How Do Physical Activity Patterns Relate to Mental Health in Children and Teens?

What you need to know

• This study followed over 17,000 children and teens in Germany for 10 years to examine how their physical activity levels related to mental health and ADHD symptoms over time.

• Most participants showed low levels of mental health problems and ADHD symptoms that remained stable or decreased slightly over the 10 years.

• Physical activity levels tended to increase in childhood and then decrease in adolescence for most participants.

• Contrary to expectations, the researchers did not find significant relationships between physical activity patterns and mental health or ADHD symptom patterns over the 10-year period.

• The lack of a group with consistently high physical activity levels may explain why no long-term benefits were observed, highlighting the importance of maintaining regular physical activity.

Background

Previous research has suggested that regular physical activity can have positive effects on mental health and ADHD symptoms in children and adolescents, at least in the short-term. However, less is known about how physical activity patterns relate to mental health over longer periods of childhood and adolescent development.

This study aimed to examine the long-term relationships between physical activity levels and both general mental health problems and ADHD symptoms in children and adolescents over a 10-year period. The researchers wanted to see if certain patterns of physical activity over time were associated with particular trajectories of mental health or ADHD symptoms.

The Study

The researchers used data from a large German health survey of children and adolescents called KiGGS. This study collected information from 17,640 children and adolescents at three time points over 10 years:

• Baseline: 2003-2006
• Wave 1: 2009-2012
• Wave 2: 2014-2017

At each time point, parents completed questionnaires about their child’s mental health and ADHD symptoms using a tool called the Strengths and Difficulties Questionnaire (SDQ). Physical activity levels were reported by parents for younger children and self-reported by adolescents.

The researchers used statistical techniques to identify different patterns or “trajectories” of how mental health problems, ADHD symptoms, and physical activity levels changed over the 10-year period for different groups of participants. They then examined whether certain physical activity trajectories were associated with particular mental health or ADHD symptom trajectories.

Key Findings

Mental Health Trajectories

For both boys and girls, the researchers identified four main trajectories of general mental health problems over the 10-year period:

1. Low difficulties (67-68% of participants): Low levels of mental health problems that remained stable over time.

2. Medium difficulties (24-25%): Started with moderate levels of problems that decreased over time.

3. High difficulties (4-5%): Started with high levels of problems that decreased over time.

4. Increasing difficulties (3-4%): Started with low levels but increased over time.

The majority of children and adolescents fell into the “low difficulties” group, showing consistently good mental health over the 10 years.

ADHD Symptom Trajectories

For ADHD symptoms, four main trajectories were also identified for both genders:

1. Low symptoms (51% of boys, 62% of girls): Consistently low levels of ADHD symptoms.

2. Medium symptoms (39% of boys, 20% of girls): Started with moderate symptoms that decreased over time.

3. High symptoms (7% of boys, 6% of girls): Started high and decreased over time.

4. Increasing symptoms (3% of boys, 12% of girls): Started low and increased over time.

Again, the majority of participants showed consistently low levels of ADHD symptoms over the 10-year period.

Physical Activity Trajectories

For physical activity levels, the patterns differed slightly between boys and girls:

Boys:

1. Increasing activity (1%)
2. Increasing then decreasing activity (58%)
3. Decreasing activity (40%)

Girls:

1. Low and decreasing activity (1%)
2. Increasing then decreasing activity (72%)
3. Increasing activity (1%)
4. High and decreasing activity (27%)

For both genders, the most common pattern was an increase in physical activity levels in childhood followed by a decrease in adolescence. This aligns with previous research showing that physical activity tends to decline as children enter their teenage years.

Relationships Between Trajectories

Surprisingly, the researchers did not find any statistically significant relationships between the physical activity trajectories and the mental health or ADHD symptom trajectories for either boys or girls. In other words, participants with more favorable physical activity patterns (e.g. consistently high levels) were not more likely to show better mental health or ADHD symptom trajectories over the 10-year period.

Implications

These findings seem to contradict previous research showing positive effects of physical activity on mental health and ADHD symptoms in children and adolescents. However, the researchers note some important considerations:

1. Most previous studies looked at shorter time periods, while this study examined patterns over 10 years.

2. There was no group that maintained consistently high levels of physical activity over the full 10-year period. The most active group still showed declining activity in adolescence.

3. The benefits of physical activity on mental health may be more immediate rather than having long-term effects over many years.

4. The study relied on questionnaires rather than objective measures of physical activity or clinical diagnoses of mental health conditions.

The lack of a consistently highly active group highlights the challenge of maintaining regular physical activity, especially during the transition to adolescence. This suggests that efforts to promote lifelong physical activity habits may be beneficial.

While this study did not find long-term associations, it does not negate the potential short-term benefits of physical activity for mental health and ADHD symptoms that have been found in other research. Regular physical activity is still recommended for its many physical and mental health benefits.

Conclusions

• Most children and adolescents in this study showed consistently low levels of mental health problems and ADHD symptoms over a 10-year period.

• Physical activity levels tended to increase in childhood and then decrease in adolescence for the majority of participants.

• No significant long-term relationships were found between physical activity patterns and mental health or ADHD symptom trajectories over the 10-year period.

• The lack of a consistently highly active group may explain why no long-term benefits of physical activity were observed in this study.

• Promoting lifelong physical activity habits, especially through the transition to adolescence, remains important for overall health and wellbeing.