Self-assessment of sexual maturity by mid-adolescents based on a global question

Characteristics of Young People Reporting a Low Sexual Desire in Switzerland

This study explores the characteristics of young female and male adults (mean age 26.3 years) reporting a low sexual desire. A 2017 Swiss national survey was carried out among young adults. Participants were divided into two groups based on their level of sexual desire: Low and High. Overall, 17.2% of females and 5.7% of males reported a low sexual desire. At the multivariate level, compared to females in the High group, females in the Low group had higher odds of being dissatisfied with their social life and with their sexual life in the past 4 weeks, having no current relationship and having accepted several times sexual intercourse without really wanting. Compared to males in the High group, males in the Low group had higher odds of reporting a non-heterosexual attraction (trend), having no current relationship and having accepted several times sexual intercourse without really wanting. The prevailing idea that young people, particularly males, always have high levels of sexual desire may not be accurate and warrants further consideration. These results show that sexual desire encompasses social aspects and underscore importance of addressing how stereotypes and social norms may influence our sexuality.

Genetically inferred birthweight, height, and puberty timing and risk of osteosarcoma

INTRODUCTION

Several studies have linked increased risk of osteosarcoma with tall stature, high birthweight, and early puberty, although evidence is inconsistent. We used genetic risk scores (GRS) based on established genetic loci for these traits and evaluated associations between genetically inferred birthweight, height, and puberty timing with osteosarcoma.

METHODS

Using genotype data from two genome-wide association studies, totaling 1039 cases and 2923 controls of European ancestry, association analyses were conducted using logistic regression for each study and meta-analyzed to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were conducted by case diagnosis age, metastasis status, tumor location, tumor histology, and presence of a known pathogenic variant in a cancer susceptibility gene.

RESULTS

Genetically inferred higher birthweight was associated with an increased risk of osteosarcoma (OR =1.59, 95% CI 1.07-2.38, P = 0.02). This association was strongest in cases without metastatic disease (OR =2.46, 95% CI 1.44-4.19, P = 9.5 ×10-04). Although there was no overall association between osteosarcoma and genetically inferred taller stature (OR=1.06, 95% CI 0.96-1.17, P = 0.28), the GRS for taller stature was associated with an increased risk of osteosarcoma in 154 cases with a known pathogenic cancer susceptibility gene variant (OR=1.29, 95% CI 1.03-1.63, P = 0.03). There were no significant associations between the GRS for puberty timing and osteosarcoma.

CONCLUSION

A genetic propensity to higher birthweight was associated with increased osteosarcoma risk, suggesting that shared genetic factors or biological pathways that affect birthweight may contribute to osteosarcoma pathogenesis.

Unexcused absence from physical education in elementary school. On the role of autonomous motivation and body image factors

Physical education (PE) is an essential school subject due to its potential to promote well-being and health in all children. Yet, PE stands out among other subjects in terms of truancy. This study is one of the first to examine if unexcused absence from PE is associated with early adolescents' body image and autonomous motivation towards PE. A total of 526 Swedish 6th graders (Mage = 12.28, SD = 0.31) reported the frequency of unexcused absence from PE and answered questions about aesthetic and functional body image, social physique anxiety, and autonomous motivation. Findings showed that unexcused absence from PE was associated with less autonomous motivation and higher social physique anxiety. Participants who had never been absent reported higher functional body image investment and satisfaction. Analyses showed that whereas the aesthetic aspects of body image were associated with decreased autonomous motivation toward PE, functional aspects predicted higher autonomous motivation. The study sheds novel light on the links between absence from PE, body image, and autonomous motivation. As absence may have real-life practical effects for school achievement, health, and well-being, the findings demonstrate the importance of mitigating social physique anxiety and promoting an inclusive and body positive PE context early on.

Non-consensual sexting: characteristics and motives of youths who share received-intimate content without consent

Background:One of the possible negative consequences of sexting is the non-consensual sharing of received-intimate content. This study aimed to determine the characteristics and motives of youths who shared received-intimate images without consent. Methods: Data were obtained from a self-administrated Swiss survey on sexual behaviours among young adults (aged 24-26 years). Out of the 7142 participants, 5175 responded to the question 'Have you ever shared (forwarding or showing) a sexy photograph/video of someone else (known or unknown) without consent'?; 85% had never shared (Never), 6% had shared once (Once) and 9% had shared several times (Several). Data are presented as relative risk ratios with 95% confidence intervals. Results: Participants who had shared received-intimate content without consent had higher odds of being male [2.73 (2.14-3.47)], foreign-born [1.45 (1.04-2.03)], reporting a non-heterosexual orientation [1.46 (1.10-1.93)], having sent one's own intimate image [1.76 (1.32-2.34)] and receiving a shared-intimate image of someone unknown [4.56 (3.28-6.36)] or known [2.76 (1.52-5.01)] compared with participants who had never shared. The main reported motivations were for fun (62%), showing off (30%) and failure to realise what they were doing (9%). Conclusions: Given the reported motivations, it appears crucial to remind youths of the seriousness of non-consensual sharing. Although females may also be perpetrators, the behaviour was more prevalent among males. Prevention and education need to consider a broad range of young people in their scenarios. Even if a particular focus on understanding and preventing males' perpetration must be considered, overall perpetration, including female's, must be discussed.

Does the Primary Resource of Sex Education Matter? A Swiss National Study

Sex education (SE) remains a subject of debate, including controversies on resources. The purpose of this paper was to determine the main SE resource during adolescence and its associations with personal characteristics and sexual behaviors of youths. Data were obtained from a self-administrated Swiss national survey on sexuality among young adults (mean age 26.3). Participants (N = 4978) were divided into six groups according to their main SE resource during their adolescence: Friends (1939; 38.9%), Parents (1361; 27.3%), School (n = 949; 19.1%), The Internet (399; 8.0%), Nobody (172; 3.5%) and Other (157; 3.2%). Groups were compared on sociodemographic, first sexual experiences, pregnancy, risky sexual behaviors, and undesired sexual experiences data. Males and non-heterosexual participants were overrepresented in the Internet group while, females more often reported their parents as their main SE resource. Participants in the School group reported the lowest rates of sexually transmitted infections and Friends the highest. Compared to the School group, those in the Friends, Internet, Nobody, and Other groups were more likely to report undesired sexual experiences. Few differences appeared between parents and school. Even though some resources such as friends or the Internet presented negative outcomes when they were assessed individually, we cannot deny the important place that they occupy in the lives of some youths.

Does regretting first vaginal intercourse have an effect on young adults' sexual behaviour?

Background The aims of this research were to determine personal differences depending on the reason for regretting or not first vaginal intercourse and its effects on sexual behaviour later on among young adults, and to assess the association between reasons for engaging in first vaginal intercourse and regretting it. Methods: Data were drawn from the 2017 Swiss national survey on youth sexual behaviours among young adults (mean age 26 years) living in Switzerland. Out of the 7142 participants, 4793 (51% females) answered the question ‘Looking back now to the first time you had vaginal intercourse, do you think that…’ with five possible answers: (1) I should not have done it (6.7%); (2) I should have waited longer (7.7%); (3) I should have done it earlier (7.4%); (4) It was about the right time (67.9%); and (5) I don’t know (10.3%). The five groups were compared on sociodemographic and sex behaviour-related variables, analysed separately by gender. Results: One-third of participants regretted their first experience. In the multivariate analysis, compared with the ‘right time’ group, all other groups were more likely to find their first experience unpleasant and to have done it with a casual partner. Those in the ‘I should not have done it’ and ‘I should have waited longer’ groups were also more likely to have done it because of external pressure, especially among females. Conclusions: The study results underline the significance to choose the right time and the right partner for first vaginal intercourse and the importance of including partner respect and avoiding external pressure as part of sexual education.

Life after childhood bullying: Body image development and disordered eating in adulthood

Studies have demonstrated that being bullied in childhood may have long-term associations with lower psychological well-being in adulthood. However, although bullying incidents frequently target the victim’s body and appearance, research has overlooked studying victims’ long-term body image development and risk of engaging in disordered eating later in life. This 14-year longitudinal research project examined childhood bullying in relation to body image development and disordered eating in emerging adulthood. Growth curve analyses of participants’ body image at ages 10–21 years ( N = 960) revealed that more victimized children experienced more body dissatisfaction at baseline and maintained their negative body image throughout adolescence and into adulthood. Mediation analyses showed that childhood bullying (age 10 years) predicted more negative body image in adolescence (age 18 years), which in turn predicted more disordered eating in adulthood (age 24 years). The indirect effect was stronger for girls than for boys. The findings suggest that bullied children are likely to face both more body image problems and disordered eating as they evolve through adolescence and into adulthood, indicating the need for early and effective interventions. Incorporating components known to promote a more positive body image could be a valuable feature of future interventions. Thus, as children and adolescents are taught to cope with bullying situations, they could also be helped to deal with the appearance culture that permeates many of these situations.

Methods for determining pubertal status in research studies: literature review and opinions of experts and adolescents

In lifecourse studies that encompass the adolescent period, the assessment of pubertal status is important, but can be challenging. We aimed to identify current methods for pubertal assessment and assess their appropriateness for population-based research by combining a review of the literature with the views of experts in the field. We searched bibliographic databases, extracted data and assessed study quality to inform a workshop with 21 experts. Acceptability of different approaches was explored with a panel of ten adolescents. We screened 11,935 abstracts, assessed 157 articles and summarised results from 38 articles. Combining these with the opinions of experts, self-assessment was found to be a practical method for use in studies where agreement with the gold standard of clinical assessment by physical examination to within one Tanner stage was acceptable. Serial measures of height and foot size accurately indicated timing of the pubertal growth spurt and age at peak height velocity, and were seen as feasible within longitudinal studies. Hormonal and radiological methods did not offer a practical means of assessing pubertal status. Assessment of voice maturation was promising, but needed validation. Young people thought that self-assessment, foot size and voice assessments were acceptable, and preferred an assessor of the same sex for clinical assessment. This review thus informs researchers working in lifecourse and adolescent health, and identifies future directions in order to improve validity of the methods.

Validity of self-assessment of pubertal maturation

BACKGROUND AND OBJECTIVES

Studies of adolescents often use self-assessment of pubertal maturation, the reliability of which has shown conflicting results. We aimed to examine the reliability of child and parent assessments of healthy boys and girls.

METHODS

A total of 898 children (418 girls, 480 boys, age 7.4-14.9 years) and 1173 parents (550 daughters, 623 sons, age 5.6-14.7 years) assessed onset of puberty or development of breasts, genitals, and pubic hair according to Tanner stages by use of a questionnaire and drawings. Physicians' assessments were blinded and set as the gold standard. Percentage agreement, κ, and Kendall's correlation were used to analyze the agreement rates.

RESULTS

Breast stage was assessed correctly by 44.9% of the girls (κ = 0.28, r = 0.74, P < .001) and genital stage by 54.7% of the boys (κ = 0.33, r = 0.61, P < .001). For pubic hair stage 66.8% of girls (κ = 0.55, r = 0.80, P < .001) and 66.1% of boys (κ = 0.46, r = 0.70, P < .001) made correct assessments. Of the parents, 86.2% correctly assessed onset of puberty in girls (κ = 0.70, r = 0.71, P < .001) and 68.4% in boys (κ = 0.30, r = 0.37, P < .001). Children who underestimated were younger and children who overestimated older than their peers who made correct assessments. Girls and their parents tended to underestimate, whereas boys overestimated their pubertal stage.

CONCLUSIONS

Pubertal assessment by the child or the parents is not a reliable measure of exact pubertal staging and should be augmented by a physical examination. However, for large epidemiologic studies self-assessment can be sufficiently accurate for a simple distinction between prepuberty and puberty.

Associations between online pornography and sexual behavior among adolescents: myth or reality?

This study aimed to compare the sexual behavior of adolescents who were or were not exposed to online pornography, to assess to what extent the willingness of exposure changed these possible associations, and to determine the profiles of youths who were exposed to online pornography. Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health, a self-administered cross-sectional, paper and pencil questionnaire. From the 7529 adolescents aged 16-20 years, 6054 (3283 males) used the Internet during the previous month and were eligible for our study. Males were divided into three groups (wanted exposure, 29.2%; unwanted exposure, 46.7%; no exposure, 24.1%) whereas females were divided into two groups (exposure, 35.9%; no exposure, 64.1%). The principal outcome measures were demographic characteristics, Internet use parameters and risky sexual behaviors. Risky sexual behaviors were not associated with online pornography exposure in any of the groups, except that males who were exposed (deliberately or not) had higher odds of not having used a condom at last intercourse. Bi/homosexual orientation and Internet use parameters were not associated either. Additionally, males in the wanted exposure group were more likely to be sensation-seekers. On the other hand, exposed girls were more likely to be students, higher sensation-seekers, early maturers, and to have a highly educated father. We conclude that pornography exposure is not associated with risky sexual behaviors and that the willingness of exposure does not seem to have an impact on risky sexual behaviors among adolescents.

Assessing inter-rater reliability (IRR) of Tanner staging and orchidometer use with boys: a study from PROS

BACKGROUND

Few studies have systematically assessed the reliability of pubertal markers; most are flawed by limited numbers of markers and ages studied.

AIM

To conduct a comprehensive examination of inter-rater reliability in the assessment of boys' sexual maturity.

SUBJECTS

Eight pairs of practitioners independently rated 79 consecutive boys aged 8-14 years.

METHODS

Two raters in each of eight practices independently rated boys aged 8-14 years, presenting for physical examinations, on key pubertal markers: pubic hair and genitalia (both on 5-point Tanner scales), testicular size (via palpation and comparison with a four-bead Prader orchidometer), and axillary hair (via a three-point scale).

RESULTS

Intraclass correlations assessing degree of inter-rater reliability for pubertal markers ranged from 0.61 to 0.94 (all significant at p < 0.001). Rater Kappas for signs of pubertal initiation ranged from 0.49 to 0.79.

CONCLUSIONS

Practitioners are able to reliably stage key markers of male puberty and identify signs of pubertal initiation.

The influence of puberty onset, body mass index, and pressure to be thin on disordered eating behaviors in children and adolescents

The main objective of this study is to verify the hypothesis that pubertal development, obesity, body satisfaction, as well as family and peer influences predict unhealthy eating habits in children and adolescents. A randomized stratified sample of young Quebecers aged 9, 13, and 16 years on March 31, 1999 [608 children aged of 9 years (325 girls and 283 boys) and 662 adolescents aged of 13 and 16 years (349 girls and 313 boys)] were used. Children's weight, height, and Body Mass Index (BMI) were recorded. Questionnaires were administered to children and a parent (usually the mother). Among 9-year-old children, this study found that weight loss or weight control behaviors were predicted mainly by the onset of puberty, lower maternal abusive control, and the level of peer pressure. Among adolescents, mother's BMI, income, peer pressure, and negative comments about the child's weight most strongly predicted behaviors to control weight, strategies to lose weight and the frequency of such behaviors. The findings suggest that both parents and children need to understand the impact of comments on a child's behavior.

Disordered eating behaviors: what about boys?

PURPOSE

To determine the characteristics specific to boys with disordered eating behaviors (DEB) and the general context in which these DEB occur.

METHOD

Data were drawn from the SMASH02 database, a survey carried out among post-mandatory school students in Switzerland aged 16-20 years in 2002. Only males (N=3890) were included, and were classified into into one of four groups based on their level of concern about weight/food and on their eating behaviors, as follows: group 1: one concern without behavior (N=862); group 2: more than one concern without behavior (N=361); group 3: at least one behavior (N=798); and a control group (N=1869), according to previously validated items. Groups were compared for personal, family, school, experience of violence, and health-compromising behaviors variables on the bivariate level. All significant variables were included in a multinomial logistic regression using Stata 9 software.

RESULTS

About one-half of the boys reported either a concern or unhealthy eating behavior. Compared with the control group, boys from the three groups were more likely to be students and to report a history of sexual abuse, delinquency, depression, and feeling fat. In addition, boys from group 3 were more likely to report a history of dieting, early puberty, peer teasing, having experienced violence, frequent inebriation, and being overweight.

CONCLUSION

DEB concern adolescent males more frequently than thought and seem to be integrated in a general dysfunctional context, in which violence is predominant. Adolescent males also need to be screened for DEB. Moreover, prevention programs should target the increasing social and media pressure regarding boys ideal body shape and raise public consciousness about this phenomenon.

Body image in adolescents with disorders of steroidogenesis

AIM

Little is known about body image in children with endocrine conditions. We evaluated body image in children with congenital adrenal hyperplasia (CAH), familial male precocious puberty (FMPP), and Cushing's syndrome (CS).

STUDY DESIGN

We compared 67 patients (41 CAH, 12 FMPP, 14 CS) age 8-18 years with 55 age-matched controls.

RESULTS

Patients expressed more weight unhappiness than controls (females: p < 0.001; males: p = 0.01). This difference remained for females after adjusting for body mass index (BMI) (p = 0.03), but not for males (p = 0.12). Unhappiness with height and age of appearance was similar between groups. In female patients, higher BMI was a significant predictor of weight unhappiness (p = 0.01).

CONCLUSION

Adolescents with CAH, FMPP, and CS are at risk for negative body image regarding weight, but not height or age of appearance. Weight unhappiness is partially related to greater weight, but factors unrelated to physical findings seem to contribute to negative body image in female patients.

Endocrine disruptors and abnormalities of pubertal development

Onset and development of puberty is regulated by the neuroendocrine system. Population-based studies worldwide have observed secular trends towards earlier puberty development. These changes are apparently caused by environmental factors such as improved socio-economic status, improved health care and nutrition. However, they may also partly result from endocrine-disrupting chemicals in the environment. Epidemiological studies have investigated the relationship between pubertal development and exposure to endocrine-disrupting chemicals (polychlorinated biphenyls, polybrominated biphenyls, 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane, phthalate esters, furans and the pesticide endosulfan). Associations with both perinatal and postnatal exposure have been reported. Studies in experimental animals support some of these findings and point to differential endocrine regulatory mechanisms linked to pubertal development acting in the perinatal and the pre-pubertal period. Pubertal development is naturally associated with growth and body composition. There is increasing evidence for a link between prenatal development and pubertal onset. In girls born small for gestational age (SGA), pubertal onset and age at menarche often are advanced, especially if there has been an extensive catch-up growth during the first months of life. In utero growth retardation may have multiple causes including exposure to xenobiotic substances as was suggested for some endocrine-disrupting chemicals. An abnormal perinatal environment of children born SGA may alter the endocrine status and the sensitivity of the receptors for endocrine and metabolic signalling that may have effects on maturation of brain and gonads. However, the causal pathways and the molecular mechanisms that may link the pubertal growth pattern of children born SGA, pubertal development and endocrine-disrupting chemicals need further study.

Precocious puberty in adolescent girls: a biomarker of later psychosocial adjustment problems

We have investigated the hypothesis that stress condition will accelerate pubertal maturation in adolescent girls and that faster maturing girls will display more behavioral problems than their on-time or late-maturing peers during pubertal development. Longitudinal data were collected yearly from 1986 to 1997. Parents of 1039 French-speaking Canadian girls completed a questionnaire about their characteristics as well as those of their family. To predict onset of puberty by time and cumulative risk factors, a Hierarchical Regression Analysis and a Survival Regression Analysis were conducted. Results revealed that: (1) anxiety at 8 years old, lower level of anxiety a year earlier and more adverse family condition predict a younger age at first menses; and (2) Body Mass Index, conflicts, and sleep disturbances significantly predict the onset of puberty. Complementary standard regression analyses demonstrated that situational stress mediated the effect of these variables. We concluded that precocious puberty could be an indicator of stress in a child, thus, allowing professionals to intervene early and to prevent later problems in psychosocial adjustment.

Gender-related psychological and behavioural correlates of pubertal timing in a national sample of Swiss adolescents

The potential consequences of early and late puberty on the psychological and behavioural development of the adolescent are not well known. This paper presents focused analyses from the Swiss SMASH study, a self-administered questionnaire survey conducted among a representative sample of 7488 adolescents from 16 to 20 years old. Data from participants reporting early or late timing of puberty were compared with those reporting average timing of maturation. Early maturing girls reported a higher rate of dissatisfaction with body image (OR=1.32) and functional symptoms (OR=1.52) and reported engaging in sexual activity more often (OR=1.93). Early maturing boys reported engaging in exploratory behaviours (sexual intercourse, legal and illegal substance use) at a significantly higher rate (OR varying between 1.4 and 1.99). Both early and late maturing boys reported higher rates of dysfunctional eating patterns (OR=1.59 and 1.38, respectively), victimisation (OR=1.61 and 1.37, respectively) and depressive symptoms (OR=2.11 and 1.53, respectively). Clinicians should take into account the pubertal stage of their patients and provide them, as well as their parents, with appropriate counselling in the field of mental health and health behaviour.

Psychopathological distress predicts suicidal ideation and self-harm in adolescent eating disorder outpatients

OBJECTIVE

This study evaluated the differences in suicidal behaviour between adolescent anorexia nervosa (AN) and bulimia nervosa (BN), and the association of age, menarche timing, duration of eating disorder (ED), depression and general psychopathological symptoms (GSI) with suicidal behaviour in adolescent ED.

METHODS

The study group comprised 57 adolescent outpatients (girls) attending for assessment because of eating disorders. Suicidal ideation, deliberate self-harm and suicidal attempts were assessed in self-report questionnaires.

RESULTS

In both ED groups, one adolescent had attempted suicide before assessment. Suicidal ideation and/or deliberate self-harm were reported in over half of the cases. Bulimics had significantly more suicidal ideation and deliberate self-harm than anorectics. In multivariate analysis, BN and depression predicted suicidal ideation, but only GSI persisted as predicting deliberate self-harm.

CONCLUSIONS

Suicidal behaviour is common in adolescent ED. Type of ED (BN), depression and higher GSI are strongly associated with suicidal ideation and deliberate self-harm. Our results point to the need to evaluate psychopathological symptoms in adolescent ED, especially in BN, in the initial assessment to prevent severe suicidal behaviour.

The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration

During the past decade, possible advancement in timing of puberty has been reported in the United States. In addition, early pubertal development and an increased incidence of sexual precocity have been noticed in children, primarily girls, migrating for foreign adoption in several Western European countries. These observations are raising the issues of current differences and secular trends in timing of puberty in relation to ethnic, geographical, and socioeconomic background. None of these factors provide an unequivocal explanation for the earlier onset of puberty seen in the United States. In the formerly deprived migrating children, refeeding and catch-up growth may prime maturation. However, precocious puberty is seen also in some nondeprived migrating children. Attention has been paid to the changing milieu after migration, and recently, the possible role of endocrine- disrupting chemicals from the environment has been considered. These observations urge further study of the onset of puberty as a possible sensitive and early marker of the interactions between environmental conditions and genetic susceptibility that can influence physiological and pathological processes.