AUTHOR=Bechtiger Laura , Thalathara Hans , Bürgin David , Eggenberger Lukas , Janousch Clarissa 
  
TITLE=Examining Secular Changes in Health Risk Behavior Profiles and Their Associations With Mental Distress During Adolescence
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609345
  
DOI=10.3389/ijph.2026.1609345
  
ISSN=1661-8564
  
ABSTRACT=ObjectivesAdolescent mental distress has increased in recent decades. It is unclear whether this is associated with changes in health-risk behaviors.MethodsWe analyzed five waves (2002–2018) of the repeated cross-sectional Swiss Health Behavior in School-aged Children study (ages 11–15; N = 30,122). Latent Profile Analyses identified health-risk behavior profiles in each wave using five indicators (physical inactivity, poor sleep, unhealthy diet, smoking, alcohol use). Associations with sociodemographic variables and mental distress (internalizing and somatic symptoms, life satisfaction) were tested using multinomial and linear regressions, including profile*sex interactions.ResultsA consistent four-profile solution (low-risk; high alcohol use/slightly elevated substance use; moderate substance use; highest risk) fit best across waves. The low-risk profile was most prevalent and increased in later cohorts (2014–2018), while elevated-risk profiles declined. Older adolescents were more likely to belong to elevated-risk groups, which were associated with greater mental distress, especially in earlier cohorts. No significant sex interactions were found.ConclusionHealth-risk behavior profiles remained stable, but their associations with mental distress weakened over time. Prevention efforts should adapt to evolving adolescent contexts.