Neurobiological, Psychosocial, and Behavioral Mechanisms Mediating Associations Between Physical Activity and Psychiatric Symptoms in Youth in the Netherlands

Genetic influence and neural pathways underlying the dose-response relationships between wearable-measured physical activity and mental health in adolescence

Adolescence is a critical period marked by significant physical and neurocognitive development as well as increased vulnerability to mental health issues. While the benefits of physical activity (PA) on adult mental health (MH) are well-established, the dose-response relationships and underlying neurobiological mechanisms in adolescents remain elusive. This study investigated the dose-response relationships between wearable-measured PA and MH outcomes in over 7000 adolescents (11-12 years) from the ABCD study through linear and nonlinear modeling. We further examined the genetic influence and mediation effects of brain structure and function underlying the relationships. We found that all intensity levels of PA were associated with reduced internalizing and thought problems but not with externalizing problems. Durations of moderate activity around 90 min and vigorous activity around 120 min each day and frequency of physical exercise four days each week were associated with lowest MH burden. Polygenic risk scores (PRSs) for neuropsychiatric disorders were associated with reduced step count and light activity, while PRS for walking was associated with reduced thought problems. Reduced functional connectivity between cingulo-parietal and auditory networks, and between cingulo-opercular network and left putamen is the common neural pathways mediating the associations between different PA measurements and better mental health. These findings suggest that excessive moderate and vigorous activity may not be always better for adolescent mental health. Brain functional integration and segregation centered on cognitive control as well as genetic interplay may be the potential neurobiological factors underlying the link between PA and MH.

The effects of physical activity on mental health in adolescents with attention-deficit hyperactivity disorder: a randomized controlled trial

BACKGROUND

Adolescents with attention-deficit hyperactivity disorder (ADHD) represent a high-risk population with an elevated likelihood of developing mental health disorders. Physical activity (PA) has emerged as a promising intervention to enhance mental health in youth. However, no studies to date have comprehensively examined the immediate and sustained effects of PA, especially aerobic exercise-based PA, on mental ill-being-including internalizing problems (e.g., depression, anxiety, and stress) and externalizing problems (e.g., aggression)-as well as on two other critical indicators of mental health: psychological well-being (e.g., resilience) and cognitive function (e.g., inhibitory control) in adolescents with ADHD. Therefore, this study aimed to investigate whether an aerobic exercise-based PA intervention could elicit immediate and sustained benefits for mental health outcomes, including internalizing problems, externalizing problems, psychological well-being, and cognitive function, in adolescents with ADHD.

METHOD

This study was an assessor-masked, multicenter, randomized clinical trial. A total of 88 adolescents with ADHD were enrolled. Eligible participants were randomized in a 1:1 ratio to either the exercise group or the control group. Participants in the exercise group attended a 60-min session of aerobic exercise once a week for 12 weeks. Depression, anxiety, stress, aggression, and resilience were assessed using self-report questionnaires, and inhibitory control was evaluated through computer-based neurocognitive tasks. Assessments were conducted at baseline (T0), at the end of the intervention (T1), and 3 months following the intervention (T2).

RESULTS

The 80 eligible participants included 72 (90%) males with a mean age of 14.74 (± 1.59) years. Generalized estimating equation analyses revealed that the current PA intervention resulted in significantly better and sustained improvements in depression, anxiety, stress, and inhibitory control. Compared to the control group, the exercise group showed a significant increase in resilience at T1, but this effect was not sustained at T2. No significant reduction in aggression was found.

CONCLUSIONS

The current aerobic exercise-based PA intervention was found to be effective in reducing depression, anxiety, and stress, as well as in promoting inhibitory control and resilience in adolescents with ADHD. The current findings suggest that an aerobic exercise-based PA intervention may be an alternative or adjunctive approach to enhancing mental health, particularly in alleviating internalizing problems, in this population.

TRIAL REGISTRATION

ChiCTR, ChiCTR2400087025. Registered 17 July 2024-Retrospectively registered, https://www.chictr.org.cn/showproj.html?proj=230614 .

Unravelling behavioural contributions to IBS risk: evidence from univariate and multivariate Mendelian randomisation

Background

While numerous studies have investigated the link between behavioural factors and irritable bowel syndrome (IBS), the causal relationships remain unresolved. This study applied Mendelian randomisation (MR) analysis to assess the causal impact of specific behavioural factors on IBS risk.

Methods

Bidirectional Mendelian randomisation analysis was employed to evaluate the causal relationships between behavioural factors and IBS risk. A genome-wide significance threshold (P < 5e-6) was applied to identify associations between genetic variants and behaviour-related traits, ensuring robust selection of instrumental variables for evaluating potential causal effects. Genetic correlations with IBS were sourced from extensive genome-wide association studies (GWASs). Various statistical methods were applied to estimate the causal effects.

Results

This study employed both univariate and multivariate Mendelian randomisation analyses to investigate the causal relationships between specific behavioural factors and the risk of irritable bowel syndrome (IBS). The results indicated that body mass index (BMI) (odds ratio (OR) = 1.074; 95% confidence interval (CI) = 1.025-1.125, P = 0.031), insomnia (OR = 1.986; 95% CI = 1.652-2.389, P < 0.001), duration of mobile phone use (OR = 1.120; 95% CI = 1.018-1.232, P = 0.021), and weekly mobile phone usage time in the past three months (OR = 1.148; 95% CI = 1.016-1.298, P = 0.021,) were associated with an increased risk of IBS. In contrast, usual walking speed (OR = 0.756; 95% CI = 0.621-0.920, P < 0.001), non-smoking status (OR = 0.779; 95% CI = 0.645-0.941, P < 0.001), and weekly alcohol consumption (OR = 0.862; 95% CI = 0.743-0.999, P = 0.015) were associated with a reduced risk of IBS. Furthermore, in the multivariate Mendelian randomisation analysis, no statistically significant causal associations were found for BMI, usual walking pace, length of mobile phone use, and smoking status. Weekly mobile phone usage time in the past three months (OR = 1.439; 95% CI = 1.126-1.840, P = 0.0037,) and insomnia (OR = 1.468; 95% CI = 1.076-2.003, P = 0.0156) were identified as risk factors, while weekly alcohol intake (OR = 0.813; 95% CI = 0.677-0.975, P = 0.0257) acted as a protective factor.

Conclusions

This study identified BMI, insomnia, duration of mobile phone use, and weekly mobile phone usage time in the past three months as risk factors for IBS. In contrast, weekly alcohol consumption, usual walking pace, and non-smoking status were observed as protective factors. Additionally, in multivariable analysis, weekly mobile phone use, insomnia, and weekly alcohol consumption showed a direct influence on IBS risk when considered simultaneously.

Association of environmental noise exposure with cortisol levels in children from eight European birth cohorts

Environmental noise is a major environmental risk factor for public health. According to the noise reaction model the release of stress hormones like cortisol in response to noise exposure, plays a key role in the development of noise-induced health effects. We aimed to study the association between environmental noise with both acute (UCC) and cumulative (HCC) cortisol levels in children 5-12 years of age. To do so, we analysed data from the HELIX cohort -with spot UCC data- and from the Generation R and INMA cohorts (Gipuzkoa and Sabadell) -with HCC data. The analytical sample involved: 750 HELIX children (mean age = 7.75), 1326 Generation R children (mean age = 6.06), 111 INMA-Sabadell children (mean age = 8.75) and 288 INMA-Gipuzkoa children (mean age = 7.85). Day-evening-night equivalent (Lden) environmental noise exposure during the year of the follow-up was estimated in the addresses of participants, using existing noise maps. Directed acyclic graphs (DAGs) were used to identify appropriate covariates and reduce the chance for biased estimation. We used mixed-effects modelling and linear modelling to examine the association between Lden and cortisol concentration using complete case analyses. None of the models reached the statistical significance. We observed no correlation between HCC and UCC in INMA-Sabadell participants, for whom both urinary and hair cortisol data were available. Future research should prioritize investigating the effects of environmental noise on HCC, as it may serve as a more reliable indicator for assessing associations with chronic exposures. Additionally, future studies on noise-induced health effects in children should incorporate other biomarkers of stress and chronic inflammation to provide a more comprehensive understanding of these associations.

Childhood Lifestyle Behaviors and Mental Health Symptoms in Adolescence

Importance

Mental health problems often arise during adolescence and early adulthood, affecting up to 25% to 30% of young people. Enhancing the ability to identify children and adolescents at increased risk of mental health problems and uncover factors that promote mental health from childhood to adolescence is important.

Objective

To investigate if cumulative lifestyle behaviors from childhood to adolescence are associated with perceived stress and depressive symptoms in adolescence.

Design, Setting, and Participants

Prospective cohort study in Finland using baseline data collected between October 2007 and November 2009 and 8-year follow-up data collected between December 2015 and December 2017 as part of the Physical Activity and Nutrition in Children (PANIC) study of children aged 6 to 9 years. Data were analyzed from January to February 2024.

Exposures

Cumulative physical activity (PA), sedentary behavior (SB), sleep, and diet quality from childhood to adolescence. PA and screen time (ST) assessed by a questionnaire; PA at different intensities, SB, and sleep duration assessed by a combined movement and heart rate sensor; diet quality assessed by 4-day food records and the Baltic Sea Diet Score computed at baseline, 2-year follow-up, and 8-year follow-up examinations.

Main Outcomes and Measures

Perceived stress assessed by the Finnish version of the Cohen Perceived Stress Scale, and depressive symptoms by the Beck Depression Inventory at 8-year follow-up examinations. Linear regression analyses were used to evaluate associations between cumulative lifestyle behaviors over 8 years with the outcomes.

Results

Altogether, 187 adolescents (97 boys [51.9%]; mean age, 15.8 [0.4] years) had valid data on self-reported lifestyle behaviors, and 170 adolescents had valid data on device-assessed lifestyle behaviors. Perceived stress scores ranged from 2 to 33 and depressive symptoms scores from 0 to 31. Self-reported total PA and supervised exercise were inversely associated with perceived stress (standardized regression coefficient [β] = -0.15; 95% CI, -0.31 to -0.01 and β = -0.15; 95% CI, -0.29 to -0.01, respectively) and depressive symptoms (β = -0.17; 95% CI, -0.31 to -0.02 and β = -0.14; 95% CI, -0.29 to -0.0, respectively). Total ST (β = 0.27; 95% CI, 0.13 to 0.41), computer use (β = 0.16; 95% CI, 0.01 to 0.30), and mobile device use (β = 0.28; 95% CI, 0.16 to 0.41) were positively associated with perceived stress. Total ST (β = 0.30; 95% CI, 0.15 to 0.44) and mobile device use (β = 0.33; 95% CI, 0.19 to 0.46) were positively associated with depressive symptoms.

Conclusions and Relevance

This cohort study of Finnish children and adolescents found that higher PA and lower ST from childhood were associated with perceived stress and depressive symptoms in adolescence. These findings emphasize reducing screen time and increasing PA to promote mental health in youth.

The longitudinal association between sport participation and self-esteem in youth in the Netherlands: The role of sport type

OBJECTIVES

To investigate the longitudinal associations of sport participation with self-esteem in youth, and whether this relationship differs between team compared to individual, and non-esthetic compared to esthetic sports.

DESIGN

Prospective data on sport participation at age 10 and self-esteem at age 13 years was used, collected from 2970 participants within Generation R, a population-based cohort study in the Netherlands.

METHODS

Hours of sports per week were measured with a questionnaire, completed by the primary caregivers. Participation in sports was classified into team vs. individual and non-esthetic vs. esthetic sports. Self-esteem was assessed by the Harter's Self-Perception Profile. Linear regression analyses, adjusted for multiple testing were conducted to test the association between sports and self-esteem subdomains. Then, differences in self-esteem among youth participating in different types of sports were explored by two separate sets of linear regression with team and non-esthetic sports as the reference groups.

RESULTS

More hours of sports were associated with higher self-esteem (β = 0.081, pfdr < 0.001). This association was driven by the subdomains social acceptance (β = 0.057, pfdr = 0.004) and athletic competence (β = 0.242, pfdr < 0.001). Participation in individual or esthetic sports was associated with lower self-esteem compared to the team (β = -0.196, pfdr < 0.001) or non-esthetic (β = -0.172, pfdr = 0.002) sports.

CONCLUSIONS

Sport participation, particularly team and non-esthetic sports, may be beneficial for self-esteem among youth, driven by aspects like socializing and one's ability to do well at sports. The aspects of different types of sports could be considered for developing improved sport-related environments and effective physical activity interventions.

Exploring the pathways linking prenatal and early childhood greenness exposure to attention-deficit/hyperactivity disorder symptoms during childhood: An approach based on robust causal inference

BACKGROUND

Epidemiological studies suggest that exposure to greenness during childhood may protect children from developing attention-deficit hyperactivity disorder (ADHD).

OBJECTIVE

We analyzed the effect of both prenatal (pregnancy) and early childhood (4-5-year follow-up) residential greenness exposure and green space availability on ADHD symptoms during childhood (up to the age of 12 years) and further explored the potential mediating role of PM2.5 and physical activity in the association.

METHODS

The study population included participants from the INfancia y Medio Ambiente (INMA) prospective birth cohort (Gipuzkoa, Sabadell, and Valencia). Average Normalized Difference Vegetation Index (NDVI) in buffers of 100-, 300- and 500-m around the residential addresses was used as an indicator of greenness, while green space availability was determined based on the presence of a major green space within 150-m from the residence. Childhood ADHD symptoms were assessed at the 6-8- and 10-12-year follow-ups using Conners Parents Rating Scale-Revised: Short Form.

RESULTS

Although no association was found for the prenatal exposure period, increased early childhood NDVI inversely associated with the OR of clinically significant ADHD symptoms during the 6-8-year follow-up at the 100-m (OR 0.03, 95% CI: 0.003 to 0.44), 300-m (OR 0.04, 95% CI: 0.003 to 0.42) and 500-m (OR 0.08, 95% CI: 0.01 to 0.76) buffers, but exclusively in the context of direct effects. Additionally, the 10-12-year follow-up analysis found moderate to weak evidence of potential total and direct effects of NDVI at both 100- and 300-m buffers on inattention scores, as well as for NDVI at the 300-m buffer on ADHD index scores. The analysis did not reveal evidence of mediation through PM2.5 or physical activity.

CONCLUSIONS

The evidence suggests that early childhood greenness exposure may reduce the risk of developing ADHD symptoms later in childhood, and that this association is not mediated through PM2.5 and physical activity.

Changes in Rest-Activity Rhythms in Adolescents as They Age: Associations With Brain and Behavioral Changes in the ABCD Study

OBJECTIVE

Adolescents with disrupted rest-activity rhythms (RARs), including shorter sleep duration, later sleep timing, and low physical activity levels, are at greater risk for mental health and behavioral problems. It remains unclear whether the same associations can be observed for within-subject changes in RARs.

METHOD

This longitudinal investigation on RARs used Fitbit data from the Adolescent Brain Cognitive Development (ABCD) Study at the 2-year follow-up (FL2) (ages 10-13 years) and 4-year follow-up (FL4) (ages 13-16 years). Good-quality Fitbit data were available for 963 youths at both time points. Changes in RARs from FL2 to FL4, their environmental and demographic contributors, and brain and behavioral correlates were examined.

RESULTS

From FL2 to FL4, adolescents showed decreases in sleep duration and physical activity as well as delayed sleep timing (Cohen d = 0.44-0.75). Contributions of environmental and demographic factors to RAR changes were greatest for sleep timing (explained 10% variance) and least for sleep duration (explained 1% variance). Delays in sleep timing had stronger correlations with behavioral problems including impulsivity and poor academic performance than reductions in sleep duration or physical activity. Additionally, the various brain measures differed in their sensitivity to RAR changes. Reductions in sleep duration were associated with decreased functional connectivity between subcortical regions and sensorimotor and cingulo-opercular networks and with enhanced functional connectivity between sensorimotor, visual, and auditory networks. Delays in sleep timing were mainly associated with gray matter changes in subcortical regions.

CONCLUSION

The current findings corroborate the importance of sleep and physical activity in brain neurodevelopment and behavioral problems in adolescents. RARs might serve as biomarkers for monitoring behavioral problems and be potential therapeutic targets for mental disorders in adolescents.

Towards active health: A study on the relationship between physical activity and body image among college students

Aims

Active health is a new concept, model, and system for maintaining a state of whole-person health. In the context of the increasing severity of college students' mental health, it is of great significance to explore the relationship between physical activity and college students' body image based on an active health perspective.

Methods

A survey was conducted among 853 college students in Zhejiang province using the physical activity rating scale, body image scale, sense of acquisition of sports body shaping scale and social adjustment scale. Using SPSS25.0 and Amos 24.0 software for data processing and analysis.

Results

(1) There is a significant positive correlation between physical activity, body image, sense of acquisition of sports body shaping, and social adjustment. There is a significant positive correlation between physical activity and body image among college students; The sense of acquisition of sports body shaping a significant mediating role between physical activity and the promotion of college students' body image. The effects of physical activity on body image were mainly achieved through the following three mediating pathways: (1) physical activity → sense of acquisition of sports body shaping → body image, the mediating effect value of this pathway was 0.18, which accounted for 31.6 % of the total effect, with a confidence interval of [0.08, 0.28], (2) physical activity → social adaptation → body image, the mediating effect value of this pathway was 0.09, which accounted for 15.8 % of the total effect of 15.8 %, with a confidence interval of [0.03, 0.15], and (3) physical activity → sense of acquisition of sports body shaping → social adaptation → body image, a pathway with a mediated effect value of 0.09, accounting for 15.8 % of the total effect, with a confidence interval of [0.01, 0.17].

Conclusions

Physical activity is an important factor in promoting the body image of college students, and there is a chain intermediary effect between physical activity and body image. School sport has its own disciplinary value and unique strengths in advancing the development of body image in adolescents, and the significant mediating effects of sense of acquisition of sports body shaping and social adaptation in this process provide theoretical support for the body image turn to move from theory to practice in the field of school sport.

A transdiagnostic group exercise intervention for mental health outpatients in Germany (ImPuls): results of a pragmatic, multisite, block-randomised, phase 3 controlled trial

BACKGROUND

Globally, mental health conditions pose a substantial burden of disease. Despite the availability of evidence-based pharmacological and psychological treatments, the symptoms of a substantial subgroup of patients do not respond to these interventions, and only a minority of patients have access to them. This study aimed to assess the efficacy of ImPuls, a 6-month transdiagnostic group exercise intervention, plus treatment-as-usual, compared with treatment-as-usual alone in outpatients with various mental disorders.

METHODS

In this pragmatic, two-arm, multisite, randomised controlled trial in Germany, ten outpatient rehabilitative and medical care facilities were involved as study sites. Participants were outpatients diagnosed according to ICD-10 with one or more of the following disorders based on structured clinical interviews: moderate or severe depression, primary insomnia, post-traumatic stress disorder (PTSD), panic disorder, or agoraphobia. Participants were required to be aged between 18 years and 65 years, insured by the health insurers Allgemeine Ortskrankenkasse Baden-Württemberg or Techniker Krankenkasse, fluent in German, and without medical contraindications for exercise. Blocks of six participants were randomly allocated to ImPuls plus treatment-as-usual or treatment-as-usual alone (allocation ratio: 1:1), stratified by study site. The randomisation sequence was generated by an external data manager. The team responsible for data collection and management was masked to the randomisation sequence. The ImPuls intervention comprised evidence-based outdoor exercises lasting 30 min, and aimed at achieving at least moderate intensity. It also incorporated behavioural change techniques targeting motivational and volitional determinants of exercise behaviour. Treatment-as-usual was representative of typical outpatient health care in Germany, allowing patients access to any standard treatments. The primary outcome was global symptom severity at 6 months after randomisation, measured using self-report on the Brief Symptom Inventory (BSI-18) and analysed in the intention-to-treat sample. No individuals with lived experience of mental illness were involved in conducting the study or writing the final publication. Safety was assessed in all participants. The trial was registered with the German Clinical Trials Register (DRKS00024152) with a completion date of June 30, 2024.

FINDINGS

600 patients provided informed consent, were recruited to the study, and underwent a diagnostic interview between Jan 1, 2021, and May 31, 2022. Following this, 199 were excluded on the basis of inclusion and exclusion criteria and one withdrew consent during the baseline assessment. Of the 400 eligible participants, 284 (71%) self-identified as female, 106 (27%) self-identified as male, and nine (2%) self-identified as other. The mean age was 42·20 years (SD 13·23; range 19-65). Ethnicity data were not assessed. 287 (72%) participants met the criteria for moderate or severe depression, 81 (20%) for primary insomnia, 37 (9%) for agoraphobia, 46 (12%) for panic disorder, and 72 (18%) for PTSD. 199 participants were allocated to the intervention group of ImPuls plus treatment-as-usual and 201 to the control group of treatment-as-usual alone. 38 (19%) participants did not receive the minimum ImPuls intervention dose. ImPuls plus treatment-as-usual demonstrated superior efficacy to treatment-as-usual alone in reducing global symptom severity, with an adjusted difference on BSI-18 of 4·11 (95% CI 1·74-6·48; d=0·35 [95% CI 0·14-0·56]; p=0·0007) at 6 months. There were no significant differences in the total number of adverse events or serious adverse events between the two groups. There was one serious adverse event (male, torn ligament) related to the intervention.

INTERPRETATION

ImPuls is an efficacious transdiagnostic adjunctive treatment in outpatient mental health care. Our findings suggest that exercise therapy should be implemented in outpatient mental health care as an adjunctive transdiagnostic treatment for mental disorders such as depression, insomnia, panic disorder, agoraphobia, and PTSD. Transdiagnostic group exercise interventions might ameliorate the existing disparity in care provision between the many individuals in need of evidence-based treatment and the few who are receiving it.

FUNDING

The German Innovation Fund of the Federal Joint Committee of Germany.

Early hybrid cardiac rehabilitation in congenital heart disease: the QUALIREHAB trial

BACKGROUND AND AIMS

Cardiopulmonary fitness in congenital heart disease (CHD) decreases faster than in the general population resulting in impaired health-related quality of life (HRQoL). As the standard of care seems insufficient to encourage and maintain fitness, an early hybrid cardiac rehabilitation programme could improve HRQoL in CHD.

METHODS

The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions. Adolescent and young adult CHD patients with impaired cardiopulmonary fitness were randomly assigned to either the intervention (i.e. cardiac rehabilitation) or the standard of care. The primary outcome was the change in HRQoL from baseline to 12-month follow-up in an intention-to-treat analysis. The secondary outcomes were the change in cardiovascular parameters, cardiopulmonary fitness, and mental health.

RESULTS

The expected number of 142 patients was enroled in the study (mean age 17.4 ± 3.4 years, 52% female). Patients assigned to the intervention had a significant positive change in HRQoL total score [mean difference 3.8; 95% confidence interval (CI) 0.2; 7.3; P = .038; effect size 0.34], body mass index [mean difference -0.7 kg/m2 (95% CI -1.3; -0.1); P = .022; effect size 0.41], level of physical activity [mean difference 2.5 (95% CI 0.1; 5); P = .044; effect size 0.39], and disease knowledge [mean difference 2.7 (95% CI 0.8; 4.6); P = .007; effect size 0.51]. The per-protocol analysis confirmed these results with a higher magnitude of differences. Acceptability, safety, and short-time effect of the intervention were good to excellent.

CONCLUSIONS

This early hybrid cardiac rehabilitation programme improved HRQoL, body mass index, physical activity, and disease knowledge, in youth with CHD, opening up the possibility for the QUALIREHAB programme to be rolled out to the adult population of CHD and non-congenital cardiac disease.

Changes in rest-activity rhythms in adolescents as they age: associations with brain changes and behavior in the ABCD study

Background

Adolescents with disrupted rest-activity rhythms (RAR) including shorter sleep duration, later sleep timing and low physical activity levels have higher risk for mental and behavioral problems. However, it remains unclear whether the same associations can be observed for within-subject changes in RAR.

Methods

Our longitudinal investigation on RAR used Fitbit data from the Adolescent Brain Cognitive Development (ABCD) Study at the 2-year (FL2: aged 10-13 years) and 4-year follow-up (FL4: aged 13-16 years). 963 youths had good-quality Fitbit data at both time points. In this study we examined changes in RAR from FL2 to FL4, their environmental and demographic contributors as well as brain and behavioral correlates.

Results

From FL2 to FL4, adolescents showed decreases in sleep duration and physical activity as well as delayed sleep timing (Cohen's d .44-.75). The contributions of environmental and demographic factors to RAR changes were greatest to sleep timing (explained 10% variance) and least to sleep duration (explained 1% variance). Delays in sleep timing had stronger correlations with behavioral problems including greater impulsivity and poor academic performance than reductions in sleep duration or physical activity. Additionally, the various brain measures differed in their sensitivity to RAR changes. Reductions in sleep duration were associated with decreased brain functional connectivity between subcortical regions and sensorimotor and cingulo-opercular networks and with enhanced functional connectivity between sensorimotor, visual and auditory networks. Delays in sleep timing were mainly associated with grey matter changes in subcortical regions.

Conclusions

The current findings corroborate the role of sleep and physical activity in adolescent's brain neurodevelopment and behavior problems. RAR might serve as biomarkers for monitoring behavioral problems in adolescents and to serve as potential therapeutic targets for mental disorders.

Mechanisms Linking Physical Activity with Psychiatric Symptoms Across the Lifespan: A Systematic Review

BACKGROUND

Physical activity has been suggested as a protective factor against psychiatric symptoms. While numerous studies have focused on the magnitude of physical activity's effect on psychiatric symptoms, few have examined the potential mechanisms.

OBJECTIVE

The current review aimed to synthesize scientific evidence of the mechanisms through which physical activity might reduce psychiatric symptoms across the lifespan.

METHODS

We included articles that were published before March 2022 from five electronic databases (MEDLINE, Web of Science, PsycINFO, Embase, and Cochrane). A qualitative synthesis of studies was conducted. The risk of bias assessment was performed using The Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. Studies were included if they explored the possible mechanisms through which physical activity influences psychiatric symptoms (i.e., internalizing and externalizing symptoms) across the lifespan.

RESULTS

A total of 22 articles were included (three randomized controlled trials, four non-randomized controlled trials, three prospective longitudinal studies, and 12 cross-sectional studies). Overall, most of the studies focused on children, adolescents, and young adults. Our findings showed that self-esteem, self-concept, and self-efficacy were the only consistent paths through which physical activity influences psychiatric symptoms (specifically depressive and anxiety symptoms) across the lifespan. There were insufficient studies to determine the role of neurobiological mechanisms.

CONCLUSIONS

Overall, future physical activity interventions with the purpose of improving mental health should consider these mechanisms (self-esteem, self-concept, self-efficacy) to develop more effective interventions.

CLINICAL TRIAL REGISTRATION

The protocol of this study was registered in the PROSPERO database (registration number CRD42021239440) and published in April 2022.

Levels of Physical Activity at Age 10 Years and Brain Morphology Changes From Ages 10 to 14 Years

Importance

Physical activity may promote healthy brain development in children, but previous research was predominantly cross-sectional and included small samples, providing limited knowledge.

Objective

To investigate the longitudinal associations of physical activity with brain morphology changes.

Design, Setting, and Participants

A 4-year longitudinal population-based cohort study in Rotterdam, the Netherlands, embedded in Generation R, a cohort from fetal life onward. From the women enrolled during pregnancy, children who had repeated measures of brain structure at ages 10 (range 8 to 12) years and 14 (range 13 to 15) years were included. Data were collected from March 2013 to November 2015 (baseline) and from October 2016 to January 2020 (follow-up). Data were analyzed from April to December 2022.

Exposure

At age 10 years, both the child and their primary caregiver reported the child's levels of physical activity with regard to sport participation, outdoor play, and total physical activity. Primary analyses were based on an average multi-informant report.

Main outcomes and measures

Brain morphology was quantified by magnetic resonance imaging. Hypothesized regions of interest were the bilateral amygdala and hippocampal volumes. Global brain measures were studied to test the specificity of the hypothesis.

Results

Data were available for 1088 children (566 girls [52%]; 693 [64%] Dutch). Their mean (SD) age at baseline was 10.1 (0.6) years. For amygdala volume change, positive associations with multi-informant reports of total physical activity (β = 2.6; 95% CI, 0.3-4.9) were found. Total physical activity was associated with hippocampal volume increases only when reported by the child (β = 3.1; 95% CI, 0.4-5.8). No robust associations with global brain measures were found.

Conclusions and relevance

In this cohort study of 1088 children, more physical activity at 10 years was consistently associated with an increase in amygdala volume in children aged 10 to 14 years. Physical activity and increases in hippocampal volume were found using child reports of physical activity only. These findings suggest physical activity in late childhood was prospectively associated with volumetric changes in specific subcortical structures, but not to global brain development, from late childhood to early adolescence. These findings may inform the design of future public health interventions to best facilitate neurodevelopment with physical activity.

Whole Person Modeling: a transdisciplinary approach to mental health research

The growing global burden of mental illness has prompted calls for innovative research strategies. Theoretical models of mental health include complex contributions of biological, psychosocial, experiential, and other environmental influences. Accordingly, neuropsychiatric research has self-organized into largely isolated disciplines working to decode each individual contribution. However, research directly modeling objective biological measurements in combination with cognitive, psychological, demographic, or other environmental measurements is only now beginning to proliferate. This review aims to (1) to describe the landscape of modern mental health research and current movement towards integrative study, (2) to provide a concrete framework for quantitative integrative research, which we call Whole Person Modeling, (3) to explore existing and emerging techniques and methods used in Whole Person Modeling, and (4) to discuss our observations about the scarcity, potential value, and untested aspects of highly transdisciplinary research in general. Whole Person Modeling studies have the potential to provide a better understanding of multilevel phenomena, deliver more accurate diagnostic and prognostic tests to aid in clinical decision making, and test long standing theoretical models of mental illness. Some current barriers to progress include challenges with interdisciplinary communication and collaboration, systemic cultural barriers to transdisciplinary career paths, technical challenges in model specification, bias, and data harmonization, and gaps in transdisciplinary educational programs. We hope to ease anxiety in the field surrounding the often mysterious and intimidating world of transdisciplinary, data-driven mental health research and provide a useful orientation for students or highly specialized researchers who are new to this area.