Risk factors of adolescent psychological distress: A study based on latent class analysis

Adolescent psychological distress (PD) represents a critical global public health concern. This study identified latent classes of PD and examined associations with health behaviors and sociodemographic factors.

Using latent class analysis on cross-sectional data from 24,711 adolescents in China (2019-2023), five distinct PD classes were derived. Logistic regression analyzed associations between PD classes and risk factors.

Five PD classes emerged: No PD, High PD, High Obsessive-Compulsive Low PD, High Internalizing PD, and High Externalizing PD. Screen time ≥ 2 h per day was a universal risk factor across all classes. High ultra-processed foods intake increased PD risk in No PD, High Internalizing PD, and High PD group. Counterintuitively, higher physical activity intensity exacerbated PD in High PD, High Obsessive-Compulsive Low PD, and No PD groups, while longer sleep duration was protective in No PD and High Obsessive-Compulsive Low PD groups.

PD manifests through heterogeneous subtypes with differential determinants. Universal screen time reduction and dietary interventions are warranted, while PA and sleep recommendations require class-specific approaches for effective adolescent mental health promotion.