Detrimental Psychological Outcomes Associated with Early Pubertal Timing in Adolescent Girls

Effects of pubertal timing on deviant behaviors in Taiwan: A longitudinal analysis of 7th- to 12th-grade adolescents

We investigated the relationship between pubertal timing and deviant behaviors in Taiwan using Taiwan Youth Project (TYP) data. The TYP used multistage-stratified and class-clustered methods in 40 randomly selected schools. We analyzed 1541 adolescents (770 boys; 50.0%) who self-reported their deviant behaviors in 7th, 8th, 10th, and 12th grades. Participants were assigned to early- (n = 244; 15.8%), on-time- (n = 992; 64.4%), and late- (n = 305; 19.8%) puberty groups, and one-way analysis of variance and latent growth modeling were used to examine the frequency of deviant behaviors between them. Early-puberty adolescents had more deviant behaviors (mean = 0.43, SD = 0.74) than did late-puberty adolescents during 7th grade (mean = 0.27, SD = 0.59; p = 0.004), but not after 8th grade. There were no significant differences in the deviance level between on-time-puberty and early- and late-puberty adolescents. Moreover, puberty was not correlated with the growth of deviant behaviors, which decreased with age. However, boys seemed to engage in more deviant behaviors at the beginning, but their engagement seemed to decline faster than it did for girls. In sum, the deviance of early-puberty adolescents seemed to diminish as they got older.

Understanding the Link Between Pubertal Timing in Girls and the Development of Depressive Symptoms: The Role of Sexual Harassment

The link between sexual maturation, or pubertal timing, in girls and adolescent depressive symptoms is well-documented, but the underlying processes remain unclear. We examined whether sexual harassment, which has previously been linked to both pubertal timing and depressive symptoms, mediates this link, using a two-wave longitudinal study including 454 girls in 7th (M age  = 13.42, SD = .53) and 8th grade (M age  = 14.42, SD = .55). Pubertal timing was linked to depressive symptoms in both age groups, and predicted an increase in depressive symptoms among the 7th graders. Sexual harassment significantly mediated the link between pubertal timing and depressive symptoms among the 7th, but not the 8th grade girls. Together, our findings suggest that one way to prevent depressive symptoms among early-maturing girls could be to address sexual harassment in preventive intervention in early adolescence.

Pubertal Timing, Peer Victimization, and Body Esteem Differentially Predict Depressive Symptoms in African American and Caucasian Girls

This study prospectively examined pubertal timing and peer victimization as interactive predictors of depressive symptoms in a racially diverse community sample of adolescents. We also expanded on past research by assessing body esteem as a mechanism by which pubertal timing and peer victimization confer risk for depression. In all, 218 adolescents (53.4% female, 49.3% African American, 50.7% Caucasian) completed both a baseline assessment and a follow-up assessment approximately 8 months later. Early maturing Caucasian girls and late maturing African American girls experienced the greatest increases in depressive symptoms at follow-up if they experienced higher levels of peer victimization between baseline and follow-up. Furthermore, body esteem significantly mediated the relationship between pubertal timing, peer victimization, and depressive symptoms for girls of both races. The interaction of pubertal timing and peer victimization did not predict depressive symptoms for boys of either race. These results support body esteem as a mechanism that contributes to increased depression among girls in adolescence-despite a differential impact of pubertal timing for Caucasian and African American girls.

Putting menarche and girls into the global population health agenda

Menarche, the onset of menstruation is a fundamental part of a girl’s transition from childhood to adolescence. Studies show that girls in many countries experience menarche with insufficient information and support. Girls from around the world report feeling ashamed and afraid. The potential health effects of such experiences include a weakening of girls’ sense of self-confidence and competence, which in turn may comprise girls’ abilities to assert themselves in different situations, including in relation to their sexuality and sexual and reproductive health. There is an important need for the public health community to assure that girls receive the education and support they need about menstruation, so they are able to feel more confident about their bodies, and navigate preventable health problems – now and in the future. For too long, the global health community has overlooked the window of opportunity presented by menarche. Family planning programs have generally focused their efforts on married couples and HIV programs have focused safer sex promotion on older adolescent girls and boys. Starting the conversation at menarche with girls in early adolescence would fully use this window of opportunity. It would engage young adolescent girls and be a natural first step for later, more comprehensive conversations about sexuality, reproduction and reproductive health. There are a number of initiatives beginning to tackle the provision of puberty information to girls and boys, but the global health community is overdue to set a global standard for the provision of such guidance.

Puberty and perimenopause: reproductive transitions and their implications for women's health

This scoping review synthesizes existing research on two major transitions in females' lives: puberty and perimenopause. These two periods of vast physiological change demarcate the beginning and the end of the reproductive life cycle and are associated with major neuroendocrine reorganization across two key systems, the hypothalamic-pituitary-gonadal (HPG) axis the hypothalamus-pituitary-adrenal (HPA) axis. Despite growing evidence suggesting that the timing and experience of puberty and perimenopause are related to various physical and mental health outcomes (e.g., mood disorders, metabolism, cardiovascular health, autoimmune conditions, and cancer), these two processes are rarely examined together. In this paper, we bridge these disparate literatures to highlight similarities, isolate inconsistencies, and identify important areas for future research in women's health.

Cigarette Smoking Trajectories From Sixth to Twelfth Grade: Associated Substance Use and High School Dropout

INTRODUCTION

The purpose of this longitudinal study was to identify distinct trajectories of cigarette smoking from sixth to twelfth grade and to characterize these trajectories by use of other drugs and high school dropout.

METHODS

The diverse sample for this analysis consisted of a cohort of 611 students from Northeast Georgia who participated in the Healthy Teens Longitudinal Study (2003-2009). Students completed seven yearly assessments from sixth through twelfth grade. We used semi-parametric, group-based modeling to identify groups of students whose smoking behavior followed a similar progression over time.

RESULTS

Current smoking (past 30 day) increased from 6.9% among sixth graders to 28.8% among twelfth graders. Four developmental trajectories of cigarette smoking were identified: Abstainers/Sporadic Users (71.5% of the sample), Late Starters (11.3%), Experimenters (9.0%), and Continuous Users (8.2%). The Abstainer/Sporadic User trajectory was composed of two distinct groups: those who never reported any tobacco use (True Abstainers) and those who reported sporadic, low-level use (Sporadic Users). The True Abstainers reported significantly less use of alcohol and other drugs and lower dropout rates than students in all other trajectories, and Sporadic Users had worse outcomes than True Abstainers. Experimenters and Continuous Users reported the highest drug use. Over one-third of Late Starters (35.8%) and almost half of Continuous Users (44.4%) dropped out of high school.

CONCLUSIONS

Cigarette smoking was associated with behavioral and academic problems. Results support early and continuous interventions to reduce use of tobacco and other drugs and prevent high school dropout.

Clarifying the associations between age at menarche and adolescent emotional and behavioral problems

Better understanding risk factors for the development of adolescent emotional and behavioral problems can help with intervention and prevention efforts. Previous studies have found that an early menarcheal age predicts several adolescent problems, including depressive symptoms, delinquency, and early age at first intercourse. Few studies, nevertheless, have explicitly tested (a) whether the associations with menarcheal age vary across racial/ethnic groups or (b) whether the sources of the associations are within-families (i.e., consistent with a direct, causal link) or only between-families (i.e., due to selection or confounding factors). The current study analyzed data from a nationally representative US Sample of females (N = 5,637). We examined whether race/ethnicity moderated the associations between early menarche and several adolescent problems by using multiple-group analyses and we examined the degree to which genetic and environmental factors shared by family members account for the associations by comparing sisters and cousins with differing menarcheal ages. Menarcheal age predicted subsequent depressive symptoms, delinquency, and early age at first intercourse in the population. The magnitudes of the associations were similar across all racial/ethnic groups for all outcomes. The within-family associations (i.e., when comparing siblings and cousins with different menarcheal age) were large and statistically significant when predicting early intercourse, but not the other outcomes. The findings suggest that selection or confounding factors account for the associations between menarcheal age and subsequent depressive symptoms and delinquency, whereas the independent association between menarcheal age and early age at first intercourse is consistent with a direct, causal effect.

Psychological impact of breast asymmetry on adolescents: a prospective cohort study

BACKGROUND

This study measures the impact of adolescent breast asymmetry compared with macromastia and female controls.

METHODS

The following surveys were given to patients with breast asymmetry, macromastia, and controls aged 12 to 21 years: Short Form Health Survey, Version 2 (Short Form-36), the Rosenberg Self-Esteem Scale, and the Eating Attitudes Test. Demographics were compared, and linear regression models, adjusted for body mass index category and age, were fit to determine the effect of case status on survey score.

RESULTS

Fifty-nine adolescents with asymmetry, 142 controls, and 160 macromastia patients participated. After controlling for differences in body mass index category, asymmetry patients scored lower on psychological Short Form-36 domains and the Rosenberg Self-Esteem Scale than controls (p < 0.05), but did not differ in physical health. When compared with macromastia adolescents, asymmetry patients scored significantly better on Short Form-36 physical health domains (p < 0.05), but had similar decrements in emotional functioning, mental health, self-esteem, and eating behaviors/attitudes, after accounting for differences in age. Age and asymmetry type and severity had no effect on survey scores, independent of body mass index category (p > 0.05). Asymmetry patients had a higher mean body mass index percentile than controls (83.36 versus 73.52) but did not differ from that of macromastia patients (83.39).

CONCLUSIONS

Breast asymmetry may negatively impact the psychological quality of life of adolescents similar to macromastia. Breast asymmetry is not just a cosmetic issue. Providers should be aware of the psychological impairments associated with asymmetry and provide proper support.

[Age of puberty and western young women sexuality]

The onset of menarche and age of first sexual experience have both lowered over the past century. Does the age of puberty influence the sexuality of the girl/young occidental woman? If so, to what degree? Besides, is the acquisition of reproductive function, regardless of age, a sign of sufficient maturity to engage in sexual activity? Studies show that early puberty, early sex, unprotected sexual intercourse in adolescence and number of sexual partners in early adulthood are closely related. These early sexual experiences could be stimulated by early drug use as well as by depressive disorders. The age of puberty has a real influence on sexuality but this link will be modulated by a number of social behavioral factors and it is not sustainable. The age of puberty is not a good indicator of maturity for teenage sexuality; early maturation and early sexual activity are usually associated with risky behaviors. However, other studies on the subject are required, including a consideration of the issues associated with delayed puberty, a subject virtually absent from the literature.

Effects of pubertal timing on alcohol and tobacco use in the early adulthood: A longitudinal cohort study in Taiwan

We aimed to examine the effects of pubertal timing on adolescents' alcohol and tobacco use from late adolescence to young adulthood. In addition, we separately explored associative factors of the use of these substances stratified by pubertal timings. A longitudinal cohort of 7th- and 9th-grade students was recruited in Taiwan. Pubertal timing was classified according to the Pubertal Developmental Scale. Effects of pubertal timing on self-reported drinking and smoking at age 20 were evaluated using generalized estimating equation analysis. Furthermore, we assessed the predictive roles of parental monitoring, parent-child relationships, peer influence, and school adhesion among participants, stratified by pubertal timing using multiple logistic regression analysis. A survey of 2290 participants was analyzed, with 51.2% being female. The smoking rate is 19.2% (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.03-2.00) and the alcohol drinking rate is 41.6% (adjusted OR 1.34, 95% CI 1.07-1.69) for early maturing adolescents as compared to 12.3% and 41.6% respectively for on-time peers. A satisfactory parent-child relationship is a protective factor and strict parental monitoring is a risk factor for future tobacco and alcohol use in logistic regression analyses. Early maturation confers risk for cigarette smoking and alcohol consumption in young adulthood. Health professionals and parents should be advised of the potential associative factors with future substance use among adolescents with different maturation tempo. Emphasis could be placed on promoting positive parenting strategies and intra-familial interactions.

Linking Childhood Maltreatment with Girls' Internalizing Symptoms: Early Puberty as a Tipping Point

Early pubertal timing in girls is one of the most frequently replicated antecedents of adolescent emotional distress. Yet understanding the impact of pubertal timing in psychosocial development has presented something of a conundrum for developmentalists, as earlier physical maturation may often be preceded by a range of early adversities and life stressors. The present paper disentangles these associations by investigating childhood maltreatment, adolescent internalizing symptoms, and perceived pubertal timing in girls who were residing in foster care at study entry (N = 100, M = 11.54 years old at Time 1). Girls were assessed at two time points two years apart. There were no significant direct effects of maltreatment on internalizing symptoms; rather, childhood sexual abuse predicted earlier perceived pubertal development at study onset which, in turn, was associated with higher levels of internalizing symptomatology. These higher levels of internalizing symptoms persisted over the two years of the study. This distinctive role for early pubertal timing - even within a sample subject to stressors and risks which far exceed the developmental norm - confirms the unique salience of pubertal timing in emotional adjustment, and suggests that the heightened sexual circumstances of puberty may be especially disturbing for girls whose lives have already been traumatically disrupted by inappropriate and unwanted sexual experiences.

Correlates of adolescent and young adult sexual initiation patterns

CONTEXT

Identifying adolescent characteristics associated with different patterns of sexual initiation is critical to promoting healthy sexual development.

METHODS

Patterns of sexual initiation were examined among 12,378 respondents to Waves 1 (1994-1995) and 4 (2008) of the National Longitudinal Study of Adolescent Health. Multinomial logistic regression explored associations between adolescent characteristics and membership in five latent classes capturing the timing, sequence, pace and variety of sexual initiation patterns.

RESULTS

Age and indicators of greater psychosocial conventionality were associated with membership in the atypical "postponers" class (characterized by postponement of oral, vaginal and anal sexual activity until early adulthood), although patterns of associations varied by gender. For example, compared with males who attended religious services at least once a week, males who never attended religious services were more likely to appear in the vaginal initiators/multiple behaviors class (characterized by initiation of vaginal sex first and then initiation of another behavior after at least one year), rather than in the postponers class (relative risk ratio, 2.5). Compared with women who prayed at least once a day, those who never prayed were more likely to be in the vaginal initiators/single behavior class (whose members typically engaged in only one type of behavior), rather than in the postponers class (2.0).

CONCLUSIONS

Individuals who are more adherent, and presumably more committed, to the attitudes, values and expectations of conventional society are more likely than others to delay multiple types of sexual activity until well beyond the norm for their peers.

Early pubertal timing as a vulnerability to depression symptoms: differential effects of race and sex

Robust evidence supports that girls and boys who experience early pubertal timing, maturing earlier than one's peers, are vulnerable to developing symptoms of depression. However, it has yet to be clarified whether early pubertal timing confers vulnerability to African American as well as to Caucasian adolescents and whether this vulnerability is specific to depressive symptoms or can be generalized to symptoms of social anxiety. In previous studies, one race or one sex was examined in isolation or sample sizes were too small to examine racial differences. Our longitudinal study consisted of a sample of 223 adolescents (Mage = 12.42, 54.3 % female, 50.2 % African American, and 49.8 % Caucasian). At baseline, depressive symptoms, social anxiety symptoms, and pubertal timing were assessed by self-report. Nine months later, we assessed depressive symptoms, social anxiety symptoms, body esteem, and stressful life events that occurred between baseline and follow-up. Analyses indicated that early pubertal timing interacted with stressful life events to predict increased symptoms of depression, but only for Caucasian girls and African American boys. Results were found to be specific to depressive symptoms and did not generalize to symptoms of social anxiety. Additionally, there was a significant positive indirect effect of pubertal timing on symptoms of depression through body esteem for Caucasian females.

Timing and tempo: Exploring the complex association between pubertal development and depression in African American and European American girls

The relative contribution of pubertal timing and tempo to the development of depression has not been tested in a large, representative sample, nor has the interface among pubertal maturation, depression, and race been tested. Participants were a community-based sample of 2,450 girls from the Pittsburgh Girls Study who were interviewed annually from ages 9 to 17 years. Pubertal timing and tempo were characterized as a unitary construct and also separately for pubic hair and breast development using child and maternal report. Depression symptoms were assessed annually. African American girls had higher depression symptoms and progressed through puberty earlier, but at a slower tempo than European American girls. Girls with earlier timing had higher levels of depression symptoms at age 10 years. Slower tempo was associated with higher depression symptoms at age 10, and faster tempo was associated with increases in depression from ages 10 to 13. As well, race moderated the associations among timing, tempo, and depression symptoms, and the association between race and depression was partially mediated by pubertal timing and tempo. Pubertal timing and tempo and race contribute to the developmental course of depression from early to late adolescence. The pattern of association varies as a function of the developmental window within which depression is assessed. Thus, repeated measures of depression symptoms and puberty across the span of pubertal development are necessary for exploring the relative importance of dimensions of pubertal development to depression etiology.

Long-term consequences of pubertal timing for youth depression: Identifying personal and contextual pathways of risk

This research explored sex differences in the pathways linking pubertal timing to depression across 4 years. A sample of 167 youth (M age = 12.41 years, SD = 1.19) and their caregivers completed measures of puberty and semistructured interviews of interpersonal stress and youth depression. Youth reported on psychological (negative self-focus, anxious arousal) and social-behavioral (coping) characteristics; parents reported on youths' social-behavioral characteristics (withdrawal/social problems) and deviant peer affiliations. Early maturation predicted stable high trajectories of depression in girls; although early maturing boys showed low initial levels of depression, they did not differ from girls by the final wave of the study. Latent growth curve analyses identified several psychological, social-behavioral, and interpersonal pathways accounting for the contribution of pubertal timing to initial and enduring risk for depression in girls as well as emerging risk for depression in boys. These findings provide novel insight into multilevel processes accounting for sex differences in depression across the adolescent transition.

Descriptive review: hormonal influences on risk for eating disorder symptoms during puberty and adolescence

OBJECTIVE

Puberty is an important period of risk for the onset of eating pathology in adolescent females. This review focuses on changes in reproductive hormones during puberty as one specific psychopathogenic mechanism.

METHOD

Studies of puberty and eating disorder-related phenotypes were identified using search databases and the reference sections of previous literature.

RESULTS

Correlational studies of adult women and experimental studies of animals provide evidence for the effects of reproductive hormones on eating disorder symptoms. Very few studies of puberty, however, have directly measured or tested the effects of hormonal change in samples of human adolescents. Commonly used measures of pubertal development, such as menarche or self-reported pubertal status, are relatively poor indicators of individual differences in hormones. The extent to which puberty-related hormonal change accounts for elevated risk for disordered eating remains unclear.

DISCUSSION

Future research is necessary to elucidate the specific relations between hormonal change during puberty and risk for disordered eating. In particular, there is a need for longitudinal studies with multivariate measurement of pubertal development, including direct measures of change in reproductive hormones.

Behavior problems and timing of menarche: a developmental longitudinal biometrical analysis using the NLSY-Children data

A powerful longitudinal data source, the National Longitudinal Survey of Youth Children data, allows measurement of behavior problems (BP) within a developmental perspective linking them to menarcheal timing (MT). In a preliminary analysis, we evaluate the bivariate relationships between BP measured at different developmental periods and the timing of menarche. Correlations were not consistent with any correlational/causal relationship between BP and MT. In the major part of our study, MT was used to moderate the developmental trajectory of BP, within a genetically-informed design. Girls reaching menarche early had behavior problem variance accounted for by the shared environment; those reaching menarche with average/late timing had behavior problem differences accounted for by genetic variance. Our findings match previous empirical results in important ways, and also extend those results. A theoretical interpretation is offered in relation to a theory linking genetic/shared environmental variance to flexibility and choices available within the family in relation to BP.

Socioeconomic status and age at menarche: an examination of multiple indicators in an ethnically diverse cohort

PURPOSE

Ethnic disparities exist in US girls' ages at menarche. Overweight and low socioeconomic status (SES) may contribute to these disparities but past research has been equivocal. We sought to determine which SES indicators were associated uniquely with menarche, for which ethnic groups, and whether associations operated through overweight.

METHODS

Using National Longitudinal Study of Youth data, we examined associations between SES indicators and age at menarche. Participants were 4851 girls and their mothers. We used survival analyses to examine whether SES, at various time points, was associated with menarche, whether body mass index mediated associations, and whether race/ethnicity modified associations.

RESULTS

Black and Hispanic girls experienced menarche earlier than whites. After adjusting for SES, there was a 50% reduction in the effect estimate for "being Hispanic" and 40% reduction for "being black" versus "being white" on menarche. SES indicators were associated uniquely with earlier menarche, including mother's unmarried status and lower family income. Associations varied by race/ethnicity. Body mass index did not mediate associations.

CONCLUSIONS

Racial differences in menarche may in large part be due to SES differences. Future experimental or quasiexperimental studies should examine whether intervening on SES factors could have benefits for delaying menarche among blacks and Hispanics.

Early menarche, depressive symptoms, and coping strategies

During the time around menarche, young women must make many emotional and social adjustments to adapt to a new life stage. We compared depressive symptomatology and coping strategies between early and average maturer Mexican adolescents girls. The relationships between elapsed time since menarche and both depressive symptomatology and coping strategies were also studied. Three hundred eighty post-menarcheal students from 11 to 15 years completed the Children's Depression Scale and the Children's Situational Coping Scale. Early maturers showed more depressive symptoms than their peers, but they reported having used fewer non-productive coping strategies. Early maturers who experienced menarche one to three years previously reported more non-productive coping strategies than those who had experienced menarche four to six years ago. However, no differences were found in the results of the average maturers depending on the time elapsed since menarche. These findings are discussed in light of the psychosocial context of early maturers.

Beyond Pubertal Timing

Dramatic physical and emotional changes mark puberty as one of the most important transitions of the human life span. To date, the majority of psychological studies on puberty have focused on pubertal timing, or when children mature relative to their peers. Yet understanding why puberty is meaningful requires adequate attention to multiple domains of developmental variation. The current article outlines four additional aspects of puberty relevant to health and well-being: tempo, synchrony, secular trends, and perceived development.

Child maltreatment and household dysfunction: associations with pubertal development in a British birth cohort

BACKGROUND

We aimed to establish the association between adverse childhood experiences (maltreatment and household dysfunction) and pubertal maturation, which is associated with later health outcome(s).

METHODS

The 1958 British birth cohort (n = 17 638) includes all born in one week, March 1958, followed up to mid adulthood. Pubertal stage was rated by medical personnel at 11 and 16 years of age (y). Childhood maltreatment (neglect or abuse) and household dysfunction scores were constructed from information ascertained in childhood and at 45 y.

RESULTS

Childhood neglect, assessed at 7 y, was associated with late pubertal development on several markers after adjusting for early life circumstances: relative risk ratio (RRRadjusted) was 1.13 (95% CI: 1.06,1.21) and 1.06 (1.00,1.12) for late menarche and breast development (females) per unit increase in neglect score ranging 0-7, respectively; 1.14 (1.08,1.20) for late voice change and 1.07 (1.02,1.13) for pubic hair growth (males). The RRRadjusted for late pubic hair (females) and genitalia and facial hair (males) development was 1.04 (P = 0.052 to 0.085). Abuse score (0-3, for physical, sexual or psychological abuse) was associated in females with late menarche [RRRadjusted = 1.17 (1.01,1.36)] and in males with late pubic hair growth [RRRadjusted = 1.16 (1.01,1.34)] per unit increase, but not with other pubertal markers. Neither score (neglect or abuse) was associated with early puberty, but sexual abuse was associated with early [RRRadjusted = 1.86 (1.06,3.29)] as well as late menarche [RRRadjusted = 1.66 (1.02,2.71)] and witnessing abuse with early genitalia development [RRRadjusted = 1.57 (1.02,2.41)]. Household dysfunction score was not associated consistently with pubertal markers.

CONCLUSIONS

Cumulative neglect by 7 y was associated with delayed development of several pubertal markers. The underlying role of pubertal development in linking childhood neglect with future adult health warrants further consideration.

Pubertal timing, menstrual irregularity, and mental health: results of a population-based study

Reproductive events have a significant impact on women's lives. The aim of this study was to analyze the effects of age at menarche and current menstrual irregularity on psychological well-being and psychopathology. Data were collected in the context of the Finnish population-based Health 2000 study with self-administered questionnaires, a home interview, and a clinical health examination. The Beck Depression Inventory (BDI-21), the General Health Questionnaire-12 (GHQ-12), and the Composite International Diagnostic Interview (M-CIDI) were used to assess psychopathology. The relationships between age at menarche and current menstrual flow irregularity vs. BDI-21 and GHQ-12 scores and M-CIDI diagnoses were studied among 4,391 women aged 30 years and over. Negative, nonsignificant associations were found between age at menarche and BDI-21 and GHQ-12 scores. Young age at menarche was associated with increased risks of any recent mental disorder (OR = 0.894, p < 0.01), major depressive episode (OR = 0.900, p < 0.05), major depressive disorder (OR = 0.888; p < 0.05), and anxiety disorder (OR = 0.892; p < 0.05). Menstrual irregularity was associated with BDI-21 (p < 0.001) and GHQ-12 (p < 0.05) scores, but not with any recent psychiatric diagnosis. Age at menarche and menstrual irregularity have an influence on mental health, particularly on mood and anxiety symptoms. Reproductive features (age at menarche and menstrual irregularity) should be paid attention to during psychiatric evaluations.

Early puberty, negative peer influence, and problem behaviors in adolescent girls

OBJECTIVE

To determine how early puberty and peer deviance relate to trajectories of aggressive and delinquent behavior in early adolescence and whether these relationships differ by race/ethnicity.

METHODS

In this longitudinal study, 2607 girls from 3 metropolitan areas and their parents were interviewed at ages 11, 13, and 16 years. Girls reported on their age of onset of menarche, best friend's deviant behavior, delinquency, and physical, relational, and nonphysical aggression. Parents provided information on family sociodemographic characteristics and girls' race/ethnicity.

RESULTS

Sixteen percent of girls were classified as early maturers (defined by onset of menarche before age 11 years). Overall, relational and nonphysical aggression increased from age 11 to age 16, whereas delinquency and physical aggression remained stable. Early puberty was associated with elevated delinquency and physical aggression at age 11. The relationship with early puberty diminished over time for physical aggression but not for delinquency. Best friend's deviant behavior was linked with higher levels of all problem behaviors, but the effect lessened over time for most outcomes. Early puberty was associated with a stronger link between best friend's deviance and delinquency, suggesting increased vulnerability to negative peer influences among early-maturing girls. A similar vulnerability was observed for relational and nonphysical aggression among girls in the "other" racial/ethnic minority group only.

CONCLUSIONS

Early puberty and friends' deviance may increase the risk of problem behavior in young adolescent girls. Although many of these associations dissipate over time, early-maturing girls are at risk of persistently higher delinquency and stronger negative peer influences.

Pubertal timing and vulnerabilities to depression in early adolescence: differential pathways to depressive symptoms by sex

Although research implicates pubertal processes in the emergence of the sex difference in depression during adolescence, few studies have examined how cognitive and affective vulnerabilities influence the effect of pubertal timing on depressive symptoms. The current study prospectively examined whether early pubertal timing predicted increases in depressive symptoms among adolescents with more negative cognitive styles and lower emotional clarity, and whether this risk was specific to adolescent girls. In a diverse sample of 318 adolescents, early pubertal timing predicted increases in depressive symptoms among adolescent boys and girls with more negative cognitive styles and adolescent girls with poor emotional clarity. These findings suggest that earlier pubertal maturation may heighten the risk of depression for adolescents with pre-existing vulnerabilities to depression, and that early maturing adolescent girls with lower levels of emotional clarity may be particularly vulnerable to depressive symptoms, representing one pathway through which the sex difference in depression may emerge.

Gender-based relationship efficacy: children's self-perceptions in intergroup contexts

This research introduces a new construct, gender-based relationship efficacy, which refers to beliefs about one's ability to relate to own- and other-gender peers. Study 1 investigated 204 fourth graders (M age = 9.56) and confirmed that own-gender and other-gender relationship efficacy represent distinguishable aspects of preadolescents' social competency beliefs that are differentially related to outcomes with own- and other-gender peers, including outcome expectancies and friendships with own- and other-gender peers. Study 2 provided further evidence of the distinctiveness of relationship efficacy for own- and other-gender peers among 403 seventh (M age = 12.48) and 453 eighth (M age = 13.50) graders and found gender and age differences. Developmental changes and implications for research on intergroup relationships are discussed.

Pubertal development, spare time activities, and adolescent delinquency: testing the contextual amplification hypothesis

Extensive evidence supports associations between early pubertal timing and adolescent externalizing behavior, but how and under which conditions they are linked is not fully understood. In addition, pubertal development is also characterized by variations in the relative speed at which individuals mature, but studies linking pubertal 'tempo' and outcomes are scarce. This study examined the mediating and moderating roles of spare time activities in associations between pubertal development and later delinquency, using data from a large (4,327 girls, 4,250 boys) longitudinal UK cohort (Avon Longitudinal Study of Parents and Children). Self-reports of Tanner stage were available from ages 9 to 14, spare time activities at age 12 and delinquency at age 15. Pubertal development was examined using latent growth models. Spare time activities were categorized using factor analyses, yielding four types (hanging out at home, hanging out outside, consumerist behavior, and sports/games), which were examined as mediators and moderators. Earlier and faster maturation predicted delinquency in boys and girls. Spare time activities partially mediated these links such that early maturing girls more often engaged in hanging out outside, which placed them at greater risk for delinquency. In addition, compared to their later and slower maturing counterparts, boys who matured earlier and faster were less likely to engage in sports/games, a spare time activity type that is linked to lower delinquency risk. No moderation effects were found. The findings extend previous research on outcomes of early maturation and show how spare time activities act as proxies between pubertal development and delinquency.

Intervention Effects on Health-Risking Sexual Behavior Among Girls in Foster Care: The Role of Placement Disruption and Tobacco and Marijuana Use

The present study examined the effects of the Middle School Success intervention (MSS), a program to promote healthy adjustment in foster girls, on their health-risking sexual behavior, using a randomized controlled trial (RCT) design. As hypothesized, girls in the intervention condition (n = 48) showed significantly lower levels of health-risking sexual behavior than did girls in the control condition (n = 52) at 36 months postbaseline. Further path analysis indicated that this intervention effect was fully mediated through its effects on girls' tobacco and marijuana use. Findings highlight the importance of providing preventive intervention services to foster girls during early adolescence.

Cognitive vulnerabilities amplify the effect of early pubertal timing on interpersonal stress generation during adolescence

Early pubertal timing has been found to confer risk for the occurrence of interpersonal stressful events during adolescence. However, pre-existing vulnerabilities may exacerbate the effects of early pubertal timing on the occurrence of stressors. Thus, the current study prospectively examined whether cognitive vulnerabilities amplified the effects of early pubertal timing on interpersonal stress generation. In a diverse sample of 310 adolescents (M age = 12.83 years, 55 % female; 53 % African American), early pubertal timing predicted higher levels of interpersonal dependent events among adolescents with more negative cognitive style and rumination, but not among adolescents with lower levels of these cognitive vulnerabilities. These findings suggest that cognitive vulnerabilities may heighten the risk of generating interpersonal stress for adolescents who undergo early pubertal maturation, which may subsequently place adolescents at greater risk for the development of psychopathology.

Pre-menarche pubertal development following unique form of immigration: the case of girls adopted from China

Our study tested the hypothesis that drastic social-cultural change has an impact on girls' pre-menarche pubertal development. We focused on a unique group of Chinese immigrants who migrated out of China in infancy through international adoption. Our sample included 298 Chinese girls who were 7.3-11.1 years in 2011 (Mean = 8.8, SD = 0.9) and were adopted at 7-24 months (Mean = 12.6, SD = 3.4). We found that 34% showed at least one of four signs of pubertal development: Growth spurt, body fat increase, breast development, and body hair. Logistic regression analyses showed that the odds of growth spurt was raised by the girls' age in 2011, behavior problems in 2005, but lowered by the adoptive families' household income; the odds of body fat increase in 2011 was raised by the adopted Chinese girls' weight in 2007 and behavior problems in 2005, but was lowered by the adoptive mother's education level; the odds for breast development in 2011 was raised by the girls' age in 2011, weight in 2007, and behavior problems in 2009. For body hair, none of the factors predicted the odds. Prevalence of precocious puberty, based on the criterion of breast development before 8 years, was 3.5%. Overall, our study suggests that the pre-menarche pubertal development of adopted Chinese girls may be slightly advanced but also is affected by factors that affect non-adopted girls' pubertal development.

Genetic influences on adolescent sexual behavior: Why genes matter for environmentally oriented researchers

There are dramatic individual differences among adolescents in how and when they become sexually active adults, and early sexual activity is frequently cited as a cause of concern for scientists, policymakers, and the general public. Understanding the causes and developmental impact of adolescent sexual activity can be furthered by considering genes as a source of individual differences. Quantitative behavioral genetics (i.e., twin and family studies) and candidate gene association studies now provide clear evidence for the genetic underpinnings of individual differences in adolescent sexual behavior and related phenotypes. Genetic influences on sexual behavior may operate through a variety of direct and indirect mechanisms, including pubertal development, testosterone levels, and dopaminergic systems. Genetic differences may be systematically associated with exposure to environments that are commonly treated as causes of sexual behavior (gene-environment correlation). Possible gene-environment correlations pose a serious challenge for interpreting the results of much behavioral research. Multivariate, genetically informed research on adolescent sexual behavior compares twins and family members as a form of quasi experiment: How do twins who differ in their sexual experiences differ in their later development? The small but growing body of genetically informed research has already challenged dominant assumptions regarding the etiology and sequelae of adolescent sexual behavior, with some studies indicating possible positive effects of teenage sexuality. Studies of Gene × Environment interaction may further elucidate the mechanisms by which genes and environments combine to shape the development of sexual behavior and its psychosocial consequences. Overall, the existence of heritable variation in adolescent sexual behavior has profound implications for environmentally oriented theory and research.

Female pubertal timing and problem behaviour

We tested the peer-socialization/contextual-amplification explanation for the link between early female puberty and problem behaviour. We propose that in cultures with high tolerance for adolescent heterosexual involvement, early puberty should be linked with problem behaviour—not in other cultures. We compared girls in two cultures (Slovakia and Sweden) that differ in acceptance of adolescent girls’ heterosexual involvement. Findings supported the hypothesis by showing that in Sweden, a culture that facilitates adolescent heterosexual involvement, early-maturing girls reported more problem behaviours than in Slovakia. The mediation link (heterosexual involvement as the mechanism linking early puberty with problem behaviour) was moderated by culture. The findings expand our understanding of the role of macro-cultural contexts in the developmental significance of female puberty.

Pubertal timing and the development of psychopathology in adolescence and beyond

This article is part of a Special Issue "Puberty and Adolescence". This paper examines consistency of effects of pubertal timing (going through puberty earlier, later or at the same time one's cohort of peers) on the development of psychopathology during adolescence as well as the persistence of effects into adulthood. It is argued that early maturing girls are at unique risk for psychopathology not only in terms of elevated internalizing and externalizing symptoms and disorders during adolescence but also persistence of elevated risk for depressive disorders and other symptomatology in adulthood. Emerging evidence supports bio-psychosocial pathways for these effects. In addition, recent evidence indicates that late maturation in males may also be a pathway for psychopathology typified by elevated symptoms of psychopathology during early and mid-adolescence and the emergence of disorder in the late adolescent period. While less well established, potential pathways for this association are also discussed.

Early menarche and depressive symptoms from adolescence to young adulthood in a UK cohort

OBJECTIVE

To examine whether early menarche is associated with depressive symptoms from adolescence to young adulthood.

METHOD

The study is based on 3,648 girls from a large UK birth cohort (Avon Longitudinal Study of Parents and Children) who provided data on age at onset of menarche and at least 1 measure of depressive symptoms assessed using the Short Mood and Feelings Questionnaire at ages 13, 14, 16.5, 18, and 19 years. Depressive symptoms were examined as binary outcomes (sum score ≥11) and continuous latent traits (using confirmatory factor analysis). Results were adjusted for socioeconomic disadvantage, paternal absence, and body mass index (BMI).

RESULTS

In early to midadolescence, there was strong evidence for increased odds of depressive symptoms in girls with early compared with late menarche. Differences remained after adjusting for confounders (adjusted odds ratio [OR] = 2.07, 95% confidence interval [CI] = 1.28-3.35 at 13 years; OR = 2.09, 95% CI = 1.41-3.09 at 14 years). At the later time points there was weak evidence for an association between early menarche and depressive symptoms in the unadjusted models. Adjusting for confounders explained a moderate amount of the effect (adjusted OR = 1.26, 95% CI = 0.86-1.85 at 16.5 years; OR = 1.33, 95% CI = 0.91-1.95 at 18 years; and OR = 1.40, 95% CI = 0.93-2.13 at 19 years). Findings were similar when we repeated the analysis using continuous depressive symptom latent traits.

CONCLUSIONS

Girls who experience earlier menarche than their peers have increased levels of depressive symptoms in early to midadolescence, but there is little evidence for an effect of early menarche on depressive symptoms in later adolescence and young adulthood.

Longitudinal reliability of self-reported age at menarche in adolescent girls: variability across time and setting

Age at menarche is critical in research and clinical settings, yet there is a dearth of studies examining its reliability in adolescents. We examined age at menarche during adolescence, specifically, (a) average method reliability across 3 years, (b) test-retest reliability between time points and methods, (c) intraindividual variability of reports, and (d) whether intraindividual variability differed by setting or individual characteristics. Girls (n = 253) were enrolled in a cross-sequential study in age cohorts (11, 13, 15, and 17 years). Age at menarche was assessed using 3 annual, in-person clinician interviews followed by 9 quarterly phone interviews conducted by research assistants. Reliability of age at menarche across time was moderate and varied by method. In-person interviews showed greater reliability (intraclass correlation coefficient [ICC] = .77) versus phone interviews (ICC = .64). Test-retest reliability in reports did not decrease across time. However, average differences in reported age varied as much as 2.3 years (SD = 2.2 years), with approximately 9% demonstrating differences greater than 4.5 years. Pubertal timing category (i.e., early, late) changed for 22.7% if categorized at the final versus the first report of age at menarche. Reliability was moderate, but average differences in reported age were notable and concerning. Using in-person clinician interviews may enhance reliability. Researchers and clinicians should be cognizant of the implications of using different methods measuring age at menarche when interpreting research findings.

The role of pubertal timing and temperamental vulnerability in adolescents' internalizing symptoms

This longitudinal study examined the joint role of pubertal timing and temperament variables (emotional reactivity and self-regulation) in predicting adolescents' internalizing symptoms. The multiethnic sample included 1,025 adolescent girls and boys followed from age 11 to age 15 (M age = 11.03 years at Time 1). In structural equation models, age 11 measures of pubertal timing, emotional reactivity, and self-regulation and their interactions were used to predict adolescents' internalizing behavior concurrently and at age 15. Results indicated that, among girls, early pubertal timing, higher emotional reactivity, and lower self-regulation predicted increased internalizing behavior. In addition, self-regulation moderated the effect of pubertal timing such that effects of earlier timing on subsequent internalizing were seen primarily among girls with relatively poor self-regulation. Among boys, higher levels of emotional reactivity and lower self-regulation predicted increased internalizing, but there were no effects of pubertal timing. After controlling for Time 1 internalizing symptoms, only self-regulation predicted change in internalizing symptoms. Discussion focuses on the possible interplay of temperament and pubertal development in predicting internalizing problems during adolescence.

Emotional and psychosocial aspects of menstrual poverty in resource-poor settings: a qualitative study of the experiences of adolescent girls in an informal settlement in Nairobi

We introduce the concept of "menstrual poverty" to categorize the multiple deprivations relating to menstruation in resource-poor settings across the Global South, and we examine how this affects the psychological well-being of adolescent girls in an urban informal settlement in Kenya. We use qualitative data collected through 34 in-depth interviews and 18 focus group discussions with girls, women, and key informants. Menstrual poverty involved practical and psychosocial challenges affecting girls at home and at school. Its emotional impacts included anxiety, embarrassment, fear of stigma, and low mood. Further research is needed on how menstrual poverty affects girls' psychological and educational outcomes.

Childhood adversity and pubertal timing: understanding the origins of adulthood cardiovascular risk

OBJECTIVE

To determine whether greater childhood adversity relates to younger menarcheal age; whether younger menarcheal age relates to increased CVD risk; and whether greater childhood adversity relates to increased CVD risk, directly or indirectly (mediated by menarcheal age).

METHODS

Among 650 pre-menopausal women (ages 25-45; M=34.9[5.6]), SEM was performed to estimate relations between childhood adversity, menarcheal age, and CVD risk.

RESULTS

Results supported a covariate-adjusted model (RMSEA=0.035; CFI=0.983) in which greater childhood adversity was related to younger menarcheal age (β=-.13, p<.01) and younger menarcheal age was related to greater CVD risk (β=-.18, p<.05). Direct and indirect effects of childhood adversity on CVD risk were non-significant. Re-evaluation of the same model with additional covariate-adjustment for adulthood body composition showed the relation between menarcheal age and CVD risk attenuated (β=-.03, p=.376).

CONCLUSIONS

Cross-sectional evidence suggests family-related adversity experiences in childhood confer risk for earlier menarche which, in turn, relates to increased CVD risk in adulthood, possibly via post-pubertal body size.

Pubertal maturation and sex steroids are related to alcohol use in adolescents

Adolescents often show risk-taking behavior, including experimentation with alcohol. Previous studies have shown that advanced pubertal maturation is related to increased alcohol use in adolescents, even when controlling for age. Little is known about the underlying mechanisms of this relation between pubertal maturation and alcohol use. The goal of the present study was twofold. In Experiment 1, we investigated whether advanced pubertal maturation is associated with higher levels of alcohol use, when controlling for age. To this end, questionnaires on pubertal development and alcohol use were administered to a large sample of 797 Dutch adolescents (405 boys) aged 11-16 years. In Experiment 2, we explored whether sex steroids contribute to this relation between pubertal maturation and alcohol use by examining the association between salivary sex steroid levels and alcohol use in 168 adolescents (86 boys). It was found that, when controlling for age, advanced pubertal maturation is related to increased alcohol use in adolescent boys and girls. Controlling for age, higher testosterone and estradiol levels correlated with the onset of alcohol use in boys. In addition, higher estradiol levels were associated with a larger quantity of alcohol use in boys. Correlations between sex steroids and alcohol use were not significant in girls. These findings show that advanced pubertal maturation is related to advanced alcohol use, and that higher sex steroid levels could be one of the underlying mechanisms of this relation in boys. Sex steroids might promote alcohol use by stimulating brain regions implicated in reward processing.

Life-course origins of the ages at menarche and menopause

A woman's age at menarche (first menstrual period) and her age at menopause are the alpha and omega of her reproductive years. The timing of these milestones is critical for a woman's health trajectory over her lifespan, as they are indicators of ovarian function and aging. Both early and late timing of either event are associated with risk for adverse health and psychosocial outcomes. Thus, the search for a relationship between age at menarche and menopause has consequences for chronic disease prevention and implications for public health. This article is a review of evidence from the fields of developmental biology, epidemiology, nutrition, demography, sociology, and psychology that examine the menarche-menopause connection. Trends in ages at menarche and menopause worldwide and in subpopulations are presented; however, challenges exist in constructing trends. Among 36 studies that examine the association between the two sentinel events, ten reported a significant direct association, two an inverse association, and the remainder had null findings. Multiple factors, including hormonal and environmental exposures, socioeconomic status, and stress throughout the life course are hypothesized to influence the tempo of growth, including body size and height, development, menarche, menopause, and the aging process in women. The complexity of these factors and the pathways related to their effects on each sentinel event complicate evaluation of the relationship between menarche and menopause. Limitations of past investigations are discussed, including lack of comparability of socioeconomic status indicators and biomarker use across studies, while minority group differences have received scant attention. Suggestions for future directions are proposed. As research across endocrinology, epidemiology, and the social sciences becomes more integrated, the confluence of perspectives will yield a richer understanding of the influences on the tempo of a woman's reproductive life cycle as well as accelerate progress toward more sophisticated preventive strategies for chronic disease.

Social and emotional predictors of the tempo of puberty in female rhesus monkeys

A cascade of neuroendocrine events regulates the initiation and progression of female puberty. However, the factors that determine the timing of these events across individuals are still uncertain. While the consequences of puberty on subsequent emotional development and adult behavior have received significant attention, what is less understood are the social and environmental factors that actually alter the initiation and progression of puberty. In order to more fully understand what factors influence pubertal timing in females, the present study quantified social and emotional behavior; stress physiology; and growth and activity measures in juvenile female rhesus monkeys to determine what best predicts eventual puberty. Based on previous reports, we hypothesized that increased agonistic behavior resulting from subordinate status in their natal group, in combination with slowed growth, reduced prosocial behavior, and increased emotional reactivity would predict delayed puberty. The analyses were restricted to behavioral and physiological measures obtained prior to the onset of puberty, defined as menarche. Together, our findings indicate that higher rates of aggression but lower rates of submission received from group mates; slower weight gain; and greater emotional reactivity, evidenced by higher anxiety, distress and appeasing behaviors, and lower cortisol responsivity in response to a potentially threatening situation, predicts delayed puberty. Together the combination of these variables accounted for 58% of the variance in the age of menarche, 71% in age at first ovulation, and 45% in the duration of adolescent sterility. While early puberty may be more advantageous for the individual from a fertility standpoint, it presents significant health risks, including increased risk for a number of estrogen dependent cancers and as well as the emergence of mood disorders during adulthood. On the other hand, it is possible that increased emotional reactivity associated with delayed puberty could persist, increasing the risk for emotional dysregulation to socially challenging situations. The data argue for prospective studies that will determine how emotional reactivity shown to be important for pubertal timing is affected by early social experience and temperament, and how these stress-related variables contribute to body weight accumulation, affecting the neuroendocrine regulation of puberty.

Testing putative causal associations of risk factors for early intercourse in the study of twin adults: genes and environment (STAGE)

Adverse childhood experiences and substance use have been identified as potential causal risk factors for early-onset sexual intercourse. While it is possible that exposure to these risk factors directly increases the likelihood of engaging in early intercourse, an alternative explanation is that observed associations between these variables are due to shared familial confounds. These unmeasured confounds may increase the likelihood of being exposed to these risk factors and of engaging in early intercourse. Participants drawn from a population-based study of Swedish adult twins (ages 19-47 years; N = 12,126) reported on their history of exposure to early physical and sexual trauma, cigarette use, and cannabis use. We investigated the nature of the association between these risk factors and young age at first intercourse, using a comparison of twins differentially exposed to each risk factor. When compared to non-exposed, unrelated individuals, participants who reported adverse childhood experiences or who engaged in early cigarette use or cannabis use were more likely to engage in early intercourse. However, co-twin comparisons indicated that observed associations between these risk factors and early intercourse may be due to familial factors shared within twin pairs, and risk factor exposure may not lead directly to early intercourse. Our results suggest that preventing trauma exposure or preventing or delaying adolescents' cigarette smoking or cannabis use may not effectively delay intercourse onset; instead, other aspects of the adolescent's environment should be addressed.

Pubertal timing and Mexican-origin girls' internalizing and externalizing symptoms: the influence of harsh parenting

Early-maturing girls are at risk for internalizing and externalizing problems. Research concerning pubertal timing and mental health among Mexican Americans or the influence of parenting behaviors on these relations has been scarce. This study addressed these gaps. This was a prospective examination of 362 Mexican-origin girls and their mothers in 3 waves of data. Measures included girls' self-report of pubertal development and girls' and mothers' report of maternal harsh parenting and daughters' mental health. Using structural equation modeling, we examined whether pubertal timing in 5th grade predicted girls' internalizing and externalizing outcomes in 10th grade. We also examined the mediating and moderating effects of harsh parenting on the relations between pubertal timing and internalizing and externalizing behaviors, as well as the influence of mothers' and daughters' nativity on these relations. Results differed depending on reporter and maternal nativity. Using daughters' report, we found that Mexican American mothers' harsh parenting acted as a moderator. At high levels of harsh parenting, early pubertal timing predicted higher externalizing scores, while at low levels of harsh parenting, early timing predicted lower externalizing scores. For Mexican immigrant mothers, harsh parenting mediated the effects of pubertal timing on girls' internalizing and externalizing problems. There were no significant pubertal effects for mothers' report. Findings suggest that maternal harsh parenting plays a key role in the relations between early pubertal timing and behavioral and emotional outcomes among Mexican-origin girls.

Other-Sex Relationship Stress and Sex Differences in the Contribution of Puberty to Depression

Research suggests that the pubertal transition, particularly when experienced earlier than age-matched peers, is associated with heightened depression in girls but less depression in boys. This study examined whether stress within other-sex relationships serves as one process through which puberty differentially contributes to depression for girls and boys. Youth (51 girls, 34 boys; M age = 12.68) and their caregivers reported on pubertal status and age of menarche. Semistructured interviews were conducted to assess youths' depression and exposure to chronic other-sex stress. As anticipated, more advanced status and earlier timing were associated with more depression in girls and less depression in boys. More advanced status and earlier timing were associated with less other-sex stress in boys; earlier age of menarche was associated with more other-sex stress in girls. Other-sex stress partially mediated the early menarche-depression association in girls, suggesting one process through which puberty promotes risk for depression in girls.

Early and late perceived pubertal timing as risk factors for anxiety disorders in adult women

Anxiety disorders generally have an early age of onset and can contribute to the development of comorbid disorders later in life. Thus, it is important to identify adolescent risk factors for anxiety. Past research has identified early pubertal timing as a risk factor for anxiety, typically measured as a general construct through self-report. The current study used data from the National Comorbidity Survey-Replication (NCS-R) to examine recollection of early and late menarche as a predictor of posttraumatic stress disorder (PTSD), specific phobias (SP), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and panic disorder (PD) among women. Findings showed that early timing predicted increased risk of a lifetime diagnosis of PTSD, SP, and SAD, whereas late pubertal timing only predicted increased rates of SAD. Examination of race as a potential moderator of these relationships did not yield significant findings, but these analyses were limited by low power. Other limitations and future directions are discussed.