual screening of reference lists, yielding nineteen peer-reviewed articles in English using qualitative, quantitative or mixed-methods designs in which PV was a central component. Narrative thematic synthesis suggests that PV can create “third spaces” for expression and co-authorship, support participation and voice, strengthen trust, self-efficacy and relational competences, and foster school connectedness. At the same time, the literature points to limitations linked to structural constraints, power hierarchies and partial institutional recognition of youth-produced narratives. Overall, the review indicates that participatory video is a promising but context-dependent approach for supporting protective factors associated with school disengagement and early school leaving and outlines implications for integrated school–community interventions and future research on longer-term impacts. Full article

Background: Problematic social media use among adolescents has emerged as a growing public health concern. This study examined gender differences in problems related to social media use and their behavioural, psychosocial, family-related, and school-related correlates among Finnish adolescents. Methods: In this cross-sectional study, binary logistic regression analyses were conducted using data from the Finnish sample of the 2024 European School Survey Project on Alcohol and Other Drugs (ESPAD), including 3293 adolescents aged 15–16 years. Results: Overall, 45% of girls and 30% of boys were classified as having problems related to social media use. Significant gender interactions were observed in the associations of gaming-related problems and perceived family socioeconomic status with problems related to social media use. Gaming-related problems were the strongest correlate, with a substantially stronger association among boys. Elevated psychological distress was associated with a higher likelihood of problems related to social media use, particularly among girls, whereas higher parental monitoring was associated with a lower likelihood only among girls. Truancy and plans for general upper secondary school were both associated with a higher likelihood of problems related to social media use among girls and boys. Conclusions: The findings suggest that problems related to social media use are closely linked to adolescent well-being and behaviour. Prevention and intervention efforts may therefore benefit from addressing problematic social media use as part of adolescent mental health and digital well-being strategies, combining universal approaches with targeted support for adolescents experiencing problematic patterns of digital media use. Full article

Background: Visual impairment is associated with mental health difficulties in children, yet emotional and behavioral profiles across different etiologies and levels of visual impairment remain poorly characterized. We investigated whether these outcomes were associated with syndromic etiology or visual impairment severity. Methods: In this cross-sectional study, parents of 69 children and adolescents aged 6–17 years with visual impairment completed the Child Behavior Checklist (CBCL/6–18). Participants were grouped by etiology (syndromic, n = 14; non-syndromic, n = 55) and by visual impairment severity (mild-to-moderate, n = 33; severe-to-profound, n = 36). Group differences were assessed using Mann–Whitney U tests with false discovery rate (FDR) correction, complemented by categorical analyses using scale-specific CBCL clinical thresholds. Results: No significant differences in emotional or behavioral symptoms were observed between the syndromic and non-syndromic groups, although the small syndromic subgroup limited statistical power. In contrast, children with mild-to-moderate visual impairment had significantly higher scores on the Anxious/Depressed and Somatic Complaints scales than those with severe-to-profound impairment, with both differences remaining significant after FDR correction. Categorical analyses also showed a higher prevalence of clinically significant Anxious/Depressed and Internalizing Problems in the mild-to-moderate group. Conclusions: Children with mild-to-moderate visual impairment exhibited higher Anxious/Depressed and Somatic Complaints scores than those with severe-to-profound impairment. These findings suggest that children with residual vision may represent an underrecognized subgroup at risk for emotional difficulties and support routine psychological screening across the spectrum of pediatric visual impairment. Full article

School-based prevention programs increasingly incorporate mental health-related components to prevent substance use among adolescents. This study aimed to evaluate the effectiveness of integrated school-based mental health and substance use prevention programs for adolescents through a systematic review and meta-analysis. A systematic literature search was conducted across 12 electronic databases for studies published between January 2016 and April 2026. Randomized controlled trials (RCTs) and cluster randomized controlled trials evaluating school-based integrated prevention programs for adolescents were included. Random-effects meta-analyses were performed for substance-use outcomes, including alcohol-related outcomes and binge drinking, using pooled odds ratios (ORs) and 95% confidence intervals (CIs). Mental health and psychosocial outcomes were synthesized narratively because heterogeneity in outcome definitions, measurement instruments, and assessment periods precluded meaningful quantitative pooling. A total of 16 reports representing 10 independent trials were included in the systematic review, and five independent trial comparisons were included in the primary meta-analysis. Integrated prevention programs significantly reduced alcohol-related behaviors among adolescents compared to control groups (OR = 0.56, 95% CI = 0.37–0.86, p = 0.008). Significant preventive effects were also observed for binge drinking outcomes (OR = 0.32, 95% CI = 0.16–0.64, p = 0.001). Most interventions incorporated emotional regulation, resilience enhancement, coping skills, stress management, and help-seeking promotion. Digital and online approaches were frequently used. Narrative findings suggested potential benefits for selected psychosocial and mental health-related outcomes; however, these outcomes were not quantitatively pooled and were not consistently sustained across follow-up periods. Integrated school-based prevention programs incorporating mental health-related components demonstrated beneficial effects on alcohol-related behaviors and binge drinking among adolescents. Evidence regarding mental health and psychosocial outcomes was based on narrative synthesis and remains less conclusive. These findings support the importance of integrated prevention approaches that simultaneously address substance use and mental health in school settings. However, additional large-scale RCTs with standardized outcome measures and long-term follow-up are needed to strengthen the current evidence base. Full article

Background/Objectives: Adolescents with anorexia nervosa (AN) face substantial medical and psychiatric risk during hospitalization. We examined predictors of length of stay (LOS), cardiovascular recovery, refeeding safety, and psychiatric comorbidity in a consecutive pediatric cohort at a national tertiary center. Methods: Retrospective cohort of 68 consecutively admitted adolescents (91.2% female; mean age 14.2 ± 1.8 years, range 8–17; 85.3% restricting type) admitted between January 2017 and May 2025. A structured nutritional rehabilitation protocol (1000–1200 kcal/day, escalating by 200 kcal/day every 48 h to 2500–3000 kcal/day) was implemented with daily serum electrolyte monitoring. Statistical analyses included paired tests, Spearman correlations, multivariable regression of log-transformed LOS, and partial correlations controlling for the admission BMI z-score. Results: Nutritional and cardiovascular parameters improved from admission to discharge. Mean supine heart rate (HR) increased by 28.4 bpm (95% CI 25.0–31.8; p < 0.001), and bradycardia prevalence (HR < 50 bpm) improved from 39.7% to 1.5%. Lower admission BMI z-score was associated with longer LOS; each 1-unit higher BMI z-score was associated with an 18.9% shorter LOS in adjusted log-LOS regression (p = 0.003). Exploratory analyses of HR recovery suggested that the magnitude of HR improvement was more closely associated with baseline BMI z-score and baseline supine HR than with caloric escalation. Systematic electrolyte monitoring documented no hypophosphatemia requiring intervention and no refeeding syndrome. Documented mental health comorbidities or clinically significant symptom clusters were present in 82.4% of patients. Conclusions: In this adolescent anorexia nervosa cohort, structured inpatient nutritional rehabilitation was associated with substantial cardiovascular and nutritional improvement. Baseline nutritional status was associated with hospital course and cardiovascular response, while LOS should be interpreted as a composite outcome influenced by nutritional severity, discharge criteria, mental health needs, and family readiness. The absence of refeeding complications is reassuring and suggests that the protocol was metabolically safe under systematic electrolyte monitoring in this specialized tertiary setting. Full article

Background/Objectives: Dietary patterns may be associated with adolescent mental health, but nationwide Brazilian evidence based on empirically derived patterns across survey editions remains limited. This study identified dietary patterns and examined their associations with a survey-specific adverse mental health indicator among school-attending adolescents aged 13–17 years in the 2015 and 2019 National Survey of School Health (PeNSE). Methods: The two independent cross-sectional surveys were analyzed separately, with the 2015 analysis restricted to Sample 2. Two dietary patterns were derived in each edition using principal component analysis. The primary outcome was membership in the highest category defined from the weighted distribution of a non-diagnostic, survey-specific composite score of adverse mental health-related indicators. Survey-weighted modified Poisson regression estimated adjusted prevalence ratios (PRs); continuous, ordinal, between-survey heterogeneity, alternative-outcome, weighted-PCA, and E-value analyses assessed robustness. Results: Both surveys yielded ultra-processed/unhealthy and healthy/traditional patterns. Compared with the highest adherence quartile (Q4), the lowest quartile (Q1) of the ultra-processed/unhealthy pattern was associated with a lower prevalence of the adverse indicator in 2015 (adjusted PR = 0.85, 95% CI: 0.73–0.98) and 2019 (adjusted PR = 0.81, 95% CI: 0.76–0.86). Conversely, Q1 of the healthy/traditional pattern was associated with a higher prevalence in 2015 (adjusted PR = 1.75, 95% CI: 1.45–2.10) and 2019 (adjusted PR = 1.34, 95% CI: 1.26–1.42). No between-survey heterogeneity was detected for the ultra-processed/unhealthy pattern, whereas the healthy/traditional estimates differed in magnitude between surveys; sensitivity analyses were directionally consistent. Conclusions: Greater ultra-processed/unhealthy adherence and lower healthy/traditional adherence were associated with a higher prevalence of the survey-specific adverse mental health indicator. Because the surveys were cross-sectional and used edition-specific measures, these findings do not establish temporality, causality, or temporal change in invariant constructs. Full article

Background/Objectives: Adolescent substance use and mental health problems frequently co-occur and share common risk and protective factors. Some school-based prevention programs address substance use and mental health within an integrated approach. However, the characteristics and intervention components of these integrated approaches remain insufficiently understood. This review aimed to describe the program characteristics of school-based integrated mental health and substance use prevention programs for adolescents that were evaluated in randomized or cluster randomized controlled trials (RCTs/cRCTs), with particular attention to their intervention components, delivery approaches and prevention strategies. Methods: This review used a structured approach comprising a systematic literature search, predefined eligibility criteria, independent study selection, standardized data extraction and coding, and descriptive synthesis. Electronic databases (PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, KMbase, KoreaMed, ScienceON, DBpia, KISS, RISS, and PQDT) were searched for studies published between January 2016 and April 2026. Studies were eligible if they were randomized or cluster randomized controlled trials evaluating school-based interventions that incorporated both substance use prevention and mental health promotion components among adolescents. Data were extracted and synthesized descriptively at the program level to summarize program characteristics and intervention components. Results: Fifteen studies representing 10 unique programs were included. Mental health literacy was identified in 5 programs and emotional regulation in 4. Drug literacy and resistance skills were each identified in 6 programs, alcohol prevention in 5, and cannabis prevention in 4. A descriptive cross-domain analysis identified overlapping patterns involving literacy, self-regulation, help-seeking, social competence, peer support, and family-focused approaches rather than mutually exclusive program types. Conclusions: The school-based integrated prevention programs evaluated in randomized or cluster randomized controlled trials and included in this review combined substance use prevention with mental health promotion components, including psychosocial skill development, peer support, and, in one program, a family-focused approach. The descriptive synthesis of program characteristics provides an initial basis for understanding the diverse approaches used in integrated school-based prevention and may inform the future design and evaluation of programs targeting adolescent mental health and substance use. Full article

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. Full article

Adapting psychological interventions from High-Income Countries (HICs) to Low- and Middle-Income Countries (LMICs) is often needed because developing new treatments requires significant resources. Contextual adaptation improves acceptability, practicality, and effectiveness in diverse settings. However, few studies clearly describe the frameworks guiding these adaptations. Our review examined the literature on conceptual and procedural frameworks for culturally adapting psychological interventions aimed at youth depression and anxiety and identified common challenges. We searched several databases for studies that had culturally adapted psychological treatments in LMICs. We used the Reporting Cultural Adaptation in Psychological Trials (RECAPT) framework to gather data and guide the thematic analysis. We reviewed 25 studies; most (n = 23) reported formative work but lacked detailed, step-by-step descriptions of the adaptation processes. When frameworks were described, processes were often unclear, making it difficult to determine what constitutes adaptation and how to implement it. The review underscores the need for more structured, detailed reporting of adaptation frameworks. Clearer documentation is vital for better understanding and successful implementation. Based on these findings, we suggest ways to improve reporting practices for the cultural adaptation of psychological interventions. We recommend (1) explicit reporting of step-by-step adaptation processes using established frameworks and (2) systematic documentation of cultural and contextual modifications based on identified conceptual and process frameworks using reporting guidelines such as RECAPT. Full article

Background: Problematic social media use (PSMU) has become increasingly prevalent among adolescents and is consistently associated with a wide range of adverse mental health outcomes, underscoring its growing significance as a contemporary psychosocial and developmental concern. However, empirical research examining protective psychological factors associated with relationships between PSMU and psychological difficulties remains limited. The present study examined whether resilience and secure attachment were associated with the relationships between PSMU and loneliness, bullying perpetration, and negative body image among adolescents. Methods: Participants were 712 adolescents aged between 13 and 18 years (M_age = 15.33, SD = 1.13; 61.1% females, 38.9% males). Standardized scales were used to assess problematic social media use, secure attachment, resilience, bullying perpetration, loneliness, and negative body image. Results: The findings indicated that higher levels of problematic social media use (PSMU) were significantly associated with lower levels of secure attachment and resilience, alongside higher levels of loneliness, bullying perpetration, and negative body image. Secure attachment and resilience were also significantly associated with lower loneliness, bullying perpetration, and negative body image. Moreover, significant indirect associations were observed between PSMU and loneliness, bullying perpetration, and negative body image through secure attachment and resilience. Conclusions: These findings suggest that secure attachment and resilience may represent important psychological resources associated with the relationships between PSMU and psychosocial difficulties during adolescence. Given the cross-sectional design of the study, these findings should be interpreted as statistical associations rather than causal processes or mechanisms. Full article

Life skills are cognitive, emotional and social competencies that help adolescents manage everyday demands and participate in school and social contexts. This study aimed to translate, culturally adapt and examine the psychometric properties of the European Portuguese Life Skills Scale (LSS). A cross-sectional methodological study included a convenience sample of 1807 Portuguese adolescents aged 13–19 years from public secondary schools in Central Portugal. The sample was randomly split for exploratory factor analysis (EFA; n = 903) and confirmatory factor analysis (CFA; n = 904). EFA supported an interpretable eight-factor solution explaining 50.7% of the variance. CFA compared the original ten-factor model with the EFA-derived eight-factor model. The ten-factor model showed significant standardised loadings (λ = 0.444–0.849) and comparatively better fit, with acceptable root mean square error of approximation (RMSEA = 0.045) and standardised root mean square residual (SRMR = 0.062), although the comparative fit index (CFI = 0.855) and Tucker–Lewis index (TLI = 0.849) remained below preferred thresholds. Internal consistency was satisfactory to excellent (α = 0.782–0.963; ω = 0.783–0.964). Average variance extracted (AVE) and heterotrait–monotrait ratio (HTMT) analyses provided partial evidence of convergent validity and additional support for discriminant validity. Supplementary multi-group CFA provided preliminary support for measurement invariance across female and male adolescents. Findings provide initial support for the European Portuguese LSS as a multidimensional measure of adolescent life skills. Full article

Background/Objectives: Positive psychological constructs such as psychological well-being, resilience, subjective vitality, and mental toughness are fundamental to students’ emotional adjustment and overall development. Physical activity (PA) is a modifiable factor known to enhance these variables; however, the influence of its timing throughout the day remains underexplored. This systematic review aimed to examine the effects of PA on psychological well-being, resilience, subjective vitality, and mental toughness in children and adolescents, considering the timing of implementation—before, during, or after school hours—and the specific characteristics of the activities performed. Methods: Following the PRISMA guidelines, a comprehensive search was conducted in Scopus, PubMed, ERIC, and Web of Science, identifying 29 studies published between 2014 and 2026, comprising 12 cross-sectional and 17 longitudinal studies. Results: Overall, PA was positively associated with all four psychological variables across different times of the day. PA before school, such as active commuting and active starts, was primarily associated with higher in well-being and vitality. During-school interventions, particularly structured programs such as active breaks and cooperative games, were associated with better resilience, emotional self-regulation, and prosocial behavior. After-school PA, especially organized and voluntary activities, was associated with higher resilience and mental toughness. The effects varied according to the intensity, structure, social context, and student role, with moderate-to-vigorous intensities and cooperative formats producing the most consistent benefits. Conclusions: In conclusion, PA appears to exert a beneficial influence on positive psychological development, with variations depending on the time and mode of practice. Schools, particularly through Physical Education programs, constitute a key context for promoting students’ emotional, motivational, and behavioral health. Full article

Background: Lifestyle habits are critical determinants of psychological health. This study aimed to determine the association between lifestyle factors and perceived stress levels, examining the potential mediating role of Mediterranean diet adherence (MDA). Methods: A cross-sectional study was conducted with 1229 participants (50.04% female, mean age of 13.45 ± 1.97 years). Lifestyle factors, including MDA, screen time (ST), sleep duration, active commuting and physical activity, were assessed. A multiple linear regression and mediation analysis were performed, adjusting for age and sex. Results: Significant sex differences were found, with females reporting higher stress and lower MDA (p < 0.001). Regression models revealed that higher MDA (p = 0.001) and lower ST (b = 0.22, p = 0.014) were significantly related to reduced stress. Mediation analysis showed that MDA statistically (partially) mediated the association between ST and stress (Indirect effect = 0.025, 95%CI; 0.005, 0.054). Specifically, MDA accounted for 10.12% of the total effect of ST on stress, representing a modest indirect contribution. Conclusions: Elevated ST routines are positively associated with adolescent perceived stress, whereas higher MDA displays an inverse relationship with stress. Additionally, this association is structurally modulated by MDA, highlighting that the unfavorable correlates of excessive television viewing and video-game use are modestly linked to concurrent variations in dietary quality within school environments. Given the cross-sectional design, these findings should be interpreted as indirect associations rather than causal pathways, and reverse or bidirectional relationships cannot be ruled out. Full article

Background/Objectives: Existing mental health help-seeking measures may not adequately reflect adolescents’ developmental and sociocultural contexts. This study developed and evaluated a mental health help-seeking scale for Korean adolescents. Methods: Following DeVellis’ guidelines, items were generated through concept analysis and in-depth interviews. Expert review reduced 50 initial items to 33 preliminary items. Data were collected from 500 adolescents in Gyeongsangbuk-do, Republic of Korea. EFA and CFA were conducted using separate samples of 250 participants. Results: The final scale comprised 16 items across three factors: Mental Health Help-Seeking Willingness, Overcoming Stigma in Mental Health Help-Seeking, and Knowledge of Mental Health Help-Seeking Resources. The factors explained 46.4% of the variance, and CFA provided preliminary support for the three-factor structure. Cronbach’s α was 0.85 overall and ranged from 0.73 to 0.85 across subscales. Conclusions: The scale provides preliminary evidence of reliability and validity for assessing mental health help-seeking among Korean adolescents and may be useful in research and early-prevention settings. Full article