Longitudinal Effects of Self-Report Pubertal Timing and Menarcheal Age on Adolescent Psychological and Behavioral Outcomes in Female Youths from Northern Taiwan

Role of Pubertal Timing and Perceived Parental Attachment in Internalizing Problem Behaviours Among Adolescents

Adolescents need supportive social institutions to help them deal effectively with the demands of pubertal changes accompanied by new social roles, reducing their susceptibility to problem behaviors. Considering this, it will be investigated how internalizing problem behaviors in teenagers is affected by the interaction between pubertal timing and perceived parental attachment. For this, cross-sectional data from 772 adolescents with ages ranging from 11 to 15 years old was used. Regression analyses showed early maturing adolescents with insecure perceived parental attachments had higher levels of depression and anxiety than their early, on-time, and late maturing counterparts with secure perceived parental attachments. This finding supports the contextual amplification model, as the detrimental consequences of early maturation are impacted by difficult parent-adolescent relationships.

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.

The value of urinary gonadotropins in the diagnosis of central precocious puberty: a meta-analysis

BACKGROUND

The gonadotropin-releasing hormone (GnRH) stimulation test is time-consuming, invasive, and costly. However, it is the diagnostic gold standard for central precocious puberty (CPP), which in girls is defined as the onset of secondary sexual characteristics before the age of 8 years accompanied by breast buds, accelerated growth, and advanced bone age. This meta-analysis was performed to compare the diagnostic value of urinary gonadotropins and the GnRH stimulation test for CPP.

METHODS

We searched six databases for relevant literature. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we estimated the sensitivity, specificity, area under the summary receiver operating characteristic curve (AUC), and publication bias.

RESULTS

Six eligible trials fulfilled the inclusion criteria. In the meta-analysis of urinary luteinizing hormone (ULH), after excluding the data of one study, we obtained an AUC of 0.90 (sensitivity = 0.81, specificity = 0.85). The meta-analysis of the ULH to urinary follicle-stimulating hormone (UFSH) ratio revealed an AUC of 0.8116 (sensitivity = 0.79, specificity = 0.84).

CONCLUSION

Both the ULH level and ULH:UFSH ratio are effective and available approaches for CPP diagnosis.

TRIAL REGISTRATION

INPLASY 2021120076 .

Relationship Between Weight Status and Self-Image Mediated by Pubertal Timing and Athletic Competence: A Cohort Study With Taiwanese Adolescents

Background

Self-image reflects overall self-acceptance in developing adolescents. Using a representative cohort of Taiwanese youth, this study aims to explore the relationship between weight status, pubertal timing, athletic competence, and adolescent self-image.

Methods

Data come from the Taiwan Youth Project that comprised a longitudinal cohort of adolescents (N = 2690, 51% males, Mage = 13.3 ± 0.5 years) surveyed annually from seventh grade. Self-image was measured by perceived satisfaction with appearance and physique. Weight status was proxied by self-reported body mass index (BMI; kg/m2). Pubertal timing was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Athletic competence was assessed by experiences with participation in competitive sports and self-perceived talent for sports. Linear regression analysis was applied to test for an association between BMI and self-image. In order to test for mediating roles of pubertal timing and athletic competence, Hayes' PROCESS macro on SPSS was conducted applying 5,000 bootstrap resamples with 95% confidence intervals of the indirect effect.

Results

BMI was inversely associated with self-image in both males (β = -0.074, [-0.095, -0.053]) and females (β = -0.095, [-0.122, -0.069]). The boot-strapped 95% confidence intervals indicated statistically significant mediating effects of pubertal timing (β = -0.008, [-0.015, -0.001]) and athletic competence (β = -0.006, [-0.011, -0.002]) in the link between BMI and self-image in females, whilst only athletic competence mediated this association (β = -0.006, [-0.009, -0.002]) in males. Moreover, BMI at baseline were also associated with long-term self-image in males (β = -0.037, [-0.057, -0.017]) and females (β = 0.132, [0.073, 0.190]).

Conclusions

Understanding the mediating factors may help enhance adolescents' self-image by providing guidance on healthy weight and physical activity behaviors according to different stages of pubertal progression.

The association between pubertal timing and quality of life among children and adolescents: a cross-sectional study in Chongqing, China

BACKGROUND

To determine the relationship between pubertal timing and quality of life (QOL) in children and adolescents and to provide a basis for QOL intervention in pubertal children in the future to promote good adaptation and healthy physical and mental development of children.

METHODS

The survey was conducted in one county using a stratified cluster sampling method. The five physiological change items of the Puberty Development Scale (PDS) were used to assess the timing of puberty in students. Compared to students of the same age and the same sex, students who scored higher than the mean + standard deviation (SD) of individual developmental scores were defined as an early pubertal timing group. A 39-item QOL Scale for Children in Puberty was used to assess the QOL of the respondents. Multiple linear regression models were fitted separately for boys and girls.

RESULTS

Of the 7223 students, 3754 (51.97%) were boys and 3469 (48.03%) were girls. The prevalence of early pubertal periods was 16.07%. The total QOL score in the early pubertal timing group (137.16 ± 18.67) was significantly lower than in the normal (on time) group (142.02 ± 17.98) and the late group (142.76 ± 18.35) (F = 37.311, P < 0.001). A multiple linear regression model showed that early pubertal timing was a risk factor for QOL (P < 0.0014), compared with normal and late pubertal timing.

CONCLUSIONS

The early pubertal timing was associated with poorer QOL in children and adolescents. More attention should be paid to children with early pubertal timing in intervening children's QOL during pubertal development. Future longitudinal studies are needed to confirm the association between pubertal timing and QOL.

Examining the Relationship between Gender Contentedness and Sex-Related Experiences among Taiwanese Youth

Little is known about how gender contentedness is related to sex-related experiences among Taiwanese adolescents. Secondary analysis of data (n = 2624, Mage = 13.3 ± 0.47 years and 51% males) on a longitudinal youth cohort was used to track the evolving development of sex-related experiences such as exposure to sexually explicit media, romantic experiences, and sexual behaviors. Hierarchical multinomial logistic regression analyses were applied to study the effects of gender contentedness on sex-related outcome variables. The results showed that nearly 10% of the subjects were not contented with their gender. As compared to peers, gender-discontented adolescents had a higher likelihood of exposures to sexually explicit media (odds ratio [OR]. = 1.70, 95% confidence interval [CI]. = 1.18–2.46) and risky sex behaviors (OR = 2.22, 95% CI = 1.03–4.81). These results shed light on the impact of self-perceived gender contentedness on sex-related experiences in Taiwanese adolescents. Our findings are helpful for the development of practical guidance on sexual health issues, particularly for those who are discontented with their gender.

Body image perception and body composition in early adolescents: a longitudinal study of an Italian cohort

BACKGROUND

Adolescence is a sensitive period of life in which everyone faces physical and psychological changes. No longitudinal studies considering changes in body image perception and body composition in Italian adolescents have been carried out. The aims of this study were to evaluate the longitudinal change in body composition and weight status in a sample of Italian students of both sexes over the 3 years of middle school and to analyse the influence of these parameters on the perception and satisfaction of one's own body image.

METHODS

Sixty-four males and seventy females were followed longitudinally from 11 to 14. Age at first measurement was 11.8 ± 0.3 yrs. in males and 11.9 ± 0.3 yrs. in females, then the students were measured again after 1 year and 2 years. Anthropometric measurements were collected and body composition was assessed by skinfolds. Maturity status was detected by age at menarche in females and by estimated age at peak height velocity in males; sports practice was assessed by a questionnaire. Body Silhouette Charts were used to assess body image perception. The degree of body image dissatisfaction and improper perception of weight status were evaluated. Univariate and multivariate analyses were applied.

RESULTS

Height, sitting height, leg length, and weight increments were higher in males than in females, and in both sexes the sitting height increment was higher than that of leg length. Skinfold thicknesses and percentage of body fat, showed a decrease in males and an increase in females over the 3 years. About 90% of the sample practiced sport during the 3 years. No significant variations in body image perception were observed among repeated measures but significantly differences were observed between sexes. Although the girls showed a lower incidence of overweight and obesity than boys, girls had a higher dissatisfaction than males. Males were less accurate in one's perception of one's own weight status.

CONCLUSIONS

The changes in body composition observed in the sample of the present study were in accordance with their maturity stage. An increase in parameters connected with adiposity is observed in females and a decrease in males. Body image perception did not seem to change with growth, but associations were found between body image perception and BMI and sex. Monitoring body image perception in young adolescents, especially in females and in overweight/obese subjects, is a priority to prevent nutritional disorders.

Effect of aromatherapy on autonomic nervous system regulation with treadmill exercise-induced stress among adolescents

Introduction

Stress is a major health issue in adolescents owing to the important transitions experienced during this period. Aromatherapy is an effective method for the reduction of stress in adolescents.

Purpose

The aims of this study were to examine the effect of aromatherapy on the regulation of the autonomic nervous system (ANS) along with stress relief and to explore the effect of aromatherapy on adolescents with different levels of stress.

Methods

This quasi-experimental study comprised three types of treatments: control (no essential oil), pure essential oil therapy (sandalwood), and blended essential oil therapy (sandalwood-lavender). The heart rate variability (HRV) was calculated to evaluate the post-exercise recovery of the ANS to the baseline level in the recruited adolescents. To examine the efficiency of aromatherapy, Friedman test was used to assess the significance of difference in all parameters (i.e., mean heart rate, SDNN, normalized LF, normalized HF, and LF/HF) between baseline and after exercise among the three treatment conditions.

Results

The participants comprised 43 junior college students (8 males and 35 females) with a mean age of 18.21 ± 0.99. Significant differences in changes of two HRV parameters (normalized LF and LF/HF) were associated with both essential oil therapies compared to those in the control group (p<0.05), and one more HRV parameter (normalized HF) exhibited significant difference related to blended essential oil therapy compared to that of the control group. Besides, changes in two HRV parameters (mean heart rate and normalized HF) of both essential oil therapies in the low level stress subgroup showed significant differences compared to those of the control group (p<0.05).

Conclusions

This study demonstrated that aromatherapy could be used for ANS regulation with stress-relieving effects in adolescents. The participants with a low stress level appeared to respond better to the blended essential oil therapy, whereas those with medium to high levels of stress appeared to respond poorly to aromatherapy compared to the control.

Exploring the Interaction Effects of Gender Contentedness and Pubertal Timing on Adolescent Longitudinal Psychological and Behavioral Health Outcomes

Background: Off-time pubertal timing (PT) and non-conforming gender identity have been reported to predict adverse health and well-being in adolescents. However, the joint effects of these two factors are less addressed. We aimed to investigate the main and interaction effects of gender identity, proxied by perceived gender contentedness (GC), and PT on longitudinal adolescent psychological and behavioral outcomes. Methods: Data (N = 1806, Mage = 13.3 ± 0.5 years) come from the Taiwan Youth Project, which prospectively followed a longitudinal cohort of Taiwanese junior high school students from 2000 (wave 1) to 2009 (wave 9). GC was self-reported at waves 1 and 9 in a binary response, and thus 4 GC trajectories were created. PT was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Multiple linear regression analyses with gender stratification were applied to examine the effects of the GC trajectory and its interaction with PT on the outcomes. Results: A total of 1,562 subjects (86.5%) remained consistently satisfied with their gender, while the GC of 226 subjects (12.6%) changed at some point. Regression analyses found that males with gender dissatisfaction at wave 9 were likely to engage in delinquent behavior, and females in this group were more likely to have lower self-esteem, as compared to those with consistent GC. The interaction effect between the GC trajectory and PT appeared to be associated with smoking and drinking only at wave 1. Conclusions: These findings indicate that healthcare professionals should concentrate on gender non-conforming individuals at early adolescence, navigating them toward a healthy adulthood.

Comparison of Growth Velocity Among School Age Children With Different Body Mass Index From Childhood Into Early Adolescence in Hualien County, Taiwan: A Retrospective Cohort Study

Objective: This study aimed to investigate the contribution of high body mass index (BMI) to growth velocity among school-aged children who remained in the same BMI categories for a 6-year period. Methods: This retrospective cohort study included children who enrolled in the school year 2009 and remained in the same BMI categories during their 1st, 4th, and 7th grades (6-7, 9-10, 12-13 years of age). Annual linear growth velocity and weight gain were calculated and compared between sexes, BMI groups, and different times. Risk analysis and repeated measures analysis of variance were performed to identify the impact of BMI on growth velocity. Results: Of the 1,637 subjects, 53.0% were male, and 2.5% and 10.9% belonged to BMI groups of overweight and obese, respectively. In students between 6 and 13 years of age, obesity was associated with higher annual weight gain and height gain. Risk analysis showed that obese subjects had higher linear growth velocity than normal BMI groups of both sexes between 6 and 9 years of age. Unexpectedly, overweight and obese girls between 9 and 13 years of age had less linear growth velocity than underweight girls at the same interval. Repeated measures analysis of variance in both sexes showed a significant statistical association between BMI and different times of growth. However, the effect was less in girls between 9 and 13 years of age. Conclusion: Puberty may dominate over BMI as the main contributor to high growth velocity in girls with underweight BMI emerging into pubertal age.

Factor Structure of the 10-Item Perceived Stress Scale and Measurement Invariance Across Genders Among Chinese Adolescents

BACKGROUND

Chinese adolescents encounter a lot of stressors, such as academic burden and parental pressure. However, little is known about their perception of stress. The 10-item Perceived Stress Scale (PSS-10) is a widely used instrument to measure individuals' appraisal of global stress in academic research and clinical practice. The current study aimed to evaluate the best-fit factor structure model of the PSS-10 and the measurement invariance across genders in Chinese adolescents.

METHODS

A total of 1,574 Chinese senior high school students completed the PSS-10 (mean age = 15.26 ± 0.56 years, female = 54%). Confirmatory factor analysis (CFA) was conducted to determine the factor structure of the PSS-10. Multigroup CFA was carried out to test the measurement invariance of the PSS-10 across genders. A subsample (N = 1,060) answered additional questionnaires measuring stressful life events, anxiety, and depression to examine the convergent and concurrent validity of the PSS-10.

RESULTS

The two-factor model was supported [i.e., χ2 (34) = 332.224, p < 0.001; non-normal fit index (NNFI) = 0.901, comparative fit index (CFI) = 0.925, root mean square error of approximation (RMSEA) = 0.075, standardized root mean square residual (SRMR) = 0.051]. Importantly, the model exhibited strong measurement invariance across female and male groups. Furthermore, the PSS-10 had adequate convergent validity for stressful life events (number: r = 0.13, p < 0.001; impact: r = 0.23, p < 0.001) and could explain incremental variance in predicting anxiety (ΔR 2 = 0.13, β = 0.38, p < 0.001) and depression (ΔR 2 = 0.16, β = 0.41, p < 0.001), suggesting excellent concurrent validity.

CONCLUSION

A two-factor model best fits the structure of PSS-10 among Chinese adolescents, with strong measurement invariance between gender groups, demonstrating its validity for assessing perceived stress among Chinese adolescents.

Psychometric properties and measurement invariance of the Weight Self-Stigma Questionnaire and Weight Bias Internalization Scale in children and adolescents

Given the negative consequences of weight bias, including internalized weight stigma, on health outcomes, two instruments—the Weight Self-Stigma Questionnaire (WSSQ) and Weight Bias Internalization Scale (WBIS)—have been developed. However, their psychometric properties are yet to be tested for Asian pediatric populations. Method:Participants aged 8 to 12 years (N = 287; 153 boys) completed the WSSQ and the WBIS, and they were classified into either a group with overweight or a group without overweight based on self-reported weight and height. Results:Both WSSQ and WBIS had their factor structures supported by confirmatory factor analyses (CFAs). The measurement invariance of two-factor structure was further supported for WSSQ across gender and weight status. The measurement invariance of single-factor structure was supported for WBIS across gender but not across weight status. Conclusions:WSSQ and WBIS were both valid to assess the internalization of weight bias. However, the two instruments demonstrated different properties and should be applied in different situations.

Gender differences in the association of smartphone use with the vitality and mental health of adolescent students

OBJECTIVE

The present study examined variations in the degree of smartphone use behavior among male and female adolescents as well as the association between various degrees of smartphone use behavior and the vitality and mental health of each gender.

PARTICIPANTS

A total of 218 adolescents were recruited from a junior college in September 2014.

METHODS

All the participants were asked to answer questionnaires on smartphone use.

RESULTS

The findings showed that adolescent females as compared with adolescent males exhibited significantly higher degrees of smartphone dependence and smartphone influence. Positive correlations were observed between the duration of smartphone use on weekends and the vitality/mental health of the male adolescents; negative correlations were found between smartphone dependence and the vitality/mental health of males.

CONCLUSION

The findings demonstrate that adolescent females are deeply affected by their smartphone use. Smartphone dependence may decrease the vitality and mental health of male adolescents.

Longitudinal impacts of pubertal timing and weight status on adolescent Internet use: Analysis from a cohort study of Taiwanese youths

Aim

To investigate the longitudinal impacts of pubertal timing and weight status on Internet use in adolescents.

Methods

Three waves of data on a longitudinal cohort of 7^th grade students (N = 2430) were retrieved from the Taiwan Youth Project. Univariate and multivariate regression models were applied using crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) to examine the concomitant impacts of pubertal timing and weight status on adolescent Internet use.

Results

The dataset identified 210 (8.7%) students using the Internet for more than 20 hours/week, and 81 (3.3%) were viewing pornographic material online. Early maturing and thin-weight adolescents were at 35% and 46% increased risks of spending long hours on Internet use, respectively. While early puberty was associated with online pornography viewing among males (adjusted OR 1.84, 95% CI 1.04–3.28), early puberty was contrarily a protective factor against online gaming in females (adjusted OR 0.59, 95% CI 0.36–0.96).

Conclusion

Early puberty was found to be positively related to adolescent Internet use. Appropriate health education and guidance regarding Internet use should be provided to those with different developing needs.

Cumulative family risks across income levels predict deterioration of children's general health during childhood and adolescence

Family is considered an important agent in the health development of children. This process is significant but quite complex because the prevalence of potential risk factors in the family can hinder children’s health. This study examined if multiple family risks might have cumulative effect on children and youth’s health across various levels of household income. The data in this study were drawn from the 2011–2012 U.S. National Survey of Children’s Health (N = 79,601). A cumulative family risk (CFR) index was developed, which included such constructs as single-parenthood, unstable employment, large family, parenting stress, poor maternal education, poor maternal general health and poor maternal mental health. Multiple logistic regression analyses showed that CFR level was significantly related to children and youth’s poor health outcome (p < .001). When poverty levels were considered, however, the impact of CFRs on children and youth’s health was attenuated. The impact of CFRs was higher on children and youth from affluent families than on those from poor families. Overall there was a consistent pattern of trend in the point estimate as well as confidence limits as levels of affluence and numbers of family risk increased although some of the confidence intervals overlapped. Living in disadvantaged families might serve as a protective factor against CFRs possibly through repeated exposure to hardships and subsequent formation of resilience among some of the disadvantaged children.