{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:53:44Z","timestamp":1785412424046,"version":"3.56.0"},"reference-count":52,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"unspecified","delay-in-days":187,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K01-MH125906"],"award-info":[{"award-number":["K01-MH125906"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01-MH139880"],"award-info":[{"award-number":["R01-MH139880"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726105121_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although mental health and healthy lifestyle interventions are associated with functional outcomes in adolescence, the extent to which particular lifestyle factors explain relationships between mental health and outcome are unclear. Here we examined mediating effects of lifestyle factors on relationships between mental health and two functional outcomes measured 2\u20133\u00a0years later, as well as moderating effects of environmental risk factors on mediation strength in early adolescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726105121_sec2\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We analyzed data from three waves of the Adolescent Brain Cognitive Development Study (ages 10\u201311, 11\u201312, and 12\u201313 years). Mediating effects of sleep quality, screen time, physical activity, and Mediterranean diet on the relationships between depression, anxiety, psychotic-like experience (PLE) distress, and total problems with two subsequent functional outcomes (academic functioning and social problems) were examined. Secondary analyses included environmental factors as moderators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726105121_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sleep quality mediated 18.5%, 36.3%, and 8.3% of the relationships between depression, anxiety, and PLE distress with academic functioning, respectively (total problems mediation was nonsignificant). Screen time was the second strongest mediator. For social problems, only sleep quality showed &gt;3% mediation (19.6\u201323.3%). Mediating effects of sleep and screen time on academic functioning decreased as financial adversity increased. Conversely, mediating effects of sleep quality on social problems increased with worsening family conflict, financial adversity, and school environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726105121_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results suggest that healthy lifestyle factors (particularly sleep quality) may partially explain associations between mental health and functioning in adolescents and suggest that these effects are modulated by environmental factors. These results may have implications for future intervention studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726105121","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:00:39Z","timestamp":1783400439000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Mediating effects of healthy lifestyle factors on associations between mental health and functional outcomes in early adolescence"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5656-7987","authenticated-orcid":false,"given":"Jason","family":"Smucny","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05rrcem69","id-type":"ROR","asserted-by":"publisher"}],"name":"University of California, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler 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