{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:04:55Z","timestamp":1790661895393,"version":"4.1.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Excessive smartphone use has become a major public health concern among adolescents, particularly in China where smartphone use is widespread. Although smartphone addiction is consistently associated with poor sleep quality, the mechanisms underlying this association remain insufficiently understood. This study examined whether physical activity engagement and depressive symptoms operate as parallel and serial mediators linking smartphone addiction to sleep quality in Chinese adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among 612 adolescents (Mage = 14.2 years, SD = 1.6; 51.3% female) from four secondary schools in Hubei Province, China. Participants completed the Smartphone Addiction Scale\u2013Short Version, the Physical Activity Questionnaire for Adolescents, the Pittsburgh Sleep Quality Index, and the Depression subscale of the Depression Anxiety Stress Scales-21. Path analysis of observed composite scores with robust maximum likelihood estimation and bias-corrected bootstrapping (5,000 resamples) was used to test the proposed parallel and serial mediation model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Smartphone addiction was positively associated with poor sleep quality (\u03b2 = .38, p &amp;lt;.001). Both physical activity (indirect effect = .04, 95% CI [.01,.07]) and depressive symptoms (indirect effect = .14, 95% CI [.09,.19]) significantly mediated this association in parallel. In addition, the serial pathway from smartphone addiction to low physical activity, elevated depressive symptoms, and poor sleep quality was significant (indirect effect = .02, 95% CI [.01,.04]). The mediators collectively accounted for 52.6% of the total effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings suggest that problematic smartphone use is associated with poorer adolescent sleep through behavioral and psychological pathways involving reduced physical activity and elevated depressive symptoms. School-based interventions that promote physical activity while reducing problematic smartphone use may help protect adolescent sleep and mental health. Longitudinal and experimental designs are needed to establish causal direction and inform intervention development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1966617","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:46:26Z","timestamp":1790660786000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Smartphone addiction, physical activity engagement, and sleep quality in Chinese adolescents: a parallel and serial mediation model"],"prefix":"10.3389","volume":"17","author":[{"given":"Weidong","family":"Zuo","sequence":"first","affiliation":[{"name":"School of Physical Education, Huanggang Normal University","place":["Huanggang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Physical Education, Huanggang Normal University","place":["Huanggang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2014.07.005","article-title":"Screen time and sleep among school-aged children and adolescents: a systematic literature review","volume":"21","author":"Hale","year":"2015","journal-title":"Sleep Med Rev"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2018.03.015","article-title":"Adverse physiological and psychological effects of screen time on children and adolescents: literature review and case study","volume":"164","author":"Lissak","year":"2018","journal-title":"Environ Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.cpr.2017.05.003","article-title":"Problematic smartphone use: a conceptual framework and review","volume":"50","author":"Elhai","year":"2017","journal-title":"Clin Psychol Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/2167702617723376","article-title":"Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010 and links to increased new media screen time","volume":"6","author":"Twenge","year":"2018","journal-title":"Clin Psychol Sci"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.13213","article-title":"Temporal association between objectively measured smartphone usage, sleep quality and physical activity among Chinese adolescents and young adults","volume":"30","author":"Lee","year":"2021","journal-title":"J Sleep Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.mhpa.2020.100323","article-title":"Associations among physical activity and smartphone use with perceived stress and sleep quality of Chinese college students","volume":"18","author":"Zhai","year":"2020","journal-title":"Ment Health Phys Act"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S462794","article-title":"The effect of physical activity on sleep quality among Chinese college students: the chain mediating role of stress and smartphone addiction during the COVID-19 pandemic","volume":"17","author":"Wang","year":"2024","journal-title":"Psychol Res Behav Manag"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0331340","article-title":"The effect of mobile phone addiction on sleep procrastination in adolescents: the longitudinal mediating role of physical activity behavior","volume":"20","author":"Yu","year":"2025","journal-title":"PloS One"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2011-090185","article-title":"Physical activity and mental health in children and adolescents: a review of reviews","volume":"45","author":"Biddle","year":"2011","journal-title":"Br J Sports Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-1642","article-title":"Physical activity for cognitive and mental health in youth: a systematic review of mechanisms","volume":"138","author":"Lubans","year":"2016","journal-title":"Pediatrics"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychsport.2008.08.002","article-title":"Do exercise and fitness buffer against stress among health care workers","volume":"10","author":"Gerber","year":"2009","journal-title":"Psychol Sport Exerc"},{"key":"B12","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.jpsychires.2016.02.017","article-title":"Exercise as a treatment for depression: a meta-analysis adjusting for publication bias","volume":"77","author":"Schuch","year":"2016","journal-title":"J Psychiatr Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2019.1759","article-title":"Association of screen time and depression in adolescence","volume":"173","author":"Boers","year":"2019","journal-title":"JAMA Pediatr"},{"key":"B14","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-021-01863-9","article-title":"The prospective effect of problematic smartphone use and fear of missing out on sleep among Chinese adolescents","volume":"42","author":"Zhang","year":"2023","journal-title":"Curr Psychol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.98.2.310","article-title":"Stress, social support, and the buffering hypothesis","volume":"98","author":"Cohen","year":"1985","journal-title":"Psychol Bull"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1207\/S15327965PLI1104_01","article-title":"The \"what\" and \"why\" of goal pursuits: human needs and the self-determination of behavior","volume":"11","author":"Deci","year":"2000","journal-title":"Psychol Inq"},{"key":"B18","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1037\/0003-066X.55.1.68","article-title":"Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being","volume":"55","author":"Ryan","year":"2000","journal-title":"Am Psychol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0083558","article-title":"The smartphone addiction scale: development and validation of a short version for adolescents","volume":"8","author":"Kwon","year":"2013","journal-title":"PloS One"},{"key":"B20","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1556\/2006.4.2015.011","article-title":"Can disordered mobile phone use be considered a behavioral addiction? An update on current evidence and a comprehensive model for future research","volume":"4","author":"Billieux","year":"2015","journal-title":"J Behav Addict"},{"key":"B21","volume-title":"The Physical Activity Questionnaire for Older Children (Paq-C) and Adolescents (Paq-a) Manual","author":"Kowalski","year":"2004"},{"key":"B22","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res"},{"key":"B23","volume-title":"Manual for the Depression Anxiety Stress Scales","author":"Lovibond","year":"1995"},{"key":"B24","volume-title":"IBM SPSS Statistics for Windows, Version 26.0","year":"2019"},{"key":"B25","volume-title":"Mplus User's Guide","author":"Muthen","year":"2017"},{"key":"B26","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach","author":"Hayes","year":"2018"},{"key":"B27","volume-title":"WHO Guidelines on Physical Activity and Sedentary Behaviour","year":"2020"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14030311","article-title":"Social networking sites and addiction: ten lessons learned","volume":"14","author":"Kuss","year":"2017","journal-title":"Int J Environ Res Public Health"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1966617\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:46:28Z","timestamp":1790660788000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1966617\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":28,"alternative-id":["10.3389\/fpsyt.2026.1966617"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1966617","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"article-number":"1966617"}}