Psychological Stress in the Association between Media Exposure, BMI, and Menstrual Characteristics among Adolescent Girls: A Cross-Sectional Study

Tri Ardayani; Liliek Fauziah; Henni Purnasari; Hanni Triana

doi:10.56741/IISTR.jphs.002034

Authors

Tri Ardayani
triardayani48@gmail.com
Institut Kesehatan Immanuel https://orcid.org/0000-0003-1681-4108
Liliek Fauziah Institut Kesehatan Immanuel https://orcid.org/0009-0000-1643-6237
Henni Purnasari Institut Kesehatan Immanuel https://orcid.org/0000-0002-3763-9153
Hanni Triana Institut Kesehatan Immanuel https://orcid.org/0009-0007-0805-8361

Keywords:

Adolescent Girls, Body Mass Index, Dysmenorrhea, Menstrual Characteristics, Psychological Stres

Abstract

Adolescence is a critical developmental period marked by biological, psychological, and social changes that influence reproductive health. Increasing digital media exposure has been linked to psychological stress and lifestyle changes that may affect body mass index (BMI) and menstrual health among adolescent girls. However, the pathways connecting media exposure to menstrual characteristics remain unclear, particularly the role of psychological stress. This study aimed to examine the mediating role of psychological stress in the relationship between media exposure, BMI, and menstrual characteristics among adolescent girls. A school-based cross-sectional analytical study was conducted among 150 adolescent girls aged 12–18 years. Media exposure was measured using a self-reported screen time questionnaire, psychological stress using the Perceived Stress Scale–10 (PSS-10), BMI from measured height and weight, and menstrual characteristics through a structured questionnaire. Data were analyzed using descriptive statistics, bivariate correlation, and structural equation modeling with bootstrapped mediation analysis. Results: The mean age was 15.2 ± 1.6 years, and the mean stress score was 19.4 ± 6.2. Media exposure was positively associated with psychological stress and BMI. Psychological stress was significantly associated with dysmenorrhea severity and menstrual cycle irregularity and partially mediated the relationship between media exposure and dysmenorrhea severity, both directly and sequentially through BMI. Psychological stress plays a key role in linking media exposure to menstrual characteristics, emphasizing the need for stress management and healthy digital media use in adolescent reproductive health promotion.

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Author Biographies

Tri Ardayani, Institut Kesehatan Immanuel

is affiliated with the Bachelor of Public Health Study Program, Faculty of Health, Institut Kesehatan Immanuel, Indonesia. Her academic interests include the fundamentals of reproductive and family health, gender, reproductive and sexual health services, environmental quality analysis, health planning and evaluation, maternity nursing, community organizing and empowerment, disaster and outbreak management, and group dynamics. She actively participates in research focused on improving public health outcomes and strengthening public health interventions. (email: triardayani48@gmail.com).

Liliek Fauziah, Institut Kesehatan Immanuel

is affiliated with the Department of Nursing, Faculty of Health, Institut Kesehatan Immanuel, Indonesia. Her research interests include pediatric nursing, patient education, and pediatric nursing practice. She is actively involved in collaborative research aimed at enhancing the quality of nursing care and healthcare services. (Email: helimezhar@gmail.com).

Henni Purnasari, Institut Kesehatan Immanuel

is affiliated with the Department of Midwifery, Faculty of Health, Institut Kesehatan Immanuel, Indonesia. Her academic interests include maternal and child health, midwifery care, reproductive health, and health promotion. She participates in research focused on improving maternal and neonatal health outcomes through evidence-based midwifery practice. (email: hennipurnasari@gmail.com).

Hanni Triana, Institut Kesehatan Immanuel

is affiliated with the Department of Midwifery, Faculty of Health, Institut Kesehatan Immanuel, Indonesia. Her research interests include maternal health, contraception and family planning service, reproductive health, and women's health. She is involved in research and community engagement activities aimed at promoting maternal and child well-being and strengthening midwifery services. (email: hani.triana1509@gmail.com).

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