Sendhi Tristanti Puspitasari, Hung-En Liao, Eri Yanuar Akhmad Budi Sunaryo, Penta Akhirul Awal
Background: Adolescent girls tend to engage in more sedentary behavior than boys, which is associated with adverse physical and psychosocial outcomes, including depression. This study examined the relationships between sedentary behavior, perceived stress, body mass index (BMI), and depressive symptoms among adolescent girls in Indonesia and tested the mediating roles of perceived stress and BMI. Methods: A cross-sectional survey was conducted among 482 female senior high school students (age 14–20) in Malang City, East Java, Indonesia. Sedentary behavior was assessed by the Adolescent Sedentary Activity Questionnaire (ASAQ) and expressed as total hours/day. Perceived stress was measured with the 10-item Perceived Stress Scale (PSS-10). Depression was measured by the Beck Depression Inventory-II (BDI-II). Descriptive statistics and Spearman correlations were computed. Parallel mediation analysis was conducted to examine indirect effects of perceived stress and BMI on the association between sedentary behavior and depressive symptoms, adjusting for age. Results: Participants’ mean age was 16.24 (SD = 1.12) years, with a mean BMI of 20.62 (SD = 3.44). The average sedentary time was 9.38 (SD = 6.06) hours/day. The mean scores for depression and perceived stress were 10.44 (SD = 7.15) and 20.24 (SD = 5.19), respectively. Higher sedentary behavior was associated with higher perceived stress (β = 0.133, p = 0.010, f 2 = 0.051). Both BMI (β = 0.133, p = 0.005, f 2 = 0.031) and perceived stress (β = 0.392, p < 0.001, f 2 = 0.209) were positively associated with depression. Mediation analysis showed a significant indirect effect of sedentary time on depression through perceived stress (β = 0.052, 95% CI [0.014, 0.100]), whereas BMI did not mediate this relationship. Conclusions: Sedentary behavior is indirectly associated with depressive symptoms through increased perceived stress among adolescent girls. Interventions should integrate reductions in sedentary behavior and stress management to prevent adolescent depression. Copyright © 2026 The Authors.
Department of Healthcare Administration, College of Medical and Health Science, Asia University, 500 Liufeng Road, Wufeng, Taichung City, Taiwan; Department of Medicine, Faculty of Medicine, State University of Malang, Semarang Street No. 5, Malang, Indonesia; Department of Nursing, Faculty of Medicine, State University of Malang, Semarang Street No. 5, Malang, Indonesia; Yogyakarta, Indonesia
