Latent class profiles of health-risk behaviors and the protective roles of psychological resilience and self-control in Chinese adolescents

Abstract

Background Health-risk behaviors (HRBs) frequently co-occur during adolescence and are associated with adverse physical and mental health outcomes. This study aimed to identify latent classes of HRBs and examine the associations of psychological resilience (PR) and self-control (SC) with class membership. Methods In this cross-sectional study conducted in 2023, 11,407 students from 90 schools were recruited using multistage stratified cluster sampling. Latent class analysis (LCA) was used to identify patterns of HRBs. Chi-square tests and multinomial logistic regression were used to examine sociodemographic and psychological factors associated with class membership. Results Four latent classes were identified: the Low-Risk Group (45.6%), the Physical Inactivity–Insufficient Sleep Group (21.8%), the Depressive Symptoms–Self-Harm–Picky Eating Group (26.3%), and the Multiple Health-Risk Behavior Group (6.4%). Relative to the Low-Risk Group, each one-point increase in psychological resilience was associated with a 3.4% reduction in the odds of membership in the Physical Inactivity–Insufficient Sleep Group (OR = 0.966, 95% CI: 0.957–0.976), a 6.6% reduction in the Depressive Symptoms–Self-Harm–Picky Eating Group (OR = 0.934, 95% CI: 0.925–0.942), and a 4.2% reduction in the Multiple Health-Risk Behavior Group (OR = 0.958, 95% CI: 0.945–0.972). Corresponding reductions in odds for self-control were 2.1% (OR = 0.979, 95% CI: 0.973–0.986), 6.2% (OR = 0.938, 95% CI: 0.932–0.943), and 8.8% (OR = 0.912, 95% CI: 0.903–0.921). Male gender was associated with significantly elevated odds of membership in the Multiple Health-Risk Behavior Group (OR = 2.275, 95% CI: 1.808–2.863), whereas rural residence was associated with lower odds of membership in the Physical Inactivity–Insufficient Sleep Group (OR = 0.530, 95% CI: 0.452–0.620) and the Depressive Symptoms–Self-Harm–Picky Eating Group (OR = 0.645, 95% CI: 0.565–0.737). Conclusion Chinese adolescents exhibited heterogeneous patterns of HRBs. Higher psychological resilience and self-control were independently associated with lower odds of membership in the three non-low-risk classes. These findings may inform class-specific prevention strategies.