A self-report measure of pubertal status: Reliability, validity, and initial norms

Vagal regulation and emotional intensity predict children's sleep problems

We examined the role of children's emotional intensity and vagal functioning in predicting sleep problems in healthy elementary school-aged children. Children's dispositional emotionality was examined via parent report, and their vagal regulation was assessed via respiratory sinus arrhythmia (RSA) during a baseline and a reaction time (RT) task. Sleep problems were examined through both child reports, and home monitoring with wrist actigraphs for four consecutive nights. Increased emotional intensity was predictive of a reduced amount of sleep and increased night activity. Less apt vagal regulation, characterized by lower levels of RSA suppression to the RT task, was predictive of increased sleep problems as assessed through both subjective and actigraphy-based measures of sleep. Results indicate that children's emotionality and regulation predict unique variance in the amount and quality of children's sleep, and suggest that they may underlie, at least in part, sleep disturbances in healthy children.

Biological, psychological, and sociocultural correlates of body change strategies and eating problems in adolescent boys and girls

The present study examines correlates of body change strategies and eating problems in youths. A large sample of adolescents aged 12 to 16 years (N = 307) was asked to complete a set of questionnaires, which measured biological (age, pubertal status, and body mass index [BMI]), psychological (self-esteem, body dissatisfaction, body importance, and body comparison), and sociocultural variables (influence of media, parents, and peers), as well as body change strategies and disturbed eating attitudes and behaviors. Results showed that boys generally try to become more muscular, whereas girls attempt to lose weight. Further, correlational and regression analyses demonstrated that biological, psychological, and sociocultural influences made unique and significant contributions to various body image and body change/eating problems variables. Finally, hierarchical regression analyses yielded theoretically meaningful models for the main body change strategies in boys and girls. In these models, BMI, self-esteem, and sociocultural influences turned out to be significant predictor variables, while body-image-related factors, and in particular body comparison (i.e., the tendency to compare one's body with that of others), partially or fully mediated the influence of some predictor variables.

Physical Activity Self-Definition Among Adolescents

Since research involving adults indicates that physical activity (PA) self-definition influences PA participation, understanding PA self-definition and related factors, such as PA frequency and enjoyment, in youth is essential for designing interventions to reverse the decline in PA that occurs from childhood through adolescence. The objective of this study was to explore correlates of PA self-definition and assess differences in PA self-definition among African American and European American boys and girls in early, middle, and late puberty. A 3 (developmental stage) ¥ 2 (gender) design was used. African American and European American boys and girls, ages 9 to 17, participated. A total of 168 adolescents completed demographic data, developmental stage, and current and future PA self-definition questionnaires. Peak VO2 was obtained as a measure of physical fitness. Current PA self-definition was positively correlated with peak VO2 (p < .01) and future PA self-definition (p < .01). Males had higher current (p = .032) and future (p = .021) PA self-definition than females. The finding that boys have stronger current and future PA self-definitions than girls highlights the challenge for health professionals to enact immediate and effective measures to alter girls’ perceptions of themselves in terms of PA participation. Since current PA self-definition is also significantly correlated with future PA participation, strategies to assist girls in developing a strong PA self-definition may contribute to increased PA in their adult years.

Puberty and the onset of substance use and abuse

OBJECTIVE

Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use.

METHODS

The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of Washington, United States, and Victoria, Australia. Participants were 5769 students in grades 5, 7, and 9, drawn as a 2-stage cluster sample in each state, and the questionnaire was completed in the school classrooms. The main outcomes of the study were lifetime substance use (tobacco use, having been drunk, or cannabis use), recent substance use (tobacco, alcohol, or cannabis use in the previous month), and substance abuse (daily smoking, any binge drinking, drinking at least weekly, or cannabis use at least weekly).

RESULTS

The odds of lifetime substance use were almost twofold higher (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.4-2.1) in midpuberty (Tanner stage III) and were threefold higher (OR: 3.1; 95% CI: 2.4-4.2) in late puberty (Tanner stage IV/V), after adjustment for age and school grade level. Recent substance use was moderately higher (OR: 1.4; 95% CI: 1.0-1.9) in midpuberty and more than twofold higher (OR: 2.3; 95% CI: 1.7-3.3) in late puberty. The odds of substance abuse were twofold higher (OR: 2.0; 95% CI: 1.2-3.2) in midpuberty and more than threefold higher (OR: 3.5; 95% CI: 2.2-5.4) in late puberty. Reporting most friends as substance users was more likely in the later stages of pubertal development, a relationship that accounted in part for the association found between later pubertal stage and substance abuse.

CONCLUSIONS

Pubertal stage was associated with higher rates of substance use and abuse independent of age and school grade level. Early maturers had higher levels of substance use because they entered the risk period at an earlier point than did late maturers. The study findings support prevention strategies and policies that decrease recreational substance use within the peer social group in the early teens.

Developmental and Individual Differences in Girls' Sex-Typed Activities in Middle Childhood and Adolescence

Girls' time in sex-typed leisure activities was studied across 2 years in middle childhood (n = 98, M = 8.2 years in Year 1), early adolescence (n = 106, M = 11.7 years), and middle adolescence (n = 86, M = 14.9 years). In annual home interviews, White middle-class girls, mothers, and fathers rated their gendered attitudes, interests, and personality qualities, and saliva samples were used to assess testosterone; activity data were collected in 7 nightly phone interviews. Girls spent more time in feminine than masculine activities except in early adolescence. Girls' and parents' personalities and interests predicted sex-typed activities at each developmental period, but associations between testosterone and activities emerged only in middle childhood.

Developmental, gender, and ethnic group differences in moods and ambulatory blood pressure in adolescents

BACKGROUND

Adolescence is characterized by profound changes in physical, psychological, and social functioning thought to be accompanied by intense and varying moods.

PURPOSE

Within a psychophysiological framework, this study examined the prevalence of 12 self-reported mood states of adolescents; investigated associations between specific mood states and ambulatory blood pressure readings; and explored effects of interactions among moods, gender, ethnic group, and maturation on ambulatory blood pressures.

METHODS

The sample included 371 African American, European American, and Hispanic American adolescents 11 to 16 years old. Systolic (SBP) and diastolic (DBP) blood pressures were measured every 30 min with an ambulatory monitor and were synchronized with electronic activity monitoring and moods self-recorded during waking hours in a checklist diary.

RESULTS

Moods differed significantly by gender, ethnic group, and maturation. Controlling for height, maturation, gender, ethnic group, mother's education, position, location, activity, other moods, and interactions of moods with other variables in a multilevel, random coefficients regression model, both positive and negative mood states were associated with higher levels of SBP and DBP; being relaxed or bored, or having a feeling of accomplishing things were associated with lower SBP and DBP. There were significant interaction effects of moods with physical maturity, gender, and ethnic group on ambulatory SBP and DBP.

CONCLUSIONS

Further study of the modifying effects of gender, ethnic group, and stage of development on reports of moods, and their associations with cardiovascular responses is recommended.

Recurrent abdominal pain, anxiety, and depression in primary care

OBJECTIVE

The prevalence of psychiatric disorder in children and adolescents with functional recurrent abdominal pain (RAP) is unknown. Our aim was to determine whether RAP is associated with psychiatric symptoms and disorders, anxious temperament, and functional impairment in pediatric primary care.

METHODS

Children and adolescents who were 8 to 15 years of age, inclusive, and presented with RAP (N = 42) or for routine care in the absence of recurrent pain (N = 38) were identified by a screening procedure in pediatric primary care office waiting rooms and recruited to participate in a case-control study. Outcome measures were psychiatric diagnoses generated by standardized psychiatric interview administered blind to subject status and self, parent, and clinician ratings of child psychiatric symptoms, temperamental traits, and functional status.

RESULTS

RAP patients were significantly more likely to receive a diagnosis of a psychiatric disorder, with a categorical anxiety disorder in 33 (79%) and a depressive disorder in 18 patients (43%), and higher levels of anxiety and depressive symptoms, temperamental harm avoidance, and functional impairment than control subjects. Anxiety disorders (mean age of onset: 6.25 [standard deviation: 2.17] years) were significantly more likely to precede RAP (mean age of onset: 9.17 [standard deviation: 2.75] years) in patients with associated anxiety.

CONCLUSIONS

Youths who present with RAP in primary care deserve careful assessment for anxiety and depressive disorders. Future studies should examine treatments that are proved to be efficacious for pediatric anxiety and/or depressive disorders as potential interventions for RAP. Longitudinal, family, and psychobiological studies are needed to illuminate the nature of observed associations among RAP, anxiety, and depression.

Sexual trajectories of abused and neglected youths

The study objective was to examine whether childhood abuse or neglect is associated with the age of onset of puberty and sexual and romantic behavior. A cohort of children (the Children in the Community study) was randomly selected and studied prospectively from childhood to adulthood. A sample of 816 youths were interviewed in their homes at a mean age of 14, 16, and 22 years in 1983, from 1985 to 1986, and from 1991 to 1994. The outcome measures included age of menarche, signs of male puberty, first being in love, dating, sexual intercourse, and pregnancy reported by youths. Child abuse and neglect were measured by official records and youth reports. A history of two or more incidents of sexual abuse was significantly associated with early puberty and early pregnancy after gender, class, race, paternal absence, and mother's age at the birth of the study child were controlled statistically. Public education regarding risk for premature sexual behavior among youths who have experienced sexual abuse is warranted. Efforts to prevent teenage pregnancy should include monitoring and educating sexually abused children as they enter puberty.

Body image, strategies to change muscles and weight, and puberty: do they impact on positive and negative affect among adolescent boys and girls?

The purpose of this study was to examine the impact of strategies to both decrease weight and increase muscle tone on negative (depression, anxiety) and positive affect among adolescent males and females. The respondents were 1185 adolescents (587 males, 598 females) who were enrolled in grades 7 and 9 (mean age for males=13.22 years; mean age for females=13.21 years). Respondents completed the Body Image and Body Change Inventory that assessed body image satisfaction, body image importance, body change strategies to decrease weight, body change strategies to increase muscle tone, and food supplements. Respondents also completed the Pubertal Development Scale, the depression and anxiety scales of the Depression Anxiety and Stress Scale, and the positive affect items from the Positive and Negative Affect Scale. Structural equation modelling was used to determine how body satisfaction and importance, body change strategies, and puberty impacted on depression, anxiety, and positive affect. The results demonstrated that for both boys and girls, there was a strong association between body change strategies and negative affect. For boys, body dissatisfaction did not predict negative affect, although this was a strong predictor for girls. Body change strategies did not strongly predict positive affect for either boys or girls, although body image satisfaction was a strong predictor for both genders. The implications of these findings for obtaining a better understanding of the role of pubertal development, body image, and body change strategies in predicting positive and negative affect among adolescent males and females are discussed.

A Biopsychosocial Model of Disordered Eating and the Pursuit of Muscularity in Adolescent Boys

This review provides an evaluation of the correlates and/or risk factors associated with disordered eating and the pursuit of muscularity among adolescent boys. One of the main conclusions is that similar factors and processes are associated with both behavioral problems. Several factors found to be consistently associated with disordered eating among boys are also similar to those found with girls. These include body mass index, negative affect, self-esteem, perfectionism, drug use, perceived pressure to lose weight from parents and peers, and participation in sports that focus on leanness. However, as many of the findings have only been verified using cross-sectional designs, prospective studies are now needed.

Physical activity, self-efficacy, and perceived exertion among adolescents

The relationship of self-efficacy, a sense of confidence in personal physical activity (PA) skills, to perceived exertion during activity was explored among 168 African American and European American boys and girls between 9 and 17 years of age. Participants walked/ran on a treadmill at a speed equivalent to 60% of their peak VO2 for 20 minutes and provided ratings of exertion every 4 minutes. Pre-activity self-efficacy predicted perceived exertion for boys only. Girls were lower than boys in pre-activity self-efficacy and subsequently reported greater perceived exertion. For both genders, lower perceived exertion during PA resulted in higher post-activity self-efficacy. Uncomfortable perceptions of exertion during initial efforts to increase PA are likely to discourage future activity. Interventions that can lower perceptions of exertion may enhance self-efficacy and promote a sense of competence in PA skills.

Weight perception and psychological factors in Chinese adolescents

PURPOSE

To investigate the pattern of weight perception and its relationship with psychological distress among Chinese adolescents.

METHODS

A sub-cohort of 2179 healthy Chinese adolescents randomly selected from schools in Wuhan, China, including 1156 boys and 1023 girls 11 to 15 years of age was included in the current study. Weight, height, self-perceptions of weight status, depressive psychological symptoms including anxiety, depression, perceived peer isolation, and other constructs were measured by a structured questionnaire. A General Linear Model was used to compare psychological differences between actual and perceived weight groups.

RESULTS

Perceived underweight was more likely to occur in boys, whereas perceived overweight was more likely to occur in girls. Compared with objective body weight status defined by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) age- and gender-specific body mass index (BMI) cutoffs, girls were more likely to misperceive themselves as overweight, whereas relatively more boys misclassified their weight status as underweight. After adjusting for age, parents' educational attainment, and urban residence, perceived overweight boys and girls were more likely to experience anxiety and depression than perceived normal and underweight subjects (p <.05). Perceived overweight girls and perceived underweight boys experienced higher peer isolation than other groups (p <.05). Significant differences were not found in social support, school connectedness, trouble with teachers, and family disharmony among different weight-perception groups.

CONCLUSIONS

Our results suggested distortion of weight perception was prevalent, and may have detrimental psychological influences in Chinese adolescents.

The association of physical maturation with family hassles among African American adolescent males

This research examined associations between physical maturation and adolescent-perceived family hassles within a sample of urban African American families who resided in high-risk communities. The purpose of the study was to examine the relations between physical maturation and youths' perceptions of their family context and the associated daily stresses experienced. The participants were 251 parent-son dyads who were interviewed separately. The combination of quantitative and qualitative results extends the literature on physical development and urban African American populations by indicating that parents are most aware of pubertal changes during early puberty. The findings suggested that adolescent-perceived hassles are indications of parental monitoring and more adaptive parenting strategies are needed for high-risk neighborhoods.

The influence of puberty and ethnicity on awareness and internalization of the thin ideal

OBJECTIVE

This study examined the effects of puberty and ethnicity on awareness and internalization of the thin ideal.

METHOD

Fourth and fifth-grade girls (N = 67) and their parents (N = 67) completed questionnaires assessing demographic variables, eating pathology, pubertal development, and awareness and internalization of the thin ideal.

RESULTS

Girls in pre/early puberty did not differ significantly from girls in mid/late puberty on awareness of the thin ideal; however, more developed girls had significantly greater internalization of the thin ideal. Caucasian and non-Caucasian girls also did not differ on awareness of the thin ideal, but non-Caucasian girls reported greater internalization. No significant interactions between race and puberty existed on the dependent variables.

DISCUSSION

Factors specifically related to puberty seem to be key to girls' development of disordered eating attitudes. The effect of puberty on increased internalization of the thin ideal cannot be explained by increased age or awareness of the thin ideal.

It's about timing and change: pubertal transition effects on symptoms of major depression among African American youths

Effects of early physical maturation and accelerated pubertal changes on symptoms of major depression were examined in 639 African American children. Three rival hypotheses, early timing, off-time, and stressful change, were tested using 2 waves of data (mean ages = 11 and 13 years). The pubertal effect operates differently according to children's gender and age. For girls, early maturation was consistently associated with elevated levels of depressive symptoms. For boys, early maturers manifested elevated levels of depression only at age 11, but these symptoms subsided by age 13. Boys who experienced accelerated pubertal growth over time displayed elevated symptom levels. Results support the early timing hypothesis for girls and the stressful change hypothesis for boys. Time at assessment is critical when examining boys' pubertal transition.

Differential heritability of eating attitudes and behaviors in prepubertal versus pubertal twins

OBJECTIVE

Differential heritability of eating pathology in prepubertal, pubertal, and 17-year-old twins was examined using a population-based twin sample.

METHOD

Participants included 530 11-year-old (452 prepubertal, 78 pubertal twins) and 602 17-year-old female twins from the Minnesota Twin Family Study. Puberty was assessed with the Pubertal Development Scale, and general eating pathology was assessed with the total score from the Minnesota Eating Disorders Inventory (M-EDI).

RESULTS

M-EDI total score intraclass correlations for the pubertal 11-year-old group were more similar to the 17-year-old twins' than the prepubertal 11-year-old twins, suggesting similar levels of genetic influence in the pubertal and older adolescent cohort. Model-fitting corroborated these impressions, indicating that genetic factors accounted for 0% of the variance in 11-year-old prepubertal twins but 54% of the variance in 11-year-old pubertal and 17-year-old twins.

DISCUSSION

Findings suggest that a portion of the genetic influence on eating pathology may become activated during puberty.

Percent body fat at age 5 predicts earlier pubertal development among girls at age 9

OBJECTIVE

This study examines the causal direction of the relationship between weight status and pubertal timing in girls using a longitudinal sample of 183 white girls followed from ages 5 to 9.

METHODS

Girls' weight status (body mass index percentile, percent body fat, waist circumference) was assessed when they were 5, 7, and 9 years old, and their pubertal development was assessed when they were 9 years old (breast development, Estradiol, Pubertal Development Scale). Information from all measures of pubertal development at 9 years was combined to identify girls exhibiting earlier (N = 44) and later (N = 136) pubertal development relative to the sample. Girls' weight status at each age (5, 7, and 9 years old) and change in weight status across the ages of 5 to 9 years were used to predict their pubertal timing at 9 years of age.

RESULTS

Girls with higher percent body fat at 5 years, and girls with higher percent body fat, higher BMI percentile, or larger waist circumference at 7 years, were more likely to be classified with earlier pubertal development at 9 years. In addition, girls showing larger increases in percent body fat from 5 to 9 years of age, and larger increases in waist circumference from 7 to 9 years of age, were more likely to exhibit earlier pubertal development at 9 years. Results were still present after controlling for accelerated growth.

CONCLUSIONS

Girls with higher weight status in early childhood were more likely to exhibit earlier pubertal development relative to peers at 9 years, indicating that weight status preceded pubertal timing in girls.

Parent-adolescent interactions after traumatic brain injury: their relationship to family adaptation and adolescent adjustment

OBJECTIVE

To examine changes in parent-adolescent interactions after traumatic brain injury (TBI) and their relationship to parent and adolescent adjustment.

DESIGN

Concurrent cohort, cross-sectional study. Analysis of variance was used to examine group differences and regression analysis to assess associations between interactional measures and concurrent adjustment.

SETTING

Four hospitals in north-central Ohio.

PARTICIPANTS

Adolescents with severe TBI (25), moderate TBI (22), and orthopedic injuries (35) and their parents.

MAIN OUTCOME MEASURES

Observer ratings of parent-adolescent interactions, Conflict Behavior Questionnaire (CBQ), Family Burden of Injury Interview (FBII), Brief Symptom Inventory (BSI), Family Assessment Device (FAD), Child Behavior Checklist, Vineland Adaptive Behavior Scale, and Children's Depression Inventory.

RESULTS

No group differences were found on ratings of parent-adolescent interaction or the parent or child CBQ. However, observed criticism/coldness and self-rated conflict had stronger associations with the FBII, BSI, and FAD in the severe TBI group than in the orthopedic injury group, suggesting that conflict is more disruptive after TBI. Ratings of criticism/coldness and parent and adolescent CBQ scores were also associated with parent and adolescent adjustment.

CONCLUSIONS

Results support the utility of observational measures in assessing dyadic interactions after TBI.

A longitudinal examination of familial risk factors for depression among inner-city African American adolescents

This research examines longitudinally associations between family risk factors and child and parent depression in 302 urban, low-income, African American adolescents (ages 9-15) and their parents across 2 waves of data collection. Diagnostic data revealed that 7.3% of parents and 3.0% of children at Time 1 and 5.4% of parents and 2.8% of children at Time 2 were clinically depressed. Regression analyses revealed that changes in family functioning were concurrently associated with changes in depression for both children and parents. Specifically, increases in conflict and decreases in parental monitoring were associated with increases in child depressive symptomatology, and increases in conflict and decreases in positive parenting were associated with increases in parental depressive symptomatology. Findings are discussed within a framework of understanding family protective factors and the prevention of depression.

Individual and familial influences on the onset of sexual intercourse among urban African American adolescents

A sample of 198 African American families, living in urban poverty, participated in a longitudinal study of adolescent sexual development beginning when children were in the 4th or 5th grade. Self-reports of family conflict and pubertal development and videotaped family interaction data were collected at 2 time points approximately 2 years apart. Youths reported on sexual debut at each time point. More boys than girls reached sexual debut early. Greater levels of family conflict predicted early sexual debut. Observational data indicated more developed preadolescents with greater family conflict and less positive affect were least likely to delay debut. Changes in pubertal development and observed family conflict were associated with early debut. Possible mediating mechanisms and implications for preventive interventions are discussed.

Sociocultural influences on body image and body changes among adolescent boys and girls

In 2 studies, the authors evaluated the role of parents, peers, and the media in body image and body-change strategies among adolescent boys and girls. The respondents for Study 1 (423 boys and 377 girls) completed the Body Image and Body Change Inventory (L. A. Ricciardelli & M. P. McCabe, 2002) and the Perceived Sociocultural Influences on Body Image and Body Change Questionnaire (M. P. McCabe & L. A. Ricciardelli, 2001b). Body mass index and age were also included in the analyses. Regression analyses demonstrated that sociocultural influences and feedback from the participant's best male friend were important predictors for all body-change strategies among boys. For girls, sociocultural influences and feedback from the participant's best female friend and mother were important predictors for body-change strategies. The most consistent predictor of weight loss, weight gain, and strategies to increase muscles was body-image importance. In Study 2, the authors examined the influence of the same sociocultural variables, as well as negative affect and puberty on body image and body-change strategies among a second group of 199 boys and 267 girls. The results demonstrated that a broad range of sociocultural influences predicted body-change strategies for boys and girls, with negative affect also having a unique influence for boys but not for girls. Puberty played a minor role, once other sociocultural variables were entered into the regression equation. The implications of these findings are discussed.

Testosterone and child and adolescent adjustment: the moderating role of parent-child relationships

In a sample of established middle- and working-class families with normally developing children and adolescents ranging in age from 6 to 18 years, sons' and daughters' testosterone levels showed little direct connection to risk behavior or symptoms of depression. In contrast, testosterone's positive relation with risk behavior and negative relation with depression were conditional on the quality of parent-child relations. As parent-child relationship quality increased, testosterone-related adjustment problems were less evident. When relationship quality decreased, testosterone-linked risk-taking behavior and symptoms of depression were more in evidence. Few relations were found between parents' testosterone and child behavior. Boys' and girls' ages and stages of pubertal development were important for understanding the expression of hormone-related problem behavior in some cases but not in others.

Relationship between Caloric Intake, Body Composition, and Physical Activity to Leptin, Thyroid Hormones, and Cortisol in Adolescents

This study examined the interrelationships between (1) the hormones leptin, TSH, free T3, and cortisol, and (2) caloric intake, body composition, and physical activity to these select hormones in adolescent boys and girls (n = 125, age = 13.4 +/- 0.9 years). The data indicate that adolescent boys and girls have some common hormonal interrelationships. However, certain hormonal relationships are not in agreement with reports for adults, suggesting that researchers should not assume that all endocrine findings in adults are automatically applicable to adolescents.

Sensation seeking, puberty, and nicotine, alcohol, and marijuana use in adolescence

OBJECTIVE

To examine the relationship among nicotine, alcohol, and marijuana use; level of sensation seeking (SS); and pubertal development.

METHOD

Subjects were early and middle adolescent males and females recruited from a psychiatric clinic (n = 77) and two general pediatric clinics (n = 131). SS was measured by using the Sensation Seeking Scale for Children. Pubertal development was measured with a modified Pubertal Development Scale that was completed by the adolescent and his/her parent about the adolescent. Adolescent self-reports of nicotine, alcohol, and marijuana use were also obtained using questionnaires.

RESULTS

SS was higher in males and females who reported nicotine and alcohol use and in males who reported marijuana use. SS was positively associated with pubertal development in males and females, even when controlling for age. Furthermore, SS mediated the relationship of pubertal development and drug use in males and females.

CONCLUSIONS

The observation that SS mediates the relationship between pubertal development and drug use in males and females may contribute to understanding changes in drug use that are seen during adolescence. In addition, SS is associated with drug use and is easily measured in a variety of clinical settings.

The measurement of puberty: a review

This paper has two main objectives. Firstly, to review the feasibility and validity of the various methods that have been used to measure puberty. With an appreciation of these measurement issues, the second objective is to summarize the evidence-base as to whether the age at menarche and the age at onset of puberty has decreased in recent years. In consideration of these methodologies, all of which report different levels of reliability and validity, it is only possible at present to draw inferences about possible changes in pubertal age and onset. Moreover, the wide variations in sample size, selection of participants (usually non-random), and study design reported in the reviewed studies have compounded this situation further. The paper closes by providing a summary of the findings which will be of relevance to those intending to critically review the current evidence surrounding age of puberty, as well as those set on carrying out future research into this area.

Femininity and fertility in sisters with twin brothers: prenatal androgenization? Cross-sex socialization?

Are sisters of twin brothers behaviorally or physiologically masculinized? Prenatal exposure to their brothers' androgens and postnatal socialization experiences unique to girls growing up with twin brothers might influence their attitudes, pubertal development, and reproductive histories. To investigate, we studied age- and cohort-matched samples of Finnish sisters from same-sex and opposite-sex twin pairs. Using data from two ongoing longitudinal studies of consecutive birth cohorts of Finnish twins, we assessed pubertal development at ages 11 and 14 and endorsement of attitudes associated with femininity at age 16. We also studied fertility in Finnish women from same- and opposite-sex twin pairs born from 1958 through 1971, obtaining information on their child-bearing histories when they were ages 15 to 28. Results of each comparison were unambiguously negative: There was no evidence of differences between sisters from same- and opposite-sex twin pairs, and thus, no evidence of either androgenization or cross-sex socialization.

Do the risk factors associated with conduct problems in adolescents vary according to gender?

The present paper examines whether there are gender differences in the associations between conduct problems and risk factors such as family conditions, peer influence, leisure activities, school-related variables and pubertal timing. We analysed self-reported data collected as part of a large general population study of Norwegian adolescents (N=9342). On the basis of earlier studies, conduct problems were decomposed into three dimensions, labelled theft and vandalism, school opposition and covert behaviour. The first dimension includes different kinds of theft and vandalism, whereas the second includes school-related conduct problems of an overt aggressive kind. The last dimension reflects avoidance of arenas under adult control. Whether or not gender differences were detected depended on the aspect of conduct problems considered. The associations between risk factors and "theft and vandalism" and "school opposition" were stronger for boys than for girls. No gender differences were detected in the associations between and risk factors and "covert behaviour". Even though there were gender differences in the strength of these associations, the same risk factors seem to be relevant in explaining conduct problems for both gender groups.

Self-efficacy and perceived exertion of girls during exercise

BACKGROUND

An important national goal in Healthy People 2010 is to reduce the high prevalence of sedentary lifestyles and resultant overweight and obesity among girls.

OBJECTIVES

The purpose of the present study was threefold: (a) to determine if pre-exercise self-efficacy predicted girls' perceptions of exertion during exercise, (b) to determine if these perceptions, in turn, influenced postexercise self-efficacy, and (c) to assess if exercise self-efficacy increased following completion of an exercise task.

METHODS

A sample of 103 girls, 8 to 17 years of age, pedaled 20 minutes on a cycle ergometer at 60% of their predetermined peak VO2 in a climatic chamber (90 degrees F, 50% relative humidity). Ratings of perceived exertion were obtained every 4 minutes. Exercise self-efficacy was assessed before and after the exercise session.

RESULTS

Controlling for peak VO2 and percent body fat, pre-exercise efficacy exerted an independent effect on perception of exertion during exercise with girls high on pre-exercise self-efficacy reporting lower perceived exertion during exercise, than girls low on self-efficacy. Both pre-exercise efficacy and perceived exertion explained postexercise efficacy. Exercise self-efficacy increased significantly from pre- to postexercise.

CONCLUSIONS

Pre-exercise efficacy is an important factor influencing girls' perceptions of exertion during exercise and their postexercise efficacy. Increased exercise self-efficacy of girls following successful completion of an exercise challenge suggests possible strategies to increase physical activity.

Pubertal timing and the onset of substance use in females during early adolescence

The goal of this study is to examine in detail the relationship between pubertal timing and substance use onset using a sample of females from The National Longitudinal Study of Adolescent Health. The sample includes 966 females who were in 7th grade at Wave 1 and 8th grade at Wave 2. Participants in the sample are approximately 69% White, 20% African American, 4% Asian or Pacific Islander, 2% American Indian, 4% other, of Hispanic origin, and 1% other, not of Hispanic origin. Twenty percent of the females were identified as early maturers based on self-reports of body changes (increased breast size and body curviness) measured in 7th grade. These participants are hypothesized to be at increased risk for substance use onset. Important differences in substance use onset were found between early maturers and their on-time and late-maturing counterparts. During 7th grade, females in the early-maturing group are three times more likely to be in the most advanced stage of substance use (involving alcohol use, drunkenness, cigarette use, and marijuana use) than are those in the on-time/late group. Prevalence rates indicate that early maturers are more likely to have tried alcohol, tried cigarettes, been drunk, and tried marijuana. Prospective findings show that early developers are significantly more likely to transition out of the "No Substance Use" stage between 7th and 8th grade (47% for early developers vs. 22% for on-time and late developers). In addition, early developers are more likely to advance in substance use in general, regardless of their level of use at Grade 7.

The role of puberty, media and popularity with peers on strategies to increase weight, decrease weight and increase muscle tone among adolescent boys and girls

OBJECTIVE

The present study was concerned with the impact of pubertal development, relationships with peers and perceived pressure from the media on body dissatisfaction and body change behaviors among adolescent boys and girls. In particular, the study investigated the underresearched area of strategies to increase weight and muscle. The exploration of body change strategies among adolescent boys has been a neglected area of research.

METHODS

Respondents were 1185 adolescents (527 males, 598 females) who were enrolled in Grades 7 and 9. Participants completed measures of pubertal development, media and peer influence, body dissatisfaction and strategies to lose weight, increase weight and to increase muscle.

RESULTS

The findings demonstrated that girls were more likely than boys to adopt strategies to lose weight, whereas boys were more likely to adopt strategies to increase muscle tone (but not weight). For boys in both Years 7 and 9, the main predictors of body change strategies were puberty and, to a lesser extent, perceived popularity with peers. The major influences for Years 7 and 9 girls were puberty and the media, but these mainly focused on weight loss. For Year 9 girls, perceived popularity with opposite-sex peers also predicted body dissatisfaction and strategies to increase muscle tone.

CONCLUSION

The implications of these findings for understanding factors related to a range of body change strategies for adolescent boys and girls are discussed.

A question for DSM-V: which better predicts persistent conduct disorder--delinquent acts or conduct symptoms?

BACKGROUND

Conduct disorder (CD), a psychiatric index of antisocial behaviour, shares similarities with delinquency, a criminological index. This study sought to examine which factors in childhood predict a repeated diagnosis of CD in adolescence, and whether self-reported delinquent acts enhance the utility of symptoms of CD in predicting later persistent CD.

METHOD

Longitudinal data used in this paper come from a clinic-referred sample of 177 boys, along with their parents and teachers, who were assessed using a structured clinical interview. The boys also reported on their delinquent behaviours, as well as a broad range of other family and life events.

RESULTS

Before age 13, 77 boys met criteria for CD according to their parent, 69 according to their own report, and 36 reported three or more delinquent acts. Forty-eight boys (29%) met criteria for CD three or more times between 13 and 17. In childhood, delinquency overlapped, but was distinct from CD. Both were present in 28 cases, while 41 cases had CD without delinquency, and eight had delinquency without CD. When tested as predictors of later persistent CD, child-reported CD was the strongest predictor of later persistent CD, but self-reported delinquency was stronger than parent-reported CD. A final model of significant predictors included child-reported CD, delinquency, poor child communication with parents, and maternal prenatal smoking.

CONCLUSIONS

It appears that delinquency does add uniquely to the prediction of persistent CD. It may be useful to expand the diagnostic criteria for CD accordingly.

Leptin and obesity in mother-child pairs

Defects in the leptin gene or the leptin receptor may be a genetic cause of obesity, but little is known about the familial associations of leptin and obesity. This study compared plasma leptin and measures of obesity in a sample of 248 subjects (124 mother-offspring pairs); 34% were African American and 66% were white. Youth were aged 12 to 16 years. Plasma leptin and body mass index (BMI) were higher in mothers than in their offspring and, among the offspring, higher in girls than boys, even after correcting for BMI or body fat. Racial differences in leptin were present in both mothers and youth when adjusting for percentage body fat but disappeared when adjusting for BMI. In univariate analyses of the associations between mothers and offspring, BMI was associated with leptin in all groups but was most strongly associated in white pairs and in mother-son pairs. In multiple regression analyses, when adjusting for BMI, significant predictors of leptin levelfor the boys and girls together were gender, BMI, and pubertal status of the offspring; in girls only BMI was significant (R2 = 0.72), and in boys the significant predictors were their BMI (R2 = 0.66) followed by their pubertal status (R2 = 0.06) and the leptin level of their mothers (R2 = 0.02). When adjusting for body fat, the predictors were the offspring's percentage bodyfat (R2 = 0. 67) and mother's leptin (R2 = 0.03), with similar results in gender-specific analyses. The authors conclude that leptin levels of youth are most closely associated with their degree of obesity or body fat; mother's leptin and, for boys only, pubertal status also play a small role. Although the small association between maternal leptin on leptin in their offspring could be due to either heredity or shared environment, the results of this study suggest that individual obesity and environmental factors are important predictors of leptin levels in children.

Gender and weight concerns in early and middle adolescence: links with well-being and family characteristics

Studied sex and developmental differences in weight concerns in early and middle adolescence and links between concerns and adolescent well-being and family experiences. Participants were mothers, fathers, and older and younger siblings (Ms = 15 and 12.5 years, respectively) from 197, Caucasian, working-middle class, 2-parent families. Parents rated their gender role attitudes and adolescents rated their weight concerns, well-being, gender role orientations, and physical development. Girls reported more concerns than boys; body mass index (BMI) correlated with weight concerns for all youth. Controlling for BMI and pubertal status, weight concerns were linked to older girls' well-being; with physical characteristics controlled, mothers' gender attitudes explained older girls' weight concerns, and siblings' weight concerns explained those of older and younger girls and boys.

Maturational timing and overweight prevalence in US adolescent girls

OBJECTIVES

This study examined the relation of age at menarche to overweight in US adolescent girls.

METHODS

Effects of age at menarche and race/ethnicity on overweight were estimated via logistic regression, after adjustment for sociodemographic characteristics, in a sample of 6507 Hispanic, Black, White, and Asian American girls who participated in wave 2 of the National Longitudinal Study of Adolescent Health.

RESULTS

Overweight prevalence rates were significantly higher in early maturing adolescents of all racial/ethnic groups but highest (57.5%) among early maturing Black girls. Early maturation nearly doubled the odds of being overweight (body mass index at or above the 85th percentile).

CONCLUSIONS

Greater public health attention should be focused on the high prevalence of overweight, particularly among minority female adolescents.

Blood pressure and sexual maturity in adolescents: the Heartfelt Study

This study investigates sexual maturity as a predictor of resting blood pressures independent of other known predictors, in 179 boys and 204 girls 11-16 years of age from the Heartfelt Study. The sample included youth of African (n = 140), Mexican (n = 117), and European and "other" (n = 126) backgrounds. Sexual maturity was assessed during clinical examination of three standard indicators for each sex. Systolic and diastolic blood pressures were higher in children of maturity stages IV and V, compared to stages I-III, in each gender/ethnic group (P < 0.01 in almost all groups). Boys and girls advanced in sexual maturity for their age group, had significantly higher systolic blood pressures (but not diastolic) than the less advanced in linear models that included height, body mass index (BMI), ethnicity, and age as co-predictors. Diastolic blood pressures were predicted by height in boys and by age and the BMI in girls. This analysis, using a very conservative approach, suggests that sexual maturity provides important and independent information on systolic blood pressure in adolescents. Further investigation of its role in 24-hr blood pressures and in blood pressures taken during physical and emotional stress, is recommended.

Racial differences in accuracy of self-assessment of sexual maturation among young black and white girls

PURPOSE

To examine the validity of maturation self-assessments and to investigate the association between race and validity of self-assessments among young black and white girls.

METHODS

Self-assessments and examiner-assessments of areolar and pubic hair development using line drawings were compared at three visits among a cohort of 11- to 14-year-old girls enrolled in the National Heart, Lung, and Blood Institute's Growth and Health Study. Accuracy rates and kappa coefficients were calculated to measure the agreement between girls and examiners. Logistic regression models were used to assess the racial differences in the accuracy of self-assessments while adjusting for possible confounders.

RESULTS

Fair to moderate agreement was found between self- and examiner-assessments (areolar self-assessments: adjusted accuracy rates: 60.7-69.9%, kappa: 0.32-0.51; pubic hair self-assessments: adjusted accuracy rates: 57.9-70.7%, kappa: 0.36-0.55). While there were indications of racial differences in the ability to perform self-assessment with black girls tending to self-assess less accurately, most of the differences disappeared after adjusting for nurse-assessed stage.

CONCLUSIONS

These findings suggest that self-assessment can substitute for examiner evaluations only when crude estimates of maturation are needed. However, when accurate maturation stage data are required, examiner-assessments are necessary. Because black girls are usually more pubertally advanced and tend to underestimate their development, the value of self-assessment is questionable for assessing populations with young black and white girls. Use of self-assessment might present biased estimates of maturation and confound research findings.

Parental autonomy granting during adolescence: exploring gender differences in context

This study investigated the ways in which 2 indicators of parental autonomy granting, adolescents' decision-making input and parental knowledge of adolescents' daily experiences, differed as a function of contextual factors (i.e., parents' gender role attitudes or sibling dyad sex composition) and boys' and girls' personal qualities (i.e., gender, pubertal status, developmental status, or birth order) in a sample of 194 families with firstborn (M = 15.0 years) and second-born (M = 12.5 years) adolescents. Firstborns were granted more autonomy than second borns, especially in families with firstborn girls and second-born boys. Girls in families marked by traditional maternal gender role attitudes were granted fewer autonomy opportunities. Postmenarcheal second-born girls were granted more opportunities for autonomy than were premenarcheal second-born girls, but only in families with less traditional maternal gender role attitudes.

Performance of a new pubertal self-assessment questionnaire: a preliminary study

We describe the performance of a new, self-assessment questionnaire that aims to measure pubertal status by using gender-specific line drawings of the Tanner puberty stages. The study was carried out on 103 children aged 12-16 years attending a paediatric endocrinology outpatient clinic and used physical examination by clinic doctors as the 'gold standard'. Of 133 consecutive, eligible children, 108 (81%) agreed to participate in the study. Data were collected from 62 (60%) males and 41 (40%) females. Mean age was 14.78 years (SD = 1.26 years, range 12.08-16.98 years). For the pubic hair distribution Tanner stage, there was agreement to within one Tanner stage for 90 children (88%), weighted kappa statistic for inter-rater agreement = 0.68 [95% CI 0.49,0.87]. For the female breast/male genitalia Tanner stage, there was agreement to within one Tanner stage for 75 children (76%), kappa = 0.48 [95% CI 0.31,0.64]. The children tended to underestimate their stage of pubertal development. Overall, the kappa statistics implied good agreement for the pubic hair question and moderate agreement for the breast/genitalia stage question in both girls and boys. The questionnaire may prove useful in situations such as large-scale epidemiological studies, in which direct examination of children to determine pubertal status is not possible, and further validation in normal adolescents is warranted.

Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms

This study examined the role of both pubertal and social transitions in the emergence of gender differences in depressive symptoms during adolescence. This study generated the following findings: (a) Gender differences in depressive symptoms emerged during 8th grade and remained significant through 12th grade. (b) Pubertal status in 7th grade was related to adolescent depressive symptoms over time. (c) Early-maturing girls represented the group with the highest rate of depressive symptoms. (d) Depressive symptoms measured in 7th grade predicted subsequent symptom levels throughout the secondary school years. (e) Recent stressful life events were associated with increased depressive symptoms. (f) Early-maturing girls with higher levels of initial symptoms and more recent stressful life events were most likely to be depressed subsequently. The findings demonstrate the importance of the interaction between the pubertal transition and psychosocial factors in increasing adolescent vulnerability to depressive experiences.

Cardiovascular responsivity to stress in adolescents with and without persistently elevated blood pressure

OBJECTIVES

The goal of this study was to compare the cardiovascular responses to behavioural stressors of three groups of adolescents who differed in blood pressure status across assessments.

DESIGN

Casual blood pressure of adolescents who were identified as having elevated blood pressure during a school screen was re-evaluated in the laboratory. The adolescents were classified into two groups: (i) those with consistently elevated blood pressure across school and laboratory assessments and (i) those with labile blood pressure whose blood pressure in the laboratory was below 130/80 mmHg. A comparison group of adolescents with consistently normal blood pressure was also included.

METHODS

Cardiovascular parameters were assessed during rest and during two behavioural stressors, the evaluated speaking task and the mirror tracing task.

RESULTS

Adolescents with elevated blood pressure were more vascularly responsive across stressors than adolescents with labile blood pressure, who, in turn, were more reactive than adolescents with normal blood pressure.

CONCLUSIONS

These results suggest that vascular reactivity to behavioural stressors may be useful in predicting risk of hypertension because of its sensitivity in distinguishing adolescents with consistently elevated blood pressure from those with labile blood pressure and those with normal blood pressure.

Changes in common activities of 3rd through 10th graders: the CHIC study

PURPOSE

This study was a longitudinal examination of the change in both the activities done and the intensity of those activities from childhood to adolescence.

METHODS

Common activities were assessed by questionnaire initially on 656 subjects from 21 elementary schools; 50.5% were female, 83.4% were Caucasian, 20.6% African-American, and 6.0% were other races.

RESULTS

Girls more often reported sedentary activities overall. Weighted least squares analyses showed boys consistently reported more vigorous activities than girls (P < 0.0008). African-American girls reported fewer vigorous activities than Caucasian or other race girls (P = 0.027). Sedentary activities were more frequently reported with increasing age (X2 P < 0.001). The youngest African-American and Caucasian boys reported similar activity patterns. However, boys from other races reported more intense activities until sixth and seventh grades when African-American boys began reporting more sedentary activities than Caucasians or other races (P = 0.004). During sixth-eighth grades, Generalized Estimating Equations (GEE) models show that girls with more advanced pubertal status reported more sedentary activities than girls who were less developed (P < 0.0001). For high school girls, race was a marginally significant predictor (P = 0.05) of activity status. Neither race nor pubertal status were significant factors in activities chosen by middle school boys. However, for male high school students, Caucasians were more likely than African-Americans to report vigorous activities (P = 0.005).

CONCLUSIONS

Variation in activities by race within gender suggests that establishing activity patterns in youth may be race-specific as well as gender-specific and must be accounted for in designing physical activity interventions. Also, pubertal maturation is a factor in activity choices in middle school girls.

Dating experiences of bullies in early adolescence

In this study, 196 young adolescents who reported that they bullied their peers were identified out of a sample of 1,758 students in Grades 5 through 8. After selecting from the total sample a group of nonbullying youth who were matched on gender, school, and grade, a comparison was made of the groups' dating experiences, quality of friend and boyfriend or girlfriend relationships, and acts of physical and social aggression. The results indicated that bullies started dating earlier and engaged in more advanced dyadic dating than comparison adolescents. Bullies were highly relationship oriented, yet their views of their friends and boyfriends or girlfriends were less positive and less equitable than the comparison adolescents. Finally, bullies were more likely to report physical and social aggression with their boyfriends or girlfriends. Although the bullies reported more advanced pubertal development, this factor did not fully account for their dating precocity and negative romantic relationships. The results confirmed our hypotheses that adolescents whose peer relationships are characterized by bullying are at risk in their development of healthy romantic relationships.

Risk behavior in a community sample of children and adolescents

OBJECTIVES

First, to investigate whether there is covariation between risk behaviors, including suicidality, in a community probability sample of children and adolescents; and second, to investigate whether risk behavior is associated with selected potential correlates.

METHOD

A sample of 9- to 17-year-old youths (N = 1,285) and their caretakers were interviewed in the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. The risk behaviors were marijuana smoking, alcohol use, intercourse, fighting, cigarette smoking, and suicidal ideation/attempts. Relationships between the risk behaviors were described using odds ratios. Linear regression analyses of an index of risk behavior on the selected potential correlates of risk behavior were conducted.

RESULTS

There were significant relationships between all pairs of risk behaviors. The score on the index of risk behavior was associated with stressors, lack of resources, family psychiatric disorder, psychopathology, and functional impairment.

CONCLUSIONS

Clinicians should be alerted to the possibility of risk behaviors, especially in children and adolescents engaging in other risk behaviors and those with inadequate resources, stressors, functional impairment, or psychopathology.

Major depression and dysthymia in children and adolescents: discriminant validity and differential consequences in a community sample

OBJECTIVES

To evaluate evidence, in a community sample, for discriminant validity between major depression (MDD) and dysthymia (Dy) in children and adolescents and to examine differential consequences of the 2 disorders for functioning.

METHOD

The National Institute of Mental Health (NIMH) Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study consists of probability samples of youths. Data for this study are derived from interviews with 1,285 complete parent-youth pairs aged 9 to 17 years from 4 geographic areas in the United States. Youths with MDD were contrasted with those with Dy and those with both (MDD-Dy) on the NIMH Diagnostic Interview Schedule for Children, Non-Clinician Children's Global Assessment Scale, Columbia Impairment Scale, and the Service Utilization and Risk Factors Module.

RESULTS

Groups with MDD, Dy, or MDD-Dy did not differ on sociodemographic, clinical, or family and life event variables. Youths with combined MDD-Dy were significantly less competent and more impaired than youths with either disorder alone.

CONCLUSIONS

The findings do not provide support for the differentiation of MDD and Dy but strongly suggest the importance of addressing the needs of youths who meet criteria for both MDD and Dy because this combination is likely to be both serious and disruptive of normal developmental processes.