REE 20(1) Riobamba ene. - abr. 2026

BY NC ND

ISSN-impreso 1390-7581

ISSN-digital 2661-6742

Healthy habits as predictors of mental health and psychological well-being in emerging adults

Hábitos saludables como predictores de la salud mental y el bienestar psicológico en adultos

emergentes

https://doi.org/10.37135/ee.04.25.01

Authors:

Sridam David Arévalo-Lara

1,2,3

- https://orcid.org/0000-0002-5948-8608

Evelyn Mishel Cuenca Yupa - https://orcid.org/0009-0004-4035-568X

Bianca Paula Dávalos Calero - https://orcid.org/0009-0003-3233-5788

David Xavier Paz-Pacheco - https://orcid.org/0009-0005-0535-5761

Affiliation:

National University of Chimborazo

University of Salamanca

Psychological Well-Being Research Group

Corresponding author: Sridam David Arévalo-Lara. National University of Chimborazo. Email:

sridamd.arevalo@unach.edu.ec sarevalo@usal.es Telephone: 0987254163

Received: October, 5 2025 Accepted: December, 7 2025

ABSTRACT:

Current empirical evidence highlights the influence of healthy habits on mental health and psychological

well-being; However, their predictive role in Latin American university populations remains limited. This

study aimed to analyze healthy habits as predictors of psychological well-being and mental health in

emerging adult Ecuadorians. Data were obtained from the clinical records of clients at a psychotherapy

center in Riobamba, Ecuador. The sample comprised 350 emerging adults (73.10 % women), aged 18–24

years (M = 20.4; SD = 2.1). A non-experimental, cross-sectional, predictive, and retrospective design was

employed. Instruments included the Green Healthy Habits Survey, the Goldberg General Health

Questionnaire (GHQ-28) for mental health, and Diener's Psychological Flourishing Scale for well-being.

Multivariate binary logistic and multiple linear regression analyses were conducted using Jamovi 2.6.45.





p < 0.001)

well-being. In conclusion, healthy habits constitute a key determinant of psychological well-being and a

protective factor against chronic psychological distress.

Keywords: Well-Being; Mental Health; Habits; Emerging Adults.

RESUMEN

La evidencia empírica actual destaca la influencia de los hábitos saludables en la salud mental y el bienestar

psicológico; sin embargo, su papel predictivo en la población universitaria latinoamericana (cambiar por

población de adultos emergentes ecuatorianos) sigue siendo limitado. El objetivo de este estudio fue analizar

los hábitos saludables como predictores del bienestar psicológico y la salud mental en adultos emergentes

ecuatorianos. Los datos se obtuvieron de los registros clínicos de los clientes de un centro de psicoterapia en

Riobamba, Ecuador. La muestra estuvo compuesta por 350 adultos emergentes (73,10 % mujeres), de entre

18 y 24 años (M = 20,4; SD = 2,1). Se empleó un diseño no experimental, transversal, predictivo y

retrospectivo. Los instrumentos utilizados fueron la Encuesta de Hábitos Saludables de Green, el

Cuestionario General de Salud de Goldberg (GHQ-28) para la salud mental y la Escala de Florecimiento

Psicológico de Diener para el bienestar. Se realizaron análisis logísticos binarios multivariantes y regresiones

lineales múltiples utilizando Jamovi 2.6.45. Los hábitos saludables predijeron significativamente el bienestar

      



 se revelaron como los predictores clínicos negativos más fuertes del bienestar. En

conclusión, los hábitos saludables constituyen un determinante clave del bienestar psicológico y un factor de

protección contra el malestar psicológico crónico.

Palabras clave: bienestar; salud mental; hábitos; adultos emergentes.

INTRODUCTION

Mental health is a fundamental human right and an essential component of overall well-being. Its

understanding transcends mere absence of mental illness or disorder, encompassing the capacity to cope with

daily adversity and maintain optimal functioning across various aspects of life.

(1)

This state enables

individuals to build resilience, make sound decisions, and establish healthy interpersonal relationships,

thereby actively contributing to their community's well-being. However, recent studies warn of a worrying

increase in mental health problems among emerging adults: approximately 50 % of this population

experiences some emotional difficulty, with depression being one of the most prevalent, affecting 20 %.

(2)

This situation poses a global challenge in promoting mental health in this age group, especially in Latin

American contexts where socioeconomic, academic, and personal vulnerabilities converge.

In this sense, the transition from adolescence to adulthood represents a critical period that demands a

complex adaptation process, both academic and psychosocial. This stage involves assimilating new learning

methodologies, building interpersonal networks, and taking on greater responsibilities, which can generate

emotional stress and affect academic performance.

(3)

Emerging adults often face high levels of stress and, in

many cases, neglect essential aspects of self-care such as nutrition, rest, and physical activity. Furthermore,

during the university socialization process, some young people adopt harmful habits related to alcohol or

tobacco use,

(4)

which negatively impact their mental health and overall well-being.

In addition, several studies have shown that healthy habits are protective factors against the development of

psychological disorders. Regular physical activity, a balanced diet, restful sleep, abstinence from

psychoactive substances, and mindfulness practice are associated with better emotional regulation and

greater psychological well-being.

(5)

These behaviors promote cognitive development, strengthen resilience,

and facilitate emotional self-regulation in this population, thus fostering more satisfactory academic

performance and a more emotionally balanced life.

Furthermore, psychological well-being has become a central theoretical construct within positive

psychology. Ryff

(6)

defines it as a multidimensional state that integrates dimensions such as self-acceptance,

autonomy, environmental mastery, positive relationships, life purpose, and personal growth. This model,

subsequently validated in different cultural contexts,

(7)

conceives of well-being not only as the presence of

positive emotions but also as a dynamic construct that enables coping with life's challenges and the

development of human potential. In the context of emerging adulthood, this well-being is crucial, as this

population faces substantial changes in their personal, family, and academic environments that directly

impact their emotional stability and educational performance. Recent research indicates that reduced levels

of psychological well-being are associated with higher rates of anxiety, depression, and academic dropout.

(8,9)

Furthermore, the scientific literature shows a growing interest in analyzing the relationship between

psychological well-being and healthy habits, understood as the optimal manifestation of human functioning.

According to Diener,

(10)

psychological well-being (psychological flourishing) implies a balance between

hedonic well-being—centered on the subjective experience of pleasure—and eudaimonic

well-being—oriented toward self-actualization and a sense of purpose—constituting a state of holistic

flourishing. In the context of emerging adulthood, these components interact with sociodemographic and

behavioral variables, shaping students' capacity to achieve full development. However, in Ecuador, empirical

research on the interaction between mental health, habits, and psychological well-being remains limited,

even though WHO reports

(1)

indicate that at least 30 out of every 100 Ecuadorians suffer from some mental

health problem.

However, significant gaps remain in the scientific literature. Most available studies employ cross-sectional

designs, making it difficult to establish causal relationships and to analyze the evolution of well-being over

time.

(11)

Furthermore, evidence is geographically concentrated in urban contexts, with limited representation

of rural populations, ethnic minorities, and vulnerable youth.

(12)

These limitations reduce the possibility of

formulating contextualized and equitable preventive strategies, especially in Latin America. Within this

framework, the present research seeks to provide robust empirical evidence on the relationship between

healthy habits, mental health, and psychological well-being in emerging Ecuadorian adults, analyzing the

predictive role of lifestyle habits in the emergence of mental health problems and in shaping psychological

well-being.

Finally, the results of this study aim to offer relevant theoretical, methodological, and practical contributions

and to open new lines of research. Theoretically, they will contribute to consolidating explanatory models of

well-being and flourishing in emerging adulthood. Methodologically, they will enable the generation of

replicable, context-specific evidence in Ecuadorian emerging adult populations. In the applied sphere, they

will provide input on the design of psychoeducational programs to promote healthy habits and prevent

psychological distress, thereby strengthening the holistic development, resilience, and emotional

sustainability of this population. And in the research sphere, they will help open new lines of inquiry into

well-being, mental health, and healthy habits.

MATERIALS AND METHODS

This study adopted a quantitative approach, employing a non-experimental, cross-sectional, descriptive,

correlational, and predictive retrospective design, according to the methodological classification proposed

by Supo and Zacarías.

(13)

The study population consisted of 350 emerging Ecuadorian adults. The sample was

selected using purposive non-probability sampling with a retrospective approach. For this purpose, the

medical records and psychometric evaluation records of the clients treated at the Ananda Psychotherapeutic

Clinic, Mental Health, located in the city of Riobamba (Ecuador), during the period between January 2023

and July 2025, were reviewed and analyzed.

The inclusion criteria were those medical records of patients who had completed the Goldberg General

Health Questionnaire (GHQ-28), the Green Survey of Healthy Habits, and the Diener Psychological

Flourishing Scale. Medical records with incomplete information or that did not correspond to the time period

defined for the study were excluded from the analysis.

As mentioned previously, the Green Survey proposed by Pérez-López

(14)

was used to assess healthy lifestyle

habits. This instrument includes items on the frequency of daily meals, fruit and water consumption, intake

of soft drinks and sodas, fat consumption, consumption of processed foods, oral hygiene, physical activity

practices, and sleep quality. The survey was developed by a group of experts in dental, nutritional, and

medical health, each with at least 15 years of experience in their respective fields. The instrument's score

ranges from -40 to +50 points, establishing six classification levels:

- Level 3: between 41 and 50 points.

- Level 2: between 21 and 40 points.

- Level 1: between 0 and 20 points.

- Level -1: between -1 and -15 points.

- Level -2: between -16 and -30 points.

- Level -3: between -31 and -40 points.

Positive levels reflect greater practice of healthy habits, while negative levels indicate a lower incorporation

of these habits into daily life.

For the mental health assessment, the abbreviated version of the Goldberg General Health Questionnaire

(GHQ-28) was used.

(15)

This self-administered instrument consists of 28 items and can be administered in 10

minutes or less. The questionnaire was adapted into Spanish by Lobo et al.

(16)

validated in the Ecuadorian

population by Moreta-Herrera et al.

(17)

and applied to both adolescents and adults. Its purpose is to assess

general aspects of health and psychological functioning quickly. The GHQ-28 is structured into four

subscales: (A) somatic symptoms, (B) insomnia and anxiety, (C) social dysfunction, and (D) severe

depression. Each item has four response options, scored on a dichotomous scale: 0, 0, 1, 1. The selection of

this instrument was guided by previous research in university populations, which has shown adequate

internal consistency with Cronbach's alpha coefficients between 0.75 and 0.98.

(17,18)

The Psychological Flourishing Scale by Diener et al.

(19)

was used to assess psychological well-being. This

instrument consists of eight items that assess subjective psychological well-being, with response options on

a seven-point Likert scale. The score ranges from 8 to 56 points, with higher scores indicating a greater level

of flourishing psychological well-being and lower scores indicating a state of languishing. Graham and

Eloff

(20)

consider that scores > 45 indicate greater flourishing, while scores < 32 indicate greater languishing.

The choice of this instrument was based on its use in previous research with emerging adult populations, in

which it has been reported to have high internal consistency (Cronbach's alpha = 0.94; 8,21).

Data tabulation was performed using Microsoft Excel spreadsheets, while statistical analysis was carried out

using Jamovi software, version 2.6.45.

(22)

The questionnaires were administered during clinical interviews

with the patients, both in person and virtually. Regarding ethical considerations, the ethical principles related

to confidentiality and the proper handling of collected information were upheld, in accordance with the

Declaration of Helsinki of the World Medical Association, including its update.

(23)

Healthy lifestyle habits, mental health, and psychological well-being were evaluated using the question: Are

healthy habits predictors of mental health and psychological well-being in emerging Ecuadorian adults?

Given that the central purpose of the research was hypothesis testing, the procedures corresponding to

statistical significance analysis were followed. First, a two-tailed hypothesis was formulated. The null

hypothesis (H) stated that healthy lifestyle habits do not significantly predict health or psychological

well-being in emerging Ecuadorian adults, whereas the alternative hypothesis (H) posited that they do.



were selected. In this case, Spearman's rank correlation coefficient was applied to assess the association

between variables that did not meet the normality assumption; multiple linear regression and multivariate

binary logistic regression were used for predictive analyses; and the Mann-Whitney U and Chi-square tests

were used for group comparisons. Finally, the decision criterion was determined: if the p-value was less than

0.05, the null hypothesis was rejected and the researcher's hypothesis was accepted.

RESULTS

The results in Table 1 present the sociodemographic characteristics of the participating population:

Table 1. Characterization variables

Table 2 presents the frequency distributions of the variables included in the study, including healthy habits

and dimensions of mental health such as somatic symptoms, anxiety-insomnia, social dysfunction,

depression, as well as the presence of chronic cases of mental disorders.



0.71), the majority of participants (63.40 %) were at Level 1, while only 1.4% reached Level 3, indicating

moderate-to-low adherence in the sample. As for clinical symptoms assessed using the GHQ-28, a low

              





as cases, indicating the presence of persistent psychological distress in most participants despite low scores

on the specific subscales. All instruments demonstrated adequate internal consistency, with Cronbach's

alphas> 0.70.

Table three presents the descriptive statistics for the study variables, highlighting psychological well-being,

with a mean of 46.40 (minimum = 8, maximum = 56), indicating greater flourishing among the participating



Table 3. Descriptive Statistics of the Study Variables.

The descriptive analysis of the study variables revealed that the mean psychological well-being score was

46.40 (SD = 8.77), with a range from 8 to 56. In contrast, the GHQ-28 subscales, which assess clinical

symptoms, presented notably low means, close to the minimum point of the scale: somatic symptoms (M =

1.09, SD = 0.28), anxiety-insomnia (M = 1.17, SD = 0.380), social dysfunction (M = 1.09, SD = 0.29 ), and

depression (M = 1.08, SD = 0.28). This trend is confirmed by the medians (Md = 1.00) and interquartile

ranges (IQR = 0.00) for these dimensions, indicating a marked positive skewness and a concentration of

responses in the absence of symptoms category. Healthy habits, meanwhile, had a mean of 4.17 (SD = 0.67)

on a scale of 1 to 6, indicating moderately positive adherence. The dichotomous variable "chronic mental

health conditions" had a mean of 1.83 (SD = 0.38), suggesting that most of the sample fell into this category.

Overall, the descriptive data indicate a sample with a high level of psychological well-being (mostly thriving

individuals), a very low prevalence of general clinical symptoms, and a moderate level of healthy habits.

Table 4. Correlations, healthy habits, psychological well-being, and mental health

Spearman's rank correlation analysis (Table 4) revealed significant associations among the study variables.



significant negative correlations with all dimensions of mental health cases (somatic, anxiety-insomnia,

               





different dimensions of the GHQ-28, highlighting the relationship between social dysfunction and



The results indicate that greater psychological well-being and the practice of healthy habits are associated

with less clinical symptomatology. At the same time, the different dimensions of mental health problems tend

to coexist.

Table 5 presents the multiple linear regression model with psychological well-being as the dependent

variable.

Table 5. Multiple linear regression model.

In the multiple linear regression model, the influence of healthy habits and various mental health indicators

on psychological well-being (psychological flourishing) was examined. The model proved significant,











–0.44, p = 0.70) did not show a significant association. These results indicate that the most significant factors

in reducing psychological well-being are deficits in health habits and, particularly, social dysfunction,

depression, and the presence of chronic mental health conditions.

Table 6. Binomial logistic regression predicting mental health



Reference categories: male, age group 23-24 years, Chimborazo province.

         

variance in the presence of mental health problems. The results indicate that a higher level of psychological



0.001), while lower levels of healthy habits were significantly associated with a higher risk of mental health



> 0.99) did not show statistically significant effects on the dependent variable. These results demonstrate the

predictive role of psychological well-being and healthy habits in the prevention of mental health problems,

while sociodemographic variables do not contribute relevant predictive value in this model.

Table 7. Comparisons of groups by gender in variables of mental health, psychological well-being, and

healthy habits.

As shown in Table 7, a variety of analyses were performed to assess whether there were statistically

significant differences between men and women in the study variables. The results indicate no significant

differences between the gender groups in any of the variables analyzed (all p-values > 0.05). The effect sizes,



                 

differences lack substantial practical relevance.

Statistical significance ritual for hypothesis testing

In accordance with the established inferential protocol for hypothesis testing, the statistical significance

󰀖󰀗

󰀖

󰀗



were selected: a multiple linear regression model, with psychological well-being as the criterion variable,

and a multivariate binary logistic regression model, with the dichotomous variable of chronic mental health

cases as the dependent variable. The decision criterion stipulated that if the p-value associated with the

󰀗

The results of the multiple linear regression model revealed that very low levels of healthy habits constituted

             

Simultaneously, the logistic regression model indicated that healthy habits were significantly associated with

                

obtained for the main predictor in both models (0.009 and 0.013) are below the established significance level

      ) is rejected, and the researcher's hypothesis (H) is accepted.

Consequently, it is concluded that there is statistically significant evidence to support the claim that healthy

lifestyle habits positively predict psychological well-being and negatively predict the presence of mental

health problems in the sample of emerging Ecuadorian adults.

DISCUSSION

The central objective of the study was to investigate and analyze healthy lifestyle habits as predictors of

mental health and psychological well-being among emerging Ecuadorian adults.

The results of this study reveal a multifaceted, sometimes paradoxical perspective on psychological

well-being and mental health among a sample of 350 emerging Ecuadorian adults. The sociodemographic

characteristics show a predominantly young sample (56.29 % between 18 and 20 years old), a female

majority (73.1 %), and a concentration mainly in the province of Chimborazo (55.7 %), a contextual factor

that must be considered in understanding the findings.

A central and seemingly contradictory finding is the coexistence of high psychological well-being (M=46.4

on a scale up to 56) with a high prevalence of chronic mental health conditions (82.6 %). The nature of the

instruments used can explain this discrepancy. The Psychological Well-Being Scale (Psychological

Flourishing) assesses positive dimensions such as purpose in life and positive relationships.

(19)

At the same

time, the chronic mental health condition indicator likely captures persistent, low-intensity psychological

distress that is not necessarily disabling but is nonetheless chronic. This suggests that emerging adults can

feel functional and possess positive psychological resources (flourishing) despite experiencing persistent

subclinical stress or distress, a phenomenon observed in life cycles such as that of the study population, as

they are primarily immersed in highly demanding academic environments such as university studies.

(24, 25, 26)

On the other hand, the notably low scores on the specific subscales of the GHQ-28 (a dichotomous variable

indicating the presence or absence of symptoms) had means of 1.00 and interquartile ranges of 0, indicating

low levels of acute clinical symptomatology. This reinforces the idea that the distress reported in the chronic

mental health cases variable is of a different nature: more diffuse, less acute, but widespread; in other words,

they are symptoms of very low intensity but of long duration.

Spearman's rank correlation analysis provides insight into the relationship between the variables. The



the scientific literature, which establishes that behaviors such as physical activity, a balanced diet, and

adequate sleep are cornerstones of optimal psychological functioning.

(27,28,29,30)

Likewise, the robust negative

correlations between well-being and all dimensions of symptomatology, especially in chronic cases

 point to the bidimensional nature of mental health, where the presence of well-being is not

merely the absence of distress, but rather both constructs are interrelated.

(31,32)

The strong correlations

             

reflect the high comorbidity of psychological symptoms. This finding is consistent across higher education

student populations.

(33)

Regression models allow for a deeper understanding of the predictability of these variables. In this case, the

linear regression model explains a substantial 41 % of the variance in psychological well-being. It is

revealing that, controlling for other variables, healthy habits at very low levels are a powerful negative



lifestyle as a modifiable determinant of well-being in this study population.

(34,35)

Among the clinical

dimensions, social dysfunction and depression were the strongest negative predictors, while somatic

symptoms and anxiety/insomnia were not significant. This indicates that in this population, difficulty

performing social roles and depressive states (which may include anhedonia and hopelessness) have a more

profound impact on the capacity for psychological well-being (flourishing) than anxiety or somatic

symptoms in isolation.

(36,37)

Additionally, the multivariate logistic regression model confirms the protective role of psychological

well-being and healthy habits against mental health problems. The fact that sociodemographic variables such

as sex, age, or province of origin were not significant predictors is a noteworthy finding. This indicates that

the risk of mental health problems in this sample is more determined by modifiable psychological and

behavioral factors than by fixed demographic characteristics, which is encouraging for the design of

universal interventions aimed at working with emerging adults from the province or elsewhere.

(38,39)

The

non-significant role of sex is also noteworthy, which is particularly interesting given that the literature often

reports higher prevalences of internalization in women.

(40,41)

The consistency of these findings was reinforced

by a complementary analysis using the nonparametric Mann-Whitney U test and Pearson's chi-squared test,

which also showed no significant differences between sexes across all variables evaluated. The effect sizes



practical relevance of the observed differences.

(40)

These results, taken together, point to a scenario where emerging adults, despite reporting positive

well-being, are generally dealing with chronic, low-intensity psychological distress. This alerts society in

general, and higher education institutions in particular, to the need to implement health promotion programs

that go beyond crisis intervention. Interventions could focus on: 1) promoting healthy habits through

psychoeducation and environmental changes, such as spaces for physical activity, the availability of healthy

food, among others, and 2) enhancing psychological well-being and social skills through workshops based

on positive psychology and cognitive behavioral therapy, which have proven effective in reducing

depression and improving social functioning in this population.

(43)

CONCLUSIONS

Regarding the predictive power of healthy habits, hypothesis testing using multiple linear regression and

binary logistic regression models allows us to reject the null hypothesis and conclude that healthy habits

constitute a statistically significant factor in both psychological well-being (flourishing) and mental health in

emerging Ecuadorian adults. The linear regression model, which explains 41 % of the variance in

              



    

                 

0.013). These findings empirically establish the role of lifestyles as an essential modulating factor in the

mental health continuum (health-illness) in this population.

Regarding the structure of mental health and its implications, the psychometric profile of the sample,

characterized by a high prevalence of chronic distress (82.60 %) coexisting with considerably high mean

scores for psychological well-being and low levels of acute symptoms on the GHQ-28, points to a distinct

clinical phenotype in this cohort. This pattern, along with the regression results that identify social



of well-being—even above anxiety-insomnia and somatic symptoms—indicates that the impact on

psychosocial functioning is more decisive than internalized acute symptoms. It was concluded that in

emerging adult populations, mental health should be conceptualized using a two-dimensional approach that

separately assesses psychological flourishing and persistent subclinical distress, the latter being particularly

sensitive to deficits in healthy habits and effective social functioning.

STUDY LIMITATIONS

The use of medical records as a data source constitutes a significant methodological limitation. The available

information may vary in quality, completeness, and level of detail, depending on the professionals who

recorded it in heterogeneous clinical contexts. Furthermore, there was no control over the conditions under

which the psychometric instruments were administered or over the presence of additional contextual

variables that could influence the results. Since the sample was drawn from consultations before

psychotherapy, the findings are not generalizable to the entire emerging adult population. Finally, the

retrospective and cross-sectional nature of the design prevents the establishment of causal relationships,

limiting inferences to predictive associations between the variables analyzed.

Funding: The researchers provided the financing themselves.

Acknowledgments: A special thanks to all participants in the research.

Conflicts of interest: The authors report no conflict of interest

Contribution statement:

Sridam David Arévalo-Lara: Review and analysis of medical records, Materials and Methods, results, and

discussion

Evelyn Mishel Cuenca Yupa: Review and analysis of medical records, Introduction, and conclusions.

Bianca Paula Dávalos Calero: Review and analysis of medical records, Introduction and bibliographic

references.

David Xavier Paz-Pacheco: Review and analysis of medical records, Introduction, review of regulations, and

abstract.

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