Adolescents

Objective: This study examined the relationships between father-related attachment and parenting variables and peer bullying among adolescent girls. Secure and insecure attachment styles, paternal caregiving styles, paternal autonomy support, and paternal involvement were investigated in relation to bullying victimization and bullying perpetration. Method: The study employed a correlational design with 200 adolescent girls aged 16–18 years attending vocational high schools in Bursa, Türkiye. Data were collected using the Adult Attachment to Father Scale, the Father Caregiving and Attachment Styles Scale, the Father Perception Scale, and the Peer Bullying Identification Scale. Pearson and Spearman correlation analyses, partial correlations, and Benjamini–Hochberg false discovery rate (FDR) corrections were conducted. Results: Secure attachment, paternal warmth/responsiveness, paternal involvement, and paternal autonomy support were negatively associated with bullying victimization and perpetration. In contrast, cold/rejecting and inconsistent/incongruent paternal attitudes were positively associated with bullying variables. Most findings remained significant after controlling for demographic variables and applying robustness and FDR correction analyses. However, some associations involving the Fearful Attachment subdimension appeared less robust. Conclusions: The findings suggest that supportive father–daughter relationships are consistently associated with lower levels of bullying involvement against peer bullying among adolescent girls. Interventions aimed at strengthening secure attachment and supportive parenting practices may contribute to reducing bullying behaviors and victimization. Full article

Internalized weight stigma is related to psychological and physiological consequences independent of actual weight status. However, as peers assume an increasingly important role in early adolescence, peer support may protect adolescents from the related costs of weight stigma. The current study examines concurrent associations between internalized weight stigma and heart rate variability in response to an acute stressor in a non-clinical early adolescent sample using a novel peer-to-peer discussion task. We hypothesized that peer acceptance will moderate the effect of internalized weight stigma on changes in sympathetic and parasympathetic indices of HRV. The study included 31 adolescents (58.1% boys; M_age = 12.82, SD_age = 1.00) from a charter middle school who completed self-report questionnaires to assess internalized weight stigma and perceived peer acceptance. Participants also completed a novel peer-to-peer discussion task to induce stress responses. Heart rate variability (HRV) was recorded during the baseline and the discussion task, and baseline-to-task change scores were used as an index of sympathetic and parasympathetic responses. Peer acceptance significantly moderated the association between internalized weight stigma and sympathetic reactivity (∆r² = 0.07, B = −0.97 *, p < 0.05). Specifically, only for adolescents with low peer acceptance, increased internalized weight stigma predicted heightened sympathetic reactivity (B = 0.84, p = 0.03). The findings of this study support the development of a novel peer-to-peer discussion task as an acute stressor and suggest that peer acceptance may alter the association between internalized weight stigma and physiological stress reactivity. Full article

Purpose: The purpose of this study is to conduct a qualitative study of perceptions of active commuting to school (ACS) amongst middle school girls. Methods: Twelve adolescent girls (M = 13.1 ± 0.7 years old) who participated in the Safe TRavel Environment Evaluation of Texas Schools (STREETS) natural experiment were recruited to participate in semi-structured interviews. The semi-structured interview guide was grounded in Social Cognitive Theory, the Theory of Planned Behavior, and the existing literature. All interviews were transcribed by WebEx and thematic analysis was conducted via NVivo 12. Results: Participants had generally neutral to positive views of ACS. Main themes included social support of peers and the convenience of active commuting. Commonly reported barriers were distance to school, safety, and concerns about lack of sleep because of an early commuting time. Areas for future intervention included reducing perceived barriers of distance, time management, and safety, increasing girls’ motivation to actively commute, and improving skills and self-efficacy related to ACS through education, social support, guided practice, and incentives. Conclusions: This study provides evidence for schools and communities to include support programs for those who want to actively commute and suggestions for school policy changes to encourage active commuting to school (ACS). When developing ACS infrastructure or programs for middle school girls, concomitant programs that address strategies to address student perceptions and psychosocial barriers should be included. Full article

Anemia among adolescent girls remains a persistent public health challenge in Indonesia, driven by limited nutritional knowledge, poor dietary practices, and suboptimal adherence to iron supplementation programs. This study is grounded in the Social–Ecological Model (SEM), which frames health behaviors as shaped by individual, interpersonal, institutional, and community-level factors. This study aimed to explore students’ knowledge and dietary behaviors related to anemia, assess perceptions of existing supplementation programs, and examine teachers’ and students’ perspectives on school-based digital education for anemia prevention in Denpasar, Bali. A qualitative descriptive design was employed across eight public junior high schools. Participants included eight teachers and 40 female students (aged 13–15 years) selected via purposive sampling. Data were collected through semi-structured in-depth interviews, non-participant observations, and document analysis. Thematic analysis was conducted using Atlas.ti version 23, with trustworthiness ensured through triangulation, member checking, peer debriefing, and iterative saturation assessment. Four inter-related themes emerged: (1) students held superficial, menstruation-centric conceptualizations of anemia with limited understanding of iron deficiency as an underlying cause; (2) dietary patterns were dominated by low-iron foods with poor vegetable consumption; (3) adherence to the Weekly Iron and Folic Acid Supplementation (WIFAS) program was inconsistent, hindered by side effects, forgetfulness, and low perceived benefit; and (4) both teachers and students expressed strong interest in digital education tools while identifying infrastructure and training gaps as barriers. Anemia prevention in school settings requires a multi-level approach integrating knowledge improvement, dietary behavior support, and institutional reinforcement. School-based digital education represents a contextually appropriate, youth-aligned innovation with strong potential to bridge the gap between health information and sustained behavioral change. Full article

Growing up without parental care may negatively affect adolescents’ behavioral and emotional development, particularly among adolescents in conflict with the law. In a selected secure care center in the Vhembe District, limited research has explored the lived experiences and behavioral impact of growing up without parents. This study aimed to explore and describe the behavioral and emotional impact of growing up without parents among adolescents in conflict with the law in a child and adolescent secure care center in Limpopo Province. A qualitative, explorative, descriptive, and contextual research design was employed. Purposive sampling was used to recruit twelve (12) adolescents aged 15–17 years admitted to a secure care center in the Vhembe District. Data was collected through individual semi-structured interviews conducted in Xitsonga or Tshivenda, depending on participants’ preferred language. Interviews were audio-recorded, transcribed, translated into English, and analyzed using Tesch’s eight steps of data analysis. Ethical considerations and measures to ensure trustworthiness were observed throughout the study. The findings revealed that adolescents experienced low self-esteem, diminished self-confidence, early initiation of substance use, poor educational engagement, survival-oriented delinquent behavior, and feelings of neglect. These findings highlight the need for an integrated intervention approach to ensure coordinated psychosocial, educational, behavioral, and socio-economic support for this population. Full article

(1) Background: Adolescence is a critical period for the development of health-related behaviors, including dietary habits and physical activity. This cross-sectional study examined the associations between participation in organized sports, nutrient intake, and body composition in a sample of Greek adolescents. (2) Methods: A total of 224 adolescents aged 12–18 years from schools in the Attica region, Greece, participated in the study. Physical activity and organized sports participation were assessed using a validated questionnaire. Body composition was estimated using bioelectrical impedance analysis, and dietary intake was evaluated using three-day self-reported food records analyzed with Cronometer^® nutrition analysis software. (3) Results: Boys had higher fat-free mass and basal metabolic rate and lower fat-mass percentage than girls. Organized sports participation was common and differed by sex, with boys reporting higher participation and greater adherence to physical activity recommendations than girls. Organized sports participation was associated with differences in selected nutrient intakes, particularly among late adolescents; however, several differences were attenuated when nutrient intake was standardized per 1000 kcal, suggesting that part of the observed pattern may reflect differences in total energy intake. (4) Conclusions: These cross-sectional findings suggest that age-defined adolescent stage and organized sports participation are associated with differences in sports involvement, body composition, and nutrient intake among Greek adolescents; however, causal relationships cannot be established, and the findings should be interpreted as associations. Full article

Objective: In-season youth gymnastics is a sport that has maintained popularity, even though the youth are exposed to psychological and physiological injuries throughout their career. The absence of clearly demarcated competitive seasons complicates the distinction between in- and out-of-season, potentially masking cumulative health changes from chronically poor sleep and inadequate autonomic recovery. The present study investigated the differences in sleep architecture and health in- and out-of-season in young, in-season gymnasts. Methods: Nine in-season youth gymnasts between the ages of 12 and 16 years were recruited. Sleep data were collected for three consecutive nights during in-season and off-season using an ambulatory sleep monitor so the subjects could sleep in their own beds. Results: Mean nocturnal pulse was significantly higher during in-season versus off-season, reflecting higher sympatho-vagal outflow during the competition season. Sleep efficiency, wake after sleep onset (WASO), and spindle duration were similar during in-season and off-season, yet they had better values during off-season. Sleep latency, rapid eye movement (REM), and non-rapid eye movement (NREM) had greater sleep regularity during the off-season. Conclusion: These data demonstrate a significant decrease in mean nocturnal heart rate when an athlete transitions from in-season to off-season. Full article

(1) Background: Adolescents’ appraisals of family relationships play an important role in bridging family dynamics and maladaptive behavior in various contexts. However, the mechanism of adolescents’ appraisals remains unclear. This review aims to map the state of the art about adolescents’ appraisals of family relationships in intact family contexts from the existing global literature. (2) Methods: The article collection was performed in accordance with the PRISMA guideline and screening articles from 5 sources. Two reviewers independently screened to obtain 10 reported articles that met the inclusion criteria. (3) Results: Analyses identified that 90% of the previous study involved adolescents aged 8–19 years from the United States (USA) and predominantly White. The majority of the samples were also identified from middle to upper class socioeconomic status (n = 6), and relatively low conflict family structure (n = 5). The most commonly used variable term of adolescents’ appraisal was interparental conflict (IPC) appraisals (n = 7), and the Cognitive Contextual Framework (CCF) by Grych et al. was used as a theoretical framework. (4) Conclusions: Based on a global literature review, the findings of this review are limited, based on age, race, socioeconomic status, family structure, and certain geographical locations. The limited range of samples may affect the sensitivity of the theoretical framework and measurement tools in capturing variations in adolescents’ appraisals of family relationships in intact family contexts. Furthermore, the generalizability of these findings may be limited. Accordingly, future studies are encouraged to replicate the present research using larger samples from diverse ages, cultural and socioeconomic status, and family structure backgrounds. Future researchers could further advance this research area by incorporating a wider variety of theoretical perspectives, methodological approaches, and measurement instruments to promote the future health and well-being of adolescents. Full article

Background: Contraceptive counseling is a critical component of reproductive healthcare, directly influencing method uptake, continuation, and user satisfaction. While global health guidelines increasingly emphasize person-centered, rights-based approaches to counseling, wide variations in practice persist, with significant implications for equity and autonomy. Objective: This narrative review aims to synthesize current evidence on the strengths, limitations, and future opportunities of contraceptive counseling within person-centered care frameworks, with particular attention to adolescents and other populations facing structural or sociocultural barriers to equitable care. Methods: A comprehensive literature search was conducted across six indexed databases (PubMed, Scopus, Embase, Web of Science, CINAHL, and PsycINFO) for peer-reviewed articles published between January 2010 and April 2025. Eligible studies included original quantitative, qualitative, and mixed-methods research examining contraceptive counseling practices, user experiences, provider–client communication, counseling interventions, or implementation strategies in reproductive healthcare settings. Results: Emerging strengths in the field include the increasing adoption of shared decision-making, motivational interviewing, and culturally tailored counseling approaches, all of which contribute to improved client satisfaction and method adherence. Digital tools and mHealth platforms have expanded the reach of counseling and show promise in supplementing in-person care. However, significant gaps remain. Provider bias, limited training, communication barriers, and a lack of socio-cultural tailoring frequently undermine the quality of care, especially for adolescents, migrants, women with disabilities, and socially vulnerable populations. Ethical challenges—such as coercion, inadequate informed consent, and structural inequities—persist in many healthcare settings. Moreover, contraceptive counseling is often treated as a one-time event rather than an ongoing, adaptive process. Conclusions: To maximize its impact, contraceptive counseling must be reframed as a longitudinal, relational, and ethically grounded practice. Future efforts should prioritize the development of structured training programs, integration into broader health services, and qualitative research that centers patient experiences. Embedding counseling within reproductive justice frameworks will be essential for advancing equity and autonomy. High-quality contraceptive counseling, when informed by evidence and empathy, is a strategic tool for reproductive empowerment and public health advancement. Full article

Using the Hierarchical Taxonomy of Psychopathology (HiTOP) as our framework, the current study examines how 13 common psychological disorders can be grouped into different spectra in two groups of adolescents: a community sample (N = 951), and a clinic-referred sample (N = 173). Scores for the disorders were obtained using the parent version of the Child and Adolescent PsychProfiler. Taken together, the findings across the two samples for factor structure, reliability, and discriminant and concurrent validity indicate the most support for a three-factor CFA oblique model with primary factors for neurodevelopment disorders (that include Specific Learning Disorder, Autism Spectrum Disorder, Language Disorder, and Speech Sound Disorder), internalizing disorder problems (that include Generalized Anxiety Disorder, Persistent Depressive Disorder, Separation Anxiety Disorder, Obsessive–Compulsive Disorder, Posttraumatic Stress Disorder, Anorexia Nervosa, and Bulimia Nervosa), and externalizing disorder problems [(that include Attention Deficit/Hyperactivity Disorder (ADHD), and Oppositional Defiant Disorder/Conduct Disorder (ODD/CD)], with a covariance for the error variance for Anorexia Nervosa and Bulimia Nervosa. Additionally, the analysis for Sample 2 supports the concurrent validity of the factors in this model. A modification of this model, with ADHD cross-loading on the neurodevelopment disorders factor, did not produce an admissible solution. The findings indicate support for a neurodevelopmental spectrum in the HiTOP model, with ADHD and ODD/CD showing stronger statistical association with the externalizing factor than with the neurodevelopmental factor in the models tested. This finding pertains to dimensional structure and does not invalidate the neurodevelopmental classification of ADHD in DSM-5-TR. Full article

Relationships are a fundamental foundation of human development, shaping developmental trajectories, well-being, and health, yet their psychological assessment remains challenging. Youths’ perceived closeness to others has been linked to a range of prosocial outcomes but has been less extensively examined in research studying problematic developmental outcomes, such as conduct problems. Further, most studies have focused on a single relationship, which ignores the potential importance of determining the extent to which youth’s perceptions of closeness extend beyond immediate social groups. The present study addressed these gaps by examining the factor structure and construct validity of an expanded measure of perceived closeness that includes a broader range of relationships, labeled the Perceived Closeness to Others Questionnaire (PCtO). A sample of 426 middle school students (216 girls; M age = 12.90 (0.91) years) was recruited and completed a visual measure of perceived closeness that utilizes visual images of pairs of circles (i.e., one indicating “the Self” and one indicating “the Other”) at different distances (i.e., from very far away to almost completely overlapping) to indicate how close they feel to others. Participants also completed self-report measures assessing a range of prosocial and problematic outcomes. An exploratory factor analysis (EFA) suggested that, despite assessing a wide range of relationships, the measure seemed to be capturing a unidimensional construct. Further, scores from the measure showed adequate reliability and were positively correlated with all the measures of prosocial outcomes and with all but one measure of problematic outcomes (i.e., conduct problems). Overall, the findings provide initial support for a measure of psychological closeness suitable for use in research with youth. This tool may help advance theories of prosocial and antisocial development and guide interventions aimed at enhancing youths’ relationships with others. Full article

Structural constraints arising from the family environment have been highlighted as a key predictor of deviant lifestyles that expose youths to criminogenic circumstances. Intervening processes are not well-understood. This study examined (a) whether family deviance is associated with students’ deviant lifestyles, (b) whether this association is mediated by low parental nurturance, and (c) whether this indirect effect is moderated by low parental education. Cross-sectional data from 233 African American, Hispanic, White, Asian American, and multiracial 11th grade students were used. The student deviant lifestyles construct was assessed using three composite indicators (student delinquent behavior, perceived peer deviance, student substance use). Using structural equation modeling, a latent moderated indirect effects model showed excellent fit (e.g., CFI = 0.986, RMSEA = 0.047, SRMR = 0.027). Parental nurturance significantly mediated the relation of family deviance with student deviant lifestyles, but only for students whose parents have low levels of education. Our results support the utility of an integrative criminogenic framework that includes structural constraints arising from the family environment and showed that high parental education can serve as a buffer against the adverse indirect effects of family deviance on adolescents’ deviant lifestyles via low parental nurturance. Full article

Mental health disorders among adolescents have risen significantly in recent years, particularly following the COVID-19 pandemic, highlighting the need for effective preventive and supportive interventions. Nurses play a key role in the promotion, early detection, and management of mental health issues in adolescents, both in school and community settings. This study aimed to synthesize quantitative and qualitative evidence on the role, effectiveness, and implementation of nursing interventions for adolescent mental health. A systematic mixed-methods review was conducted in accordance with the PRISMA 2020 guidelines. It was registered in PROSPERO (CRD42024502076). Databases including PubMed, Scopus, SciELO, Dialnet, BVS, and Cuiden were searched for studies published between 2014 and 2024. Twelve studies met the inclusion criteria, comprising randomized and non-randomized quantitative studies, qualitative studies, and previous reviews. The interventions identified included cognitive-behavioral therapy programs, resilience and life skills training, physical activity initiatives, digital interventions, and mental health literacy strategies. Overall, the findings suggest improvements in symptoms of anxiety and depression, coping skills, resilience, and knowledge about mental health, particularly in structured school-based programs. Qualitative evidence highlighted the importance of accessibility, multidisciplinary collaboration, cultural sensitivity, and sustained commitment for successful implementation. However, considerable heterogeneity was observed in study designs, interventions, and outcome measures. In conclusion, nursing interventions can make a positive contribution to adolescents’ mental health, particularly in school and community settings. However, further rigorous, long-term studies are needed to strengthen the evidence base. Full article

Child and adolescent mental health (CAMH) is a global concern that is increasingly recognized and prioritized. Worldwide, mental health conditions affect a significant number of children and adolescents; however, access to CAMH services remains limited. This study sought to explore the implementation of child and adolescent mental health services in the rural Chris Hani District of the Eastern Cape province, South Africa, from the perspectives of health professionals and teachers, focusing on strengths, weaknesses, opportunities, and threats. Using a qualitative approach, a sample of 36 participants (12 health professionals and 24 teachers) was purposively recruited. Data were collected through face-to-face, semi-structured individual interviews and focus group discussions. Thematic analysis identified several strengths, including effective screening and identification of CAMH problems, training in psychiatry and psychology, teacher support, collaboration with stakeholders, and the availability of policy and guidelines. Key weaknesses included inadequate CAMH training, a limited CAMH workforce, personal barriers, guidelines primarily oriented toward physical health, and insufficient basic infrastructure. Opportunities for improvement include enhancing the skills of the existing workforce, increasing engagement in extramural activities, and empowering parents with knowledge of available CAMH services. Identified threats included the normalization of CAMH symptoms, challenges involving parents and feeder schools, stigma, poor stakeholder collaboration, and inadequate guidelines. Overall, the analysis of strengths, weaknesses, opportunities, and threats reflects the broader challenges present in low-resource settings that hinder the implementation of CAMH services. It also highlights the need for integrative approaches to implementing CAMH services in rural contexts, while identifying opportunities to improve service delivery. Full article

This pilot clinical trial evaluated the feasibility and changes following the BeBuddies, which is a school-based program designed to promote mental health Literacy (MHL) among adolescents, based on MHL being a key protective factor for well-being in adolescence. Twenty-eight adolescents (57% girls; Mage = 16.46) were randomly assigned to either an intervention (n = 14) or a control group (n = 14). Participants were asked both qualitatively and quantitatively about their perception of acceptability, usability and satisfaction regarding each intervention session; they were also asked to fill in self-report questionnaires at pre-intervention, post-intervention, and follow-up. Program satisfaction and acceptability were consistently high, highlighting its potential to bind participants due to its experiential and dynamic nature. About changes over time, preliminary findings suggest that the BeBuddies yielded improvements primarily in symptom recognition and problem-solving, with more favorable change patterns in the intervention group. A slight reduction in stigma was also observed in the intervention group, in contrast with a small increase in the control group. These results are consistent with the existing literature and point to the feasibility and potential benefits of structured, school-based interventions focused on promoting MHL programs in adolescence. Full article

The present study investigated the relationship between resilience, self-esteem, and academic performance in primary school students. The sample comprised 124 pupils (59 males and 65 females) enrolled in the 5th and 6th grades. Psychometric assessment was conducted using the Resilience Scale and the Rosenberg Self-Esteem Scale, while academic achievement was evaluated based on students’ grades in Language, Mathematics, Science, English, and Physical Education. Data analysis was performed using ANOVAs and Pearson correlation coefficients. The results indicated that higher academic performance was positively correlated with both increased resilience and self-esteem. Furthermore, a strong positive correlation was observed between self-esteem and resilience. Regarding gender, no significant differences were found in resilience or self-esteem levels. However, academic performance variations were identified exclusively in English language proficiency; specifically, for male students, higher performance in English was significantly associated with greater resilience. In conclusion, these findings suggest that integrating self-esteem and resilience-building activities into the educational curriculum is essential. Such interventions may enhance students’ capacity to manage adversity and facilitate the attainment of their academic goals. Full article

Excessive internet use among adolescents is a growing public health concern, yet data from Cyprus are scarce. This cross-sectional study used parent reports for 248 adolescents (12–17 years; 54.4% boys) to describe problematic internet use and examine associations with emotional–behavioral difficulties and family functioning. Based on published Parent–Child Internet Addiction Test (PCIAT) cut-offs, used descriptively rather than as clinically validated Cypriot thresholds, 74.2% of adolescents in this parent-reported convenience sample fell within the broader problematic internet use range. This sample-specific proportion comprised 38.3% in the mild, 33.9% in the moderate, and 2.0% in the severe PCIAT category. Adolescents using the internet >3 h/day (n = 112) had significantly higher PCIAT scores than those using it <3 h/day (n = 136; U = 3100.00, Z = −4.72, p < 0.001). PCIAT scores correlated with conduct problems (r = 0.449), hyperactivity/inattention (r = 0.441), and total difficulties (r = 0.475), and inversely with prosocial behavior (r = −0.471; p < 0.001). Family functioning worsened across PCIAT severity categories (GF-12 means: 18.83 in the PCIAT 20–30 range vs. 29.00 in the severe range; H(3) = 28.30, p < 0.001). In multivariable regression, daily use (B = 8.02), poorer family functioning (B = 0.42), conduct problems (B = 5.28), and hyperactivity/inattention (B = 6.81) independently predicted higher PCIAT scores (R² = 0.24), whereas emotional symptoms were not significant (p = 0.637). Findings from this convenience sample highlight the potential importance of prevention efforts targeting screen-time regulation and family relationships; longitudinal, representative, multi-informant studies are warranted. Full article

Psychological readiness for career choice represents a critical developmental task during adolescence, shaping subsequent educational paths and vocational self-determination. This study investigates the formation of such readiness among grade nine students in a public secondary school in Almaty, Kazakhstan, using an integrated psychological assessment approach. Grounded in Holland’s RIASEC theory and temperament-based perspectives, the study examines how vocational interests, temperament characteristics, and educational decision status interact in early career planning. Data were collected from 185 students during structured school-based diagnostic sessions employing a RIASEC vocational interest inventory, a temperament assessment, and a brief educational decision questionnaire. The findings reveal a differentiated structure of vocational interests, with social and investigative orientations most prevalent. While a majority of students reported preliminary career or educational choices, a substantial proportion remained undecided, indicating heterogeneous levels of psychological readiness. Temperament distributions suggest that emotional regulation plays an important role in translating vocational interests into concrete decisions. Overall, the results support conceptualizing psychological readiness as a multidimensional construct encompassing interest clarity, personality-related regulation, and decision commitment. The study highlights the importance of sustained, psychologically informed career guidance during key educational transitions and offers practical implications for school-based career counseling. Full article

In this quantitative study, we investigated the conditional mediating role of students’ mathematical language self-efficacy in the relationship between self-regulation and mathematics anxiety. The study employed a relational research design and included survey data from 706 middle school students attending public schools in Turkey. Findings indicated that both self-regulation and perceived self-efficacy in mathematical language use were significantly associated with mathematics anxiety. Moreover, the effect of self-regulation on mathematics anxiety was significantly mediated by students’ perceptions of their ability to understand and use mathematical language self-efficacy. The indirect effect was negative while the direct effect was positive, indicating a suppression (competitive mediation) effect, whereby self-regulation exerts both anxiety-reducing and potentially anxiety-inducing influences through different pathways. Conditional mediation analysis further revealed that this mediating effect varied as a function of students’ perceived academic support, with the indirect effect being non-significant for students who did not receive support. Measurement invariance across gender and grade level was examined to ensure that the constructs were measured equivalently across groups. These findings highlight the importance of fostering both self-regulation skills and mathematical language proficiency, particularly in contexts where students may lack sufficient support. These findings provide a theoretically grounded and practically relevant framework for understanding mathematics anxiety within inclusive mathematics education contexts. Full article