Exercise-level differences in depressive symptoms among rural Chinese adolescents: Gender-specific patterns and an indirect link through body satisfaction.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.