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

Earlier Menarche in Greek Girls Born by Caesarean Section: A Case-Control Study

Objectives: The purpose of this study was to report on the menarcheal age in girls of Greek origin and assess its potential associations with their demographic and perinatal data, as well as their maternal menarcheal age. Methods: In this case-control study, adolescent girls were recruited between September 2021 and September 2022 from two Pediatric Endocrinology Units, Aristotle University of Thessaloniki, Greece. Eligible participants included Greek girls up to the age of 18 years, with menarche and the absence of chronic disease or chronic medication use. Participants were divided into two groups, the early menarche group and the control group (menarche before or after 11 years of age, respectively). Data included participants' maternal menarcheal age, their chronological age, place of residence, anthropometric data (at recruitment) and perinatal data (birth order, gestational age, type of delivery, birth weight/length). Results: A total of 100 girls aged 7-17 years (mean age ± SD 12.51 ± 2.59 years) were included in this study. The mean ± SD menarcheal age of the total sample was 11.47 ± 1.55 years (median 11.20 years; range 7.50-16.25 years); 43% had early menarche (median menarcheal age 10.50 years; range 7.50-10.91 years), and 57% had menarche after age 11 (median menarcheal age 12.08 years; range 11.00-16.25 years). The caesarean section rate was significantly (p < 0.001) higher in girls with early menarche (83.7%) than controls, whereas other variables did not differ significantly between groups. Conclusions: This Greek sample demonstrated a relatively young age at menarche with a significant proportion of girls with early menarche; in the latter group, the rate of caesarian sections was significantly higher than controls.

Internalizing Symptoms among Kosovar Adolescents: Pubertal Correlates in Boys and Girls

Pubertal status/stage of maturation and pubertal timing have been linked with emotional symptoms of problems among youth, particularly in vulnerable developmental contexts at risk for stress exposure. The present study tested the extent to which pubertal status/stage of maturation and pubertal timing were associated with anxious/depressed, withdrawn/depressed, and somatic complaint symptoms in Kosovar adolescents. It also tested whether sex moderated these relationships. Data were collected from N = 1,342 Kosovar adolescents (665 girls; M age = 13.26 years, SD = 1.27; 677 boys M age = 13.19 years, SD = 1.31). Regression analyses provided evidence that pubertal status/stage was positively associated with rates of anxious/depressed, withdrawn/depressed, and somatic complaint symptoms in girls, but only with withdrawn/depressed symptoms in boys. Additionally, pubertal timing was positively associated with anxious/depressed, and somatic complaint symptoms in girls; no significant links were found for boys. The present study provided evidence that advanced pubertal status/stage as well as timing is positively associated with internalizing symptoms in girls; however, only pubertal status/stage was positively associated with withdrawn/depressed symptoms in boys. The study highlights the importance of pubertal development for internalizing symptoms in a developmental context known for high stress exposure, particularly for girls.

The sexual and reproductive health covariates of early menarche among adolescent girls

INTRODUCTION

Research suggests that girls who reach menarche at an early age are at greater risk for negative sexual and reproductive health (SRH) outcomes than their later-maturing counterparts, but very little research has examined this issue in sub-Saharan Africa, especially in West Africa. The goal of the current study was to determine whether early menarche was associated with any SRH outcomes in a sample of Ghanaian girls.

METHODS

The study data were drawn from the baseline assessment of a longitudinal study involving two age cohorts (13-14 and 18-19 years) of 700 adolescent girls from Ghana. Logistic regressions were used to assess the association between early menarche (before age 13) and seven SRH outcomes (adolescent sexual activity, early sexual initiation, inconsistent condom use, transactional sex, sexual violence, multiple sexual partners, and adolescent pregnancy).

RESULTS

Early menarche was significantly associated with adolescent sexual activity (odds ratio [OR] = 6.4; 95% confidence interval [CI] 2.1-19.7), and sexual violence (OR = 3.2; 95% CI 1.6-6.2) in the younger cohort and early sexual initiation (OR = 3.2; 95% CI 1.19-8.61) and multiple sexual partners (OR = 3.7; 95% CI 1.39-9.87) in the older cohort. Early menarche was also associated with transactional sex and teen pregnancy in the full sample.

CONCLUSIONS

These findings suggest the need for special attention to the needs of early-maturing girls in SRH programming. Interventions are needed to delay adolescent sexual activity in girls with early menarche. Efforts to prevent sexual violence among adolescent girls in Ghana may benefit from targeting and addressing the specific needs of early-maturing girls.

The relationship between timing of onset of menarche and depressive symptoms from adolescence to adulthood

AIMS

Girls who experience an earlier onset of menarche than their peers are at increased risk of depressive symptoms in mid-adolescence, but it is unclear if this association persists into adulthood. This study examines whether longitudinal patterns of depressive symptoms from adolescence to adulthood vary according to timing of menarche.

METHODS

About 4,864 female participants in the UK Avon Longitudinal Study of Parents and Children provided data on age at onset of menarche (assessed in repeated questionnaires from 8 to 17 years) and depressive symptoms across nine time points (13 to 26 years) using the Short Mood and Feelings Questionnaire. We compared patterns of depressive symptoms in girls with 'early' (<11.5 years), 'normative' (11.5 to 13.5 years) and 'late' (≥13.5 years) menarche using a linear spline multilevel growth curve model adjusted for indicators of socioeconomic position, father absence and body mass index.

RESULTS

Early, compared with normative, menarche was associated with higher levels of depressive symptoms at age 14 (imputed adjusted estimated difference = 0.94, 95% confidence interval [CI] = 0.44, 1.45), but the association attenuated at 24 years (0.24 [-0.72, 1.19]). Late menarche, compared with normative, was associated with a lower level of depressive symptoms at age 14 (-0.69 [-1.10, -0.29]), but this association also attenuated at 24 years (-0.15 [-0.92, 0.62]).

CONCLUSIONS

This study did not find a persistent effect of early menarche, compared to normative, on depressive symptoms. However, our findings are consistent with the level of depressive symptoms increasing at the onset of menarche irrespective of timing. The late onset girls 'catch up' with their peers who experience menarche earlier in terms of depressive symptoms. Future studies should continue to assess the impact of timing of menarche further into adulthood.

The Effects of Pubertal Timing on Academic Performance in Adolescence and Career Success in Adulthood: Evidence from a 16-year Longitudinal Study

Previous research showed inconsistent effects of pubertal timing on adolescent academic performance and adult career success. Moreover, the relative importance of biological vs. perceived pubertal timing has not been examined. This study examined effects of biological and perceived pubertal timing on academic performance throughout adolescence and career success in adulthood together with sex differences in an understudied population of pre-dominantly Black youth from lower income families. The sample included 704 youth (52% male, 76% Black, 22% White) interviewed at four time points (Mean ages: 11.8, 13.2, 17.6, and 27.7 years). The results from a mediation path model showed that among males, perceived off-time pubertal timing uniquely predicted lower concurrent academic performance as well as lower objective career success in adulthood; this effect was mediated by lower academic performance throughout adolescence. Additionally, results from bivariate correlation analyses showed associations between early biological pubertal timing and lower concurrent academic performance in males and early perceived pubertal timing and lower concurrent academic performance among females. These findings contribute to the understanding of more nuanced links between pubertal timing, academic performance and subsequent career success in an understudied population of pre-dominantly Black youth from lower income families.

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

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

Parenting Styles as a Moderator of the Association between Pubertal Timing and Chinese Adolescents' Drinking Behavior

BACKGROUND

Previous work has indicated that pubertal timing and parenting styles are associated with adolescents' drinking behavior, but studies on the relationship between the above three variables are lacking.

METHODS

Participants were 1408 Chinese adolescents aged 11-16 years old (46.52% girls). The data emphasized pubertal timing, parenting styles, drinking behavior, and socioeconomic and demographic characteristics of the adolescent and his or her family.

RESULTS

Early pubertal timing was related to drinking behavior; however, parenting styles played a moderating role. For male adolescents, father emotional warmth, mother rejection, and mother emotional warmth moderated the relationship between early pubertal timing and drinking behavior. For female adolescents, mother rejection, mother emotional warmth, and mother over-protection moderated the relationship between pubertal timing and drinking behavior.

CONCLUSIONS

Parenting styles that include emotional warmth, rejection, and over-protection appear to influence the negative outcomes associated with early pubertal timing, and may be useful in reducing adolescents' drinking behavior.

Sex Feelings: A Mediated Group Path Analysis of the Association of Perceptions of Parent Communicated Sexual Values with Sexual Attitudes and Outcomes in Emerging Adulthood

Although communication between parents and children about sexually transmitted diseases and avoiding unwanted pregnancy has been shown to be effective in increasing safe sex practices, parents also implicitly (or explicitly) communicate their own values and attitudes about sex in conversations with their children that might have impacts on their children's sexual feelings and behaviors beyond adolescence. Data were collected from undergraduate students in a human development class (N = 351; 265 women). Multiple group path analysis was used to investigate how emerging adults' perceptions of their parents' sexual values, either leaning toward sexual exploration or abstinence, were associated with their own sexual attitudes, frequency of sexual activity with a partner, desired frequency of sexual activity with a partner and sexual satisfaction. Sexual exploration and abstinence values communicated by parents were significantly associated with emerging adults' permissive and instrumental sexual attitudes; however, only permissive sexual attitudes mediated relationships between parental values and emerging adult sexual outcomes. Only parent-communicated abstinence values had significant direct effect on any of the sexual outcomes (sexual satisfaction). Additionally, gender only moderated the direct relationship between parental abstinence values and sexual frequency; this relationship was significant only for women.

Parenting Styles as a Moderator of the Association between Pubertal Timing and Chinese Adolescents' Smoking Behavior

BACKGROUND

Pubertal timing refers to the timing of an individual regarding pubertal sexual maturation, both physiologically and psychologically. Existing research shows that pubertal timing is associated with behavioral problems. This study investigated the role of parenting style in the relationship between pubertal timing and Chinese adolescents' smoking behavior.

METHODS

The study examined the association of pubertal timing, parenting style and adolescents' smoking behavior, using the Pubertal Development Scale (Chinese version), Simplified Parenting Style Scale-Chinese version, and three items related to adolescents' smoking situation. Participants were 1391 Chinese adolescents aged 11-16 years old (53.41% boys). Hierarchical linear regression analyses assessed the moderating role of parenting style on the association between pubertal timing and adolescent smoking behavior.

RESULTS

The results indicated that parenting style moderates the relationship between pubertal timing and adolescent smoking behavior. For male adolescents, father rejection moderated the relationship between early pubertal timing and smoking behavior. For female adolescents, father rejection, father emotional warmth, and mother emotional warmth moderated the relationship between pubertal timing and smoking behavior.

CONCLUSIONS

Findings from the study highlight the importance of parenting style, which may influence the negative outcomes associated with early pubertal timing and can help improve interventions aimed at reducing these negative outcomes.

Pubertal Development: What's Normal/What's Not

Onset of puberty, as defined by breast stage 2, appears to be starting at younger ages since the 1940s. There is an ongoing controversy regarding what is normative, as well as what is normal, and the evaluation that is deemed necessary for girls maturing before 8 years of age. There are potential implications of earlier pubertal timing, including psychosocial consequences during adolescence, as well as longer term risks, such as breast cancer and cardiometabolic risks. There are additional consequences derived from slower pubertal tempo, for age of menarche has not decreased as much as age of breast development; these include longer interval between sexual initiation and intentional childbearing, as well as a broadened window of susceptibility to endocrine-related cancers.

Early pubertal timing predicts onset and recurrence of depressive episodes in boys and girls

BACKGROUND

Recurrent depressive episodes during adolescence result in significant impairment and increased risk for subsequent adverse outcomes throughout the life span. Evidence suggests that early pubertal timing predicts the onset of depressive episodes (particularly for girls); however, it is not known if pubertal timing prospectively predicts recurrent depressive episodes in youth.

METHODS

At baseline, 603 youth (56% female, at baseline: M_age  = 12.09, SD = 2.35) reported on their pubertal development. Youth and their parents completed a semistructured diagnostic interview to assess depressive episodes at baseline and then evaluated for onset repeatedly every 6 months for a period of 36 months.

RESULTS

Controlling for past history of depression, Cox proportional hazards models examined whether earlier pubertal timing predicted (a) days to first depressive episode from baseline and (b) days to a second (recurrent) depressive episode from the end of the first episode. Early pubertal timing predicted the onset of the first depressive episode after baseline (b = .19, Wald = 5.36, p = .02, HR = 1.21), as well as a recurrent episode during course of study follow-up episode (b = .32, Wald = 6.16, p = .01, HR = 1.38).

CONCLUSIONS

Findings reinforce the importance of considering the impact of early pubertal timing on depression risk. Investigation on how pubertal timing interacts with other risk factors to predict depression recurrence is needed.

Pubertal timing and self-harm: a prospective cohort analysis of males and females

AIMS

Early puberty is associated with an increased risk of self-harm in adolescent females but results for males are inconsistent. This may be due to the use of subjective measures of pubertal timing, which may be biased. There is also limited evidence for the persistence of pubertal timing effects beyond adolescence, particularly in males. The primary aim of the current study was therefore to examine the association between pubertal timing and self-harm in both sexes during adolescence and young adulthood, using an objective measure of pubertal timing (age at peak height velocity; aPHV). A secondary aim was to examine whether this association differs for self-harm with v. without suicidal intent.

METHODS

The sample (n = 5369, 47% male) was drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort study. Mixed-effects growth curve models were used to calculate aPHV. Lifetime history of self-harm was self-reported at age 16 and 21 years, and associated suicidal intent was examined at age 16 years. Associations were estimated using multivariable logistic regression adjusted for a range of confounders. Missing data were imputed using Multiple Imputation by Chained Equations.

RESULTS

Later aPHV was associated with a reduced risk of self-harm at 16 years in both sexes (females: adjusted per-year increase in aPHV OR 0.85; 95% CI 0.75-0.96; males: OR 0.72; 95% CI 0.59-0.88). Associations were similar for self-harm with and without suicidal intent. There was some evidence of an association by age 21 years in females (adjusted per-year increase in aPHV OR 0.91; 95% CI 0.80-1.04), although the findings did not reach conventional levels of significance. There was no evidence of an association by age 21 years in males (adjusted per-year increase in aPHV OR 0.99; 95% CI 0.74-1.31).

CONCLUSIONS

Earlier developing adolescents represent a group at increased risk of self-harm. This increased risk attenuates as adolescents transition into adulthood, particularly in males. Future research is needed to identify the modifiable mechanisms underlying the association between pubertal timing and self-harm risk in order to develop interventions to reduce self-harm in adolescence.

Timing of menarche and self-harm in adolescence and adulthood: a population-based cohort study

BACKGROUND

Previous studies of pubertal timing and self-harm are limited by subjective measures of pubertal timing or by the conflation of self-harm with suicide attempts and ideation. The current study investigates the association between an objective measure of pubertal timing - age at menarche - and self-harm with and without suicidal intent in adolescence and adulthood in females.

METHOD

Birth cohort study based on 4042 females from the Avon Longitudinal Study of Parents and Children (ALSPAC). Age at menarche was assessed prospectively between ages 8 and 17 years. Lifetime history of self-harm was self-reported at ages 16 and 21 years. Associations between age at menarche and self-harm, both with and without suicidal intent, were examined using multivariable logistic regression.

RESULTS

Later age at menarche was associated with a lower risk of lifetime self-harm at age 16 years (OR per-year increase in age at menarche 0.87; 95% CI 0.80-0.95). Compared with normative timing, early menarche (<11.5 years) was associated with an increased risk of self-harm (OR 1.31, 95% CI 1.04-1.64) and later menarche (>13.8 years) with a reduced risk (OR 0.74, 95% CI 0.58-0.93). The pattern of association was similar at age 21 years (OR per-year increase in age at menarche 0.92, 95% CI 0.85-1.00). There was no strong evidence for a difference in associations with suicidal v. non-suicidal self-harm.

CONCLUSIONS

Risk of self-harm is higher in females with early menarche onset. Future research is needed to establish whether this association is causal and to identify potential mechanisms.

The role of pubertal timing in the link between family history of alcohol use disorder and late adolescent substance use

BACKGROUND

Youth who experience puberty earlier than their peers are at heightened risk for substance use during adolescence. However, little is known about whether pubertal timing exacerbates effects of relevant early risk factors, such as family substance use history, as predicted by the "accentuation hypothesis". Using longitudinal data from youth with and without a family history of alcohol use disorder (AUD FHx), we evaluated whether pubertal timing intensifies preexisting familial risk effects on late adolescent substance use.

METHODS

Participants were 568 males and 245 females from the Michigan Longitudinal Study. Pubertal timing was indexed by fitting mixed-effects linear models to repeated measures of self-reported Tanner stage. Multilevel models then tested: (a) whether AUD FHx predicted pubertal timing, and (b) whether AUD FHx, pubertal timing, or their interaction predicted alcohol and marijuana use at ages 16-18.

RESULTS

AUD FHx was unrelated to pubertal timing in either males or females. In males, alcohol and marijuana use in late adolescence were predicted by AUD FHx and timing, but not their interaction. In females, AUD FHx predicted alcohol-related outcomes, but there were no main or interaction effects of timing.

CONCLUSIONS

Pubertal timing does not moderate the link between AUD FHx and late adolescent substance use, in contrast to the accentuation hypothesis. In males, measures of pubertal maturation and familial risk provide unique information for prediction of use. Females displayed no link between pubertal timing and use, which may suggest different risk pathways, or may have been due to the female sample's smaller size.

Early Menarche and Internalizing and Externalizing in Adulthood: Explaining the Persistence of Effects

PURPOSE

Earlier ages at menarche are associated with elevations in internalizing and externalizing that persist into adulthood. The present study examines whether early pubertal timing precipitates experiences during adolescence that account for long-term elevations in depressive symptoms and antisocial behavior among early maturing girls.

METHODS

Using data from the National Longitudinal Study of Adolescent and Adult Health (Add Health), the study examines significant postmenarcheal life events that might mediate associations of age at menarche with depressive symptoms and antisocial behavior in adulthood: teenage criminal arrest, teenage pregnancy and childbearing, high school dropout, and different forms of postpubertal physical and sexual traumatic assault.

RESULTS

Results indicate that earlier menarche was associated with greater likelihood of postmenarcheal discontinued education, physical and sexual assault, and teenage pregnancy and childbearing. Discontinued education, physical assault, and sexual assault mediated associations of pubertal timing with adult depressive symptoms; sexual assault mediated associations of pubertal timing with adult antisocial behavior.

CONCLUSIONS

Earlier menarche seems to precipitate postpubertal stressful events that, in turn, account for higher rates of psychological problems in adulthood. These results suggest that the adolescent experiences of early maturing girls channel them into life paths where stress, adversity, and other risks to psychological well-being are more likely to be a continuing facet of daily life.