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. 2025 Apr;60(4):797-809.
doi: 10.1007/s00127-024-02712-3. Epub 2024 Jul 4.

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents

Cuihong Huang #  1 , Yuwei Yang #  2 , Ciyong Lu  1 , Pei Qin  3 , Weiqing Jiang  1 , Jianping Ma  4 , Lan Guo  5   6
Affiliations

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents

Cuihong Huang et al. Soc Psychiatry Psychiatr Epidemiol. 2025 Apr.

Abstract

Purpose: The role of adherence to the recommendations for 24-hour movement behaviors (24-HMB), including physical activity (PA), screen time (ST), and sleep duration (SLP), in relation to emotional and behavioral problems in Chinese adolescents remains uncertain. This study aimed to investigate these associations and explore potential sex differences.

Methods: This school-based cross-sectional study included 15,071 Chinese adolescents with a mean age of 14.53 (SD: 1.65) years. Data on emotional and behavioral problems and 24-HMB (including PA, ST, and SLP) were collected. Analysis was performed using general linear mixed models, with additional sex-stratified analyses conducted.

Results: The number of 24-HMB recommendations met was negatively associated with total difficulties (β estimate=-0.96, 95% CI: -1.07 to -0.85) and positively related to prosocial behavior (β estimate = 0.41, 95% CI: 0.37 to 0.46) among adolescents. Compared with none of the recommendations met, meeting all recommendations (total difficulties: β estimate=-2.98, 95% CI: -3.41 to -2.55; prosocial behaviors: β estimate = 1.05, 95%CI: 0.87 to 1.24) demonstrated the strongest association with both difficulties and prosocial behaviors, followed by meeting recommendations for PA + ST (total difficulties: β estimate=-2.15, 95% CI: -2.41 to -1.90; prosocial behaviors: β estimate = 0.98, 95% CI: 0.87 to 1.09). These associations were consistently significant in both boys and girls.

Conclusion: Adherence to more 24-HMB recommendations, particularly meeting all recommendations or combined PA + ST recommendations, could improve emotional and behavioral well-being among adolescent girls and boys. The significance of balanced movement behaviors for promoting adolescent mental health merits increased attention.

Keywords: Adolescents; Emotional and behavioral problems; Physical activity; Screen time; Sleep duration.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Conflict of interest: The authors declare that they have no conflicting interests. Ethical approval: The Sun Yat-Sen University School of Public Health Institutional Review Board (Ethic Number: L2021079) reviewed and approved the administration protocol, and written informed consent was provided to the participants in this study. All methods are performed in accordance with the relevant guidelines and regulations. Consent to Publish: We can attest that this paper is neither presently under consideration at another publication nor will be while it is under consideration by Social Psychiatry and Psychiatric Epidemiology.

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