Physical activity, sedentary behavior, and psychological symptoms among US high school students during COVID-19

Background and aims

A significant amount of literature documents the importance of potentially modifiable risk factors, including inadequate physical activity and excessive sedentary behaviors, as contributors to adolescent mental health problems. This study examined associations between variations in vigorous physical activity, weight training/muscle toning, sports team involvement, and sedentary behavior (screen time) in cluster subgroups of high school-age young men and young women that were defined based on the presence or absence of depressed mood, suicide contemplation, and suicide attempts during 2021, a period of COVID-19 restriction.

Method

Data from the 2021 US Centers for Disease Control Youth Risk Behavior Survey (YRBS) was used to form mental health status subgroups and to evaluate physical activity and sedentary behavior. Two-Step Cluster Analysis (SPSS) of YRBS items involving depressive episodes, suicide contemplation, and suicide attempts was used to define mental health subgroups. Multinomial regression evaluated differences among subgroups in physical activity, sports team involvement, and sedentary behavior (screen time).

Results

The proportions of females identified in symptomatic subgroups (61 %) defined by the presence of depression episodes or depression and suicidal behavior differed substantially from those in similarly defined symptomatic male subgroups (35 %). Among female students, those in the asymptomatic versus depression episode and depression with suicide risk subgroups showed a significantly higher likelihood of daily aerobic exercise (44 % vs. 27 % and 28 %) and sports team involvement (52 % vs 43 % and 43 %), and a lower likelihood of 3+ hours of daily screen time (74 % vs 83 % and 84 %). Among male students, those in the asymptomatic versus depression episode and depression with suicide risk subgroups showed a significantly higher likelihood of daily aerobic exercise (58 % vs 49 % and 48 %) and sports team involvement (54 % vs 48 % and 46 %), and a lower likelihood of 3+ hours of daily screen time (73 % vs 78 % and 79 %).

Conclusions

Findings are consistent with previous research linking depressive symptoms and suicidal behavior with limited aerobic exercise, sports team involvement, and excessive screen time. Few differences in exercise or screen time were found in comparisons between depression episode and depression and suicidal behavior subgroups in comparisons involving young women or young men. Low proportions reporting daily aerobic exercise, particularly among young women, and high proportions reporting elevated screen time, were identified across symptomatic and asymptomatic subgroups. Interventions designed to increase physical activity and reduce excessive screen time are recommended for high school students, particularly those experiencing depressive symptoms and suicidal risk behaviors.