This study explored the associations among peer support, psychological resilience, and exercise adherence in adolescents, paying particular attention to different gender groups and educational stages. Psychological resilience was regarded as a potential explanatory mechanism in the relationship between peer support and exercise adherence. A cross-sectional study with a mixed approach was conducted in Zhejiang Province, China (2023), involving a total of 2,137 adolescents (aged 10–18; 49.6% were girls), who completed three standardized questionnaires measuring psychological resilience, peer support, and exercise adherence. Semi-structured interviews were conducted with 21 students, teachers and parents. Male students scored higher than female students in terms of psychological resilience, peer support, and exercise adherence (p < 0.001). Elementary and middle school students scored higher than high school students across three dimensions, with elementary school students also performing better than middle school students (p < 0.001). There was a positive association between peer support and exercise adherence, with psychological resilience shown as a potential mediating factor. Multi-group analysis revealed stronger direct associations between peer support and exercise adherence among males and middle school students. Qualitative interviews indicated that peer support influenced adolescents exercise adherence through multi-level mechanisms. The understanding of peer support and psychological resilience among adolescents developed progressively at different educational stages, and there were differences in the development trends of different genders. The interviews also showed that the match of peer skill levels was a key condition for the effectiveness of support, and that the victory experience in sports might help adolescents form a positive cycle. Peer support not only directly enhanced psychological resilience in sports scenarios, but also transferred the cultivated target concentration and emotional regulation ability to academic and life fields through the "springboard effect". This research emphasized the roles of peer support and psychological resilience in promoting exercise adherence among adolescents, which showed distinct pathways across different gender and developmental stages. The results highlighted the need to create a better peer support environment and improve psychological resilience.

This study aimed to evaluate the effects of exercise on anxiety and depression in individuals with type 2 diabetics mellitus (T2DM) and to determine the optimal exercise prescription for this population. A comprehensive search of PubMed, Web of Science, EBSCO, Cochrane Library, and Scopus databases was conducted through 13 May 2025. Pooled analyses were performed using standardized mean difference (SMD) and 95% confidence interval. Exercise significantly alleviated anxiety (SMD, −0.66, p < 0.00001) and depression (SMD, −0.55, p < 0.0001) in individuals with T2DM. Subgroup analyses revealed that aerobic exercise (anxiety, SMD, −0.68, p < 0.00001; depression, SMD, −0.63, p = 0.005) and interventions performed ≥3 times per week (anxiety, SMD, −0.72, p < 0.00001; depression, SMD, −0.72, p < 0.00001), lasting < 60 min per session (anxiety, SMD, −0.78, p < 0.00001; depression, SMD, −0.67, p < 0.00001), and accumulating ≤ 180 min per week (anxiety, SMD, −0.60, p < 0.00001; depression, SMD, −0.60, p = 0.0008) were most effective in alleviating anxiety and depression. While the findings of this meta-analysis suggest that engaging in exercise at a frequency of at least 3 times per week, with each session lasting less than 60 min (accumulating to approximately 180 min per week), may be associated with greater psychological improvements, these recommendations should be interpreted cautiously due to variability in study quality, intervention types, and sample characteristics.

Background: This study aimed to comprehensively explore the formation reasons and constituent elements of pre-free-throw ritualized behaviors (RBs) among Chinese basketball players under competitive pressure, and to investigate participants’ perceptions of how RBs influence their psychological states and sports performance. The study was conducted within China’s official Athlete Technical Level Grading System , where athletes are classified into hierarchical levels reflecting their competitive achievements. Methods: We conducted one-on-one semi-structured interviews with 20 Chinese basketball players at or above the National Level 2. Using a qualitative research approach based on codebook thematic analysis (TA), we explored the usage background, usage goals, usage habits, usage experiences and effectiveness evaluation of their RBs. Results: Participants reported that Chinese basketball players primarily adopt pre-free-throw RBs to alleviate negative emotions and enhance attentional focus, which they perceived as beneficial to their performance. The execution steps of pre-free-throw RBs predominantly consist of 3 to 4 actions, which typically include dribbling, deep breathing, spinning the ball, wiping shoe soles and focusing on the basket. Moreover, as competition intensity increases, both the duration and frequency of RB use tend to increase. Participants reported that performing pre-free-throw RBs produced a series of positive psychological effects, and they perceived a noticeable improvement in their free-throw accuracy. Conversely, if athletes were required to refrain from performing pre-free-throw RBs, they anticipated negative effects, including a perceived decline in free-throw accuracy. Conclusions: The study suggests that pre-free-throw RBs may play a role in free-throw accuracy in high-level Chinese basketball players under competitive pressure. Participants perceived that RBs helped alleviate negative emotions, optimize attentional resource allocation, which they believed may be associated with improved sports performance in competition. Practical implications: The study provides a player-centered perspective on how athletes perceive and experience pre-free-throw RBs under competitive pressure. The findings may offer preliminary guidance for coaches and sport psychologists to consider when developing support strategies aimed at helping athletes manage psychological readiness and sports performance, particularly within China''s elite sport system.