Cited by 250Physical Activity and HealthYouth Development and Social SupportChild and Adolescent Psychosocial and Emotional Development

The effects of physical activity interventions on psychosocial outcomes in adolescents: a meta-analytic review

Open access
Spruit, Anouk, Assink, Mark, van Vugt, Eveline, van der Put, Claudia, Stams, Geert Jan·2016·Clinical Psychology Review

Abstract

Physical activity interventions are often implemented in the adolescent mental health care practice to prevent or treat psychosocial problems. To date, no systematic review of the effect of these physical activity interventions in adolescents has been conducted. In the current study, four multilevel meta-analyses were performed to assess the overall effect of physical activity interventions on externalizing problems, internalizing problems, self-concept, and academic achievement in adolescents. In addition, possible moderating factors were examined. In total, 57 studies reporting on 216 effect sizes were included, and the results showed significant small-to-moderate effects of physical activity interventions on externalizing problems (d=0.320), internalizing problems (d=0.316), self-concept (d=0.297), and academic achievement (d=0.367). Further, moderator analyses showed that outcome, study, sample, and intervention characteristics influenced the effects of physical activity interventions on psychosocial outcomes. Implications for theory and practice concerning the use of physical activity interventions in adolescent mental health care practice are discussed.

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Written from the paper’s full text.

TL;DR

This meta-analytic review found that physical activity interventions produced significant small-to-moderate improvements in adolescents’ externalizing problems, internalizing problems, self-concept, and academic achievement. Effects varied by outcome, study, sample, and intervention characteristics, but no publication bias was indicated.

Key findings

  • Across 57 studies and 216 effect sizes, physical activity interventions significantly reduced externalizing problems (d = 0.320, 95% CI 0.023–0.616, p = .036) and internalizing problems (d = 0.316, 95% CI 0.073–0.558, p = .011).
  • Physical activity interventions significantly improved self-concept (d = 0.297, 95% CI 0.127–0.468, p = .001) and academic achievement (d = 0.367, 95% CI 0.038–0.697, p = .030).
  • Moderator analyses showed: externalizing effects were larger when the comparison group received some other intervention/activity and no effect when it received no treatment; internalizing effects were weaker in RCTs than quasi-experimental studies and larger in samples with fewer males and with a clinical diagnosis; self-concept effects were larger for exercise than sports; academic achievement effects were larger when measured by grades than standardized tests.
  • Trim-and-fill analyses did not impute missing effect sizes on the left side for any outcome, indicating publication bias was unlikely.

Methods

  • Four separate multilevel meta-analyses were conducted on externalizing problems (14 studies, 35 effect sizes, N = 1169), internalizing problems (24 studies, 79 effect sizes, N = 2974), self-concept (33 studies, 68 effect sizes, N = 2647), and academic achievement (10 studies, 34 effect sizes, N = 1488).
  • Studies were included if they evaluated a sports or aerobic exercise intervention, had a mean participant age between 11 and 18 and age range between 10 and 21, used an experimental or quasi-experimental design with a comparison group, and reported sufficient statistics for effect-size calculation.
  • Three-level random-effects models were estimated in R with the metafor package, with moderator analyses for outcome, study, sample, and intervention characteristics; continuous moderators were mean-centered and categorical moderators dummy-coded.

Limitations

  • The paper states that some included studies were low quality, had small samples, and did not provide enough information to code all moderators, creating possible power problems for detecting small or moderate moderator effects.
  • The paper states that none of the primary studies controlled for leisure-time physical activity in intervention and comparison groups, which may influence intervention effects.
  • The paper states that the psychosocial outcomes overlap and cannot be interpreted independently, and that the externalizing and academic achievement meta-analyses were based on small numbers of studies (14 and 10, respectively), limiting generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.cpr.2016.03.006

Cites

163 of 163 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 44 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § a b s t r a c t · p. 2

    Physical activity interventions have a significant small-to-moderate effect on self-concept in adolescents (d = 0.297).

    “the results showed significant small-tomoderate effects of physical activity interventions on externalizing problems ( d =0.320), internalizing problems ( d =0.316), self-concept ( d =0.297), and academic achievement ( d =0.367).”
    Quote in the paperSubstantial claim
  • Findingown data
    § a b s t r a c t · p. 2

    Physical activity interventions have a significant small-to-moderate effect on internalizing problems in adolescents (d = 0.316).

    “the results showed significant small-tomoderate effects of physical activity interventions on externalizing problems ( d =0.320), internalizing problems ( d =0.316), self-concept ( d =0.297), and academic achievement ( d =0.367).”
    Quote in the paperSubstantial claim
  • Findingreasoning
    § 2.4. Calculations and analyses · p. 6

    In the majority of the included studies, more than one effect size could be calculated.

    “In the majority of the studies, it was possible to calculate more than one effect size.”
    Quote in the paperSubstantial claim
  • Findingnone given
    § 2.4. Calculations and analyses · p. 6

    Most included studies reported on multiple outcome variables, multiple scales to assess the variable of interest, multiple informants that reported about the outcome variable, or reported the effects of physical activity interventions in subsamples separately.

    “Most studies reported on multiple outcome variables, multiple scales to assess the variable of interest, multiple informants that reported about the outcome variable, or reported the effects of physical activity interventions in subsamples separately.”
    Quote in the paperSubstantial claim
  • Findingown data
    § a b s t r a c t · p. 2

    Physical activity interventions have a significant small-to-moderate effect on academic achievement in adolescents (d = 0.367).

    “the results showed significant small-tomoderate effects of physical activity interventions on externalizing problems ( d =0.320), internalizing problems ( d =0.316), self-concept ( d =0.297), and academic achievement ( d =0.367).”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim. 6
  • May combine two claims. 28
  • Classified as probably not a substantial claim. 25
  • The quote only partly states this claim.

    Findingown data
    § 3.1.1. Overall effect on externalizing problems · p. 7

    Physical activity interventions had a significant small-to-medium effect on externalizing problems (d=0.320, 95% CI 0.023;0.616, p=.036).

    “A significant small-to-medium effect ( d =0.320) of physical activity interventions on externalizing problems was found”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data
    § 3.1. Effect of physical activity interventions on externalizing problems · p. 7

    The meta-analysis on externalizing problems contained 14 independent studies, 35 effect sizes, and a total sample of 1169 subjects (534 intervention, 635 comparison).

    “The meta-analysis on the effect of physical activity interventions on externalizing problems contained 14 independent studies ( s ), reporting on 35 effect sizes ( k ), and a total sample of N =1169subjects. The total sample consisted of n =534 subjects in the intervention groups, and n =635 subjects in the comparison groups.”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim.

    Findingown data
    § 3.5.1. Overall effect on academic achievement · p. 10

    Physical activity interventions had a significant small-to-medium effect on academic achievement (d=0.367, 95% CI 0.038;0.697, p=.030).

    “A significant small-to-medium effect ( d =0.367) was found for physical activity interventions on academic achievement”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim.

    Findingown data
    § 3.4.1. Overall effect on self-concept · p. 9

    Physical activity interventions had a significant small-to-medium effect on self-concept (d=0.297, 95% CI 0.127;0.468, p=.001).

    “Physical activity interventions increased positive self-concept in adolescents, indicated by a significant small-to-medium effect size ( d = 0.297).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data
    § 3.4. Effect of physical activity interventions on self-concept · p. 9

    The meta-analysis on self-concept contained 33 independent studies, 68 effect sizes, and a total sample of 2647 subjects (1374 intervention, 1273 comparison).

    “The meta-analysis on the effect of physical activity interventions on self-concept contained 33 independent studies ( s ), with 68 effect sizes ( k ), and a total sample of N =2647. The total sample contained n = 1374 in the intervention groups, and n = 1273 in the comparison groups.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data
    § 3.2. Effect of physical activity interventions on internalizing problems · p. 7

    The meta-analysis on internalizing problems contained 24 independent studies, 79 effect sizes, and a total sample of 2974 subjects (1332 intervention, 1642 comparison).

    “The meta-analysis on the effect of physical activity interventions on internalizing problems contained 24 independent studies ( s ), with 79 effect sizes ( k ), and a total sample of N = 2974. The total sample contained n =1332 in the intervention groups, and n =1642 in the comparison groups.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data
    § 3.4.2. Results of moderator analyses on self-concept · p. 10

    No moderating effects were found for the type of intervention, duration and frequency, team/individual, and instructor background on self-concept.

    “No moderating effects were found for the type of intervention, the duration and frequency of the intervention, whether the intervention consisted of team or individual physical activities, and whether or not the instructor/therapist had any pedagogical background.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data
    § 3.3.2. Study characteristics · p. 8

    Study design moderated the strength of the effect of physical activity interventions on internalizing problems; RCT studies showed weaker effects than quasi-experimental studies.

    “The study design moderated the strength of the effect of physical activity interventions on internalizing problems. Studies using an RCT design showed weaker effects than studies using a quasi-experimental design.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data
    § 4. Discussion · p. 11

    Close inspection of studies reporting pretest scores and where experimental groups interacted showed that five studies found increased externalizing problems in the comparison group, four studies found scores remained the same, and one study found scores decreased.

    “five studies found increased levels of externalizing problems in the comparison group. In four studies the scores remained the same, and in one study the scores of the comparison group decreased.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data
    § 3.5. Effect of physical activity interventions on academic achievement · p. 10

    The meta-analysis on academic achievement contained 10 independent studies, 34 effect sizes, and a total sample of 1488 subjects (729 intervention, 759 comparison).

    “The meta-analysis on the effect of physical activity interventions on academic achievement contained 10 independent studies ( s ), with 34 effect sizes ( k ), and a total sample of N = 1488. The total sample contained n =729in the intervention groups, and n =759in the comparison groups.”
    Quote in the paperNot a substantial claim
  • The quote only partly states this claim.

    Findingown data
    § 3.2.1. Overall effect on internalizing problems · p. 7

    Physical activity interventions had a significant small-to-medium effect on internalizing problems (d=0.316, 95% CI 0.073;0.558, p=.011).

    “A significant small-to-medium effect ( d = 0.316) was found for physical activity interventions on internalizing problems”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given
    § 4. Discussion · p. 11

    No indications of publication bias were found in the meta-analyses.

    “No indications of publication bias were found.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data
    § 4. Discussion · p. 12

    Differences between effect sizes of independent and dependent authors for externalizing problems were considerable (d = 0.184 vs. d = 0.671), but this was not identified as a significant moderator.

    “Differences between effect sizes of independent and dependent authors seem quite considerable for the meta-analysis of externalizing problems (respectively, d =0.184 vs. d =0.671), but was not identified as a significant moderator.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § 2.4. Calculations and analyses · p. 6

    Moderator analyses were only performed if each category of the potential moderator was filled with at least three studies.

    “For each of the four meta-analyses, moderator analyses were only performed in case each category of the potential moderator was filled with at least three studies.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given
    § a b s t r a c t · p. 2

    To date, no systematic review of the effect of physical activity interventions on psychosocial outcomes in adolescents has been conducted.

    “To date, no systematic review of the effect of these physical activity interventions in adolescents has been conducted.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation
    § 1.2. Previous reviews and gaps in the literature · p. 4

    Spruit et al. (2015) found in their meta-analysis of 52 studies, including 431 effect sizes, that there was no overall relation between sports participation and juvenile delinquency.

    “For example, Spruit et al. (2015) recently found in their meta-analysis of 52 studies, including 431 effect sizes, that there was no overall relation between sports participation and juvenile delinquency”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Spruit et al., 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 1.2. Previous reviews and gaps in the literature · p. 4

    Spruit et al. (2015) found that sports participation was in some cases related to more juvenile delinquency.

    “and that sports participation was in some cases even related to more juvenile delinquency.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Spruit et al., 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given
    § 1.2. Previous reviews and gaps in the literature · p. 4

    To date, no systematic review of the effect of physical activity on externalizing problems has been conducted.

    “To date, no systematic review of the effect of physical activity on externalizing problems has been conducted.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

    Study design and conductown data
    § 2.3. Coding the studies · p. 6

    The percentages of agreement for the moderator variables ranged from 79% to 100%, and for the calculated effect size and sample sizes the percentages of agreement were 95% and 100%, respectively.

    “The percentages of agreement for the moderator variables ranged from sufficient (79%) for the variable frequency of intervention, to perfect (100%) for the variables dependence of authors, duration of treatment, follow-up period, proportion of males, proportion of minority groups, type of internalizing problem, type of externalizing problem, type of academic achievement, and type of informant.”
    • Also stated in: § 2.3. Coding the studies · p. 6 · plain
      “For the calculated effect size and the sample sizes the percentages of agreement were 95% and 100%, respectively.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation
    § 2.5. Publication bias · p. 7

    Not including unpublished studies may lead to an overestimation of the true effect size, the so-called publication bias.

    “Not including these studies may lead to an overestimation of the true effect size, the so called ' publication bias ' (Rosenthal, 1979).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rosenthal, 1979 source

      Not checked in the free run.

    • Rests on an assumption: Studies may not have been published because of non-significant or unfavorable findings, and therefore are difficult to locate.
  • The quote only partly states this claim.

    Interpretationown data
    § H I G H L I G H T S · p. 2

    Physical activity interventions can be effective in reducing psychosocial problems in adolescents.

    “Physical activity interventions can be effective in reducing psychosocial problems.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation
    § 2.4. Calculations and analyses · p. 6

    A multilevel approach accounts for the hierarchical structure of the data, in which effect sizes are nested within studies.

    “The multilevel approach accounts for the hierarchical structure of the data, in which effect sizes are nested within the studies (Van Den Noortgate & Onghena, 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Van Den Noortgate & Onghena, 2003 source

      Not checked in the free run.

    • Rests on an assumption: Effect sizes from the same study are more alike than effect sizes from different studies.
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § 1. Introduction · p. 3

    Physical activity interventions are widely used to treat or prevent all kinds of psychosocial problems in youth.

    “Hence, physical activity interventions are widely used to treat or prevent all kinds of psychosocial problems in youth.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Physical activity interventions are often implemented in adolescent mental health care practice to prevent or treat psychosocial problems.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data
    § 2.5. Publication bias · p. 7

    A trim and fill procedure was performed to check the presence of publication bias in the meta-analyses.

    “In order to check the presence of publication bias in our meta-analyses, we performed a trim and fill procedure (Duval & Tweedie, 2000) by drawing a trim-and-fill plot in R (Version 3.2.0) using the function ' trimfill ' of the metafor package (Viechtbauer, 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Duval & Tweedie, 2000 source

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    • cites Viechtbauer, 2010 source

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    • Rests on an assumption: Studies may not have been published because of non-significant or unfavorable findings, and therefore are difficult to locate.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 1.2. Previous reviews and gaps in the literature · p. 4

    Local governments and institutions all over the world have implemented physical activity interventions to prevent externalizing problems of juveniles.

    “Local governments and institutions all over the world have implemented physical activity interventions to prevent externalizing problems of juveniles (Coakley, 2002; Kelly, 2013; Nichols, 2010; Chamberlain, 2013).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Coakley, 2002

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    • cites Kelly, 2013 source

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    • cites Nichols, 2010

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § 1.2. Previous reviews and gaps in the literature · p. 4

    Rasberry et al. (2011) showed that almost half of the outcomes of physical activity on children's academic achievement in intervention studies were positive (48%), the other half neutral (49%), and only one outcome (3%) was negative, implicating that physical activity can improve academic achievement.

    “They showed that almost half of the outcomes of physical activity on children's academic achievement in intervention studies were positive (48%), the other half neutral (49%), and only one outcome (3%) was negative, implicating that physical activity can improve academic achievement (Rasberry et al., 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rasberry et al., 2011 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation
    § 1.3. The current meta-analysis · p. 5

    The multilevel meta-analytic techniques enable the use of all available effect sizes in the analyses, so all information can be preserved and maximum statistical power is generated.

    “The multilevel meta-analytic techniques enable the use of all available effect sizes in the analyses, so all information can be preserved and maximum statistical power is generated (Assink et al., 2015).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Assink et al., 2015 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § 2.3. Coding the studies · p. 6

    To assess interrater agreement, 14 studies (k = 74) were randomly selected and double coded by a research assistant.

    “To assess interrater agreement, 14 studies ( k =74) were randomly selected, and double coded by a research assistant.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation
    § 1.2. Previous reviews and gaps in the literature · p. 4

    Fedewa and Ahn (2011) combined experimental and correlational studies to assess the effect of physical activity interventions on academic achievement in children (d = .24 on grade point average), which limits the possibility of statements about causality.

    “The meta-analysis of Fedewa and Ahn (2011) combined experimental studies and correlational studies to assess the effect of physical activity interventions on academic achievement in children ( d =.24 on grade point average), which limits the possibility of statements about causality.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fedewa & Ahn, 2011 source

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    Premisecitation
    § 2.4. Calculations and analyses · p. 6

    A multilevel meta-analysis enables using all effect sizes reported in primary studies, preserving all information and achieving maximum statistical power.

    “Further, a multilevel meta-analysis enables using all effect sizes reported in the primary studies, so that all information is preserved and maximum statistical power is achieved (Assink et al., 2015).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Assink et al., 2015 source

      Not checked in the free run.

    • Rests on an assumption: Effect sizes from the same study are more alike than effect sizes from different studies.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 2.5. Publication bias · p. 7

    In systematic reviews, the aim is to include all studies previously conducted that meet the inclusion criteria.

    “In systematic reviews, the aim is to include all studies previously conducted that meet the inclusion criteria (Lipsey & Wilson, 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lipsey & Wilson, 2001

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    Study design and conductnone given
    § 1.3. The current meta-analysis · p. 5

    The current study takes into account the shortcomings of previous systematic reviews by focusing on a narrow age range and including only (quasi-)experimental studies.

    “By focusing on a narrow age range, and including only (quasi-)experimental studies, the current study takes into account the shortcomings of previous systematic reviews.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Premisenone given
    § 2.4. Calculations and analyses · p. 6

    Significant variance on level 2 or 3 indicates a heterogeneous effect size distribution, meaning that the effect sizes cannot be treated as estimates of a common effect size.

    “Significant variance on level 2 or 3 indicates a heterogeneous effect size distribution, meaning that the effect sizes cannot be treated as estimates of a common effect size.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation
    § 1.2. Previous reviews and gaps in the literature · p. 4

    Rasberry et al. (2011) did not report about the strength of the effect of physical activity interventions on academic achievement, and generalization of conclusions was difficult due to methodological weaknesses of included studies, the diversity of the samples, and the limited number of studies included.

    “However, the authors did not report about the strength of the effect of physical activity interventions on academic achievement, and the generalization of conclusions was difficult due to methodological weaknesses of included studies, the diversity of the samples, and the limited number of studies included (Rasberry et al., 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rasberry et al., 2011 source

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  • May combine two claims.

    Interpretationcitation
    § 4. Discussion · p. 12

    Previous reviews show that physical activity interventions are more effective in reducing internalizing problems in samples with more females and more severe/clinical cases.

    “showing that physical activity interventions are more effective in reducing internalizing problems in samples with more females, and more severe/clinical cases”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Ahn & Fedewa, 2011 source

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    • cites Calfas & Taylor, 1994

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    • cites Craft & Landers, 1998

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    Study design and conductnone given
    § 4. Discussion · p. 11

    It was not possible to test whether the changes in externalizing problems in the comparison group were significant.

    “it was not possible to test whether these changes were significant”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Study design and conductown data
    § 3.4.1. Overall effect on self-concept · p. 9

    Publication bias was not found for self-concept, as the trim-and-fill procedure did not impute effect sizes on the left side.

    “Publication bias was not found, since the trim-and-fill procedure did not impute effect sizes on the left side (see Fig. 3 in Appendix C).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Studies may not have been published because of non-significant or unfavorable findings, and therefore are difficult to locate.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation
    § 4. Discussion · p. 11

    The findings of this meta-analysis are consistent with findings of previous reviews.

    “These findings are consistent with findings of previous reviews”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Ahn & Fedewa, 2011 source

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    • cites Biddle & Asare, 2011 source

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    • cites Chamberlain, 2013 source

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    Study design and conductown data
    § 4. Discussion · p. 12

    The meta-analysis of the effect of physical activity on externalizing problems and academic achievement was based on a small number of studies (14 and 10 studies respectively), which may negatively influence generalizability.

    “Finally, the meta-analysis of the effect of physical activity on externalizing problems and academic achievement was based on a small number of studies (14 and 10 studies respectively), which may negatively influence generalizability.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning
    § 4. Discussion · p. 12

    The power problem may apply to the moderator authors in the meta-analysis of externalizing problems and to background of instructor in the meta-analysis of internalizing problems.

    “This may be the case for the moderator authors in the meta-analysis of externalizing problems, and for background of instructor in the meta-analysis of internalizing problems.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation
    § 4. Discussion · p. 12

    Exercise interventions often focus on generating a minimum level of physical exertion, obtaining the physiological effects of exercise, and developing strength and stamina.

    “Exercise interventions often focus on generating a minimum level of physical exertion, obtaining the physiological effects of exercise, and developing strength and stamina”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lubans, Plotnikoff & Lubans, 2012

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  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data
    § 4. Discussion · p. 12

    The main results of the current study provide justifications for the increasing use of physical activity interventions in adolescent mental health care practice.

    “All in all, the main results of the current study provide justifications for the increasing use of physical activity interventions in adolescent mental health care practice.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data
    § 4. Discussion · p. 12

    According to the outcomes of the meta-analyses, physical activity interventions appear to be effective in reducing both internalizing and externalizing problems, and in improving self-concept and academic achievement.

    “According to the outcomes of the meta-analyses, physical activity interventions appear to be effective in reducing both internalizing and externalizing problems, and in improving self-concept and academic achievement.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning
    § 4. Discussion · p. 12

    Prior differences in physical activities between intervention and comparison groups may influence the strength of the intervention effects.

    “prior differences in physical activities between intervention and comparison groups may influence the strength of the intervention effects”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § 4. Discussion · p. 12

    Physical activity is a fairly common leisure activity for adolescents.

    “Physical activity is a fairly common leisure activity for adolescents”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Linver, Roth, & Brooks-Gunn, 2009

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    Interpretationcitation
    § 4. Discussion · p. 12

    This finding is in line with a previous meta-analysis showing larger effects for exercise compared to sports in RCT-studies.

    “This finding is in line with the previous meta-analysis on the effect of physical interventions on mental health in children, showing larger effects for exercise in comparison to sports in RCT-studies”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ahn & Fedewa, 2011 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given
    § 4. Discussion · p. 12

    The outcome measures of interest in the current study are closely associated to one another.

    “Third, we acknowledge that the outcome measures of interest in the current study are closely associated to one another.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationcitation
    § 4. Discussion · p. 12

    Exercise may more strongly improve the sense of feeling well about yourself than sports activities, which are more focused on the social environment and the competitive element.

    “This may more strongly improve the sense of ' feeling well about yourself ' than sports activities, which are more focused on the social environment and the competitive element”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Fraser-Thomas, Cote, & Deakin, 2005 source

      Not checked in the free run.

    • Rests on an assumption: The sports element of winning a game can lead to increased self-esteem, whereas losing the game may have adverse effects on self-esteem.
  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationreasoning
    § 4. Discussion · p. 12

    Although physical activity interventions are generally effective, empirical and theoretical insights from the current study showed that these interventions may be harmful in certain situations.

    “Although physical activity interventions are generally effective, empirical and theoretical insights from the current study showed that these interventions may be harmful in certain situations.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation
    § 4. Discussion · p. 12

    A negative self-concept is a risk factor for both internalizing and externalizing problems.

    “a negative self-concept is a risk factor for both internalizing and externalizing problems”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ybrandt, 2008 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given
    § 4. Discussion · p. 12

    Many included studies had small samples and did not always provide enough information to code all the moderators.

    “Many studies had small samples, and did not always provide enough information to code all the moderators.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationcitation
    § 4. Discussion · p. 12

    The stability of IQ may also explain smaller effects for standardized achievement tests and larger effects for grades.

    “which may also explain smaller effects for standardized achievement tests, and larger effects for grades”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given
    § 4. Discussion · p. 12

    Increasing the quality of the physical activity context can improve the effects of physical activity interventions.

    “as it is expected that increasing the quality of the physical activity context can improve the effects of physical activity interventions.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation
    § 4. Discussion · p. 12

    Standardized achievement tests better predict IQ, whereas grades better predict academic behaviors.

    “Standardized achievement tests and grades differ to the extent that standardized achievement tests better predict IQ, whereas grades better predict academic behaviors”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Duckworth, Quinn, & Tsukayama, 2012 source

      Not checked in the free run.

54 of 54
  • The paper relies on this without support.

    Physical activity interventions are often implemented in adolescent mental health care practice to prevent or treat psychosocial problems.

    “Physical activity interventions are often implemented in the adolescent mental health care practice to prevent or treat psychosocial problems.”
  • The paper relies on this without support.

    Studies may not have been published because of non-significant or unfavorable findings, and therefore are difficult to locate.

    “However, a common problem is that studies may not have been published because of non-significant or unfavorable findings, and therefore are difficult to locate.”
  • The paper relies on this without support.

    Effect sizes from the same study are more alike than effect sizes from different studies.

    “It is possible that effect sizes from the same study are more alike than effect sizes from different studies.”
  • The paper relies on this without support.

    The sports element of winning a game can lead to increased self-esteem, whereas losing the game may have adverse effects on self-esteem.

    “The sports element of winning a game can lead to increased selfesteem, whereas losing the game may have adverse effects on selfesteem.”
  • The paper relies on this without support.

    It is unethical to withhold interventions from children who experience serious problem behaviors.

    “In general, it is perceived unethical to withhold interventions from children who experience serious problem behaviors.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Internalizing activity-type coefficient disagrees with subgroup means

    Minor

    In Table 3, the exercise mean is 0.381 and the sports reference mean is 0.211. Their difference is 0.170, not the reported coefficient of 0.107.

    Reported 0.107 · recomputed 0.17

  • Externalizing sample-type coefficient disagrees with subgroup means

    Minor

    In Table 2, the clinical mean is 0.453 and the community reference mean is 0.265. Their difference is 0.188, not the reported clinical coefficient of −0.100.

    Reported -0.1 · recomputed 0.188

  • Externalizing effect size differs in the discussion

    Minor

    The discussion reports an overall effect of d = 0.345 for externalizing problems, whereas the abstract, results, and Table 1 report d = 0.320.

  • Self-concept follow-up row lists more studies than effect sizes

    Minor

    Table 4 lists 11 independent studies but only 5 effect sizes for the follow-up analysis. An analysis cannot draw effect sizes from more studies than it contains effect sizes.

4 of 4

Cites

Flagged first, then by citations

7 of the 170 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Spruit, A., Assink, M., van Vugt, E., van der Put, C., & Stams, G. J.
Affiliations
University of Amsterdam (NL)
Corresponding author
Spruit, Anouk
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2016-04
Volume
45
Pages
56-71
ISSN
0272-7358 (ISSN-L)
OpenAlex
W2321893984
Cited by
250
References
170
Citations by year
2026: 22 · 2025: 24 · 2024: 31 · 2023: 27 · 2022: 37 · 2021: 27 · 2020: 39 · 2019: 18 · 2018: 17 · 2017: 5 · 2016: 2 · 2013: 1
FWCI
1.64
Type
journal article
Language
en
Open access
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Social Sciences › Safety Research › Youth Development and Social Support
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
physical activity interventions, adolescents, psychosocial outcomes, externalizing problems, internalizing problems, self-concept, academic performance, adolescent mental health, moderators
MeSH terms
Adolescent, Adolescent Behavior, Mental Disorders, Humans, Social Behavior, Exercise

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

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