Longitudinal Associations of Pubertal Timing and Tempo With Adolescent Mental Health and Risk Behavior Initiation in Urban South Africa

• Type of Material: Article
• Authors: Alysse J Kowalski, Emory University; O. Addo, Emory University; Michael Kramer, Emory University; Reynaldo Martorell, Emory University; Shane Norris, Emory University; Rachel N Waford, Emory University; Linda M Richter, University of Witwatersrand; Aryeh Stein, Emory University
• Language: English
• Date: 2021-06-22
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jadohealth.2020.09.043
• Title of Journal or Parent Work: JOURNAL OF ADOLESCENT HEALTH
• Volume: 69
• Issue: 1
• Start Page: 64
• End Page: 73
• Grant/Funding Information: The authors would like to acknowledge the generous support of the NIH Fogarty International Center (R25TW009337), Bill & Melinda Gates Foundation (OPP1164115), Wellcome Trust (077210/Z/05/Z), the DSI-NRF Centre of Excellence hosted by the University of the Witwatersrand, and the South African Medical Research Council.
• Keywords: Socioemotional adjustment; Low- and middle-income countries; Pediatrics; EATING ATTITUDES; Eating attitudes; Psychology, Developmental; MATURATION; SYMPTOMS; Science & Technology; Birth to Twenty Plus; Health risk behavior; OPPORTUNITIES; BOYS; DEPRESSION; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; TRANSITION; Adolescent health; DISORDERS; Pubertal timing; Tanner sexual maturation scale; GROWTH; Menarche; Psychology; AMERICAN; Pubertal tempo; Social Sciences
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Purpose: In high-income countries, early and rapid pubertal development is consistently associated with poor adjustment and increased risk behavior in adolescence. This study contributes to the meager knowledge of these associations in lower income countries. Methods: We used longitudinal data from 1,784 urban black South Africans in the Birth to Twenty Plus cohort. We used regression analyses to assess associations between age at menarche and latent classes of pubertal timing and tempo and adolescent internalizing and externalizing emotional and behavioral problems, eating attitudes, and patterns of health risk behavior initiation. Results: Relatively earlier and faster pubertal timing and tempo were associated with increased health risk behavior initiation (e.g., adjusted odds ratio [95% confidence interval] high- vs. low-risk pattern = 5.7 [1.7, 19.06] for male genital development; adjusted odds ratio = 3.45 [1.13, 10.49] for female breast development). Among males, earlier and faster pubertal timing and tempo were associated with increased externalizing problems in early adolescence and increased oppositional defiant problems in midadolescence, whereas later and slower pubertal timing and tempo were associated with decreases. Among females, earlier and faster pubertal timing and tempo were associated with increased internalizing and externalizing problems in midadolescence and increased dieting behaviors in early and late adolescence (β [95% confidence interval] = 2.51 [.87, 4.15] for pubic hair development), whereas later and slower pubertal timing and tempo were associated with decreases. Conclusions: In this urban South African cohort, relatively earlier and faster pubertal development was detrimental to mental health and risk behavior activity, whereas later and slower maturation was somewhat protective.