Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality

Abstract

Objectives. Evidence concerning physical activity and mental health remains less well documented for children and adolescents. An updated review of systematic reviews and meta-analyses was undertaken concerning physical activity and mental health in children and adolescents, and to judge the extent to which associations can be considered causal. Methods. Systematic reviews and meta-analyses were identified to update our previous review of reviews (Biddle & Asare, 2011), with papers identified between November 2010 and the end of 2017. Criteria were used to judge causality (Hill, 1965), including strength of association, dose-response association, and experimental evidence. Results. Since 2011, the quantity (k=42 reviews) and quality of research has increased in depression (evidence from 10 reviews), self-esteem (10 reviews) and cognitive functioning (25 reviews). Anxiety had only three new, small, reviews. Intervention effects for depression are moderate in strength while observational data show only small or null associations. Variable effect sizes are evident from interventions for the reduction of anxiety and improvement in self-esteem. Higher or improved fitness and physical activity are associated with better cognitive health and performance. There was partial support for a causal association with depression, a lack of support for self-esteem, but support for cognitive functioning. Conclusions. There are significant increases in research activity concerning physical activity and depression, self-esteem, and cognitive functioning in young people. The strongest evidence for a causal association appears to be for cognitive functioning, and there is partial evidence for depression.

Pathways to Increasing Adolescent Physical Activity and Wellbeing: A Mediation Analysis of Intervention Components Designed Using a Participatory Approach

“…This also supports other work suggesting that there may be potential for change in mental health to impact physical activity as a disengagement in everyday activities and the loss of enjoyment that characterises poor mental health is been proposed to reduce future physical activity [58][59][60]. It is less commonly explored how mental wellbeing (as opposed to depression) may influence physical activity; the direction of causality between wellbeing and physical activity remains as changes in physical activity have been proposed to lead to improvements in mental wellbeing [58,61,62]. It would be valuable to further examine the direction and strength of these associations, particularly among adolescents and using accelerometer-assessed physical activity.…”

“…This analysis provides insight for informing future interventions aiming to target wellbeing. Many interventions use components such as mentorship, leadership, class-based activity sessions and online activity tracking to increase physical activity; the potential for these physical activity interventions to additionally target wellbeing is becoming increasingly salient [62,80,81]. Despite this widespread use, relatively little is known about the mechanisms by which these intervention components may target outcomes via proposed mediators.…”

Physical Activity and Mental Health in Young People

“…We have recently conducted an updated review of reviews of the Biddle and Asare paper, and in this we assessed whether any association between physical activity and mental health outcome can be considered causal [5]. Specifically, we assessed some of the criteria proposed by Sir Austin Bradford in his classic paper on causality in epidemiological research [6].…”

Physical Exercise, Fitness, Cognitive Functioning, and Psychosocial Variables in an Adolescent Sample

“…Numerous studies have supported the health benefits of regular physical activity (any movement that requires energy expenditure) and exercise (physical activity that is planned, structured and repetitive) [1,2]. However, recent years have seen an increase in sedentary lifestyles among younger people, limiting the potential effects of active lifestyles [3,4].…”