The effects of pubertal timing on externalizing behaviors in adolescence and early adulthood: A meta-analytic review

Does the timing matter? The association between childhood adversity and internalizing and externalizing problems from childhood to adolescence and its sex differences

BACKGROUND

Childhood adversity (CA) is a well-known risk factor for mental distress, and its impacts may vary depending on its timing. However, relevant empirical studies are rare and ambiguous. Similarly, prior studies have given little attention to possible moderating effects by sex, particularly in the context of developmental stages.

OBJECTIVE

This study sought to identify when the impacts of CA on children's mental health become pronounced and the extent to which these relations and sensitive timing vary by gender.

PARTICIPANTS AND SETTING

Data were from the Young Women and Child Development Study (n = 360), covering ages 4.3 to 17.6.

METHODS

Time-varying effect models, including moderation by child gender, were evaluated.

RESULTS

The effect of CA on mental health surged during middle childhood (b = 0.93 at age 10 and 1.94 at age 9 for internalizing and externalizing problems, respectively) and peaked at age 15 (b = 2.35 and 3.53 for internalizing and externalizing problems, respectively). Gender interaction findings suggest that gender moderation effects were limited to between ages 10.3 (b = 0.88) and 14.3 (b = 1.11) for internalizing problems and between ages 5.3 (b = 1.06) and 7.0 (b = 1.31) for externalizing problems. For girls, the influence began escalating at an earlier age.

CONCLUSIONS

Middle childhood and early adolescence should be considered key intervention points to prevent CA from worsening children's mental health. Intervention timing should be tailored by gender to effectively disrupt the impacts of childhood adversity on mental health.

Assessing the stability of psychobiological stress reactivity during adolescence: mixed-effect modelling of cortisol responses to laboratory stressors

Background

Puberty has been historically considered as a time of risk and vulnerability for young people. It is associated with rapid development in the hypothalamus, which is central in the production of both stress and sex steroids. While patterns of stress reactivity are calibrated in early life, this time of rapid development may provide a means for these patterns to change. This purpose of this study was to examine whether patterns of cortisol reactivity remained stable across one year of pubertal development, and whether variations in pubertal development impacted on this stability.

Methods

This study used a secondary dataset comprised of 102 adolescent-aged children and adolescents. Children and adolescents took part in the Trier Social Stress Test to elicit a physiological stress response. Cortisol reactivity was measured as the increase in salivary cortisol concentration taken at five time points throughout the session. Pubertal stage was measured by nurse report where possible, and parent/self-report otherwise and was used to calculate pubertal timing and tempo relative to peers. Measures of anxiety, BMI, and socio-economic status were taken and included in analysis.

Results

Results of a linear mixed-effect model found there to be a significant difference in cortisol reactivity over time, indicating that cortisol stress reactivity did not remain stable during this time (Estimate= 3.39, t=3.67, p<.001, CI[1.56, 5.22]). Additionally, results show children and adolescents who developed slower/quicker than peers displayed decreased stress reactivity (Estimate= -3.59, t=-2.13. p=.03, CI[-6.92, -0.25]).

Conclusions

This research contributes to a relatively small but consistent body of research noting pattern of increased cortisol reactivity during pubertal development. While a significant effect was found for pubertal tempo, this finding should not be considered indicative of any true effect.

Pubertal Development and Pregnancy Outcomes Among System-Involved Youth

System-involved youth are a vulnerable population at high-risk of experiencing numerous sexual reproductive health (SRH) outcomes. They are likely to have several risk factors for teen pregnancy and parenting including abuse and neglect histories, lack of a supportive consistent adult in their lives, and limited opportunities to experience normal romantic relationships. Issues of pubertal development are rarely addressed in this population. Data is from system-involved adolescents (n = 301) enrolled in a SRH intervention. The final analysis is restricted to those who were sexually active at baseline (n = 229). Most participants were African Americans between 13-21 years of age. More than 70% reported an early mean age of first sex. Approximately a quarter self-reported early pubertal development. Logistic regression was utilized to examine the odds of pregnancy in relation to self-reported pubertal timing. The findings support the need to develop programming for system-involved youth which address their unique needs.

Self-Reported Gonadal Pubertal Timing Predicts Adolescent Borderline Personality Symptoms: Two Extended Replications With Prospective and Cross-Sectional Data

The current study investigated the understudied relationship between pubertal timing and borderline personality disorder (BPD) symptoms in males and females. We conducted hierarchical linear regressions in a longitudinal Cohort 1 (N = 117) and a cross-sectional Cohort 2 (N = 127). Cohort 1: Pubertal timing was self-reported at age 10; BPD symptoms and covariates were assessed between ages 13 and 19. Cohort 2: All assessments were between ages 8 and 12. Covariates: race, age, internalizing and externalizing symptoms, and income-to-needs ratio. Sex differences were examined post hoc. In Cohort 1, early gonadal timing was associated with more BPD symptoms in females (beta = .46, p = .002), and late gonadal timing was associated with more BPD symptoms in males (beta = -.23, p = .035). In Cohort 2, early gonadal timing was associated with more BPD symptoms (beta = .21, p = .033) without sex moderation. Results indicate that early gonadal development could be a risk indicator for the emergence of BPD in adolescence, particularly in females, which could inform causal mechanisms and intervention targets.

Pubertal progression and its relationship to psychological and behavioral outcomes among adolescent boys

Variations in pubertal timing and tempo have relevance to psychosocial development. Accounting for pubertal timing, tempo, and psychosocial development simultaneously in a model remains challenging. This study aimed to document the typology of pubertal development in a cohort of Taiwanese adolescent boys and then to examine how the associations between psychosocial variables across time vary by the patterns of pubertal development. A group of adolescent boys (n = 1,368) reported pubertal signs and psychosocial variables for 3 years since seventh grade. The growth mixture model revealed three major classes of pubertal transition: average pubertal growth, late-onset with rapid catch-up, and late-onset with slow catch-up. In a cross-lagged panel model, the multigroup analysis found the regression coefficients mostly invariant across all three classes, except those between deviant behavior and subsequent changes in depressive symptoms that were significantly positive only in the late-onset with slow catch-up group. Adolescent boys in this group were estimated to have the highest marginal level of depressive symptoms and deviant behavior in ninth grade among the three classes. Our study highlights the heterogeneity in boys' pubertal development and the role of the pubertal development pattern in their psychosocial development.

Developmental inflection point for the effect of maternal childhood adversity on children's mental health from childhood to adolescence: Time-varying effect of gender differences

Childhood adversities have a well-established dose-response relationship with later mental health. However, less attention has been given to intergenerational influences. Further, it is unknown how intergenerational influences intersect with children's developmental stages and gender. The current study examined whether a developmental inflection point exists when the intergenerational influences of childhood adversities gain salience and explored differences by children's gender. Data were from the Young Women and Child Development Study (n = 361). Time-varying effect models (TVEMs) and moderation TVEMs by child's gender were evaluated. Our findings reveal that ages 5-8, the period of transition into primary schools, may represent a developmental inflection point when the intergenerational influences of maternal childhood adversity start emerging substantially. The results from gender interaction TVEMs reveal that maternal childhood adversity was a statistically significant predictor of internalizing problems until age 11, regardless of child's gender, and remained statistically significant for girls' internalizing problems until age 16.7. For externalizing problems, maternal childhood adversity was a statistically significant predictor until age 13, regardless of gender.

Navigating puberty, identity, and race among transnationally, transracially adopted Korean American adolescents

This exploratory study examined the relation between pubertal timing and dimensions of ethnic-racial identity among adopted Korean Americans raised transracially in White families. The study also examined whether internalized racism moderated the association between pubertal timing and ethnic-racial identity. Adopted Korean American adolescents (N = 202; 108 females; ages 13-19 years) completed measures of pubertal development, ethnic-racial identity, and internalized racism in 2007. There was no significant main effect of pubertal timing for either male or female adolescents. Internalized racism moderated the relation between pubertal timing and ethnic-racial identity clarity (B = -.16, p = .015) among male adolescents. Specifically, earlier pubertal timing was significantly associated with lower ethnic-racial identity clarity for male adolescents with higher levels of internalized racism.

The Distinct Roles of Biological and Perceived Pubertal Timing in Delinquency and Depressive Symptoms from Adolescence to Adulthood

Pubertal timing is a robust predictor of externalizing and internalizing problems in adolescence, but controversies remain whether only early or off-time (both early and late) pubertal timing is associated with negative developmental outcomes and whether effects differ across perceptions of pubertal timing and actual biological pubertal timing. Additionally, less is known about the longevity of pubertal timing effects and mediators of effects that persist through adolescence and into adulthood. This longitudinal study investigated the effects of early and off-time pubertal timing, in form of perceived pubertal timing relative to peers and reported biological pubertal timing relative to age, on delinquency and depressive symptoms in adolescence and young adulthood between 2003 and 2022. Peer deviance and school connectedness were examined as mediators of any persisting effects. The sample included 704 youth (52% male, 76% African American, 22% Non-Hispanic White) who were assessed at four time points from early adolescence (Mean ages: 11.8, 13.2) to late adolescence (Mean age: 17.6) and young adulthood (Mean age: 27.7). Perceived off-time pubertal timing in males and early biological pubertal timing in both males and females were risk factors for persistent delinquency into young adulthood, but neither form of pubertal timing was associated with depressive symptoms. None of the effects were mediated by peer deviance or school connectedness. These findings advance the understanding of more nuanced effects of pubertal timing on adjustment problems in diverse youth as they develop from early adolescence to adulthood.

Social Support and Family Functioning during Adolescence: A Two-Wave Cross-Lagged Study

The influence of social and family factors on adolescent mental health has been widely valued. Considering adolescents' family systems in a broader social context facilitates a better understanding of their mental health, which also has special significance in the post-epidemic era. The purpose of the present study was to explore the relationship between social support and family functioning during adolescence. Students from two middle schools in Fujian province, China, were recruited as participants. Seven hundred and fifty-four participants completed the questionnaire twice in six-month intervals. We constructed a cross-lagged model by using IBM SPSS AMOS 26.0 to test the relationship between these two variables. Social support and family functioning predicted each other in the girls, but not for the boys' sample. The results of this study suggested that the interaction between family and social factors and the possible gender differences should be considered when dealing with adolescents' mental health problems.

Elucidating early pubertal timing effects on disordered eating symptoms in young adult women

INTRODUCTION

Early pubertal timing increases risk for disordered eating (DE) in females, but the extent to which associations persist after puberty and are relevant to all types of DE symptoms is unclear. Factors that link pubertal timing and DE also remain unknown, although leading theories posit that adiposity and body-focused psychosocial factors play a key role. Thus, this study examined pubertal timing effects on several types of DE symptoms in young adult women and evaluated whether body mass index (BMI), pressures for thinness, thin-ideal internalization, and/or history of weight-based teasing account for such associations.

METHODS

This study included a racially and ethnically diverse sample of 342 female college students (M_age = 20.44, SD = 3.46). Women retrospectively reported their age at onset of menses, which served as the pubertal timing indicator, and completed self-report questionnaires on DE symptoms, perceived pressures for thinness, thin-ideal internalization, and history of weight-based teasing. BMI was calculated from height/weight measurements.

RESULTS

Earlier pubertal timing was associated with body dissatisfaction and binge eating, but not other DE symptoms (dieting, excessive exercise, muscle building) in young adult women. BMI accounted for pubertal timing effects on body dissatisfaction, whereas none of the examined factors explained pubertal timing effects on binge eating.

CONCLUSIONS

Earlier pubertal timing may exert long-term effects on only some DE symptoms in women, and the etiologic factors underlying pubertal timing effects on DE outcomes may differ across symptom types.

Applying Behavioral Economics to Improve Adolescent and Young Adult Health: A Developmentally-Sensitive Approach

Each day, adolescents and young adults (AYAs) choose to engage in behaviors that impact their current and future health. Behavioral economics represents an innovative lens through which to explore decision-making among AYAs. Behavioral economics outlines a diverse set of phenomena that influence decision-making and can be leveraged to develop interventions that may support behavior change. Up to this point, behavioral economic interventions have predominantly been studied in adults. This article provides an integrative review of how behavioral economic phenomena can be leveraged to motivate health-related behavior change among AYAs. We contextualize these phenomena in the physical and social environments unique to AYAs and the neurodevelopmental changes they undergo, highlighting opportunities to intervene in AYA-specific contexts. Our review of the literature suggests behavioral economic phenomena leveraging social choice are particularly promising for AYA health. Behavioral economic interventions that take advantage of AYA learning and development have the potential to positively impact youth health and well-being over the lifespan.

Longitudinal Associations of Pubertal Timing and Tempo With Adolescent Mental Health and Risk Behavior Initiation in Urban South Africa

PURPOSE

In high-income countries, early and rapid pubertal development is consistently associated with poor adjustment and increased risk behavior in adolescence. This study contributes to the meager knowledge of these associations in lower income countries.

METHODS

We used longitudinal data from 1,784 urban black South Africans in the Birth to Twenty Plus cohort. We used regression analyses to assess associations between age at menarche and latent classes of pubertal timing and tempo and adolescent internalizing and externalizing emotional and behavioral problems, eating attitudes, and patterns of health risk behavior initiation.

RESULTS

Relatively earlier and faster pubertal timing and tempo were associated with increased health risk behavior initiation (e.g., adjusted odds ratio [95% confidence interval] high- vs. low-risk pattern = 5.7 [1.7, 19.06] for male genital development; adjusted odds ratio = 3.45 [1.13, 10.49] for female breast development). Among males, earlier and faster pubertal timing and tempo were associated with increased externalizing problems in early adolescence and increased oppositional defiant problems in midadolescence, whereas later and slower pubertal timing and tempo were associated with decreases. Among females, earlier and faster pubertal timing and tempo were associated with increased internalizing and externalizing problems in midadolescence and increased dieting behaviors in early and late adolescence (β [95% confidence interval] = 2.51 [.87, 4.15] for pubic hair development), whereas later and slower pubertal timing and tempo were associated with decreases.

CONCLUSIONS

In this urban South African cohort, relatively earlier and faster pubertal development was detrimental to mental health and risk behavior activity, whereas later and slower maturation was somewhat protective.

Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis

BACKGROUND

Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention).

METHODS

We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number.

RESULTS

295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features.

CONCLUSION

Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.

Understanding trajectories of externalizing problems: Stability and emergence of risk factors from infancy to middle adolescence

Despite considerable efforts to understand the processes that underlie the development of externalizing behavior problems, it is still unclear why externalizing problems remain chronically high for some children, emerge early and cease by late childhood for others, and arise in adolescence in some cases. The purpose of this study was to examine how a wide range of child and family risk factors are linked to trajectories of externalizing behavior and how these relationships vary from infancy to middle adolescence. We used data from the community-based Norwegian Tracking Opportunities and Problems (TOPP) study sample (n = 921). A Cholesky factorization model was specified to separate stable and emerging risk doses across four developmental periods (infancy, early and middle childhood, and middle adolescence). Children in the High Stable class were characterized by substantially elevated risk levels in multiple domains throughout the study period. Children in the High Childhood Limited class had very high levels of temperamental emotionality, internalizing symptoms, and maternal mental distress, suggesting a substantial intrinsic emotional basis for their externalizing problems. Intrinsic factors seemed less salient for the Adolescent Onset class. These findings emphasize the need for a dynamic perspective on risk factors and support the importance of prevention and intervention efforts across multiple domains from early childhood and throughout adolescence.

Managing precocious puberty: A necessity for psychiatric evaluation

OBJECTIVE

Precocious puberty (PP) is one of the most common endocrine disorders in school-age girls. It has been reported that there is an increased tendency for psychiatric disorders for early maturing girls. The aim of this study was to determine the prevalence of psychiatric problems and to investigate depression and anxiety levels, and self-concept characteristics in girls with PP.

METHODS

Girls with PP (n = 41) and controls (n = 45) aged 7-11 years participated in this study. Psychiatric evaluations were conducted with semi-structured interviews. Behavioral and emotional problems were assessed using Child Behavior Check List and Teacher Report Form. Children's Depression Inventory, State-Trait Anxiety Inventory for Children and Piers-Harris Children's Self Concept Scale were administered, respectively.

RESULTS

Girls with PP had significantly more psychiatric diagnosis than controls (68.3 % vs 20 %, p < 0.001). PP group had significantly higher anxious-depressed, somatic complaints, social problems, aggresive behaviors and interestingly autistic traits. Increased symptom levels of depression and anxiety, and lower self-concept scores were also obtained from PP subjects.

CONCLUSIONS

PP is an independent predictor of psychiatric disorders. It is also associated with poorer psychiatric status, lower self esteem characteristics, and autistic traits. A multidisciplinary approach combining endocrinologic and psychiatric evaluations seem to be beneficial for the management of girls with PP.

Early pubertal maturation and externalizing behaviors: Examination of peer delinquency as mediator and cognitive flexibility as a moderator

INTRODUCTION

While peer delinquency is a known mediator between early pubertal timing and externalizing behaviors, little is known about factors that could protect against the adverse influence of peer delinquency. This study assesses the possible moderating role of cognitive flexibility, which is one index of executive functioning that facilitates flexible and adaptive responses to challenging situations. We assessed the interactive influence of peer delinquency and cognitive flexibility in the association between pubertal maturation and externalizing behaviors in boys and girls.

METHOD

Participants were 220 adolescents (111 boys) from the United States, between the ages of 11 and 16 years (M = 13.2, SD = 1.53) who participated in the Adolescent Emotion Study (AES).

RESULTS

Findings from the cross-sectional path modeling analyses provided evidence for the mediating role of peer delinquency for boys and girls, indicating that early maturing adolescents tend to affiliate with delinquent peers, which in turn exacerbates externalizing problems. Additionally, the moderating role of cognitive flexibility was also demonstrated for both boys and girls. Region of significance tests revealed that relatively well-developed cognitive flexibility skills could protect against the adverse influences of peer delinquency, whereas lower levels could exacerbate those negative influences.

CONCLUSION

These findings suggest that involvement with deviant peers increases vulnerability for both early maturing boys and girls. Additionally, cognitive flexibility was an important moderating factor for adolescents, such that youths with less developed skills would be at a higher risk for psychopathology, whereas those with better development could be protected.

Racial/Ethnic Differences in Age at Menarche and Lifetime Nonmedical Marijuana Use: Results from the NHANES 2005-2016

Early age at menarche has been linked to many adverse health outcomes among women, including substance use. However, little is known on the association between age at menarche and nonmedical use of marijuana, and no study has assessed the potential racial/ethnic differences. In this study, the 2005-2016 National Health and Nutrition Examination Survey data were used to investigate the association between age at menarche and the risk of lifetime nonmedical use of marijuana. Logistic regression models were used to examine such association adjusting for sociodemographic factors. Interactions between age at menarche and race/ethnicity were also assessed. Among the 10,302 women included, 53.9% had lifetime nonmedical use of marijuana. The regression model shows that women with early menarche had 1.26 (95% CI 1.09, 1.45) times the odds of having lifetime nonmedical use of marijuana compared with women with normal age at menarche. When assessing the association by race/ethnicity, marginally positive associations were observed for both the early and late menarche groups among non-Hispanic White women. However, among women with race/ethnicity other than non-Hispanic White, early menarche is significantly associated with increased risks of lifetime nonmedical marijuana use, while late menarche is significantly associated with decreased risks. This study suggests that early menarche may be a risk factor of lifetime nonmedical use of marijuana, and racial/ethnic differences may exist in the association. Future studies are warranted to examine and confirm these findings.

Timing of peripubertal steroid exposure predicts visuospatial cognition in men: Evidence from three samples

Experiments in male rodents demonstrate that sensitivity to the organizational effects of steroid hormones decreases across the pubertal window, with earlier androgen exposure leading to greater masculinization of the brain and behavior. Similarly, some research suggests the timing of peripubertal exposure to sex steroids influences aspects of human psychology, including visuospatial cognition. However, prior studies have been limited by small samples and/or imprecise measures of pubertal timing. We conducted 4 studies to clarify whether the timing of peripubertal hormone exposure predicts performance on male-typed tests of spatial cognition in adulthood. In Studies 1 (n = 1095) and 2 (n = 173), we investigated associations between recalled pubertal age and spatial cognition in typically developing men, controlling for current testosterone levels in Study 2. In Study 3 (n = 51), we examined the relationship between spatial performance and the age at which peripubertal hormone replacement therapy was initiated in a sample of men with Isolated GnRH Deficiency. Across Studies 1-3, effect size estimates for the relationship between spatial performance and pubertal timing ranged from. -0.04 and -0.27, and spatial performance was unrelated to salivary testosterone in Study 2. In Study 4, we conducted two meta-analyses of Studies 1-3 and four previously published studies. The first meta-analysis was conducted on correlations between spatial performance and measures of the absolute age of pubertal timing, and the second replaced those correlations with correlations between spatial performance and measures of relative pubertal timing where available. Point estimates for correlations between pubertal timing and spatial cognition were -0.15 and -0.12 (both p < 0.001) in the first and second meta-analyses, respectively. These associations were robust to the exclusion of any individual study. Our results suggest that, for some aspects of neural development, sensitivity to gonadal hormones declines across puberty, with earlier pubertal hormone exposure predicting greater sex-typicality in psychological phenotypes in adulthood. These results shed light on the processes of behavioral and brain organization and have implications for the treatment of IGD and other conditions wherein pubertal timing is pharmacologically manipulated.

Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood

Background

Sexually explicit media exposure during early adolescence has been found to be associated with risky sexual behavior. However, previous study suffered from methodological issue, such as selection bias. Furthermore, little is known about the effect of multi-modality sexually explicit media exposure on risky sexual behavior, and how this relationship can be applied to non-western societies.

Objectives

This study aimed to improve upon previous studies by using instrumental variable estimation. In addition, this study also included multi-modality of sexually explicit media and three risky sexual behavior measure from a sample of Taiwanese adolescents.

Methods

Participants were recruited from a prospective longitudinal study (Taiwan Youth Project). All were in 7^th grade (mean age = 13.3) when the study was initiated in 2000. Sexually explicit media exposure, including ever-exposure and number of modalities exposed to, was measured in wave 2 (8^th grade). Risky sexual behavior was measured in waves 8 (mean age = 20.3) and 10 (mean age = 24.3). A two-stage least squares regression was employed, with pubertal timing as the instrumental variable.

Results

About 50% of participants had been exposed to sexual media content by 8^th grade, from an average of one modality. Sexually explicit media exposure predicted early sexual debut, unsafe sex, and multiple sexual partners (all: p < .05). Furthermore, exposure to more media modalities increased the likelihood of risky sexual behaviors. However, only the effect on early sexual debut was gender invariant.

Conclusions

Exposure to sexually explicit media in early adolescence had a substantive relationship with risky sexual behavior in the emerging adulthood. Knowledge of this causal like effect provides a basis for building better preventive programs in early adolescence. One prominent way is early education on media literacy, and physicians themselves may need to be familiar with such content to initiate it.

Bumpy and Smoother Pathways of Puberty Hormone Change: A Novel Way to Define Gonadal Hormone Trajectories in Adolescents

CONTEXT

The study of gonadal hormone effects on adolescent wellbeing has been limited by logistical challenges. Urine hormone profiling offers new opportunities to understand the health and behavioral implications of puberty hormones.

OBJECTIVE

To characterize pubertal change in urinary testosterone and estradiol among male and female adolescents, respectively.

DESIGN

Three-year prospective cohort study.

SETTING

Australian regional community.

PARTICIPANTS

282 (163 male) normally developing adolescents aged 11.8 ± 1.0 years at baseline.

MAIN OUTCOME MEASURE

Quarterly urine measurements of testosterone and estradiol (mass spectrometry); annual anthropometric assessment and Tanner stage (TS) self-report.

RESULTS

Two-class sigmoidal and quadratic growth mixture models (centered on age at TS3) were identified as best-fit for describing testosterone (male) and estradiol (female) change. Classes 1 (male: 63%; female: 82%) and 2 (male: 37%; female: 18%) were respectively named the "stable" and "unstable" trajectories, characterized by different standard deviation of quarterly hormone change and magnitude of hormone peaks and troughs (all P < 0.001). Compared with class 1 (stable), class 2 males were taller at baseline (154 vs 151 cm), reported earlier and faster TS progression (P < 0.01), and showed higher serum testosterone levels at baseline and 3 years (P ≤ 0.01). Class 2 females exhibited smaller height and weight gains over the 3 years and had higher baseline serum estradiol (249 vs 98 pmol/L; P = 0.002) than class 1.

CONCLUSIONS

Adolescents showed 2 distinct urinary gonadal hormone trajectories, characterized by stability of change over time, which were not associated with consistent anthropometric differences. Results provide a methodology for studying gonadal hormone impacts on other aspects of biopsychosocial wellbeing. Identification of potential "at-risk" hormone groups would be important for planning supportive interventions.

Old-for-Grade Status and Suicide Risk in U.S. High School Students

Health-risk behaviors associated with increased risk of suicide are more prevalent in old-for-grade students compared to age-appropriate-for-grade peers; however, the association between old-for-grade status and suicidal behavior is largely unknown. This study investigated sex-specific differences in suicidal ideation, planning, attempts, and other risk behaviors by old-for-grade status. Secondary analyses utilizing bivariate and logistic regression methods for complex samples were conducted using data from the 2011, 2013, and 2015 National Youth Risk Behavior Survey for 16,579 female and 17,282 male high school students in grades 9 through 11. Among both males and females, students considered old-for-grade reported increased drug use, feeling sad/hopeless, violence, sexual activity, and limited/no seatbelt use compared with their peers. Old-for-grade students were also more likely to report a suicide attempt with increased suicidal ideation and planning observed only in old-for-grade males. Associations between old-for-grade status and suicide risk-related outcomes were attenuated in both sexes after adjusting for demographic characteristics and other health-risk behaviors. Findings suggest that common risk factors (e.g., sadness, substance use) may explain increased rates of suicidal behaviors in old-for-grade students.

Disentangling the Effects of Boys' Pubertal Timing: The Importance of Social Context

Some prior studies have found that, for boys, earlier puberty is linked to higher crime and delinquency, while other studies have found that earlier puberty is associated with greater social competence and beneficial psychosocial development. The current study suggests that these seemingly contradictory results actually represent two divergent pathways by which earlier pubertal timing can affect adjustment. Which pathway boys take is highly dependent on psychosocial context. Using a sample of 310 African American boys and their primary caregivers tracked across three waves of data collection from ages 10.55-18.84 from the Family and Community Health Study (FACHS), the current study utilizes Latent Moderated Structural Equation Modeling (LMS) to analyze effects of interactions between pubertal timing and social contextual factors on criminal behavior and social competence. Results suggest that criminogenic effects of early puberty are contingent on deviant peer group, poor school experience, harsh parenting, and neighborhood disorganization, whereas the association between earlier puberty and social competence is attenuated by harsh parenting. Results suggest that modeling both positive and negative development outcomes together may give a clearer picture of the developmental consequences of pubertal timing for boys. In addition, this study shows the importance of social context in shaping the meaning and consequences of biological variables like pubertal timing.

The impacts of peer education based on adolescent health education on the quality of life in adolescents: a randomized controlled trial

PURPOSE

During adolescence, adolescents are more susceptible to internalizing and externalizing problems influencing quality of life (QoL). The purpose of the study is to verify the effectiveness of a peer education on improving QoL of adolescents.

METHODS

A cluster randomized controlled trial (RCT) was conducted involving 1564 subjects who were divided into an intervention group (n = 714) and a control group (n = 850). The intervention group received 1-year peer education. Their QoL and basic information were assessed using a Adolescent Quality of Life Scale and a self-designed basic situation questionnaire.

RESULTS

After the intervention, significant increases were found in the psychological, and social, pubertal dimensions, and in total QoL (P < 0.05) in the intervention group relative to the control group. Significant decrease was found in physical dimension (P < 0.05), but the change in the intervention group (0.74 decrease) was much less than that in the control group (1.94 decrease). The improvements of physical (B = 1.215, SE = 0.305, P < 0.001), psychological (B = 1.496, SE = 0.598, P = 0.013), pubertal (B = 0.828, SE = 0.244, P = 0.001), and total (B = 3.455, SE = 1.429, P = 0.016) QoL in the intervention group were higher than in the control group in mixed model.

CONCLUSIONS

The peer education based on adolescent health education is effective in improving the physical, psychological, pubertal, and total QoL of adolescents, but no social QoL.

Heightened HPA-axis stress reactivity and accelerated pubertal progression predicts depressive symptoms over 4-year follow up

Pubertal timing has been suggested as biological factors implicated in the onset of depression in girls. This study aims to examine the prospective association between accelerated pubertal progression with depressive symptoms, and to further explore the possible role of individual reactivity to social stress in this association. A total of 56 girls with early puberty timing (assessed through breast Tanner stage) and 56 age-matched normal breast development girls were recruited at Wave 1 (grade 3) and followed for 4 years biennially. Hypothalamic-pituitary-adrenal axis stress reactivity was indexed by four cortisol samples collected before, during and after the Groningen Social Stress Test (GSST) at Wave 1. Depressive symptoms were interviewed through Mood & Feeling Questionnaire (MFQ) at each wave. About 42.9% (24/56) from early pubertal timing group and 19.6% (11/56) from normal control group were found accelerated breast development during 4-year follow-up. Mixed effects linear models illustrated that among accelerated breast development girls, those with heightened stress reactivity is likely to have a 6.62 (95% CI, 1.14-12.11)-point higher MFQ scores, and 41.9% (95%CI: 25.2 to 58.6%) higher probability for depressive symptoms, compared with girls with persistent normal breast development and moderate stress reactivity. However, no similar effects were found in girls with accelerated breast development but attenuated stress reactivity. The finding suggests that heightened cortisol reactivity to social stress may represent a useful biomarker in identifying girls at greatest risk of development of depressive symptoms following accelerated pubertal progression.

Contextualizing pubertal development: The combination of sexual partners' age and girls' pubertal development confers risk for externalizing but not internalizing symptoms among girls in therapeutic day schools

OBJECTIVE

Early pubertal development is associated with negative health and mental health outcomes. Research on the influence of puberty on mental health underscores a need to examine the interplay between puberty and exposure to environmental risk. This study investigates a more rarely studied aspect of girls' environments - romantic relationships with boyfriends. Specifically, this study examined sexual partner age and the timing of girls' pubertal development in relation to externalizing and internalizing symptoms among female students attending therapeutic day schools in the United States, a population at elevated risk for negative mental health outcomes.

METHODS

A total of 121 13 to 19-year-old adolescent girls (Mean age = 15.4; SD = 1.5) reported on the relative age of their past 3 sexual partners, their age of pubertal onset, and mental health challenges via clinical assessments of externalizing and internalizing symptoms.

RESULTS

Forty-three percent of participants qualified for at least one mental health diagnosis. Earlier pubertal onset predicted greater internalizing symptoms, and this effect did not depend on the age of girls' sexual partners. However, early-developing girls who also reported having a sexual partner more than 2 years older than them were at increased risk for externalizing symptoms.

CONCLUSIONS

Findings underscore that sexual relationships are an important risk factor for early-developing girls already at risk for mental health problems. Early developing girls with older partners may experience stronger social pressure to stay in relationships that expose them to partner violence and delinquency-related pressure, which combine with interpersonal stress to predict externalizing symptoms.

Pubertal Timing as a Transdiagnostic Risk for Psychopathology in Youth

Evidence suggests that early pubertal timing may operate as a transdiagnostic risk factor (i.e., shared across syndromes of psychopathology) for both genders. The current study examined associations between pubertal timing and dimensional psychopathology, structured across different levels of three organizational models: 1) DSM-based syndrome model, 2) traditional model of internalizing and externalizing factors, and 3) bifactor (p-factor) model, which includes a general psychopathology factor as well as internalizing- and externalizing- specific factors. For study analyses, 567 youth-parent pairs completed psychopathology measures when youth (55.5% female) were 13.58 (SD = 2.37, range = 9-17). Findings across all models revealed that early pubertal timing served as a transdiagnostic risk factor and also displayed some syndrome specific associations. Gender did not moderate any relationships between pubertal timing and psychopathology. Study findings reinforce the importance of examining risk across different levels of psychopathology conceptualization and analysis.

Puberty and Girls' Delinquency: A Test of Competing Models Explaining the Relationship between Pubertal Development and Delinquent Behavior

A substantial amount of research indicates precocious pubertal development is associated with delinquent behavior in girls. However, no clear consensus on theoretical mechanisms underlying this association has been established. Using a prospective panel study of 480 African American girls, the current study uses latent growth curve analysis to compare two competing models-context of risk (CR) and life history (LH) theory-offering potential explanations of this phenomenon. The CR model suggests that early pubertal development substantially shapes girls' social worlds such that they are exposed to more risk factors for delinquency; whereas, LH theory argues environmental unpredictability and harshness in childhood cause accelerated physical development, which predicts risky behavior. Results indicate that girls with precocious pubertal timing have more deviant peers and are exposed to harsher parenting, and that risk factors do not predict pubertal timing, providing more support for the CR model. Implications and future directions for research are discussed.

Early pubertal timing and adult adjustment outcomes: Persistence, attenuation, or accentuation?

Early pubertal timing is associated with internalizing and externalizing problems during adolescence. However, few studies explicitly test whether early puberty is especially problematic for those with pre-existing problems (i.e., accentuation) and little is known about whether the negative correlates of early pubertal timing persist past young adulthood. We address these questions using longitudinal data from up to 451 participants in the Iowa Youth and Families project (e.g., Ge, Conger, & Elder, 1996, 2001). We replicated and extended previous results reported for this sample during adolescence (e.g., early maturing boys and girls reported more substance use) and found some evidence for accentuation in adolescence for psychological distress and substance use. However, correlations between early puberty and adult outcomes assessed up to two decades later were largely indistinguishable from zero including attenuation effects. These results suggest that any negative correlates of early pubertal timing are attenuated by the fourth decade of life.

Perceived pubertal timing and borderline personality pathology in female adolescent inpatients

Borderline personality pathology typically onsets during adolescence. An important consideration in understanding adolescent psychopathology is pubertal development. Perceived pubertal timing is one facet of puberty that is especially relevant to adolescent psychopathology, especially when timing is perceived to be early. Despite links between early pubertal timing and core features of borderline personality disorder, and between early pubertal timing and disruptions in the interpersonal context, perceived pubertal timing has yet to be studied in relation to adolescent borderline pathology. This preliminary study aimed to test the association between perceived pubertal timing and borderline symptoms in adolescent girls, controlling for internalizing and externalizing pathology. Forty-two female adolescent inpatients (ages 12-15, Mage = 14.02, 81% White) completed measures of perceived pubertal development and borderline symptoms and a diagnostic interview. Results indicated that earlier perceived pubertal timing was uniquely associated with higher borderline symptoms even when internalizing and externalizing disorders were covaried.

The role of stress response in the association between autonomy and adjustment in adolescents

Developing autonomy is an important developmental task that has implications for adolescent adjustment and may be impacted by adolescents' response to stress. This study examined whether stress reactivity (i.e., cortisol and heart rate reactivity) to a parent-adolescent conflict interaction moderates the effect of autonomy on adjustment assessed one year later in 100 adolescents (M age = 15.09; 68% girls). Multiple group models suggested that youth who evidenced higher stress reactivity when compared to those with lower stress reactivity were more likely to report decreased externalizing problems and internalizing problems when their parents granted more autonomy. In contrast, youth who evidenced higher stress reactivity who experienced undermining of autonomy were more likely to report increased externalizing and internalizing problems than youth who evidenced lower stress reactivity. Results support biological sensitivity to context theory and highlight the importance of considering individual differences in the effect of developmental milestones on adolescents' adjustment.

Proactive and Reactive Aggression Subgroups in Typically Developing Children: The Role of Executive Functioning, Psychophysiology, and Psychopathy

This study aimed to assess whether groups of aggressive children differed on psychopathic traits, and neuropsychological and neurobiological measures of prefrontal functioning consistent with the objectives of their aggression-reactive or proactive. Including 110 typically developing children (9-11 years), a latent class analysis identified a low aggression group, a high reactive aggression group, and a mixed (high reactive and proactive) aggression group. Results show high callous-unemotional traits and low resting respiratory sinus arrhythmia increased the likelihood of children being in the mixed aggression group, when compared to the reactive and low aggression groups. However, deficits in planning and inhibitory control increased the likelihood of children being in the reactive aggression group, when compared to the mixed and low aggression groups. Executive functioning deficits did not differentiate the mixed group from the low aggression group. These findings highlight psychobiological and executive functioning differences that may explain heterogeneity in childhood aggression.

Effects of harsh parenting and positive parenting practices on youth aggressive behavior: The moderating role of early pubertal timing

Prior research indicates that early pubertal timing is associated with aggressive behavior, particularly in the context of adversity as postulated in the contextual amplification hypothesis. However, few studies have examined harsh parenting as the context for the effect of early pubertal timing. Even fewer studies have tested the interactive effect of early pubertal timing and positive parenting on aggressive behavior. In this study, we tested the proposition that early pubertal timing, contrary to the general conception of it as a vulnerability, indexed susceptibility, and thus early maturing individuals were affected more by their environment in a "for better and for worse" manner. The sample consisted of 411 community-recruited youth aged 11-12 years (51% boys, 80% African Americans). Participants reported Tanner Stages of pubertal development, aggressive behavior and harsh parenting practice of their parents. Puberty scores were standardized with groups of the same age, sex, and ethnicity, and those that scored the top one-third were defined as early maturing individuals. Parents reported youth's aggressive behavior and their parenting practices towards the youth, including harsh parenting and positive parenting. Early pubertal timing significantly moderated the relationship between harsh/positive parenting and aggressive behavior. Specifically, harsh parenting was positively associated with aggressive behavior to a larger degree among early maturing individuals than among on-time/late-maturing individuals. Positive parenting was inversely associated with aggressive behavior but only among early maturing individuals. This study is the first to document support for early pubertal timing as susceptibility to the environmental influences in relation to aggressive behavior. Theoretical and intervention implications are discussed.

Early Pubertal Timing and Childhood Family Adversity Interact to Predict Newlywed Women's Anxiety Symptoms

The contextual amplification hypothesis posits that girls' early pubertal timing will predict anxiety and depression symptoms most strongly when early puberty occurs under adverse conditions. Research supporting this hypothesis has consistently linked early pubertal timing occurring in adverse contexts to symptoms during adolescence, but little is known about the link to adult symptoms. The present study examined the extent to which women's reports of early pubertal timing and childhood family adversity interact to predict symptoms of anxiety and depression during the first two years of marriage. Married women (N = 226) completed questionnaires within 7 months into their first marriage (Time 1) and approximately 19 months later (Time 2). Analyses indicated that at both Time 1 and 2, women's reports of earlier pubertal timing predicted anxiety symptoms only when women reported a history of greater childhood family adversity. Additional analyses indicated that the interaction of earlier pubertal timing and greater childhood family adversity predicted symptoms of traumatic intrusions and panic, but not social anxiety, at Time 1, and panic symptoms at Times 1 and 2. These findings expand our understanding of the relation of early pubertal timing to adult emotional health and the family conditions that moderate this relation.