Frontiers in Psychology 发表 MASEM 研究:心理韧性中介青少年体力活动与手机成瘾的关联
Physical activity, psychological resilience, and adolescent mobile phone addiction—a meta-analytic structural equation modeling study
一项发表于 Frontiers in Psychology 的元分析结构方程模型(MASEM)研究整合58项研究、共98,946名青少年与青年样本,发现体力活动与手机成瘾呈显著负相关(r=−0.225,95% CI [−0.282, −0.166]),体力活动与心理韧性正相关(r=0.370),心理韧性与手机成瘾负相关(r=−0.362)。
这项元分析整合98,946名青少年数据,量化了心理韧性在体力活动与手机成瘾之间的中介比例,为干预设计提供机制线索。
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摘要
背景与目的:
随着移动互联网的广泛使用,青少年智能手机成瘾已成为全球重大公共卫生问题。
方法:
本研究综合实证证据,定量考察青少年体力活动(PA)、心理韧性(PR)与手机成瘾(MPA)之间的关系,并探讨PR的中介作用。遵循PRISMA指南,系统检索五个数据库(PubMed、Web of Science、PsycINFO、SPORTDiscus、CNKI),共纳入58篇相关文献(三对关系共63条相关系数记录),包括横断面和纵向研究,总样本量为98,946名青少年和年轻成人。结合传统元分析与MASEM;采用随机效应模型合并效应量,并采用两阶段结构方程建模方法检验中介效应。
结果:
PA与MPA之间存在显著负相关(r = −0.225 [95% CI:−0.282至−0.166])。PA与PR呈正相关(r = 0.370 [95% CI:0.250至0.479])。PR与MPA呈负相关(r = −0.362 [95% CI:−0.518至−0.184])。Egger检验和Begg检验均未显示三对关系中的任何一对存在统计学显著的小样本效应。MASEM分析显示,PR起显著中介作用,间接效应为−0.120,占总效应的53.3%。所有分析均观察到显著异质性(I2 > 96%),调节效应分析中教育水平、研究设计和测量工具部分解释了这种异质性。
结论:
PA总体上与较低的MPA相关(r = −0.225);在中介模型中,直接效应降至临界不显著,该关联在很大程度上(约53%)由心理韧性中介。研究结果提示,针对青少年和年轻成人手机成瘾的有效干预应将体力活动促进与心理成分相结合。然而,鉴于证据基础以观察性研究为主,这些建议应审慎看待,未来需要干预研究来确立因果关系。
系统综述注册:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420261398773,标识符:CRD420261398773。
1 引言
数字技术的快速发展和移动互联网的广泛普及,使智能手机成为青少年日常生活、学习和社交中不可或缺的工具。中国互联网络信息中心(CNNIC)于2024年12月发布的第55次《中国互联网络发展状况统计报告》显示,中国10—19岁网民规模达1.86亿,占全部网民的16.7%(CNNIC,2025)。青少年群体的智能手机普及率超过98%(Fang等,2024)。智能手机在为青少年提供便捷信息获取和丰富社交体验的同时,也带来了一系列不容忽视的问题。手机成瘾已成为影响青少年身心发展的全球性公共卫生问题。近期调查数据显示,中国青少年手机成瘾问题日益严重。Mei等(2022)采用手机成瘾指数量表对946名中国大学生进行横断面调查,报告手机成瘾检出率为36.6%,严重成瘾与一系列心理、躯体及睡眠相关健康问题显著相关。
手机成瘾可导致青少年注意力难以集中、学业成绩下降、睡眠质量降低,还可能引发焦虑、抑郁、孤独等情绪问题,并可能增加冲动行为和社会隔离的风险。长时间使用手机会导致青少年体力活动显著减少,造成久坐行为、手机成瘾和不愿参与体育运动日益普遍。这对青少年的身体健康构成极大风险(Zhu等,2023)。此外,中国青少年体力活动不足问题严重。根据《中国学生体质与健康监测报告》,不到30%的中小学生每天达到至少1小时的中高强度体力活动。对于大学生而言,这一比例更低,超过60%报告体力活动水平较低(Yang等,2020)。
在国际上,青少年和年轻成人中问题性智能手机使用的流行率同样令人担忧。来自印度的研究报告称,39–45%的年轻成人表现出问题性智能手机使用模式(Haripriya et al., 2019;Kumar et al., 2024)。在土耳其,Numanoğlu-Akbaş et al. (2020) 发现,体力活动水平低的大学生表现出智能手机成瘾的可能性显著更高。在韩国,Kim and Ahn (2023) 的纵向证据表明,基线运动时间可预测中学生随后的智能手机依赖。在欧洲,Cocozza et al. (2020) 考察了意大利居民休闲活动(包括体力活动)与心理韧性之间的关系,强调了针对青少年开展专门研究的必要性。在美国,Belaire et al. (2024) 调查了学龄儿童社会情感学习、韧性与体力活动之间的关系。在香港,Ho et al. (2015) 报告称,在中国青少年中,体力活动通过更高的韧性而与更好的心理健康相关。这些国际研究共同凸显了PA–韧性–MPA关联的全球相关性。
选择心理韧性作为PA–MPA关系中的主要中介变量,基于三个互补的理论视角。第一,韧性理论(Masten, 2001;Connor and Davidson, 2003)认为,韧性并非固定特质,而是个体与环境相互作用所产生的动态发展过程。体力活动作为一种有结构且具有挑战性的活动,为青少年提供了反复体验掌控、克服障碍和建立应对资源的机会,从而培养韧性。第二,自我调节理论(Baumeister and Heatherton, 1996;Bandura, 1991)表明,体力活动可增强自我调节资源——如目标设定、自我监控和冲动控制——这些资源可迁移至包括技术使用在内的其他领域。自我调节能力更强的个体更有能力管理其智能手机使用并抵制成瘾模式。第三,行为成瘾的人-情感-认知-执行交互(I-PACE)模型(Brand et al., 2016)将心理韧性确定为关键的保护性个人变量,可降低发展行为成瘾(包括问题性智能手机使用)的易感性。根据该模型,韧性较低的个体更可能将智能手机作为应对压力和负性情绪的一种机制,而韧性较高的个体则能够采用适应性应对策略。总之,这三个框架为假设心理韧性是PA–MPA关系的中介变量提供了连贯的理论依据。
尽管取得了这些进展,国际和中国的研究都存在局限性。大多数研究是横断面的(>85%),依赖中国或大学生样本(>70%),并且检验的是单一中介变量而非整合模型。尚无研究使用元分析结构方程模型(MASEM)来定量综合心理韧性在PA-MPA关系中的中介作用。这一空白直接证明了本MASEM研究的合理性。因此,本研究采用MASEM方法,全面分析和总结国内外相关文献的结果,探讨青少年身体活动、心理韧性与手机成瘾之间的关系,并阐明心理韧性中介作用的程度。这对于进一步理解身体活动影响青少年手机成瘾的机制具有重要意义,并为预防和干预青少年手机成瘾提供参考。
基于元分析和结构方程模型,本研究综合了国内外相关文献,分析了青少年身体活动、心理韧性与手机成瘾之间的关系,并探讨了心理韧性中介效应的程度和大小。主要目标包括:第一,使用传统元分析获得青少年身体活动与手机成瘾、身体活动与心理韧性、心理韧性与手机成瘾之间关系的总体效应量,测量不同变量对之间关联的紧密程度。第二,比较研究之间的差异以识别异质性来源。第三,检验发表偏倚是否影响结论,确保研究结果的可靠性。第四,使用MASEM方法构建SEM,检验心理韧性是否起中介作用,估计直接、间接和总效应量,并确定中介效应的比例。
基于文献中发现的空白,具体研究问题如下:(1)青少年身体活动与手机成瘾之间是否存在显著的负相关?(2)身体活动是否与青少年更高水平的心理韧性显著相关?(3)心理韧性是否中介青少年身体活动与手机成瘾之间的关系?(4)如果存在中介效应,其大小如何?
2 方法
2.1 研究设计
本研究采用传统元分析和元分析结构方程模型(MASEM;Assink and Wibbelink, 2016)。首先,运用传统元分析对国内外相关文献进行综合,获得青少年和青年身体活动、心理韧性与手机成瘾之间关系的合并效应量。其次,基于元分析结果构建结构方程模型,考察心理韧性在青少年身体活动与手机成瘾关系中的中介作用。该方法克服了单一研究因样本量小而导致结果不稳定的问题,在更大范围内反映变量间的关系,并增强了研究结果的可靠性和说服力。
2.2 概念界定
世界卫生组织将身体活动定义为由骨骼肌产生的、导致能量消耗的任何身体运动。身体活动涵盖日常生活中所有形式的身体运动,包括职业活动、家务劳动、交通出行和休闲活动。心理韧性最初用于描述个体在经历严重挫折后良好恢复的能力。早期研究将韧性视为一种固定的人格特质。然而,后来发现韧性并非静态的,而是一个动态的发展过程,是个体与其环境持续相互作用的结果。手机成瘾是一种行为成瘾,指个体无法控制自己的手机使用,从而导致身体、心理和社会生活方面的问题。
2.3 文献检索与筛选
本研究检索了5个中英文权威数据库。中文数据库为中国知网(CNKI)。英文数据库包括PubMed、Web of Science、PsycINFO和SPORTDiscus。检索时间范围为2015年1月至2026年5月(选择2015年1月作为截止点,主要是因为智能手机大约在这一时期开始广泛普及)。中文检索词包括:身体活动(体力活动、体育锻炼、运动)、心理韧性(心理韧性、心理弹性)、手机成瘾(手机成瘾、手机依赖、智能手机成瘾、问题性手机使用)。英文检索词包括:physical activity、exercise、sport、resilience、psychological resilience、mobile phone addiction、smartphone addiction、problematic mobile phone use。检索采用MeSH主题词与自由词相结合的方式。不同变量的检索词之间用“AND”连接,同一变量的不同表达方式之间用“OR”连接。
2.4 纳入标准
符合以下标准的研究被纳入:(1) 采用实证研究方法,包括横断面和纵向队列研究;(2) 研究对象为青少年和年轻成人,即样本的平均/中位年龄在10–24岁范围内(例如初中、高中和大学/学院学生)。即使少部分参与者略超过24岁,但样本主要处于该年龄段的研究仍予以保留;(3) 报告了三个变量(青少年体力活动、心理韧性、手机成瘾)中至少两个变量之间的相关系数,或可转换为相关系数的统计数据(标准化回归系数、t值、F值);(4) 提供了具体样本量;(5) 以期刊文章或硕士/博士学位论文形式发表。
2.5 排除标准
符合以下任一标准的研究被排除:(1) 非实证研究,如综述、评论、理论探讨或会议摘要;(2) 重复发表(仅保留最早或最完整的版本);(3) 涉及青少年和年轻成人范围之外的参与者或特殊人群,如临床疾病患者、老年人或残障人士;(4) 无法提取有效效应量数据,且无法联系作者提供补充数据;(5) 以中文或英文之外的语言撰写。
2.6 数据提取与编码
数据提取与编码由研究组两名经过培训的研究人员独立完成。他们首先从三篇随机选取的文章中预提取数据,以规范提取和编码规则,然后再进行全样本提取。分歧通过讨论解决。若无法达成共识,则由研究负责人做出最终决定。提取的信息包括四个维度:文献基本特征(第一作者、发表年份、文献类型)、参与者特征(总样本量、平均年龄、性别比例、教育水平)、测量工具信息(体力活动、心理韧性和手机成瘾的量表名称)以及效应量数据(变量之间的相关系数或可转换为相关系数的其他统计指标)。独立双人数据提取的评分者间一致性为高度至优秀(分类变量的Cohen's kappa = 0.87;连续变量的组内相关系数 = 0.92)。
遵循了标准化的编码方案:对于报告同一关系同一类型多个相关系数的研究,采用平均值作为该研究的效应量,使用Fisher z转换进行计算以确保适当的加权。如果仅有标准化回归系数(β)可用,则使用公式r = 0.98β + 0.05λ(其中当β为正时λ = 1,当β为负时λ = −1)将其转换为Pearson相关系数(r),该公式经Peterson and Brown (2005)通过蒙特卡洛模拟验证,平均误差小于0.01。这种转换方法已在元分析研究中广泛使用(Aloe and Becker, 2012)。当同时报告r和β时,直接使用相关系数。对于具有多个测量时间点的横断面研究,使用基线数据进行计算,以确保研究间的可比性。
2.7 数据分析方法
2.7.1 传统元分析
遵循Hunter and Schmidt (1990)框架,使用Stata 19软件进行元分析,效应量通过Fisher z转换计算。由于相关系数r的抽样分布非正态,所有相关系数均转换为Fisher Z分数以合并效应量,然后再转换回r(Briki, 2018)。鉴于纳入研究在样本特征、所用量表和研究方法上的预期差异,选择随机效应模型合并效应量。该模型同时考虑研究内抽样变异和研究间差异,具有更好的普适性。合并效应量的统计显著性使用95%置信区间(CI)确定;如果CI不包含零,则认为结果具有统计学显著性。
研究间的异质性使用Q检验和I2统计量评估。Q检验p值 < 0.05表示存在显著异质性。I2值:<25%表示无显著异质性,25% ≤ I2 < 75%表示中等异质性,≥75%表示较大异质性。发表偏倚使用漏斗图、Egger's和Begg's线性回归检验评估,通过漏斗图对称性和Egger's检验p值 > 0.05来判断(Doucouliagos et al., 2014)。如果检测到显著发表偏倚,则使用剪补法调整合并效应量。敏感性分析使用留一法(迭代剔除一项研究并重新计算合并效应量)进行,以评估总体结果的稳定性和可靠性。
鉴于观察到的异质性极高(三项分析的I2 > 96%),进行了调节效应分析以探索研究间变异的潜在来源。分类调节变量——包括国家/地区(中国与其他国家)、教育水平(初中、高中、大学/学院)、研究设计(横断面与纵向)、测量工具类型——使用亚组Q检验进行检验。连续调节变量(平均年龄、发表年份、男性百分比、研究方法学质量)使用随机效应元回归进行检验。
2.7.2 元分析结构方程模型
本研究使用 R 包 metaSEM(版本 1.3.0),遵循 Cheung 的两阶段方法(Cheung, 2014)。阶段 1:采用随机效应模型(metaSEM)合成一个汇总的 3 × 3 相关矩阵。三个两两相关系数分别从部分不重叠的研究集合中估计:PA–MPA(k = 42)、PA–PR(k = 13)和 PR–MPA(k = 8)。在纳入的 58 项研究中,只有两项(Shen and Gao, 2024;Zhang and Gao, 2023)报告了全部三个两两相关系数,一项报告了两对(PA–PR 和 PR–MPA),55 项报告了一对(40 项 PA–MPA、10 项 PA–PR、5 项 PR–MPA)。每项研究贡献其报告的相关性;缺失的相关性在随机缺失(MAR)假设下通过全信息最大似然(FIML)估计处理,在 metaSEM:tssem1 中实现。由于三个两两相关系数是从部分不重叠的研究集合中估计的,tssem1 在随机效应模型(REML)下联合估计 3 × 3 汇总相关矩阵及其渐近协方差矩阵。汇总矩阵从全部 58 项研究中估计,对角线为 1.0,非对角线为 REML/Fisher-z 汇总相关性(已验证正定性)。
阶段 2:基于合成的相关矩阵,构建了一个中介模型。采用 Bootstrap 方法(5,000 次重抽样)检验中介效应的显著性,分解总效应、直接效应和间接效应。指定的中介模型为饱和模型(df = 0),意味着完美拟合。由于阶段 2 模型是饱和的(df = 0),常规拟合指数(χ2/df、RMSEA、CFI、TLI)不具信息性,仅报告以说明模型精确再现了汇总相关矩阵;结论基于路径系数、其标准误、95% CI 以及间接效应的 bootstrap CI。在阶段 2 中,阶段 1 汇总相关性的渐近协方差矩阵作为抽样协方差矩阵提供给 metaSEM:tssem2,从而使阶段 1 的估计不确定性传播到阶段 2 路径系数和间接效应的标准误及 bootstrap CI 中。阶段 1 的输出是汇总的 3 × 3 相关矩阵及其渐近协方差矩阵(ACov),其非对角线元素非零,反映了报告多个相关性对的三项研究的共享信息。完整的 ACov 被传递给 metaSEM:tssem2,因此阶段 1 的估计不确定性传播到阶段 2 的标准误和间接效应的 bootstrap CI 中。因此,阶段 2 的总效应等于汇总的 PA–MPA 相关性。其他分析细节,包括研究层面的矩阵和完整的 MASEM 代码,见 Supplementary Table S8。
2.8 质量评估
采用纽卡斯尔-渥太华量表(NOS)评估纳入研究的方法学质量,并针对横断面和纵向观察性研究进行了改编(Wells et al., 2009)。方法学质量采用9条目NOS进行评估(Wells et al., 2009),涵盖三个领域:选择、可比性和结局(最高=9分)。鉴于横断面研究占比较大,我们采用了针对队列特异性NOS条目的既有横断面改编方案,在所有研究中均使用相同的九个条目,以生成可比较的总分。每个条目评分为1分(明确符合标准)或0分(不符合/未报告);不通过推断给予分数,以确保评分的保守性。总分被归类为高质量(7–9分)、中等质量(4–6分)和低质量(0–3分)。两名研究者独立完成全文质量评价,通过讨论解决分歧。所有58项研究的条目级评分见补充表S7。
3 结果
3.1 文献检索结果
研究选择遵循PRISMA 2020指南进行。去除重复记录后,对文献记录进行标题和摘要筛选。可能相关的引文进入全文报告评估。全文报告因四个预设原因被排除:(1)参与者不符合目标年龄或人群标准;(2)无法提取效应量数据;(3)非实证性综述出版物;(4)缺乏可用的定量效应量估计。本系统综述未检索试验注册库。完整的研究选择流程见图1。在5个数据库(Web of Science、PubMed、SPORTDiscus、CNKI、PsycINFO)中进行系统检索,初步获得1,368条记录。使用EndNote X9软件去除286条重复记录后,剩余1,082条记录进行标题和摘要筛选。筛选标题和摘要排除了929条记录(主题无关、非实证研究),剩余153条记录进行全文资格评估。在全文评估期间,排除了95条记录。最终,58项研究包含63条相关性记录符合纳入标准,包括54项横断面研究和4项纵向/交叉滞后研究,总样本涵盖98,946名青少年和年轻成人。
图1
这项meta分析纳入了以下研究:Belaire et al. (2024);Cao et al. (2023);Cetin et al. (2022);Ceylan and DemİRdel (2023);Chao et al. (2022);Chen and Huan (2021);Chen et al. (2022);Cui and Zhang (2022);Ding et al. (2021);Dong Yaqi (2023);Gao et al. (2023);Gong et al. (2023);Guo et al. (2022);Han et al. (2023);Haripriya et al. (2019);Ho et al. (2015);Hu et al. (2024);Jin et al. (2024);Huang et al. (2022);Kim et al. (2015);Kim and Ahn (2023);Kumar et al. (2024);Li et al. (2021);Li et al. (2022);Li et al. (2023);Lin et al. (2022);Liu (2020);Liu and Sun (2023);Lu et al. (2022);Ma et al. (2022);Meng et al. (2024);Niu (2023);Numanoğlu-Akbaş et al. (2020);Sezer Efe et al. (2023);Shen and Gao (2024);Su et al. (2024);Tian et al. (2025);Tong et al. (2022);Tong and Meng (2023);Wan and Ren (2023);Wang et al. (2023);Wang et al. (2024);Wei (2023);Wu et al. (2024);Xiao (2022);Xie et al. (2023);Xu et al. (2023);Yang et al. (2019);Zeng et al. (2022);Zhang D. et al. (2022);Zhang Z. et al. (2022);Zhang and Gao (2023);Zhang et al. (2023);Zhao et al. (2022);Zhao et al. (2024);Zheng and Ma (2020);Zhou and zhou (2022);Zhu et al. (2023)。纳入meta分析的研究特征总结见补充表S6。全部58项研究的条目级NOS评分报告于补充表S7。平均总分为6.50(SD = 1.22;中位数6.5,范围3–9)。29项研究(50.0%)被评为高质量(7–9),28项(48.3%)为中等质量(4–6),1项(1.7%)为低质量(0–3)。所有研究均满足两个可比性条目和结局评估条目,81.0%的研究报告了效应量及其置信区间,或报告了足以计算效应量的统计量。扣分集中在三个条目:样本代表性(41.4%满足)、应答率或有效问卷率的报告(41.4%),以及数据收集时间结构的记录(39.7%),反映出该文献中便利样本占主导。各关系对之间的平均得分相当(PA–MPA 6.62,PA–PR 6.38,PR–MPA 5.38)。
3.2 Meta分析结果
采用随机效应模型对三组两两关系进行meta分析。合并效应量总结于表1。
表1
| 变量关系 | k | n | 合并相关系数 r | 95% CI | p值 | I2 (%) |
|---|---|---|---|---|---|---|
| PA–MPA | 42 | 70,027 | −0.225 | [−0.282, −0.166] | <0.001 | 98.46 |
| PA–PR | 13 | 13,100 | 0.370 | [+0.250, +0.479] | <0.001 | 98.40 |
| PR–MPA | 8 | 18,800 | −0.362 | [−0.518, −0.184] | <0.001 | 99.44 |
随机效应单变量meta分析结果。
k,研究数量;n,总样本量;I2,异质性指数。PA,身体活动;PR,心理韧性;MPA,手机成瘾。
3.2.1 身体活动与手机成瘾的合并效应量
采用随机效应模型,对来自42项研究的42个效应量进行了传统元分析,总样本涵盖70,027名青少年。结果显示,青少年身体活动与手机成瘾之间存在显著负相关,合并相关系数 r = −0.225(95% CI:[−0.282, −0.166]),Z = −7.24,p < 0.001。根据Cohen的标准,该效应量属于小到中等。展示各研究效应量、其95% CI及合并结果的森林图见图2。
图2
3.2.2 身体活动与心理韧性的合并效应量
采用随机效应模型,对来自13项研究的13个效应量进行了传统元分析,总样本涵盖13,100名青少年。结果显示,青少年身体活动与心理韧性之间存在显著正相关,合并相关系数 r = 0.370(95% CI:[0.250, 0.479]),Z = 5.50,p < 0.001。根据Cohen的标准,该效应量属于中等。森林图见图3。
图3
3.2.3 心理韧性与手机成瘾的合并效应量
采用随机效应模型,对来自8项研究的8个效应量进行了传统元分析,总样本涵盖18,800名青少年。结果显示,青少年心理韧性与手机成瘾之间存在显著负相关,合并相关系数 r = −0.362(95% CI:[−0.518, −0.184]),Z = −3.60,p < 0.001。根据Cohen的标准,该效应量属于中等。森林图见图4。
图4
3.2.4 发表偏倚检验结果
采用Egger线性回归检验和Begg秩相关检验评估发表偏倚,并辅以漏斗图的视觉检查(补充图S1–S3)。对于PA–MPA关系(k = 42),Egger检验的截距为−1.04(SE = 1.468,p = 0.478),Begg检验不显著(z = −1.82,p = 0.072);漏斗图大致对称。对于PA–PR关系(k = 13),Egger截距为1.83(SE = 7.285,p = 0.801),Begg检验不显著(z = 0.79,p = 0.428);漏斗图对称。对于PR–MPA关系(k = 8),Egger截距为−5.06(SE = 6.316,p = 0.423),Begg检验不显著(z = −0.37,p = 0.902);大致对称,尽管研究数量较少限制了视觉评估。总体而言,对于三种两两关系中的任何一种,Egger检验和Begg检验均未表明存在统计学显著的小样本效应,提示发表偏倚不太可能实质性扭曲合并估计值。
3.2.5 敏感性分析结果
进行了一项留一法敏感性分析,以考察任何单项研究对合并估计值的影响(补充图 S4–S6)。对于这三种关系,依次剔除任何单项研究后,合并相关系数均保持稳定,与总体估计值相近。没有任何单项研究实质性改变了合并估计值。这些结果表明,总体发现是稳健的,并未受到任何单项研究的不当驱动。有一项效应(Zhao et al., 2022,PA–PR,r = 0.195)取自未经调整的单预测变量标准化回归系数(β),而非零阶相关系数;没有任何效应是从调整后的标准化回归系数转换而来的。在敏感性分析中排除该研究后,所有结果基本保持不变。
3.2.6 亚组与元回归分析
进行了亚组分析以探索异质性的来源(表 2)。对于 PA–MPA 关系,仅在研究设计上检测到显著的组间差异(Qb = 8.23,p = 0.004);PA–MPA 负相关在横断面研究中(r = −0.237,k = 38)强于纵向/交叉滞后研究(r = −0.120,k = 4)。地区(Qb = 0.03,p = 0.874)、教育水平(Qb = 1.14,p = 0.567)和身体活动测量工具(Qb = 3.10,p = 0.212)的组间检验均不显著,表明这些因素不能解释 PA–MPA 关联中的异质性。对于 PA–PR 关系,PA 测量工具出现了显著的亚组差异(Qb = 6.21,p = 0.013);当使用 PARS-3 评估 PA 时(r = 0.453,k = 8),PA–PR 关联强于使用其他/自我报告工具时(r = 0.251,k = 4)。教育水平的检验不显著(Qb = 4.62,p = 0.099),且地区无法进行组间比较,因为仅有一个多研究亚组(中国大陆)可估计。对于 PR–MPA 关系,教育水平的亚组差异显著(Qb = 5.56,p = 0.018);该关联在中学(12–18 岁)样本中更强(更负)(r = −0.505,k = 4)高于高等教育样本(r = −0.194,k = 4)。地区或研究设计无法进行组间比较,因为所有纳入的 PR–MPA 研究均为横断面研究且在中国大陆进行。
表 2
| 调节变量 | 亚组 | PA–MPA | PA–PR | MPA–PR |
|---|---|---|---|---|
| 地区 | 中国大陆及其他地区 | −0.222 [−0.287, −0.156] (34) | 0.376 [0.247, 0.492] (12) | −0.362 [−0.490, −0.219] (8) |
| 其他国家 | −0.233 [−0.348, −0.110] (8) | 0.294 (1) | — | |
| Qb 检验 | Qb = 0.03,p = 0.874 | – | – | |
| 教育水平 | 混合 | −0.223 (1) | — | — |
| 小学/初中(<12 岁) | −0.177 [−0.265, −0.086] (3) | 0.251 [0.224, 0.278] (3) | — | |
| 中学(12–18 岁) | −0.334 [−0.602, 0.002] (4) | 0.559 [0.109, 0.819] (2) | −0.505 [−0.687, −0.264] (4) | |
| 高等教育(18–24 岁) | −0.215 [−0.272, −0.156] (34) | 0.359 [0.230, 0.475] (8) | −0.194 [−0.282, −0.102] (4) | |
| Qb 检验 | Qb = 1.14,p = 0.567 | Qb = 4.62,p = 0.099 | Qb = 5.56,p = 0.018 | |
| 研究设计 | 横断面 | −0.237 [−0.298, −0.174] (38) | 0.370 [0.262, 0.469] (13) | −0.362 [−0.490, −0.219] (8) |
| 纵向/交叉滞后 | −0.120 [−0.169, −0.070] (4) | — | — | |
| Qb 检验 | Qb = 8.23,p = 0.004 | – | – | |
| PA 测量工具 | PARS-3 | −0.267 [−0.352, −0.177] (22) | 0.453 [0.298, 0.585] (8) | — |
| IPAQ | −0.169 [−0.250, −0.086] (12) | 0.098 (1) | — | |
| 其他/自我报告 | −0.172 [−0.261, −0.080] (8) | 0.251 [0.226, 0.275] (4) | −0.362 [−0.490, −0.219] (8) | |
| Qb 检验 | Qb = 3.10,p = 0.212 | Qb = 6.21,p = 0.013 | – |
三种两两关系的亚组分析。
单元格内为合并相关系数 r [95% CI](k = 独立研究数量)。Qb 行报告该调节变量在各关系中的组间异质性检验。— = 不可估计(仅一个亚组提供数据,或无可用研究)。PA,身体活动;MPA,手机成瘾;PR,心理韧性;PARS-3,身体活动评定量表-3;IPAQ,国际身体活动问卷。
元回归分析(表3)显示,男性参与者比例显著调节了 PA–MPA 关联(b = −0.007,SE = 0.003,p = 0.023;R2 = 10.3%)。相比之下,方法学质量(九条目 NOS 总分)、平均年龄和发表年份均未显著调节这三种关系中的任何一种(所有 p > 0.05)。
表3
| 调节变量 | PA-MPA | PA-PR | MPA-PR |
|---|---|---|---|
| 平均年龄 | k = 33 b = 0.00774 (SE = 0.01480) p = 0.605 R2 = 0.0% | k = 7 b = 0.01413 (SE = 0.03264) p = 0.683 R2 = 0.0% | k = 5 b = 0.02535 (SE = 0.11079) p = 0.834 R2 = 0.0% |
| 男性百分比 | k = 33 b = −0.00694 (SE = 0.00289) p = 0.023 R2 = 10.3% | k = 8 b = 0.00943 (SE = 0.01314) p = 0.500 R2 = 0.0% | k = 8 b = −0.00546 (SE = 0.00768) p = 0.503 R2 = 0.0% |
| 发表年份 | k = 42 b = 0.02291 (SE = 0.01980) p = 0.254 R2 = 0.0% | k = 13 b = 0.02857 (SE = 0.03123) p = 0.380 R2 = 0.0% | k = 8 b = 0.04157 (SE = 0.11412) p = 0.728 R2 = 0.0% |
| NOS 质量评分(九条目总分) | k = 42, b = 0.00335 (SE = 0.02870), p = 0.908, R2 = 0.0% | k = 13, b = 0.05341 (SE = 0.05109), p = 0.318, R2 = 0.7% | k = 8, b = −0.08857 (SE = 0.09668), p = 0.395, R2 = 0.0% |
元回归结果。
每个单元格报告研究数量(k)、非标准化系数 b 及其标准误(SE)、p 值以及所解释的异质性比例(R2)。为简洁起见,t、τ2(null) 和 τ2(residual) 被省略;如有需要可提供。PA,身体活动;MPA,手机成瘾;PR,心理韧性。
3.3 MASEM 中介模型检验结果
本研究采用两阶段 MASEM 程序(Cheung, 2014)。在第一阶段,合成了一个针对身体活动(PA)、心理韧性(PR)和手机成瘾(MPA)的 3 × 3 合并相关矩阵(图5)。在第二阶段,使用该矩阵拟合一个路径模型,其中 PR 被指定为 PA–MPA 关联的中介变量。在该模型中,路径系数为标准化偏回归系数,因此单预测变量路径(PA → PR)的系数等于相应的合并相关系数,而进入 MPA 的系数(PA → MPA 直接、PR → MPA)为控制另一预测变量后的部分效应。总效应、直接效应和间接效应使用标准恒等式 总效应 = 直接效应 + (a × b) 进行分解,并据此计算中介比例。模型设定和结果报告于图6和表4。
图5
图6
表4
| 路径 / 效应 | 合并 r | 标准化 β | 标准误 | p 值 | 95% CI |
|---|---|---|---|---|---|
| 直接路径 | |||||
| PA → PR (a) | 0.37 | 0.370 | 0.059 | <0.001 | [0.250, 0.479] |
| PR → MPA (b) | −0.362 | −0.324 | 0.101 | <0.001 | [−0.509, −0.115] |
| PA → MPA (c′ 直接) | −0.225 | −0.105 | 0.055 | 0.053 | [−0.208, +0.007] |
| 间接效应 | |||||
| PA → PR → MPA(a × b) | −0.120 | 0.043 | 0.006 | [−0.209, −0.039] | |
| 总效应 | |||||
| PA → MPA (c 总) | −0.225 | 0.030 | <0.001 | [−0.282, −0.166] | |
中介模型的标准路径系数与效应分解。
中介效应占总效应的比例 = 53.3%。PA,身体活动;PR,心理韧性;MPA,手机成瘾。
路径分析(表4)表明,在SEM模型中,身体活动与手机成瘾呈负相关(β = −0.105,p = 0.053),为边缘不显著的直接效应。身体活动对心理韧性也有显著正向影响(β = 0.370,p < 0.001),而心理韧性对手机成瘾有显著负向影响(β = −0.324,p < 0.001)。因此,心理韧性起到了显著的中介作用,间接效应量为−0.120,占总效应的53.3%。这支持了以下假设:身体活动并非直接与较低的手机成瘾相关,而是通过增强心理韧性间接与较低的手机成瘾相关。此外,中介比例相当大(53.3%),表明心理韧性占总效应的一半以上,其他路径仍在发挥作用。身体活动对手机成瘾的影响更为复杂,可能涉及其他中介变量,如自我控制、孤独感、睡眠质量和同伴关系,这些都需要进一步研究。因此,这一结果支持了“身体活动→心理韧性→手机成瘾”假设的结构方程模型(见图6),丰富了对青少年身体活动与心理健康关联机制的理解,并为制定有效干预措施提供了基础。
4 讨论
4.1 核心发现的解读
4.1.1 身体活动与手机成瘾之间的直接关系
本研究对58项研究(N = 98,946)的传统元分析显示,青少年身体活动与手机成瘾之间存在显著负相关(r = −0.225,95% CI:−0.282至−0.166),为小到中等效应量。这一发现得到众多单项研究的支持,表明身体活动对青少年手机成瘾具有稳健的负向关联。这一发现与既往研究或元分析证据一致。Zeng等(2022)报告中国大学生的汇总相关系数为r = −0.21,Lin等(2025)在一项全球MASEM研究中报告汇总相关系数为r = −0.204,两者均与我们的结果高度吻合,支持了这种关联的跨文化普遍性。与Zeng等(2022)的轻微差异可能归因于我们更广泛的样本,除大学生外还包括初中和高中学生。单项大样本研究,如Yang等(2020)(r = −0.21)和Tong等(2022)(r = −0.18),均落在我们的95% CI内,表明我们的合并效应准确反映了中国青少年的情况。
尽管效应量属于小到中等,但考虑到中国青少年中手机成瘾(27.8%)和身体活动不足(>60%活动不足)的高流行率,其实际意义仍然相当可观(Wan and Ren, 2023)。即使在人群层面上身体活动的少量增加,也可能帮助大量青少年。其机制可能包括:(1)时间替代:身体活动占用了空闲时间,减少了可用于使用手机的时间,并打破了久坐—使用手机的循环。(2)神经递质效应:持续运动会释放多巴胺、血清素和内啡肽,增强大脑奖赏系统功能,并降低对手机虚拟奖赏的渴求。(3)情绪改善:运动可缓解焦虑和抑郁,减少将手机用于逃避现实的倾向(Kim and Ahn, 2023)。
4.1.2 身体活动与心理韧性之间的关联
本研究发现,青少年身体活动与心理韧性之间存在显著正相关(r = 0.370,95% CI:0.250 至 0.479),效应量为中等。这与 Cui et al., 2025 于2025年开展的一项MASEM研究一致(汇总相关系数 r = 0.26),表明跨研究一致性较高。国内单样本研究报告了相似的相关系数(例如,Shen and Gao, 2024;r = 0.37)。身体活动与心理韧性之间的关联机制是多方面的。在生理层面,中等强度活动可促进海马体神经发生,并与更高的前额叶皮层执行功能相关,从而增强情绪调节和压力应对能力。在心理层面,在活动中实现目标会提升自我效能感和自信心(Kim and Ahn, 2023)。团队运动有助于培养社交技能和面对失败的韧性,而在运动中克服挑战则能培养坚持性和积极态度。
4.1.3 效应量的异质性
三项成对 meta 分析中的异质性均极高(PA-MPA:I2 = 98.46%,k = 42;PA-PR:I2 = 98.40%,k = 13;PR-MPA:I2 = 99.44%,k = 8),表明真实效应在不同研究间差异显著,合并值应被解读为总体趋势而非精确的点估计。重要的是,尽管存在这种变异,每个关联的方向都保持一致——身体活动与手机成瘾呈负相关,与心理韧性呈正相关,而韧性与成瘾呈负相关——提示这些关联在方向上具有稳健性,即使其幅度取决于具体情境。亚组分析和 meta 回归定位了这种变异的若干来源。教育水平仅显著调节了 PR–MPA 关系(Qb = 5.56,p = 0.018),研究设计调节了 PA–MPA 关联(横断面 r = −0.237 vs. 纵向 r = −0.120,Qb = 8.23,p = 0.004),身体活动测量工具调节了 PA–PR 关系(Qb = 6.21,p = 0.013);相比之下,地区、教育水平(对 PA–MPA 和 PA–PR)以及 PA 测量工具(对 PA–MPA)未能显著解释异质性。男性参与者百分比解释了 10.3% 的方差,而平均年龄和发表年份则未能解释(R2 ~ 0%,所有 p > 0.20)。由于仍有相当大比例的异质性未被解释,未来的原始研究应更详细地报告样本特征——尤其是性别构成和发表类型——以便进行更精细的调节变量分析。
4.1.4 心理韧性的中介作用
本研究使用 MASEM,首次在 meta 分析层面定量检验了心理韧性的中介作用。结果证实存在显著的中介效应(间接效应 = −0.120,占总效应的 53.3%)。这与国内单样本研究总体一致,尽管效应量有所差异。既往研究报告的比例较小,如 Shen and Gao (2024)(18.3%)和 Zhao et al. (2022)(15.2%)。与另一个关键中介变量相比,Lin et al. (2025) 的 MASEM 研究发现自我控制占效应的 49.7%,提示自我控制可能是身体活动-手机成瘾关联中更为核心的心理机制。中介比例的差异可能源于:(1) 方法学:meta 分析综合了异质性研究,而单样本研究具有更高的内部一致性。(2) 测量工具:不同的韧性量表(如 CD-RISC vs. RS-14)具有不同的因子结构和心理测量学特性。(3) 模型选择:一些研究使用链式中介模型,而本研究仅考察了韧性的单一中介作用。
中介比例(53.3%)提出了一个重要问题:还有哪些其他机制可以解释身体活动与手机成瘾之间的剩余关系。文献中已识别出若干替代路径:(1)自我控制:Lin et al. (2025) 在一项 MASEM 研究中发现,自我控制解释了 PA–MPA 关系的 49.7%,表明它可能是更为突出的中介变量。(2)睡眠质量:Kumar et al. (2024) 报告身体活动、睡眠质量与手机成瘾在实证上相互关联——睡眠不佳与低身体活动和高手机成瘾同时出现。(3)情绪调节:身体活动与较低的焦虑和抑郁相关,而焦虑和抑郁是已知的手机成瘾风险因素。(4)时间替代:最简单的机制——用于身体活动的时间就是未用于手机的时间。这些机制可能并行运作,并可能相互作用。未来研究应采用多重中介模型来同时检验这些路径。
4.2 实践意义
本研究的结果对青少年健康促进具有实践意义,尽管应结合以观察性证据为主的研究基础来加以考量。在学校层面,将身体活动促进与心理韧性训练相结合可能是一种有前景的方法,但其有效性应在未来的随机对照试验中加以检验。在家庭层面,父母可以通过限制自己的手机使用并参与家庭身体活动来示范健康行为。在个体层面,应鼓励青少年保持规律的身体活动并培养韧性技能。需要强调的是,这些建议基于观察性证据,而“身体活动加心理干预”联合方案的有效性应在广泛实施之前经过实证检验。
4.3 研究局限性
This study has limitations. First, the included studies are predominantly cross-sectional (54 out of 58). Causal relationships cannot be firmly established; only associations are demonstrated. Second, the generalisability of the findings is limited by the composition of the evidence base. Forty-nine of the 58 included studies (84.5%) were conducted in China (including Taiwan and Hong Kong), and 42 (72.4%) sampled university students, with comparatively few studies from other cultural regions, primary/secondary school populations, or non-student adolescents. Consequently, the pooled estimates should be interpreted as most applicable to Chinese university and secondary-school adolescents, and caution is warranted when extrapolating to other cultural contexts, younger age groups, or adult populations. Greater geographic and developmental diversity in future primary research is needed before the mediation model can be considered universally robust. Third, the study only examined the single mediator of psychological resilience, ignoring other potential mediators or moderators, thus providing an incomplete picture of the mechanisms linking physical activity to phone addiction.
5 Conclusion
Using traditional meta-analysis and MASEM, this study synthesized 58 studies involving 98,946 adolescents and young adults to examine the relationships among physical activity (PA), psychological resilience (PR), and mobile phone addiction (MPA). The main findings are as follows: PA is negatively correlated with MPA (the summary correlation of r = −0.225), supporting PA as a small-to-medium factor associated with lower MPA, possibly via time displacement, neurotransmitter regulation, and mood improvement. PA is positively correlated with PR (the summary correlation of r = 0.370, medium effect), indicating regular exercise is associated with higher resilience development. PR mediates the PA–MPA relationship (indirect effect = −0.120, accounting for 53.3% of the total effect). Thus, PA is indirectly associated with lower MPA through its positive relationship with resilience, though other mechanisms likely exist. This is the first MASEM study to quantify the mediating role of psychological resilience. The findings suggest that combined PA-plus-psychological approaches merit testing in longitudinal and experimental studies. Efforts should simultaneously promote physical activity and foster psychological resilience.
Statements
Data availability statement
The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author.
Author contributions
SiL: Conceptualization, Data curation, Formal analysis, Methodology, Resources, Visualization, Writing – original draft, Writing – review & editing. LC: Investigation, Methodology, Software, Visualization, Writing – review & editing. SaL: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Software, Visualization, Writing – original draft, Writing – review & editing.
Funding
The author(s) declared that financial support was not received for this work and/or its publication.
Conflict of interest
The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Supplementary material
The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2026.1914677/full#supplementary-material
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Keywords
adolescent physical activity, MASEM, mediating effect, mobile phone addiction, psychological resilience
Citation
Li S, Chen L and Liu S (2026) Physical activity, psychological resilience, and adolescent mobile phone addiction—a meta-analytic structural equation modeling study. Front. Psychol. 17:1914677. doi: 10.3389/fpsyg.2026.1914677
Received
20 June 2026
Revised
19 September 2026
Accepted
21 September 2026
Published
02 October 2026
Volume
17 - 2026
Edited by
Min-Seong Ha, University of Seoul, Republic of Korea
Updates
Copyright
© 2026 Li, Chen and Liu.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Shaohua Liu, liushaohua0728@163.com
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
来源:Frontiers in Psychology · frontiersin.org
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