Exercise-level differences in depressive symptoms among rural Chinese adolescents: Gender-specific patterns and an...

Physical exercise is associated with fewer depressive symptoms in adolescence, but variation by exercise volume and gender and the role of body satisfaction remain understudied among rural adolescents.

Cross-sectional data were collected from 2837 Grade 7-9 students in rural China (mean age = 14.60 years, SD = 1.08; 52.5% girls). Depressive symptoms, body satisfaction, and physical exercise were assessed using the CES-D-10, a five-item subscale of the NPSS, and the PARS-3, respectively. Exercise volume was classified as minimal, low, moderate, or high. Regression models with HC3 inference were used to examine gender differences and gender-conditioned indirect associations through body satisfaction.

Relative to minimal exercise, the low-, moderate-, and high-exercise groups showed lower depressive symptoms among both girls and boys. The pattern within the exercise groups varied by gender: girls in the high-exercise group had the lowest adjusted depressive-symptom scores, and boys in the moderate-exercise group had the lowest scores. All three exercise groups also showed higher body satisfaction than the minimal-exercise group. Higher body satisfaction was associated with fewer depressive symptoms and formed a significant conditional indirect link between exercise category and depressive symptoms in both genders, with stronger indirect associations among girls.

Minimal exercise was associated with less favorable body-satisfaction and depressive-symptom profiles among rural Chinese adolescents. Body satisfaction provided a relevant psychological link across genders and carried greater weight among girls. Low-threshold exercise opportunities and gender-sensitive support for body satisfaction warrant further evaluation in rural schools.