Self-harm among young people is a global concern. Parents and caregivers play a central role in supporting young people who self-harm, however, many report difficulties in understanding the behaviour and its meaning. This systematic review, therefore, aimed to identify variations in how self-harm is defined within studies and synthesize qualitative evidence on parents’ and caregivers’ understanding of self-harm in young people. Four electronic databases were searched to December 2024, alongside hand-searching and citation tracking. Study quality was appraised using the CASP qualitative checklist. Data were synthesized using thematic synthesis, with confidence assessed using GRADE-CERQual. Of 4,238 studies screened, ten met inclusion criteria. Thematic analysis revealed four main themes for parents and caregivers understanding of self-harm: (1) self-harm as an emotional regulation strategy, (2) self-harm as a means of communication or expression, (3) self-harm within developmental and contextual narratives and (4) self-harm linked to mental health difficulties and life history. GRADE-CERQual indicated moderate confidence across all themes. Findings demonstrate that parents’ and caregivers’ interpretations are multidimensional, reflecting emotional, interpersonal, developmental and contextual processes. Integrating these perspectives provides a developmental informed framework for understanding how families construct meaning around self-harm. Trial registration This systematic review was prospectively registered with PROSPERO (Registration number. CRD42024548743). The preregistration specified the review objectives, eligibility criteria, search strategy, study selection process, data extraction methods, qualityassessmentandplannedmethodsfordatasynthesisand analysis. https://www.crd.york.ac.uk/PROSPERO/view/CRD42024548743 .
Although socio-developmental models of social media use among adolescents have indicated that social media usage may be associated with body image concerns and disordered eating behaviors, a comprehensive quantitative review of the evidence on this relationship among adolescents is not yet available. The current systematic review and meta-analysis examined the pooled association between social media use, body image concerns and eating symptoms among adolescents. Eligible studies published from 2005 to mid 2024 were searched for in scientific databases. A three-level meta-analytic model was used to calculate effect sizes for body image outcomes (i.e., body concerns, eating symptoms, self-objectification, and internalization of appearance ideals). A total of 45 studies with 33,086 adolescent participants met the eligibility criteria and were included in the meta-analysis. The results indicated a significant association between elevated levels of social media engagement and higher body image and eating disorder symptoms both in cross-sectional and longitudinal studies. Meta-regression analyses showed a stronger association between body image outcomes, eating symptoms and social media use in studies that examined the Instagram use compared to those that encompassed all social media platforms, and those with a higher percentage of female participants. The results of the study indicate a need for increased social media literacy among adolescents and interventions designed to mitigate the potentially detrimental effects of excessive social media use.
The growing use of digital technologies has generated new dynamics in the interpersonal and sexual relationships of adolescents and young adults. Forms of Technology-Facilitated Sexual Violence (TFSV), such as image-based sexual harassment and image-based sexual abuse, have gained relevance. This phenomenon particularly affects girls, perpetuating structural gender inequality dynamics in digital environments. This study aims to examine how technology-facilitated sexual violence has been addressed in a sample of adolescents and young adults in recent scientific literature, contributing to its reconceptualization. A review of reviews was conducted based on international scientific literature. The search was conducted across academic databases, including Scopus, Web of Science, Medline, PubMed, PsycINFO, and ERIC, and limited to systematic and scoping reviews published between 2015 and 2025. This article synthesizes the selected reviews, organized around eight key dimensions: conceptualization, perception, attitudes, behaviors, risk factors, consequences, help-seeking, and prevention. Twenty-six reviews, comprising 1,114 studies, met the inclusion criteria. The results show high conceptual variability regarding behaviors derived from technology-facilitated sexual violence. An emotional and social impact on adolescent girls is highlighted, as well as an institutional tendency to minimize these forms of violence. Preventive interventions tend to focus on individual risk, neglecting structural dimensions such as gender and power. The reconceptualization of image-based sexual harassment and abuse within the framework of technology-facilitated sexual violence is proposed, highlighting the need for a standardized measurement instrument to enable study comparisons. This review underscores the need for more contextualized interventions that protect the sexual and digital rights of adolescents and young adults.
Children and adolescents experience rapid developmental changes that shape both the opportunities and challenges of using chatbots for mental health support. Younger children are still developing emotion regulation and social learning skills, while adolescents navigate identity formation and autonomy. These transitions influence how youth understand, trust, and engage with chatbots. Existing reviews on mental health chatbots tend to focus on young adults, leaving little evidence for younger users. This pre-registered meta-analysis extends existing reviews by synthesizing experimental evidence focused on youth below 18 years old. Through seven databases and backward citation tracking searched between January, 2014 and March, 2025, 2,398 studies were retrieved. After double-blinded screening, 12 studies were included (Rangeage = 3 18 years old, Ntotal = 2,961, NES = 51). Meta-analysis results showed that chatbots are effective for reducing mental health issues (ES = 0.47, p = .027), but no evidence for improvement in psychosocial well-being outcomes. Moderator analysis showed that, compared to text-based chatbots, audio-based ones are more effective for children and adolescents. These findings advance developmental science by specifying which design features enhance mental health chatbots’ effectiveness, providing guidance for creating digital tools that align with children’s and adolescents’ developmental needs. Lastly, readers must interpret the results with some key limitations in mind, including the small sample size, treatments’ short durations, significant heterogeneity, self-reported outcome measures, and publication bias.
Physical activity has been increasingly recognized as a promising non-pharmacological approach for managing attention-deficit/hyperactivity disorder (ADHD), yet evidence regarding its effects on core symptoms, executive functions, and sleep remains inconsistent. This systematic review and three-level meta-analysis of randomized controlled trials (RCTs) aimed to clarify these effects and identify potential moderators that may explain variability in outcomes. Following a comprehensive search across eight English and Chinese databases up to August 31, 2025, 42 RCTs (45 publications) were included. Data were analyzed using a three-level random-effects model with subgroup, meta-regression, and meta-CART analyses to explore moderators. Across studies, physical activity was associated with significant improvements in core symptoms and executive functions, as well as subjective sleep quality, whereas no significant overall effect was observed for objectively measured sleep. Importantly, effect estimates were characterized by substantial heterogeneity and wide prediction intervals, indicating considerable variability in magnitude and direction across studies. Subgroup analyses suggested that motor skill type significantly moderated effects on core symptoms, while intervention type, control condition, and exercise dose influenced executive function outcomes. Statistically significant effects were observed across multiple symptom and executive function domains. Meta-CART analysis further revealed interactive effects among intervention length, total sessions, and total duration for both core symptoms and executive functions. Overall, these findings suggest that physical activity is associated with beneficial outcomes across several functional domains in youth with ADHD, while also underscoring marked heterogeneity within the current evidence base.
Given the persistent impacts of growth mindset during adolescence, a systematic understanding of its societal correlates and historical trajectory is indispensable for advancing the field. However, prior research has predominantly focused on its consequences, overlooking socio-cultural antecedents, and has lacked a quantitative synthesis of its long-term trends. This study addresses these gaps via cross-temporal meta-analysis, jointly investigating birth cohort changes in growth mindset among American adolescents and their associations with macro-contextual factors. Comprehensive database searches yielded 51 eligible studies (N = 25,702; k = 81). Results showed a slight yet significant decrease in growth mindset between 2005 and 2023 (b=-0.39, SE = 0.14, p < 0.01). Additionally, growth mindset was significantly correlated with key social indicators across four domains: economic conditions (e.g., Gini coefficient, unemployment rate), social connectedness (e.g., urbanization level, divorce rate, average household size), realistic threats (e.g., violent crime rate, internet penetration rate), and materialistic values—suggesting these factors may constitute societal antecedents of the observed decline. These findings underscore the critical need for targeted interventions aimed at fostering growth mindset among American adolescents.
Empathy, the ability to share and understand others’ emotional and mental states, is essential for socioemotional functioning. In adolescence, its development is significantly affected by the social environment. Despite a growing body of research on the effects of increasing social networking site use in adolescence on mental health, relatively little is known about its effects on social skills such as empathy. This systematic review examines the existing literature on the influence of social networking site use on empathy skills in adolescents. The search across eight databases yielded 2,413 results, of which 33 studies were found eligible and included in the analysis. Findings indicate that specific types of use, particularly those classified as problematic or excessive, rather than the mere duration or frequency of use are associated with lower levels of empathy. Assumed moderating effects of personality, media richness, and gender were only examined in a few studies and could not be confirmed based on the results. Overall, the results were relatively heterogeneous and, due to mostly cross-sectional designs, do not allow for causal conclusions. The review further highlights the current limitations of the field, such as a lack of integrative theoretical models, longitudinal and experimental designs, and objective measurement methods.
Although various interventions exist to address adolescent test anxiety, their comparative efficacy remains unclear, creating a gap in evidence-based guidance for researchers, clinicians, and educators. This study aimed to provide the first comprehensive evidence on the comparative efficacy of interventions for test anxiety in adolescents using a Bayesian network meta-analysis, a method that allows for the simultaneous comparison of multiple treatments. A systematic search of eight English and Chinese databases up to June 17, 2025 identified 16 studies (17 randomized controlled trials) involving 1,973 adolescents. The participants were predominantly high school students (11/17 trials), with a majority of studies conducted in China (10/17 trials). The results demonstrated that mindfulness-based interventions, multi-component interventions, and cognitive behavioral therapy were significantly more effective than non-active controls. Mindfulness-based interventions showed the largest effect size (g = -1.82, 95
Non-consensual dissemination of sexts refers to the non-consensual sharing of intimate or sexual photos or videos of an individual previously obtained through sexting. This scoping review examines the factors associated with perpetration and victimization of this behavior among adolescents and young adults. The analysis of 63 quantitative, qualitative and mixed-methods studies revealed that non-consensual dissemination of sexts is a form of online sexual gender-based violence and that a variety of factors related to sociodemographics, interpersonal relations, personal characteristics, mental health, sexuality, online behavior, perceptions of non-consensual dissemination of sexts, deviant and criminal behavior, and other factors are associated with it. Furthermore, the review shows that most of the identified factors are associated with perpetration of the behavior. Fewer factors have been found to be associated with victimization of non-consensual dissemination of sexts. Overall, more attention has been paid to risk factors than to protective factors for involvement in these behaviors. Based on these findings, some recommendations for future research are formulated. In terms of education and prevention, it would be particularly interesting to focus on peer norms and pressure, gender and sexual role dynamics and stereotypes, and ideas, norms and attitudes towards sexting and non-consensual dissemination of sexts in particular. In terms of support, it is particularly important to focus on the (mental health) vulnerabilities of young people involved in the behavior.
Health literacy is critical for health promotion and equity, yet limited evidence exists on how it can be supported among socioeconomically disadvantaged adolescents. Given the importance of schools in promoting adolescent health, this study reviewed school-based health literacy interventions targeting socioeconomically disadvantaged adolescents aged 13–24, with a secondary focus on participatory implementation strategies. A comprehensive search across six databases identified 7152 records published between 2010 and 2024, of which 26 met the inclusion criteria. Eligible studies included randomized controlled trials, non-randomized studies, qualitative studies, and mixed-methods designs. Study quality was assessed using the Mixed Methods Appraisal Tool. Most interventions focused on physical activity, diet, or mental health, but none explicitly measured health literacy. However, health literacy-relevant components were common, especially functional health literacy, while critical health literacy was nearly absent. While educational, hands-on learning and participatory approaches were often employed, student involvement was limited, and few interventions addressed the broader social and structural context influencing adolescent health literacy. The findings underscore the need for youth-centered approaches, improved conceptual clarity, and greater attention to the socioeconomic and cultural context. Strengthening school-based strategies in this way is crucial for supporting health equity during a key developmental period.
Youth self-harm and suicidality are internationally considered serious health concerns, and while multiple studies in recent decades suggest that familial Expressed Emotion may increase risk, the existing research has not previously been systematically reviewed. Addressing this important gap, a comprehensive systematic search was undertaken to identify studies investigating associations between familial Expressed Emotion and youth self-harm and/or suicidality. Of the 2050 articles identified, 20 studies were included, consisting of 13 cross-sectional and seven longitudinal designs and a total population of 5752 youth (mean age 11.32 years, 64
Given the rising prevalence in Asian adolescents who engage in multiple risk behaviors and the lack of a consolidated evaluation of multibehavior intervention outcomes, this systematic review examined the effectiveness of lifestyle interventions targeting two or more of the “Big 6” behavioral risk factors: physical inactivity, excessive sedentary time, poor sleep, unhealthy diet, smoking, and alcohol use. A comprehensive search of seven databases (Public Medline, Embase, Psychological Information Database, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials) identified 28 eligible randomized controlled trials. Of these, 13 demonstrated effectiveness in addressing two or more of the target behaviors, most commonly addressing combinations of physical activity and diet (n = 5), and physical activity and sedentary behavior (n = 3). Effective interventions were delivered over 3 to 39 weeks, with weekly durations ranging from 0.5 to 5 h, and all were school-based. Seven interventions incorporated active family involvement, and two included digital components either independently or alongside family engagement. Nine interventions were guided by explicit theoretical frameworks and consistently applied behavior change techniques that provided clear and actionable guidance. The evidence suggests that multibehavior interventions show potential for improving adolescent health behaviors in Asia, particularly when delivered in school settings, supported by families, enhanced through accessible digital technologies, and grounded in theory-based strategies.
Although numerous resilience interventions have been developed for adolescents (age 10–19) and young adults (age 20–25), their comparative effectiveness remains unclear. This systematic review and network meta-analysis aimed to compare the efficacy of different resilience interventions and further investigate whether the intervention effects differed based on participants’ condition (at-risk or non-at-risk) and age group (adolescents or young adults). A systematic search across PsycINFO, Embase, PubMed, and Web of Science was conducted from inception to October 31, 2024. A total of 46 randomized controlled trials involving 8729 participants were identified (mean age = 15.61 years; 54.18
Bullying victimization and cyberbullying victimization are pervasive phenomena with documented adverse psychological consequences. Although loneliness has been conceptualized as both an antecedent and outcome of victimization experiences, the nature of these relationships remains insufficiently understood. This systematic review synthesizes evidence on the relationships between bullying victimization, cyberbullying victimization, and loneliness, while examining conceptualizations and assessment of loneliness. Following PRISMA guidelines, 7253 articles were evaluated, including 100 studies meeting inclusion criteria. Selected studies included samples from a variety of countries, balanced in terms of gender and with ages ranging from childhood to adulthood. Most studies emphasized loneliness as distress arising from perceived deficiencies in social relationships, with measurement approaches varying considerably. The findings reveal complex, bidirectional relationships between victimization and loneliness, with stronger associations in adolescent samples compared to younger children or adults. While traditional bullying consistently demonstrated significant associations with loneliness, the cyberbullying-loneliness relationship showed greater variability. Some factors such as bystander behaviour or school connectedness moderated this relationship, being this protective effect stronger for girls. This review identifies critical gaps in understanding how different forms of loneliness interact with victimization across developmental stages and cultural contexts, providing a foundation for designing targeted interventions that address loneliness in victimized youth, particularly during adolescence.
Although numerous early studies have reported a significant positive association between adolescent internet gaming disorder and depression, existing reviews have largely failed to systematically examine recent findings indicating that this association may have weakened or become nonsignificant. Additionally, prior reviews have lacked comprehensive quantitative analyses considering developmental stage, cultural differences, and study designs. This review aims to fill these gaps by synthesizing existing evidence to re-examine the relationship between adolescent internet gaming disorder and depression, while further exploring how different factors may moderate this association. We conducted two separate meta-analyses to explore the relationship between the two variables. By searching five major databases, a total of 11,041 relevant articles were identified. After a rigorous screening process, 46 articles were included in the meta-analysis of correlation, while 18 articles were included in the regression meta-analysis as a sensitivity analysis. A significant positive association between internet gaming disorder and depression among adolescents was found in the meta-analysis (r = 0.29). Subgroup analyses indicated that there are significant differences in the correlation between the two across Eastern and Western countries, as well as among various nations. The correlation coefficients between the two was higher in Eastern countries (reast = 0.31) compared to Western countries (rwest = 0.22). Moreover, the association was marginally significantly stronger in cross-sectional study designs (r = 0.33) than in longitudinal ones (r = 0.26). These findings were further validated through the sensitivity analysis. This review not only provides the latest quantitative evidence on the relationship between adolescent internet gaming disorder and depression but also highlights the important role of cultural context and study designs in shaping this relationship, laying a crucial literature foundation for future research on mechanisms and intervention design.
Mental health interventions delivered through the internet are more scalable, affordable, and demand less training. Yet, the effects of these online programs and factors contributing to the effectiveness, especially for children and adolescents, remain unclear. This meta-analysis aims to not only understand the impact of online mental health interventions for both positive and negative mental health outcomes, but also compare online programs to school-based programs to provide practical implications. The research team applied meticulous search strategies, including database queries, handsearching, forward and backward citation tracking. Double-blinded screening against stringent inclusion criteria identified 28 eligible studies. Overall, online interventions effectively reduced negative outcomes, such as depression and anxiety (ES = 0.19, p < .001, NES = 135, 95
Although the beneficial psychological effects of self-compassion are well documented, less is known about its contributing factors. Attachment theory and social mentality theory posit that parenting might contribute to adolescent self-compassion. Nevertheless, no previous meta-analysis has systematically investigated this association. Furthermore, self-compassion might be a mediator in explaining the well-established link between parenting and adolescent internalizing problems, although previous meta-analyses have rarely systematically explored this nor investigated how these processes unfold differently for adolescents with different characteristics and from different cultures. This meta-analysis included 110 articles comprising 120 independent samples with 88,349 adolescents. The results of three-level meta-analyses revealed that positive and negative parenting were associated with higher and lower adolescent self-compassion, respectively, with small to moderate effect sizes. Additionally, meta-analytic structural equation modeling result showed that self-compassion mediated the relationships between both positive and negative parenting and internalizing problems. These associations in the mediation model were largely equivalent across adolescent age, gender and different cultures except for a stronger effect of self-compassion on internalizing problems in samples with higher proportions of female adolescents and from more individualistic cultures. The findings imply that parenting and adolescent self-compassion might be crucial targets for mitigating adolescent internalizing problems.
Family conflict encompasses hostility, emotional dysregulation, and tension in parent–child and interparental relationships. Emerging evidence suggests that family conflict may contribute to problematic digital media use. However, no prior review has systematically synthesized the evidence on this association and its underlying psychological pathways. This narrative systematic review integrates existing empirical evidence on family conflict and problematic digital media use and reports a consistent positive association: in all 20 included studies, higher levels of family conflict were associated with increased risk of problematic digital media use. The synthesis identified three psychological pathways through which family conflict may contribute to problematic digital media use: emotional distress, self-concept disruption, and social-interpersonal disruptions. Conversely, strong self-control, secure peer attachments, and positive school climate serve as protective factors. These findings highlight family and ecological factors in problematic digital media use, suggesting that family-based prevention may promote healthier digital engagement in children and adolescents.
The intervention effects of martial arts on children’s prosocial behaviors have long been debated. On one hand, they are considered an ideal means of enhancing prosocial behaviors, while on the other hand, they are also believed to potentially increase children’s aggression. The purpose of this study is to synthesize the available randomized controlled trials (RCTs) regarding martial arts interventions on children’s prosocial and aggressive behaviors, in order to determine the relationship between martial arts and these behaviors. This review follows the PRISMA guidelines and comprehensively searched relevant literature from its self-constructed database up until March 2025, covering core databases such as PubMed, Embase, Cochrane Library, Web of Science, Ovid Medline, CNKI, and Wanfang, with a total of 16 randomized controlled trials included. The study found that martial arts interventions significantly enhanced children’s prosocial behaviors and reduced their aggressive behaviors. Subgroup analysis revealed that an intervention period of 12 ≤ 16 weeks, with weekly sessions lasting 46 ≤ 59 min, showed a significant positive effect on enhancing children’s prosocial behaviors. Additionally, an intervention period of 12 ≤ 16 weeks, with at least three weekly sessions and session durations ≤ 45 min, significantly reduced children’s aggression. The findings further confirm the benefits of martial arts in enhancing children’s prosocial behaviors and provide new insights for the design of future martial arts intervention programs.
Although physical activity is known to support mental health, the specific effects of structured Physical Education interventions across different school levels remain insufficiently understood, limiting evidence-based guidance for educators and policymakers. To address this gap, a systematic review was performed of studies published between 2014 and 2024 that examined the effectiveness of Physical Education interventions in improving mental health outcomes among students aged six to 18 years. The review focused on differences in well-being constructs (e.g., self-esteem, body image) and distress-related outcomes (e.g., anxiety, stress), across educational stages. In accordance with the 2020 PRISMA guidelines, studies were retrieved from PubMed, Cochrane Library, Web of Science, Scopus, SPORTDiscus, PsycINFO, and ERIC. A total of 22 studies including 23,730 participants met inclusion criteria, and risk of bias and methodological quality were assessed using Cochrane tools. Findings indicate that Physical Education interventions positively influence mental health in schoolchildren and adolescents, with effects varying according to activity type and educational stage. In primary school, programs involving yoga, mindfulness, gymnastics, active games, and innovative pedagogical models mainly enhanced resilience, mood, self-esteem and physical self-concept, and reduced anxiety. In secondary school, interventions based on sports, dance, physical circuits and pedagogical models promoted emotional intelligence, emotion regulation, self-esteem and body self-concept, and decreased anxiety. In baccalaureate, yoga, mindfulness and physical training programs improved emotional regulation, self-regulation and body image perception. These results demonstrate that targeted Physical Education programs can effectively promote psychological well-being and alleviate stress across educational stages, providing evidence-based guidance for educators and policymakers to design age-appropriate interventions that address this previously underexplored area.
