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Development is not the same as ageing: the relevance of puberty to health of adolescents
... Despite modern paediatrics' fascination with growth and development from birth to puberty, and the invention of the developmental curve of the 'normal child' (Armstrong, 1983), comprehensive medical reviews reveal that the timing and pace of pubertal development varies significantly, depending on a wide range of personal, social and environmental factors (e.g. Currie, 2019;Walvoord, 2010). Among the factors that contribute to earlier puberty are proximal social determinants related to chronic stress in personal life. ...
... This is evident in several ways. First, the physical appearance of the applicants seems to be interpreted through predetermined and generalised notions of development from childhood to adulthood, despite the fact that timing and pace of development depend on various personal, social and environmental factors (Currie, 2019;Walvoord, 2010). Second, the body language of applicants is also often understood through an ethnocentric lens, where certain moves and behaviours are attributed to specific life course stages (i.e. ...
This article explores how professionals within the Norwegian immigration authorities conceptualise age when doing non‐medical age assessments. By using social constructivism, which challenges an ethnocentric quantifying understanding of age, we delve into how socially constructed perceptions of childhood and adulthood manifest in assessment practices and the implications of these. By examining how applicants’ physical appearance, body language and life experience are used as an assessment basis, we argue that the ways age is conceptualised relate to Western ideas and ideals while overlooking other social and cultural backgrounds in which age is embedded.
... At the millennium shift, a new biological perspective in understanding the role of puberty and associated bodily changes on adolescent health and wellbeing was introduced [34,35]. Building on this more recently a biopsychosocial or bioecological perspective [36] has been applied which recognises the importance of the dynamic interplay between biological, psychological and interpersonal factors and wider contextual factors in shaping health outcomes at the individual level [37,38]. ...
The Health Behaviour in School-aged Children (HBSC) study is a large cross-national research study, conducted in partnership with the World Health Organization (WHO). The study has surveyed young people aged 11, 13 and 15 years every 4 years since the mid-1980s and has grown to include 50 countries across Europe, North America, and Western-Central Asia. Over the past 40 years more than 1.6 million students have participated. HBSC aims to advance understanding of adolescent health behaviours, health and wellbeing within social contexts, inform national and international health promotion policies and practice, and foster collaboration among researchers, policymakers, and practitioners. In this paper we share the history and development of the HBSC study covering: i) theory-driven and novel research impact, ii) unique long-term trends in adolescent health behaviours and perceived health and wellbeing, iii) methodological rigor to allow cross-national comparison, and iv) embedding youth involvement and maximizing policy impact.
... Then, we summarize the current evidence on the acute and long-term effects of cannabis on cognition generally and in specific age groups. Finally, we conclude with an evaluation of the evidence for age-related differences in cannabis effects, acknowledging that age is an imperfect proxy for development [15]. ...
Purpose of Review
To examine the acute and long-term effects of cannabis use on cognitive functioning across the lifespan, and to evaluate the evidence for the hypothesis of developmental sensitivity to cannabis effects.
Recent Findings
Acute cannabis intoxication impairs cognitive functioning, and frequent cannabis use is associated with subtle cognitive deficits after intoxication has passed, in adolescence, young adulthood, and midlife. Longitudinal studies show that more frequent and longer-term cannabis use are associated with cognitive decline, though associations are small and inconsistent in studies of adolescents and young adults and small-moderate in studies of longer-term use to midlife. Older adults are understudied. Findings on prenatal and early postnatal cannabis exposure and cognitive functioning, though mixed, caution against use during pregnancy.
Summary
It seems likely that cannabis use is associated with cognitive deficits across the lifespan. However, the very young and the old are understudied, and there are few within-study comparisons of age differences in cognitive effects. The evidence on age-related differences in sensitivity to cannabis effects on cognitive functioning in humans is inconclusive.
... Puberty is a period of change between childhood and adolescence, characterized by dynamic physical changes that cause physical, psychological and behavioral changes. Signs of puberty in girls are changes in breasts and the start of menstruation, while in boys changes in the penis and testicles are larger, deeper voice and more muscular appearance (Currie, 2019). Early puberty or also called precocious puberty is when girls have signs of puberty before the age of 11 years while boys before 12 years. ...
Puberty is a period of change between childhood and adolescence towards adulthood. Early puberty or also called precocious puberty is when girls have signs of puberty before the age of 11 years. The incidence of early menarche in adolescents is increasing in Indonesia. Early menarche increases the risk of cancer such as breast cancer, abdominal obesity, fat accumulation in adipose tissue, cardovascular disease, hypertension and premarital pregnancy. In adolescence, lifestyles and habits change, and one of them is trying new foods. This study identifies whether there is an association between fast food factors and adolescent activity with the occurrence of early menarche. The results of the study on 40 elementary school students in Cikarang female students who did not have early menarche were 20 (50.0%) and female students who had early menarche were 20 (50.0%). In an unhealthy lifestyle and early menarche as many as 14 or 70.0% of students. As for the physical activity of sports schoolgirls with the category of light exercise and early menarche as many as 7 or 35.0%. in students often consume Fast Food and early menarche as many as 15 or 75.0%.
... Additionally, during adolescence, the physical maturation of puberty marks an important and irreversible change in the adolescent's life: at this point, the adolescent is biologically able to become a parent in their own right. Moreover, the hormonal changes brought on by puberty affect mental functioning and generate more active sexual interest, bringing focus to issues of reproduction [43]. It remains unknown whether the development of a reproductive identity in adolescence is likely to influence adolescents' interest in their donors and/or surrogates, as shown by research with adopted adolescents and their biological parents [44]. ...
Assisted reproduction techniques (ARTs) are employed by single individuals and couples who are not otherwise able to conceive spontaneously. While the use of ARTs is increasing, research is lacking on the attempts made by adolescent offspring conceived via ARTs to integrate their ART conception into their identity and negotiate a connection with, and autonomy from, their parents. The present article reviews studies investigating adolescent development and the parent–adolescent relationship in diverse family forms created by ARTs (mainly heterosexual and lesbian parent families), and discusses the results in light of attachment, identity development, and emotional distance regulation theories. Overall, the results indicate that the psychological adjustment of adolescents conceived via ARTs is not undermined by the manner of their conception, and that they enjoy positive relationships with their parents with no difference from those enjoyed by spontaneously conceived adolescents. However, it remains unknown whether the development of a reproductive identity in adolescence is likely to influence adolescents’ interest in searching for or contacting their donors, surrogates, and/or donor siblings. The results suggest the relevance of considering the parent–adolescent relationship, disclosure, and identity formation issues when planning psychological counseling and support interventions with ART parents and their adolescent offspring, and emphasize the need to further investigate these aspects in diverse ART families, including single-, gay-, bisexual-, and trans*-parent families.
... In the three cycles, it was found that the increase in students' understanding was 33.3% from 100% (Mutiah, 2020). Most male and female students who have reached puberty do not understand the changes (physical, psychological and emotional) that occur to them (Akbari Kamrani & Farid, 2017;Currie, 2019;de Vries, 2020;Kaltiala et al., 2020). Teenagers tend to be closed with their parents when they feel physical changes (Wardah, 2018). ...
This study aims to determine the effect of group guidance in assisting children reaching puberty in Central Lombok. The strategy uses group guidance and the media uses youtube videos and hands-on practice with tutorials. Group guidance services function as an understanding and prevention of deviant behavior during the transition from childhood to early adulthood. The research method used is experimental with pretest and posttest designs. Subjects consisted of 6 students aged 9-13 years. The topics discussed are 1) what and how puberty is, (2) the influence of puberty in the social environment, 3) the meaning of menstruation, and how to live a healthy lifestyle. Based on the data, the results of the pretest showed an average value of 21% and a standard deviation of 2.44%. The posttest results showed an average value of 24.8%, standard deviation of 4.49%. It shows that the enactment of group guidance is effective in increasing the understanding of puberty teenagers. Based on the satisfaction questionnaire after being given group guidance, a score of 20-24 is included in the very good category.
... The adapted model includes the maturational stage of the individual which acknowledges the importance of puberty to the health of adolescence. This recognised determinant in adolescent mental health has recently been discussed in an editorial by Currie (2019). The adapted model that Bronfenbrenner developed is known as the 'process person context time' model (Bronfenbrenner & Ceci, 1994). ...
This paper extracts, organises and summarises findings on adolescent mental health from a major international population study of young people using a scoping review methodology and applying a bio-ecological framework. Population data has been collected from more than 1.5 million adolescents over 37 years by the Health Behaviour in School-Aged Children: WHO Cross-National (HBSC) Study. The paper reviews the contribution that this long standing study has made to our understanding of the individual, developmental, social, economic, cultural determinants of adolescent mental health by organising the findings of 104 empirical papers that met inclusion criteria, into individual, microsystem, mesosystem and macrosystem levels of the framework. Of these selected papers, 68 were based on national data and the other 36 were based on international data, from varying numbers of countries. Each paper was allocated to a system level in the bio-ecological framework according to the level of its primary focus. The majority (51 papers) investigate individual level determinants. A further 28 concentrate primarily on the microsystem level, 6 on the mesosystem level, and 29 on the macrosystem level. The paper identifies where there is evidence on the determinants of mental health, summarises what we have learned, and highlights research gaps. Implications for the future development of this population health study are discussed in terms of how it may continue to illuminate our understanding of adolescent mental health in a changing world and where new directions are required.
Background
CHD influences many aspects of life in affected individuals. Puberty, a major aspect of development, is a concern for patients and families.
Objectives
We investigated pubertal status in children and adolescents with CHD.
Methods
Patients with CHD aged 6–18 were enrolled. Cardiac diagnoses were confirmed using history, examination, and paraclinical tools including echocardiography. An endocrinologist determined pubertal stages, and the second Tanner stages for pubarche (P2), thelarche (B2), and gonadarche (G2) were considered as the pubertal onset. A study with a large sample size on pubertal onset in a normal population was used for comparison.
Results
Totally, 451 patients (228 girls and 223 boys) at a median (10th–90th percentile) age of 10.79 (8.02–14.28) years for the girls and 10.72 (8.05–14.03) years for the boys were enrolled. The median (10th–90th percentile) ages at B2 and P2 in the girls with CHD were 10.77 (9.55–12.68) and 10.53 (9.39–12.28) years, respectively, which were higher than the median ages of 9.74 (8.23–11.94) and 10.49 (8.86–12.17) years in the normal girls.
The median (10th–90th percentile) ages at G2 and P2 in the boys with CHD were 11.04 (8.85–13.23) and 11.88 (9.78–13.46) years, correspondingly, which were higher than the median ages of 9.01 (6.00–11.84) and 10.34 (6.84–13.10) years in the normal boys.
Conclusions
Pubertal onset could be delayed in children with CHD when compared with the normal population.
Purpose:
This study assesses the relationship between unequal gender perceptions, socioecological factors, and body satisfaction among early adolescents in six urban poor settings in four countries.
Methods:
A cross-sectional study, part of the Global Early Adolescent Study, was conducted in Shanghai, China; Cuenca, Ecuador; Kinshasa, DRC; and three cities in Indonesia: Denpasar, Semarang, and Bandar Lampung. Bivariate and multiple linear regressions were conducted to assess the relationships between body satisfaction, perceptions of gender norms, and socioecological factors. A final sample of 7840 respondents aged between 10 and 14 years were included in the analysis.
Results:
Adolescents who endorsed more traditional sex roles and traits were more likely to be satisfied with their bodies in Kinshasa and Indonesia, while only endorsement of GST was associated with body satisfaction in Shanghai. Individual factors related to body satisfaction varied by site and included perceived health status, perception of body weight, height, and growth rate. Family and neighborhood factors related to increased body satisfaction varied by site and sex and included closeness to parents, parental communication, discussing bodily changes with anyone, parental awareness, and perception of neighborhood.
Conclusion:
The results highlight the association between gender norms and social factors at individual, family, and neighborhood levels with body satisfaction. While associations differ significantly by site and sex, namely in perception of body weight and height, there exists commonalities that suggest body satisfaction, gender norms, and social context are intertwined.
Inequalities in young people's mental health have been documented according to social class but less is known about determinants that can buffer or mediate the relationship. Social capital has the potential to contribute to alleviating observed health inequalities. However, clarity about how it can be understood and measured in relation to mental health among younger populations remains inconsistent. This scoping review examined published literature to investigate how social capital has been researched for young people's mental health. An established framework was used to guide the methodology. Studies were included: on age (10-19 years); publication year (since 2000); language (English). Only studies using social capital as a central theme were included. No restriction was placed on mental health outcomes. Nine bibliographic databases were interrogated. Articles (1541) were screened, 793 retained for analysis and 73 articles were included. Most studies were conducted in North America and Europe. Twenty per cent provided insights into how social capital should be described in relation to young people. A majority of the studies provided links between varying social capital indicators and a range of mental health outcomes (70%), however such evidence was associational. Only few studies inferred the causal direction between social capital and health (10%) and there were no dedicated studies on measurement. Findings suggest that literature on social capital and young people's mental health has grown but continues to be variously described and measured. It requires better utilization of existing knowledge and new research to improve its application in practice.
In the transition from early to mid-adolescence, gender differences in pubertal development become significant. Body dissatisfaction is often associated with body mass, low self-esteem and abnormal eating habits. The majority of studies investigating body dissatisfaction and its associations have been conducted on female populations. However, some evidence suggests that males also suffer from these problems and that gender differences might already be observed in adolescence.
To examine body dissatisfaction and its relationship with body mass, as well as self-esteem and eating habits, in girls and boys in transition from early to mid-adolescence.
School nurses recorded the heights and weights of 659 girls and 711 boys with a mean age of 14.5 years. The Rosenberg Self-Esteem Scale and the Body Dissatisfaction subscale of the Eating Disorder Inventory were used as self-appraisal scales. Eating data were self-reported.
The girls were less satisfied with their bodies than boys were with theirs (mean score (SD): 30.6 (SD 12.2) vs. 18.9 (SD 9.5); p < 0.001). The girls expressed most satisfaction with their bodies when they were underweight, more dissatisfaction when they were of normal weight and most dissatisfaction when they had excess body weight. The boys also expressed most satisfaction when they were underweight and most dissatisfaction when they had excess body weight. The boys reported higher levels of self-esteem than did the girls (mean (SD): 31.3 (4.8) vs. 28.0 (5.9); p < 0.001). The adolescents self-reporting abnormal eating habits were less satisfied with their bodies than those describing normal eating habits (mean (SD): 33.0 (12.9) vs. 21.2 (10.2); p < 0.001).
Body mass, self-esteem and eating habits revealed a significant relationship with body dissatisfaction in the transitional phase from early to mid-adolescence in girls and boys, but significant gender differences were also found.
The aim of this study was to investigate associations between specific mental health problems and pubertal stage in (pre)adolescents participating in the Dutch prospective cohort study TRAILS (first assessment: N=2230, age 11.09±0.56, 50.8% girls; second assessment: N=2149, age 13.56±0.53, 51.0% girls). Mental health was assessed by the Youth Self-Report, pubertal (Tanner) stage by parent-rated drawings of secondary sex characteristics. Overall, higher Tanner stages were related to more reported tiredness, irritability, rule-breaking behaviors, and substance use; and fewer fears and somatic complaints. Girls showed increases in social uncertainty, depressed mood, and worries; boys a decrease in self-criticism. Increasing problems during puberty were mostly related to the process of physical maturation, whereas decreasing problems were rather related to general age-related developments. Pubertal timing was associated with different symptoms than pubertal status or age. Puberty seems to affect girls more negatively than boys.
Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use.
The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of Washington, United States, and Victoria, Australia. Participants were 5769 students in grades 5, 7, and 9, drawn as a 2-stage cluster sample in each state, and the questionnaire was completed in the school classrooms. The main outcomes of the study were lifetime substance use (tobacco use, having been drunk, or cannabis use), recent substance use (tobacco, alcohol, or cannabis use in the previous month), and substance abuse (daily smoking, any binge drinking, drinking at least weekly, or cannabis use at least weekly).
The odds of lifetime substance use were almost twofold higher (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.4-2.1) in midpuberty (Tanner stage III) and were threefold higher (OR: 3.1; 95% CI: 2.4-4.2) in late puberty (Tanner stage IV/V), after adjustment for age and school grade level. Recent substance use was moderately higher (OR: 1.4; 95% CI: 1.0-1.9) in midpuberty and more than twofold higher (OR: 2.3; 95% CI: 1.7-3.3) in late puberty. The odds of substance abuse were twofold higher (OR: 2.0; 95% CI: 1.2-3.2) in midpuberty and more than threefold higher (OR: 3.5; 95% CI: 2.2-5.4) in late puberty. Reporting most friends as substance users was more likely in the later stages of pubertal development, a relationship that accounted in part for the association found between later pubertal stage and substance abuse.
Pubertal stage was associated with higher rates of substance use and abuse independent of age and school grade level. Early maturers had higher levels of substance use because they entered the risk period at an earlier point than did late maturers. The study findings support prevention strategies and policies that decrease recreational substance use within the peer social group in the early teens.
b>Objective : Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use.
Methods : The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of Washington, United States, and Victoria, Australia. Participants were 5769 students in grades 5, 7, and 9, drawn as a 2-stage cluster sample in each state, and the questionnaire was completed in the school classrooms. The main outcomes of the study were lifetime substance use (tobacco use, having been drunk, or cannabis use), recent substance use (tobacco, alcohol, or cannabis use in the previous month), and substance abuse (daily smoking, any binge drinking, drinking at least weekly, or cannabis use at least weekly).
Results : The odds of lifetime substance use were almost twofold higher (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.4–2.1) in midpuberty (Tanner stage III) and were threefold higher (OR: 3.1; 95% CI: 2.4–4.2) in late puberty (Tanner stage IV/V), after adjustment for age and school grade level. Recent substance use was moderately higher (OR: 1.4; 95% CI: 1.0–1.9) in midpuberty and more than twofold higher (OR: 2.3; 95% CI: 1.7–3.3) in late puberty. The odds of substance abuse were twofold higher (OR: 2.0; 95% CI: 1.2–3.2) in midpuberty and more than threefold higher (OR: 3.5; 95% CI: 2.2–5.4) in late puberty. Reporting most friends as substance users was more likely in the later stages of pubertal development, a relationship that accounted in part for the association found between later pubertal stage and substance abuse.
Conclusions : Pubertal stage was associated with higher rates of substance use and abuse independent of age and school grade level. Early maturers had higher levels of substance use because they entered the risk period at an earlier point than did late maturers. The study findings support prevention strategies and policies that decrease recreational substance use within the peer social group in the early teens.<br /
Though often discussed as a discrete event, puberty comprises one segment of a larger developmental continuum and is notable for rapid transformation across a multitude of domains. While an earlier timing of puberty relative to peers stands as one of the most well-replicated antecedents of adolescent difficulties for girls, findings have been less consistent for boys’ development. The current review synthesizes the research on pubertal timing and psychosocial development in adolescent boys. Results are evaluated in the context of three theoretical perspectives by which precocious development is believed to affect the emergence of adverse outcomes: biological, psychosocial and selection.
Relations between self-esteem, pubertal timing, and body image were investigated with a representative sample of Scottish schoolgirls 11 (n = 1,012, X = 11.53 years, SD = 0.32) and 13 (n = 799, X = 13.53, SD = 0.32) years of age. Data were derived from the Health Behaviour in School Children: WHO Cross-National Survey, specifically the Scottish survey. Among 11-year-olds, early maturation and lower ratings of body image (body size and perceived appearance) were associated with lower reported levels of selfesteem. There also was evidence that body image mediated the relation of pubertal timing on self-esteem for this age group. Among 13-year-olds, reports of body size concerns and poorer perceived appearance were predictive of lower ratings of self-esteem, as was late maturation. In this case, there was no evidence of mediation. Results lend support to the contention that pubertal timing influences body image and self-esteem.
A unique standardized international data set from adolescent girls in 34 countries in Europe and North America participating in the Health Behaviour in School-aged Children Study (HBSC) is used to investigate the contribution of body mass index (BMI) at individual and country level to cross-national differences in age at menarche.
Two independent nationally representative survey data sets from 15-year-olds (n = 27,878, in 34 countries, year = 2005/2006) and 11-year-olds (n = 18,101, in 29 countries, year = 2001/2002) were analyzed. The survey instrument is a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated using Kaplan-Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). "Country-level obesity" was measured by prevalence of overweight/obesity (%) in each country.
Country-level median age at menarche ranged between 12 years and 5 months and 13 years and 5 months. Country-level prevalence of overweight among 15-year-old girls ranged from 4% to 28%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = -1.01; 95% CI, -1.09 to -.94) and country-level aggregate overweight at age 11 (unstandardized regression coefficient beta = -.25; 95% CI, -.43 to -.08). Individual- and country-level measures of BMI account for 40% of the country-level variance in age at menarche.
The findings add to the evidence that obesity in childhood is a risk factor for early puberty in girls and accounts for much of the cross-national variation in age at menarche. Future HBSC surveys can track this relationship in the wake of the obesity "epidemic."
Puberty is accompanied by physical, psychological, and emotional changes adapted to ensure reproductive and parenting success. Human puberty stands out in the animal world for its association with brain maturation and physical growth. Its effects on health and wellbeing are profound and paradoxical. On the one hand, physical maturation propels an individual into adolescence with peaks in strength, speed, and fitness. Clinicians have viewed puberty as a point of maturing out of childhood-onset conditions. However, puberty's relevance for health has shifted with a modern rise in psychosocial disorders of young people. It marks a transition in risks for depression and other mental disorders, psychosomatic syndromes, substance misuse, and antisocial behaviours. Recent secular trends in these psychosocial disorders coincide with a growing mismatch between biological and social maturation, and the emergence of more dominant youth cultures.
Whether the secular trend of a decreasing age of puberty has continued over the past 50 years remains controversial. Data that had been classically used to address this issue are reviewed and large epidemiologic studies, which had not previously been included, are now considered to challenge the conclusions of prior debates of this topic. The effect and timing of excessive weight gain are discussed in detail and recent observations about the opposing effects of obesity on the pubertal timing of girls versus boys are considered. The second half of the review examines both the causes and the long-term health consequences of early puberty, touching on the possible effect of stress and endocrine-disrupting chemicals along with the risks of reproductive cancers, metabolic syndrome, and psychosocial consequences during adolescence and beyond.
This study set out to assess the relationship between pubertal timing and emotional and behavioural problems in middle adolescence. The study involved a school based survey of health, health behaviour and behaviour in school as well as questions about emotional and behavioural problems (the School Health Promotion Study). Secondary schools in four regions and 13 towns in Finland participated in the study in 1998. The respondents were 36,549 adolescents aged 14-16. The study included questions on depression, bulimia nervosa, psychosomatic symptoms, anxiety, drinking, substance use, smoking, bullying and truancy. Among girls, both internalising and externalising symptoms were more common the earlier puberty occurred. Among boys, externalising symptoms only were associated with early puberty. It is concluded that early pubertal timing is associated with increased mental health problems. Professionals working with adolescents should consider the mental health needs of early maturing adolescents.
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under review) Family characteristics and the age at menarche
- M Steppan
- J Mceachran
- R Whitehead
- C Currie
Steppan M, McEachran J, Whitehead R, Currie C (under review)
Family characteristics and the age at menarche