ArticleFrontiers in public health2026
Physical activity and adolescent anxiety trajectories: a longitudinal analysis of exercise self-efficacy and body image.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Adolescent anxiety develops heterogeneously, yet most evidence on physical activity remains cross-sectional and variable-centered. This study examined whether baseline physical activity was associated with differential anxiety trajectory membership across one academic year and whether exercise self-efficacy and body image were related to these associations. Methods: A three-wave longitudinal study was conducted among 1,395 middle school students. Of these, 1,243 provided complete data across all waves. Participants were first stratified into stability-dominant and variability-dominant subgroups based on cross-wave similarity. Anxiety trajectories were then estimated within the variability-dominant subgroup using latent class trajectory modeling. Associations of baseline physical activity with later exercise self-efficacy, body image, and anxiety trajectory membership were examined using linear regression, multinomial logistic regression, and bootstrap-based indirect pathway models controlling for grade, sex, and age. Results: Most adolescents with complete data were classified into the stability-dominant subgroup (76.7%), whereas 23.3% were classified into the variability-dominant subgroup. Within the variability-dominant subgroup, a 3-class solution was retained, comprising Stable Elevated (60.0%), Declining Improvement (18.6%), and Increasing Risk (21.4%) trajectories. Baseline physical activity differentiated subsequent trajectory membership and positively predicted later exercise self-efficacy and body image. Exercise self-efficacy also positively predicted later body image. However, the hypothesized serial indirect pathway through exercise self-efficacy and body image was not consistently supported across trajectory contrasts. Conclusion: Physical activity was associated with differential anxiety trajectory membership, but these associations unfolded within a broader pattern of psychosocial stability. Exercise self-efficacy showed a more consistent role than body image, whereas the hypothesized serial pathway was not robustly supported. Physical activity may therefore be more relevant to developmental positioning across anxiety trajectories than to a simple uniform symptom-reduction model.
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