Adolescent health

Anxiety and depressive symptoms frequently co-occur during adolescence. Physical activity is associated with adolescent mental health at the scale-score level, but its links with individual symptoms and their temporal ordering remain less clear. This study examined contemporaneous and one-year prospective associations between physical activity and individual anxiety/depression symptoms, evaluated the robustness of pooling three annual wave-pair cohorts, and compared network patterns between male and female adolescents. Three adjacent annual wave-pair cohorts (2020–2021, 2021–2022, and 2022–2023) from a Chinese national adolescent health survey were analyzed ( N = 13,785 wave-pair records). Physical activity was measured with the PAQ-A and anxiety/depression symptoms with the SCL-90. Gaussian graphical models and cross-lagged panel networks (CLPNs) were estimated. Annual-cohort invariance, missingness, centrality, bridge centrality, accuracy, stability, and male/female differences were examined. Annual-cohort comparisons showed no detectable network-structure differences (M = 0.07–0.08, p = 0.120–0.270) or global-strength differences (ΔS = 0.12–0.32, p = 0.150–0.320). Little’s test was nonsignificant (χ² = 79.39, df = 89, p = 0.531), providing no evidence against a completely-at-random missingness mechanism. In the pooled contemporaneous network, physical activity had negative partial correlations with low motivation (weight = -0.0732), low energy (-0.0651), and nervousness (-0.0532). Worthlessness (expected influence [EI] = 1.39), tension (EI = 1.38), and nervousness (EI = 1.34) were influential nodes. Panic had the highest reported bridge EI (0.659). In the CLPN, physical activity was prospectively associated with lower low motivation ( β = -0.0602) and low mood ( β = -0.0561), while nervousness was associated with lower subsequent physical activity ( β = -0.0539). Male and female networks differed in structure (M = 0.112, p < 0.001) but not global strength (ΔS = 0.19, p = 0.709). Physical activity occupied a peripheral position in the contemporaneous network but showed small prospective associations with selected anxiety and depressive symptoms. These temporal associations do not establish causality. The stable annual-cohort pattern and male/female-specific edge configuration support further confirmatory work using designs that can address unmeasured confounding and within-person change.

Background: Bullying remains a significant adolescent health and school safety concern. Self control may influence students' behavioral regulation and involvement in bullying. Objectives: This study examined the association between self control and bullying behavior among students at SMPN 1 Cikembar, Sukabumi Regency, Indonesia. Methods: A correlational cross sectional study included 293 students selected from a population of 1,059 using proportional stratified random sampling. Self control and bullying behavior were assessed using questionnaires based on the Brief Self Control Scale and Revised Olweus Bully/Victim Questionnaire. Associations were analyzed using the Chi square test and prevalence ratios (PR) with 95% confidence intervals (CI). Results: High self control was reported by 185 students (63.1%), while 184 (62.8%) demonstrated low bullying behavior. High bullying behavior occurred in 56.5% of students with low self control compared with 25.9% of those with high self control. Low self control was significantly associated with higher bullying prevalence (PR = 2.18; 95% CI: 1.62–2.92; X² = 27.22; p < 0.001). Conclusions: Lower self control was significantly associated with bullying behavior, without establishing causality. School prevention programs should integrate behavioral assessment, counseling, and coordinated teacher and parent support.

زمینه: زورگویی همچنان یکی از نگرانی‌های مهم سلامت نوجوانان و ایمنی مدارس است. خودکنترلی ممکن است بر تنظیم رفتاری دانش‌آموزان و مشارکت آن‌ها در رفتارهای زورگویی تأثیرگذار باشد. هدف: این پژوهش به بررسی ارتباط بین خودکنترلی و رفتار زورگویی در میان دانش‌آموزان مدرسه متوسطه اول دولتی شماره ۱ چیکمبار، شهرستان سوکابومی، اندونزی پرداخت. روش‌ها: این مطالعه مقطعی همبستگی شامل ۲۹۳ دانش‌آموز بود که از جمعیت ۱۰۵۹ نفره با استفاده از نمونه‌گیری تصادفی طبقه‌بندی‌شده متناسب انتخاب شدند. خودکنترلی و رفتار زورگویی با استفاده از پرسشنامه‌هایی بر اساس Brief Self Control Scale و Revised Olweus Bully/Victim Questionnaire ارزیابی شد. ارتباطات با استفاده از آزمون کای‌اسکوئر و نسبت شیوع (PR) با فاصله اطمینان ۹۵٪ (CI) تحلیل گردید. یافته‌ها: ۱۸۵ دانش‌آموز (۶۳/۱٪) خودکنترلی بالا و ۱۸۴ نفر (۶۲/۸٪) رفتار زورگویی پایین را گزارش کردند. رفتار زورگویی بالا در ۵۶/۵٪ از دانش‌آموزان با خودکنترلی پایین در مقایسه با ۲۵/۹٪ از افراد با خودکنترلی بالا مشاهده شد. خودکنترلی پایین به طور معناداری با شیوع بالاتر رفتار زورگویی مرتبط بود (PR = 2.18؛ ۹۵٪ CI: 1.62–2.92؛ X² = 27.22؛ p < 0.001). نتیجه‌گیری: خودکنترلی پایین به طور معناداری با رفتار زورگویی مرتبط بود، بدون آنکه رابطه علیت اثبات شود. برنامه‌های پیشگیری مدرسه‌ای باید ارزیابی رفتاری، مشاوره و حمایت هماهنگ معلمان و والدین را دربرگیرد.

Bullying victimization is an important public health concern that has been linked to adverse psychological outcomes among adolescents. The study used mental health well-being data collected in the most recent Bangladesh Adolescent Health and Wellbeing Survey (2019–2020) (BAHWS). A total of 9,116 adolescents aged 15–19 years with complete depression data were included in the analysis. A three-level linear mixed-effects model was employed to account for the hierarchical structure of the survey, with adolescents nested within primary sampling units and districts. Additional analyses examined gender and marital status interactions, subgroup differences, and the cumulative association between multiple forms of bullying and depressive symptoms using a composite bullying measure. The findings revealed that verbal bullying (β = 1.39, p < 0.001) and cyberbullying (β = 1.15, p = 0.012) were independently associated with higher depressive symptom scores. The association between physical bullying and depressive symptoms differed significantly by gender, whereas interactions of gender with verbal and cyberbullying were not statistically significant. Exploratory subgroup analyses showed variation in the magnitude of estimated associations across ever-married females, unmarried females, and unmarried males. A graded association was observed for cumulative bullying exposure: compared with adolescents reporting no bullying exposure, those exposed to on (β = 1.25), two (β = 2.61), and three (β = 4.99) bullying types had progressively higher depressive symptom scores (all p < 0.001). Adolescent Age, Current school or college attendance and higher household wealth were associated with lower depressive symptom scores. Bullying victimization, particularly verbal bullying, cyberbullying, and exposure to multiple forms of bullying, was associated with higher depressive symptoms among Bangladeshi adolescents. These findings highlight the need for comprehensive bullying prevention strategies and accessible psychosocial support services, with particular attention to adolescents experiencing multiple forms of bullying and other vulnerable groups.

Digital media has evolved from passive screen viewing into an algorithmically curated ecosystem of social platforms, short form video, games, generative artificial intelligence (AI), conversational agents, connected toys and educational technologies. These systems can support learning, creativity, communication, disability access and healthcare; however, engagement optimized design, commercial surveillance and synthetic content create risks that are not adequately captured by screen-time measures alone. This narrative review examines the effects of contemporary digital ecosystems on child and adolescent health and outlines implications for pediatric practice. PubMed/MEDLINE, Google Scholar and guidance from the World Health Organization, United Nations Children's Fund, UNESCO and the American Academy of Pediatrics were reviewed, with emphasis on evidence published from 2019 to June 2026. Associations have been reported between problematic digital media use and sleep disruption, reduced physical activity, visual and musculoskeletal symptoms, obesity related behaviours, anxiety, depressive symptoms, cyberbullying, disordered eating and impaired attention. Causal interpretation remains difficult because effects are heterogeneous, often small, bidirectional and strongly modified by age, content, context, displacement, family relationships and pre-existing vulnerability. AI adds distinct concerns: persuasive personalization, inaccurate health information, anthropomorphic dependency, deepfakes, sexual exploitation, biased outputs, privacy loss and erosion of learning through uncritical outsourcing. Benefits are also substantial when technologies are developmentally appropriate, evidence-based, inclusive and used with adult support. Pediatric counselling should shift from counting hours alone toward assessing the child's digital ecosystem, sleep, function, content, compulsivity, safety and relationships. Effective protection requires shared family practices, school digital literacy, safety by design, age-appropriate assurance, transparent algorithms, data minimization and independent research. The goal is not a screen free childhood but a child centred digital environment that supports health, agency and development.

Sleep health in adolescence is a global public health concern. However, limited studies on adolescent sleep health in Africa exist, and the extent of the available literature on the African continent has not been previously mapped. This review aimed to map the studies on adolescent sleep health in Africa with a focus on the geographical distribution, publication trends, pattern of sleep health measures, prevalence of sleep disorders, the barriers and facilitators to good sleep health, rural-urban disparities, as well as the associations of sleep health with mental health, school schedule and cardio-metabolic risk among the adolescents. All published articles on adolescent sleep health in Africa in English, French, Spanish, Portuguese, and Italian languages were to be included. We conducted a scoping review by searching five databases: MEDLINE (via PubMed), CINAHL (via EBSCOHost), PsycINFO (via EBSCOHost), Scopus, and the African Journal Online (AJOL), from the inception of the databases to January 2025. As previously highlighted in our published protocol, we used the JBI methodology for the scoping review. After screening 921 titles and abstracts and 78 full-text articles, we included 43 articles. There has been an increasing number of studies on adolescent sleep in Africa in the past 25 years. Cross-sectional studies were the most frequent design (67.4%). Most studies focused on sleep quantity and quality, with small sample sizes and scanty evidence on other aspects of sleep health. Inadequate weekday sleep duration was common among adolescents, often compensated by longer weekend sleep durations. Screen use at bedtime, sleeping environment, school schedules, and chronic medical conditions were the major risk factors for sleep disturbances. Poor sleep was associated with poor academic performance, depression, anxiety, and adverse cardiometabolic risk. This review shows a lack of studies on the multidimensional aspects of sleep health and the need for more objective sleep measures to better characterise the sleep health of adolescents in Africa. Larger studies with longitudinal and mixed-method designs are needed to drive the planning and execution of interventions to improve sleep health among African adolescents.

سلامت خواب در دوره نوجوانی یک دغدغه جهانی در حوزه سلامت عمومی است. با این حال، مطالعات محدودی درباره سلامت خواب نوجوانان در آفریقا وجود دارد و میزان ادبیات موجود در این زمینه در قاره آفریقا تاکنون ترسیم نشده است. هدف این مرور، ترسیم مطالعات انجام‌شده درباره سلامت خواب نوجوانان در آفریقا با تمرکز بر توزیع جغرافیایی، روندهای انتشار، الگوی سنجش سلامت خواب، شیوع اختلالات خواب، موانع و تسهیل‌کننده‌های سلامت خواب مطلوب، تفاوت‌های روستایی-شهری، و همچنین ارتباط سلامت خواب با سلامت روان، برنامه مدرسه و ریسک کاردیومتابولیک در میان نوجوانان بود. تمامی مقالات منتشرشده درباره سلامت خواب نوجوانان در آفریقا به زبان‌های انگلیسی، فرانسوی، اسپانیایی، پرتغالی و ایتالیایی وارد مطالعه شدند. ما یک مرور محدوده‌ای با جستجو در پنج پایگاه داده MEDLINE (از طریق PubMed)، CINAHL (از طریق EBSCOHost)، PsycINFO (از طریق EBSCOHost)، Scopus و African Journal Online (AJOL) از ابتدای پایگاه‌ها تا ژانویه ۲۰۲۵ انجام دادیم. همان‌گونه که در پروتکل منتشرشده ما ذکر شده بود، از روش‌شناسی JBI برای مرور محدوده‌ای استفاده کردیم. پس از غربالگری ۹۲۱ عنوان و چکیده و ۷۸ مقاله متن کامل، ۴۳ مقاله وارد مطالعه شدند. در ۲۵ سال گذشته تعداد مطالعات درباره خواب نوجوانان در آفریقا رو به افزایش بوده است. مطالعات مقطعی رایج‌ترین طرح پژوهشی بودند (۶۷.۴٪). بیشتر مطالعات بر کمیت و کیفیت خواب تمرکز داشتند و حجم نمونه‌ها کوچک و شواهد درباره سایر ابعاد سلامت خواب اندک بود. ناکافی بودن مدت خواب در شب‌های هفته در میان نوجوانان رایج بود که اغلب با خواب طولانی‌تر در آخر هفته جبران می‌شد. استفاده از صفحه‌نمایش هنگام خواب، محیط خواب، برنامه مدرسه و بیماری‌های مزمن از مهم‌ترین عوامل خطر اختلالات خواب بودند. خواب نامطلوب با عملکرد تحصیلی ضعیف، افسردگی، اضطراب و ریسک کاردیومتابولیک نامطلوب همراه بود. این مرور نشان می‌دهد که مطالعات اندکی درباره ابعاد چندگانه سلامت خواب وجود دارد و نیاز به سنجش‌های عینی‌تر برای توصیف بهتر سلامت خواب نوجوانان آفریقایی احساس می‌شود. مطالعات بزرگ‌تر با طرح‌های طولی و روش‌های ترکیبی برای هدایت برنامه‌ریزی و اجرای مداخلات به منظور بهبود سلامت خواب نوجوانان آفریقایی مورد نیاز است.

Artificial intelligence (AI) chatbots are increasingly embedded in adolescents’ daily lives, yet developmental science research struggles to keep pace with adoption. This mixed-methods study gathered developmental expert perspectives via a survey ( n = 141 researchers studying youth and technology and adjacent professionals) and semi-structured interviews ( n = 15) to inform a coordinated research and policy agenda on adolescent AI use. The study aims were to identify (1) priority AI use cases for future study, (2) priority research questions and methods, as well as barriers to future research, and (3) societal guardrails that developmental professionals recommend enacting now, while research is underway. Participants cautioned against vague “screen time” measures and agreed that nearly all use cases merit study but prioritized those with severe or irreversible immediate-term harms, AI literacy, AI as a social/relational actor, AI-generated (mis)information, and overreliance. Participants emphasized that methodological pluralism and triangulation, including within individual studies, are essential, agreeing that different methods can be complementary to address distinct research questions. Key barriers included the rapid pace of change in AI technology and use relative to academic timelines, limited industry transparency, funding gaps, and misaligned academic incentives. Proposed solutions included shared infrastructure, interdisciplinary consortia, and community partnerships. Participants underscored that responsibility for safe AI should not rest primarily on adolescents and families and identified three immediate guardrails: enforceable youth-centered regulation, developmentally informed design, and multidimensional AI literacy. Findings clarify a preliminary direction for the field and emphasize that coordination among researchers and between sectors is needed.

چت‌بات‌های هوش مصنوعی (AI) به طور فزاینده‌ای در زندگی روزمره نوجوانان جای گرفته‌اند، اما پژوهش‌های علم رشد با سرعت پذیرش این فناوری همگام نیستند. این مطالعه با روش ترکیبی، دیدگاه‌های متخصصان رشد را از طریق یک پیمایش (n = 141 پژوهشگر حوزه نوجوانان و فناوری و حرفه‌ای‌های مرتبط) و مصاحبه‌های نیمه‌ساختاریافته (n = 15) گردآوری کرد تا دستورکار هماهنگ پژوهشی و سیاستی درباره استفاده نوجوانان از هوش مصنوعی را تدوین کند. اهداف مطالعه عبارت بودند از: (1) شناسایی موارد اولویت‌دار استفاده از هوش مصنوعی برای پژوهش‌های آتی، (2) شناسایی پرسش‌ها و روش‌های پژوهشی اولویت‌دار و همچنین موانع پژوهش‌های آینده، و (3) تعیین چارچوب‌های محافظتی اجتماعی که متخصصان رشد توصیه می‌کنند همزمان با انجام پژوهش‌ها، اجرایی شوند. شرکت‌کنندگان نسبت به سنجش‌های مبهم «زمان استفاده از صفحه‌نمایش» هشدار دادند و توافق داشتند که تقریباً همه موارد استفاده شایسته مطالعه هستند، اما مواردی با آسیب‌های شدید یا غیرقابل بازگشت در کوتاه‌مدت، سواد هوش مصنوعی، نقش اجتماعی/ارتباطی هوش مصنوعی، اطلاعات (نادرست) تولیدشده توسط هوش مصنوعی و اتکای بیش از حد را در اولویت قرار دادند. شرکت‌کنندگان تأکید کردند که کثرت‌گرایی روشی و مثلث‌سازی، حتی در درون یک مطالعه، ضروری است و توافق داشتند که روش‌های مختلف می‌توانند برای پاسخ به پرسش‌های پژوهشی متفاوت، مکمل یکدیگر باشند. موانع کلیدی شامل سرعت بالای تغییرات فناوری و استفاده از هوش مصنوعی نسبت به زمان‌بندی‌های دانشگاهی، شفافیت محدود صنعت، کمبود منابع مالی و عدم تطابق مشوق‌های دانشگاهی بود. راه‌حل‌های پیشنهادی شامل زیرساخت مشترک، کنسرسیوم‌های میان‌رشته‌ای و مشارکت‌های اجتماعی بود. شرکت‌کنندگان تأکید کردند که مسئولیت ایمنی هوش مصنوعی نباید عمدتاً بر دوش نوجوانان و خانواده‌ها باشد و سه چارچوب فوری را شناسایی کردند: مقررات قابل اجرا با محوریت نوجوانان، طراحی مبتنی بر رشد و سواد چندبعدی هوش مصنوعی. یافته‌ها جهت‌گیری مقدماتی این حوزه را روشن می‌کند و بر ضرورت هماهنگی میان پژوهشگران و بین بخش‌ها تأکید دارد.