The interplay of psychological resilience and adolescent mobile phone addiction in Henan province, China: insights from latent class analysis.

Background: The aim of this study was to classify distinct subgroups of adolescents based on the severity levels of their mobile phone addiction and to investigate how these groups differed in terms of their psychosocial characteristics. We surveyed a total of 2,230 adolescents using three different questionnaires to assess the severity of their mobile phone addiction, stress, anxiety, depression, psychological resilience, and personality. Latent class analysis was employed to identify the subgroups, and we utilized Receiver Operating Characteristic (ROC) curves and multinomial logistic regression for statistical analysis. All data analyses were conducted using SPSS 26.0 and Mplus 8.5. Methods: We classified the subjects into subgroups based on their mobile phone addiction severity, and the results revealed a clear pattern with a three-class model based on the likelihood level of mobile phone addiction (p < 0.05). We examined common trends in psychosocial traits such as age, grade at school, parental education level, anxiety levels, and resilience. ROC analysis of sensitivity versus 1-specificity for various mobile phone addiction index (MPAI) scores yielded an area under the curve (AUC) of 0.893 (95% CI, 0.879 to 0.905, p < 0.001). We also determined diagnostic value indices for potential cutoff points ranging from 8 to 40. The optimal cutoff value for MPAI was found to be >14, which corresponded to the maximum Youden index (Youden index = 0.751). Results: The latent classification process in this research confirmed the existence of three distinct mobile phone user groups. We also examined the psychosocial characteristics that varied in relation to the severity levels of addiction. Conclusion: This study provides valuable insights into the categorization of adolescents based on the severity of mobile phone addiction and sheds light on the psychosocial characteristics associated with different addiction levels. These findings are expected to enhance our understanding of mobile phone addiction traits and stimulate further research in this area.

The mediating effect of bullying on parental-peer support matching and NSSI behaviour among adolescents.

BACKGROUND: Being subjected to bullying is a significant risk factor for non-suicidal self-injury (NSSI) among adolescents. Parental support, peer support, and social connectedness play protective roles in mitigating NSSI in this population. However, the precise impact of the combined effects of parental and peer support on bullying and NSSI requires further investigation. METHODS: This study employed the Child and Adolescent Social Support Scale, Delaware Bullying Victimisation Scale, Social Connectedness Scale, and the Ottawa Self-Injury Inventory to survey 1277 Chinese adolescents. Polynomial regression analysis and response surface analysis were applied to examine the mediating role of bullying and social connectedness in the relationship between parental and peer support matching and NSSI. RESULTS: The results indicate that parental support (r = 0.287, P < 0.001), peer support (r = 0.288, P < 0.001), and social connectedness (r = 0.401, P < 0.001) were protective factors against NSSI in adolescents. Conversely, bullying (r = 0.425, P < 0.001) acts as a risk factor for NSSI in this population. Adolescents with low parental and peer support experienced more bullying than those with high parental and peer support, while those with low parental but high peer support experienced less bullying than those with high parental but low peer support (R^2 = 0.1371, P < 0.001). Social connectedness moderated the effect between bullying and NSSI in this model (ß = 0.006, P < 0.001). LIMITATIONS: Due to the under-representation of participants and lack of longitudinal data support, the explanatory power of causality between variables was limited. Future studies should include national samples and incorporate longitudinal studies to enhance the generalisability and robustness of the findings. CONCLUSION: This study reveals the influence mechanism of parental and peer support matching experienced by adolescents on bullying and NSSI and the moderating role of social connectedness. These findings enrich the developmental theory of adolescent NSSI and provide reference for the prevention and intervention of adolescent NSSI behaviour.

A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: statistical analysis plan for a pragmatic cluster randomised controlled trial.

BACKGROUND: Globally, violence against children poses substantial health and economic challenges, with estimated costs nearing USD 7 trillion. This prompts the urgent call for effective evidence-based interventions in preventing and mitigating violence against children. ParentApp is a mobile, open-source application designed to offer a remote version of the Parenting for Lifelong Health (PLH) programme. ParentApp is the first digital parenting intervention for caregivers of adolescents aged 10-17 years to be tested in low- and middle-income settings. METHODS: This study is a pragmatic, two-arm, cluster-randomised trial in Mwanza, Tanzania's urban and peri-urban areas. Assessments are set for baseline, 1 month post-intervention, and 12 months post-intervention. We randomised 80 clusters, each with about 30 caregiver-adolescent dyads, with a 1:1 ratio stratified by urban or peri-urban location. Both arms receive an entry-level smartphone preloaded with Kiswahili apps-ParentApp for intervention and WashApp control. The primary method of analysis will be generalised linear mixed-effects models with adjustment for person-level characteristics and multiple imputation. In three-level models, measurement waves are nested within a person, nested within a sub-ward. Regressions will constrain groups to be equal at baseline and include covariates for stratification, percentage of male caregivers, and individual-level characteristics. DISCUSSIONS: Preparations for the trial began in December 2022, including community mobilisation and sensitisation. Rolling recruitment, baseline data collection, and implementation onboarding took place between April and September 2023. One-month post-test data collection began in August 2023 and thus far achieved 97% and 94% retention rates for caregivers and adolescents respectively. Final post-test data collection will begin in September 2024, anticipated to run until April 2025. This SAP was submitted to the journal before the interim analysis to preserve scientific integrity under a superiority hypothesis testing framework. TRIAL REGISTRATION: The trial was registered on the Open Science Framework on 14 March 2023: https://doi.org/10.17605/OSF.IO/T9FXZ . The trial protocol was published in Trials 25, 119 (2024): Baerecke, L., Ornellas, A., Wamoyi, J. et al. A hybrid digital parenting programme to prevent abuse of adolescents in Tanzania: study protocol for a pragmatic cluster-randomised controlled trial. Trials 25, 119 (2024). https://doi.org/10.1186/s13063-023-07893-x .

Being on top versus not dangling at the bottom: Popularity motivation and aggression in youth.

Whereas research on aggression and status motivation in youth has predominantly looked at a promotion focus (striving for popularity), a prevention focus (wanting to avoid low popularity) could also be an important determinant of aggression, as youth who fear low popularity may use strategic aggression to secure their position. The aim of the current study was to develop reliable measures for both popularity motivations, and examine how both motivations are uniquely and jointly related to aggression. Participants were 1123 Dutch secondary school students (M age = 14.4 years, 48% girls), who completed a 3-item measure of striving for high popularity based on existing questionnaires (Li & Wright, 2014; Ojanen et al., 2005), and a 3-item measure of avoiding low popularity consisting of an adapted version of the high popularity items. Aggressive behavior was measured through peer nominations. Motivations were moderately correlated (r = .51), but did not always co-occur within the same person, as 17% of the sample belonged to a cluster that scored low on striving for popularity, but moderately high on avoiding low popularity. When considered simultaneously, striving for high popularity was not related to any type of aggression, whereas avoiding affiliation with unpopular peers was related to strategic aggression. For physical and verbal aggression, gossiping, excluding and bullying, the association of avoiding low popularity with aggression was strongest when youth also strived for high popularity. Future work should take both popularity motivations into account to better understand, predict and intervene on youth's aggression toward peers.

Reactions of adolescent cyber bystanders toward different victims of cyberbullying: the role of parental rearing behaviors.

BACKGROUND: Group-based situations are common settings for cyberbullying, making bystander responses crucial in combating this issue. This study investigated how adolescent bystanders respond to various victims, including family members, friends, teachers, and celebrities. This study also examined how different parenting styles influenced children's cyber bystander involvement. METHODS: This study employed data from a cross-sectional school survey covering 1,716 adolescents aged 13-18 years from public and vocational schools in China collected in 2022. Logistic regression analyses were conducted to measure demographic characteristics, cyberbullying experiences, and parental rearing behaviors in predicting bystander reactions. RESULTS: The findings showed that middle school students preferred to "ask for help" while high school students tended to choose "call the police" when witnessing cyberbullying incidents. Bystanders growing up with parental rejection and overprotection, having previous cyberbullying victimization experiences, where the victims were disliked by them, exhibited fewer defensive reactions. CONCLUSIONS: This study has implications for future research and practices involving parental involvement in cyber bystander interventions, which could provide implications for future practice in designing specific intervention programs for cyberbullying bystander behavior. Future research and interventions against cyberbullying may provide individualized training including parents' positive parenting skills and parent-child interactions.

Internet addiction among adolescents during the COVID-19 pandemic: Associations with sociodemographic and psychological distress.

Background: The COVID-19 pandemic has had tremendous implications for billions of adolescents worldwide due to school closures, forcing students to embrace internet usage for daily tasks. Uncontrolled use of the internet among adolescents makes them vulnerable to internet addiction (IA). This study aims to determine the prevalence of IA among adolescents and assess its association with sociodemographic factors, smartphone use, and psychological distress during the pandemic. Method: A cross-sectional self-administered online survey was conducted among students aged 13-17 from May 15th, 2021, until May 30th, 2021, using the Malay version of the Internet Addiction Test (MVIAT), the Depression, Anxiety, and Stress Scale (DASS-21), and the Coronavirus Impacts Questionnaires, as well as a sociodemographic information form. The data was analyzed with IBM SPSS Statistics version 23. Results: A total of 420 adolescents participated in the survey. The majority of them (70.7%) were female, with a mean age of 15.47 years (±1.49 years old). About 45.5% of the respondents were classified as internet addicted users. The Chi-square test analysis showed that age (p = 0.002), smartphone usage (p = 0.010), rate of midnight use (p < 0.001), frequency (p < 0.001), duration (p < 0.001) of device usage, and presence of depression, anxiety, and stress (p < 0.001) were all significantly associated with IA. Multiple logistic regression showed age (aOR = 1.16, 95% CI [1.00-1.35], p = 0.048), smartphone usage (aOR =3.52, 95% CI [1.43-8.67], p = 0.006), mild or moderate depression (aOR = 2.43, 95% CI [1.36-4.34], p = 0.003), severe or extremely severe stress (aOR = 6.41, 95% CI [2.18-18.82], p = 0.001) were significantly related to IA. Conclusions: Late adolescence, the use of smartphones, and the presence of psychological distress like depression, and stress were potentially associated with IA. Wise use of smartphones and early identification of any psychological distress among adolescents are warranted, especially during the pandemic.

Co-occurrence of problematic facebook and video game use: prevalence and association with mental health disorders among adolescents.

INTRODUCTION: The rapid proliferation of technology and its impact on adolescents' lives have raised concerns about addictive behaviors and its potential consequences, including behavioral and mental health problems. This study investigates the prevalence and risk factors associated with the co-occurrence of Problematic Facebook Use and Problematic Video game Use among Tunisian adolescents. METHODOLOGY: We conducted a cross-sectional study in the urban area of Sousse governorate in Tunisia during the 2018/2019 school year. We selected a representative sample of high school students enrolled in public educational institutions in Sousse. Data collection was performed through a self-administered structured questionnaire, which gathered information on sociodemographic characteristics, lifestyle behaviors, and mental health disorders. Problematic Facebook Use was assessed using the validated Arabic version of the Bergen Scale, while Problematic Video Game Use was measured using the 21-point Lemmens Scale, which was translated into Arabic. Statistical analysis was carried out using the SPSS program (version 20). RESULTS: We enrolled a total of 1342 high school students in our study, of whom, 63.2% were female with a mean age of 17.5 ± 1.44 years. The prevalence of Problematic Facebook Use and Problematic Video Game Use was  28.3% and  13% respectively. Regarding the co-occurrence of the two problematic behaviors, 31.3% of participants faced a singular addictive behavior, either related to problematic Facebook or video game use, while 5% had both addictive behaviors simultaneously. In a multivariate analysis, risk factors for the co-occurrence of Problematic Facebook and Video Game Use, in decreasing order of significance, included severe depression (AOR = 4.527; p = 0.003), anxiety (AOR = 4.216; p = 0.001), male gender (AOR = 4.130; p < 0.001), problematic internet use (AOR = 3.477; p = 0.006), as well as moderate depression (AOR = 3.048; p = 0.007). CONCLUSION: Our study found that Problematic Facebook and Video Game Use were prevalent among Tunisian adolescents. The co-occurrence of these disorders is strongly linked to male gender, problematic internet use, depression, and anxiety disorders. These findings underscore the urgency of implementing tailored and effective awareness and prevention programs to address these emerging challenges.

Network analysis of trait aggression among community youths and juvenile offenders.

OBJECTIVE: The mainstream view in trait aggression research has regarded the structure as representing the latent cause of the cognitions, emotions, and behaviors that supposedly reflect its nature. Under network perspective, trait aggression is not a latent cause of its features but a dynamic system of interacting elements. The current study uses network theory to explain the structure of relationships between trait aggression features in juvenile offenders and their peers. METHODS: Network analysis was applied to investigate the dynamic system of trait aggression operationalized by the Buss-Perry Aggression Questionnaire in a sample of community youths (Mage = 17.46, N = 715) and juvenile offenders (Mage = 18.36, N = 834). RESULTS: The facet level networks showed that anger is a particularly effective mechanism for activating all other traits. In addition, anger was more strongly associated with physical aggression and the overall network strength was greater in juvenile delinquency networks than in their peers. The item level networks revealed that A4 and A6 exhibited the highest predictability and strength centrality in both samples. Also, the Bayesian network indicated that these two items were positioned at the highest level in the model. There are similarities and differences between juvenile delinquents and community adolescents in trait aggression. CONCLUSION: Trait aggression was primarily activated by difficulty controlling one's temper and feeling like a powder keg.

Promoting Adolescent Suicide Prevention Programmes in Pakistan: An Insight into Challenges and Opportunities.

Suicide is a global health concern, with profound social, emotional, and economic repercussions for individuals, families, and communities. Suicidal behaviour among adolescents, encompassing ideation, self-harm, and suicide attempts poses a significant global public health challenge. The cultural, social, and economic factors that contribute to suicide in Pakistan are complex and multifaceted, making it imperative to develop tailored interventions, necessitating collaborative efforts involving researchers, educators, clinicians, practitioners, and policymakers. The purpose of this study is to emphasise the risk factors contributing to adolescent suicidal behaviour and to delve into the strategies and interventions that can help prevent suicide in Pakistan, considering the unique challenges and opportunities within the country. This study highlights the relevance of the WHO (2023) Thinking Healthy Programme and stress management measures tailored to the needs of low- and middle-income nations like Pakistan. These resources empower healthcare workers to enhance mental health screening and identification of adolescents within their communities. In conclusion, dispelling the myths, reducing the societal stigma associated with mental health, and enhancing the accessibility of mental health services is an imperative mission that demands concerted efforts from all sectors of the society. Key Words: Suicide, Adolescent, Mental health, WHO (2023) Thinking Healthy Programme.

"Nobody Here Likes Her"-The Impact of Parental Verbal Threat Information on Children's Fear of Strangers.

Parental verbal threat (vs. safety) information about strangers may induce fears of these strangers in adolescents. In this multi-method experimental study, utilizing a within-subject design, parents provided standardized verbal threat or safety information to their offspring (N = 77, Mage = 11.62 years, 42 girls) regarding two strangers in the lab. We also explored whether the impact of parental verbal threat information differs depending on the social anxiety levels of parents or fearful temperaments of adolescents. Adolescent's fear of strangers during social interaction tasks was assessed using cognitive (fear beliefs, attention bias), behavioral (observed avoidance and anxiety), and physiological (heart rate) indices. We also explored whether the impact of parental verbal threat information differs depending on the social anxiety levels of parents or fearful temperaments of adolescents. The findings suggest that a single exposure to parental verbal threat (vs. safety) information increased adolescent's self-reported fears about the strangers but did not increase their fearful behaviors, heart rate, or attentional bias. Furthermore, adolescents of parents with higher social anxiety levels or adolescents with fearful temperaments were not more strongly impacted by parental verbal threat information. Longitudinal research and studies investigating parents' naturalistic verbal expressions of threat are needed to expand our understanding of this potential verbal fear-learning pathway.

[Smoking cessation influencing factors and interventions in adolescents].

Smoking can negatively influence the development of the respiratory and cardiovascular systems of adolescents and increase the risk for chronic diseases in adulthood. Promotion smoking cessation in adolescents is important for the protection of adolescent health and reduction of smoking rate in adults. Although many foreign studies have explored the influencing factors and interventions for smoking cessation in adolescents, limited relevant studies have been conducted in China, especially the study of smoking cessation intervention, which is still in its infancy, so the research and practice in this field need to be strengthened. This paper summarizes the factors associated with smoking cessation in adolescents both at home and abroad from the perspective of individual, family, school, and social surrounding, and introduce existing smoking cessation interventions for adolescents to provide references for future studies.

Determinants of Disordered Eating Behaviours (DEBs) among Adolescent Female School Students in Riyadh, Saudi Arabia: A Qualitative Study.

The risk of DEB is more prevalent in girls, particularly during adolescence. The onset of DEB can be triggered by many inter-related factors, including biological, social, parental, and psychosocial. To date, very little is known about the determinants of DEBs in Saudi adolescent girls. Using a qualitative analysis, this study explored potential determinants of DEB among adolescent girls in Riyadh. Eighteen semi-structured interviews were carried out with adolescent girls (mean age = 14.06, SD = 0.87) who reported a high risk of DEB (EAT-26 ≥ 20) in intermediate and secondary schools in Riyadh. The mean weight was 51 kg (SD = 11.8) with BMI ranging from 14.18 kg/m2 to 27.51 kg/m2. EAT-26 scores ranged from 21 to 42 (M = 26.8, SD = 5.6). Data were transcribed and revised, then themes and sub-themes were assigned using MAXQDA 24. The most common DEBs reported were dieting and binging, followed by induced vomiting. Major themes were related to negative cognitions, conscious imitation/copying behaviours, bullying, comparisons, and negative comments. Some participants identified the possibility of biological and familial factors in increasing the likelihood of DEB. Our findings provide a framework that could be used to increase understanding of DEB and inform the development of interventions to address underlying causes of DEB in Saudi adolescent girls.

[Risk factors and protective factors for substance abuse among adolescents].

The article presents a brief descriptive review aimed at identifying risk factors and protective factors of drug abuse among adolescents in three important areas - personality, family and society. Individual risk factors are described: high impulsivity, rebelliousness, violation of emotional balance, alexithymia. Family risk factors were prenatal smoking of the mother, and her poor psychological status, low education of parents, the presence of family members who use psychoactive substances. Among the risk factors in society was the presence of peers who abuse drugs in the environment of a teenager. Protective factors are also identified: individual optimism, the desire to preserve their health, etc.

Social Media Use During Coronavirus Disease 2019 and the Impact on Adolescent Health.

During the coronavirus disease 2019 lockdown, adolescents spent a great deal of time using social media. There have always been a host of positives and negatives associated with social media use. The negatives are more notable with heavier use. Once restrictions lifted and normalcy returned, social media usage appears to be returning to prepandemic rates in adolescents. Adolescents are reporting mostly positive and neutral personal effects of social media on their postpandemic lives.

Temporal relationships in the movement behaviour of adolescents: Testing and methodological considerations of the ActivityStat hypothesis.

The study aimed to investigate the ActivityStat hypothesis by examining the presence and the timeframe of the temporal relationships among physical activity (PA) levels and stationary time (ST) in adolescents. A secondary analysis was performed on data involving 356 adolescents in Dunedin, New Zealand. Participants wore a waist-worn accelerometer for several consecutive days to assess PA levels [i.e. light PA (LPA), and moderate-to-vigorous PA (MVPA)] and ST. Bayesian continuous-time structural equation modelling (CT-SEM) was used to examine the relationship between the behaviours over time and the timeframe during which these relationships occur. Increases in LPA, MVPA, and ST were positively associated with their later behaviours until 2.5, 1.7, and 2 days later, respectively. A cross-behavioural reciprocal and negative relationship between LPA and ST was demonstrated 0.4 days later. A positive relationship between ST and MVPA was observed until about 0.4 days later. This is the first study to investigate the ActivityStat hypothesis using Bayesian CT-SEM in adolescents, examining the multivariate relationships among different behaviours and the associated timeframes. To conclude, evidence of activity synergy was suggested for the within-behavioural relationships, while behavioural compensation was noted for ST. Thus, the findings provide some support for the ActivityStat hypothesis in adolescents.

Attentional Biases and Nonsuicidal Self-Injury Urges in Adolescents.

Importance: Nonsuicidal self-injury (NSSI) is a significant clinical concern among adolescents. Exposure to NSSI-related content on social media platforms has been suspected to potentially act as a trigger for NSSI. Objective: To use free-viewing eye-tracking and dot-probe paradigms to examine attentional bias and psychophysiological responses to NSSI-related pictorial and textual stimuli in adolescents with and without a history of NSSI. Design, Setting, and Participants: From June 2022 to April 2023, adolescent participants in Vienna, Austria with and without a history of NSSI were exposed to NSSI-related stimuli in this nonrandomized controlled trial. Data were analyzed from December 2023 to January 2024. Exposure: Exposure to NSSI-related stimuli. Main Outcomes and Measures: During both tasks, subjective arousal, NSSI urges, and autonomic nervous system activity were assessed. Results: A total of 50 adolescents in 2 groups, 25 who engaged in NSSI (mean [SD] age 15.86 [1.14] years; 19 female participants [76%]) and 25 who did not (mean [SD] age 16.40 [1.71] years; 19 female participants [76%]) were included. Adolescents with a history of NSSI-but not those without a history of NSSI-showed a clear attentional bias toward NSSI-related images during eye-tracking, as indicated by increased initial fixations (500 ms stimulus presentation mean difference, 28.64%; 95% CI, 18.31%-38.98%; P < .001; 1000 ms stimulus presentation mean difference, 18.50%; 95% CI, 9.05%-27.95%; P < .001) and longer fixation durations (500 ms mean difference, 29.51 ms; 95% CI, 4.3-54.72 ms; P < .001; 1000 ms mean difference, 39.83 ms; 95% CI, 6.90-72.76 ms; P < .001), regardless of stimulus duration. This bias was associated with a heightened urge to engage in NSSI (d = 1.22; 95% CI, 0.69-1.73; P < .001), a trend not seen in adolescents without a history of NSSI. Similarly, in the dot-probe task, only the NSSI group showed an attentional bias toward NSSI images but not toward trauma images, emphasizing the specificity of their attentional bias. Physiological measures revealed no significant differences, suggesting that viewing NSSI images is not associated with increased autonomic arousal. Textual NSSI content did not provoke an attentional bias or heighten NSSI urges in either group. Conclusions and Relevance: In this nonrandomized controlled trial of 50 adolescents, results highlighted a specific attentional bias toward NSSI-related pictorial stimuli in adolescents with a history of NSSI, particularly a difficulty in disengaging from NSSI images. These findings contribute to understanding maladaptive information processing in NSSI and suggest implications for clinical management and cognitive models addressing NSSI triggers. Trial Registration: German Clinical Trials Register identifier: DRKS00025905.

Identifying the challenges of policy content related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in adolescents.

BACKGROUND: This study aims to identify policy content challenges related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in Iranian adolescents. METHODS: This qualitative study analyzed high-level and national documents pertaining to adolescent health, high-risk sexual behaviors, stimulant, and alcohol consumption in adolescents. The documents, which were published by public organizations between January 1979 and February 2023 and publicly available, were complemented by interviews with policymakers and executives. The study involved reviewing 51 papers and conducting interviews with 49 policymakers and executives at the national, provincial, and local levels who were involved in addressing adolescent behaviors related to high-risk sexual behaviors, stimulant, and alcohol consumption. The data collected was analyzed using conventional content analysis. RESULTS: The study's results involved examining policy content and identifying challenges related to policy content. The analysis revealed that from the beginning of the Iranian revolution in 1979 until the late 1990s, the dominant approach in Iran was to deny the existence of high-risk behaviors among adolescents. However, in the early 2000s, the country began to adopt a new approach that acknowledged the social harms and ineffectiveness of previous strategies. As a result, a new policy framework was introduced to address high-risk behaviors among adolescents. The study's interviews with policymakers and executives identified 12 challenges related to policy content, including parallel programs, lack of institutional mapping, lack of evidence-based policymaking, lack of integrated approach regarding training, late parent training, lack of consideration of all occurrence reasons in adolescents' high-risk behaviors policymaking, and the existence of many abstinence policies regarding high-risk behaviors. CONCLUSIONS: The study's findings suggest that high-risk behaviors among adolescents in Iran are primarily a health issue, rather than a social or ideological one. Unfortunately, ideological approaches, stigma, and policymaking based on anecdotes rather than evidence have had a significant impact on this area. To improve policymaking in this domain, it is crucial to address these challenges by tackling stigma, adopting an integrated and holistic approach, and implementing evidence-based policies that consider all relevant aspects, including adolescents' subcultures and policy audiences. Such an approach can also be useful for other countries facing similar conditions.

Different Categories of Social Media Use and Their Association With Body Image Among Adolescents in 42 Countries.

Objectives: Social media has become integrated into adolescents' lives and influences body image perceptions. Our study examined four patterns of social media use (SMU): non-active, active, intensive, and problematic. We hypothesised that intensive SMU and problematic SMU would be associated with negative body image (negative subjective body weight) and over/underestimated body weight congruence, compared to non-active and active SMU. In addition, we expect these associations to be stronger for girls. Methods: Data from 190,892 respondents aged 11, 13, and 15 from 42 countries involved in the Health Behaviour in School-aged Children study were analysed. Results: Findings revealed higher rates of intensive or problematic SMU among adolescents who perceived themselves as too fat or too thin. Two-level regression analyses showed intensive and problematic SMU as more likely to perceive themselves as too fat or too thin than active users. The association was significant among intensive and problematic girl social media users, whereas, among boys, the relationship was only significant for problematic users. Conclusion: Our findings highlight the importance of assessing SMU patterns to evaluate associations with body image.