Exploring sex differences in trajectories of pubertal development and mental health following early adversity.

Despite evidence that early life adversity (ELA) affects mental health in adolescence, we know little about sex differences in how distinct dimensions of adversity affect development and their corresponding effects on mental health. In this three-wave longitudinal study, 209 participants (118 females; ages 9-13 years at baseline) provided objective (salivary hormones, BMI, age of menarche) and subjective (perceived gonadal and adrenal status) measures of puberty and physical development, and reported on levels of internalizing and externalizing symptoms at all timepoints. Participants also reported lifetime exposure to three distinct types of ELA: deprivation, threat, and unpredictability. Using generalized additive mixed models, we tested within each sex whether dimensions of adversity were associated with longitudinal changes in measures of pubertal and physical development, and whether these indices of development were associated with trajectories of internalizing and externalizing symptoms. In females, experiences of threat and unpredictability were significantly associated with earlier pubertal timing (e.g., age of menarche) whereas experiences of deprivation were associated with steeper increases in BMI; further, faster pubertal tempo (i.e., steeper increases in pubertal stage) was associated with increases in internalizing and externalizing symptoms. In males, however, ELA was not associated with any measures of pubertal or physical development or with symptoms. Together, our results suggest that adverse experiences during early life have sex-selective consequences for pubertal and physical maturation and mental health trajectories in ways that may elucidate why females are at higher risk for mental health difficulties during puberty, particularly following exposure to unpredictable and threatening experiences of adversity.

Corticolimbic connectivity mediates the relationship between pubertal timing and mental health problems.

BACKGROUND: Undergoing puberty ahead of peers ('earlier pubertal timing') is an important risk factor for mental health problems during early adolescence. The current study examined pathways between pubertal timing and mental health via connectivity of neural systems implicated in emotional reactivity and regulation (specifically corticolimbic connections) in 9- to 14-year-olds. METHOD: Research questions were examined in the Adolescent Brain Cognitive Development (ABCD) Study, a large population representative sample in the United States. Linear mixed models examined associations between pubertal timing and resting-state corticolimbic connectivity. Significant connections were examined as potential mediators of the relationship between pubertal timing and mental health (withdrawn depressed and rule-breaking) problems. Exploratory analyses interrogated whether the family environment moderated neural risk patterns in those undergoing puberty earlier than their peers. RESULTS: Earlier pubertal timing was related to decreased connectivity between limbic structures (bilateral amygdala and right hippocampus) and the cingulo-opercular network, left amygdala and somatomotor (mouth) network, as well as between the left hippocampus and ventral attention network and visual network. Corticolimbic connections also mediated the relationship between earlier pubertal timing and increased withdrawn depressed problems (but not rule-breaking problems). Finally, parental acceptance buffered against connectivity patterns that were implicated in withdrawn depressed problems in those undergoing puberty earlier than their peers. CONCLUSION: Findings highlight the role of decreased corticolimbic connectivity in mediating pathways between earlier pubertal timing and withdrawn depressed problems, and we present preliminary evidence that the family environment may buffer against these neural risk patterns during early adolescence.

Navigating puberty, identity, and race among transnationally, transracially adopted Korean American adolescents.

This exploratory study examined the relation between pubertal timing and dimensions of ethnic-racial identity among adopted Korean Americans raised transracially in White families. The study also examined whether internalized racism moderated the association between pubertal timing and ethnic-racial identity. Adopted Korean American adolescents (N = 202; 108 females; ages 13-19 years) completed measures of pubertal development, ethnic-racial identity, and internalized racism in 2007. There was no significant main effect of pubertal timing for either male or female adolescents. Internalized racism moderated the relation between pubertal timing and ethnic-racial identity clarity (B = -.16, p = .015) among male adolescents. Specifically, earlier pubertal timing was significantly associated with lower ethnic-racial identity clarity for male adolescents with higher levels of internalized racism.

Sex and pubertal influences on the neurodevelopmental underpinnings of schizophrenia: A case for longitudinal research on adolescents.

Sex is a significant source of heterogeneity in schizophrenia, with more negative symptoms in males and more affective symptoms and internalizing comorbidity in females. In this narrative review, we argue that there are likely sex differences in the pathophysiological mechanisms of schizophrenia-spectrum disorders (SZ) that originate during puberty and relate to the sex-specific impacts of pubertal maturation on brain development. Pubertal maturation might also trigger underlying (genetic or other) vulnerabilities in at-risk individuals, influencing brain development trajectories that contribute to the emergence of SZ. This review is the first to integrate links between pubertal development and neural development with cognitive neuroscience research in SZ to form and evaluate these hypotheses, with a focus on the frontal-striatal and frontal-limbic networks and their hypothesized contribution to negative and mood symptoms respectively. To test these hypotheses, longitudinal research with human adolescents is needed that examines the role of sex and pubertal development using large cohorts or high risk samples. We provide recommendations for such studies, which will integrate the fields of psychiatry, developmental cognitive neuroscience, and developmental endocrinology towards a more nuanced understanding of the role of pubertal factors in the hypothesized sex-specific pathophysiological mechanisms of schizophrenia.

Pubertal progression and its relationship to psychological and behavioral outcomes among adolescent boys.

Variations in pubertal timing and tempo have relevance to psychosocial development. Accounting for pubertal timing, tempo, and psychosocial development simultaneously in a model remains challenging. This study aimed to document the typology of pubertal development in a cohort of Taiwanese adolescent boys and then to examine how the associations between psychosocial variables across time vary by the patterns of pubertal development. A group of adolescent boys (n = 1,368) reported pubertal signs and psychosocial variables for 3 years since seventh grade. The growth mixture model revealed three major classes of pubertal transition: average pubertal growth, late-onset with rapid catch-up, and late-onset with slow catch-up. In a cross-lagged panel model, the multigroup analysis found the regression coefficients mostly invariant across all three classes, except those between deviant behavior and subsequent changes in depressive symptoms that were significantly positive only in the late-onset with slow catch-up group. Adolescent boys in this group were estimated to have the highest marginal level of depressive symptoms and deviant behavior in ninth grade among the three classes. Our study highlights the heterogeneity in boys' pubertal development and the role of the pubertal development pattern in their psychosocial development.

Infancias y adolescencias en el game digital. Subjetivación en juego / Childhood and adolescence in the digital game. Subjectivation at stake / Enfance et adolescence dans le jeu numérique (game). Subjectivation en jeu / Infância e adolescência no jogo digital. Subjetivação em jogo

Este trabajo parte de un interrogante actual y acuciante: qué condiciones de subjetivación encuentran las infancias y adolescencias contemporáneas en el ambiente tecnológico. Tomando el jugar como hilo conductor por su valencia estructurante y considerando su derrotero en los contextos virtuales, se van examinando las posibilidades y las encerronas que niños y adolescentes tienen en la actualidad. Se emplea la distinción winnicottiana entre jugar (play) y juego (game) como modelo para examinar tanto la cualidad del hacer de niños y adolescentes con la virtualidad, como así también la propuesta cultural conectiva. Por último, se describe la configuración de un gameepocal destituyente del jugar y del lazo social y se propone restituir una política sobre el jugar como apuesta subjetivante, dado que sin creatividad y sin poder pensar con otros, resulta extremadamente difícil habitar un mundo tan tambaleante, complejo y disruptivo AU

This work is based on a current and pressing question, what conditions of subjectivation do contemporary childhoods and adolescentsfind in the technological environment. Taking play as a guiding thread due to its structuring valence and considering its course in virtual contexts, the possibilities and obstacles that children and adolescents have today are examined. The Winnicottian distinction between playing (play) and game (game) is used as a model to examine both the quality of children and adolescents doing with virtuality, as well as the connective cultural proposal. Finally, the configuration of an epochal game destituting playing and the social bond is described and it is proposed to restore a policy on playing as a subjectivizing bet, given that without creativity and without being able to think with others, it is extremely difficult to inhabit such a shaky world. complex and disruptive AU

Ce travail est basé sur une question actuelle et pressante, quelles conditions de subjectivationles enfances et les adolescents contemporains trouvent-ils dans l'environnement technologique. En prenant le jeu comme fil conducteur en raison de sa valence structurante et en considérant son déroulement dans des contextes virtuels, les possibilités et les obstacles que les enfants et les adolescents ont aujourd'hui sont examinés. La distinction winnicottienne entre playet gameest utilisée comme modèle pour examiner à la fois la qualité des enfants et des adolescents faisant avec la virtualité, ainsi que la proposition culturelle connective. Enfin, la configuration d'un jeu d'époque dénué de jeu et de lien social est décrite et il est proposé de restituer une politique du jeu comme pari subjectivant, étant donné que sans créativité et sans pouvoir penseravec les autres, il est extrêmement difficile d'habiter un monde si instable, complexe et perturbateur AU

Este trabalho parte de uma questão atual e premente, quais as condições de subjetivação que as infâncias e os adolescentes contemporâneos encontram no ambiente tecnológico. Tomando o brincar como fio condutor por sua valência estruturante e considerando seu percurso em contextos virtuais, examinam-se as possibilidades e os obstáculos que as crianças e adolescentes têm hoje. A distinção winnicottiana entre brincar (jogar) e jogo (jogo) é utilizada como modelo para examinar tanto a qualidade do fazer de crianças eadolescentes com a virtualidade, quanto a proposta cultural conectiva. Por fim, descreve-se a configuração de um jogo epocal que destitui o brincar e o vínculo social e propõe-se restaurar uma política do brincar como aposta subjetivante, pois sem criatividade e sem poder pensar com os outros é extremamente difícil habitar um mundo tão instável, complexo e perturbador AU

Age at menarche relates to depression in adolescent girls: Comparing a clinical sample to the general pediatric population.

CONTEXT: The timing of puberty, physical features of pubertal development, and hormones are closely intertwined but may also individually contribute to the risk for depression and depression severity. Additionally, their effects on mood may depend on depression severity, but previously this has only been studied in mostly subclinical depression. METHODS: In 184 girls from a single psychiatric hospital with significant depressive symptoms (Beck Depression Inventory-II score > 13), the relationship between depression severity and age at menarche (AAM), pubertal status, and gonadal/adrenal hormones (estradiol, progesterone, DHEA-S, androstenedione, testosterone, dihydrotestosterone) was investigated. Moreover, AAM in depressed girls was compared to that from a representative sample of German adolescents without a psychiatric disorder (N = 1674). Androgen levels were compared to those of age- and sex-matched controls (N = 59). RESULTS: AAM but not pubertal stage or biochemical parameters related to depression. Girls with AAM at the lower normative range of pubertal development were 61 % more likely to develop depression and scored 4.9 points higher on the depression scale than girls experiencing menarche at the population average. Androstenedione levels were increased in the psychiatric sample, but neither androgen nor gonadal hormone levels were associated with depression severity. LIMITATIONS: The study is cross-sectional. CONCLUSIONS: These observations confirm previous studies in mostly subclinical depression and highlight the importance of AAM for adolescent depression. Thus, AAM could be considered a prognostic factor for a clinical risk score assessing the probability of adolescent depression. Moreover, these findings suggest fostering efforts that address risk factors that contribute to an earlier AAM.

Clinical Follow-up of Two Adolescents Diagnosed with Gender Dysphoria. / Cinsiyetinden Hosnutsuzlugu Olan Iki Ergenin Klinik Izlem Süreci.

Rapid physical, psychological and sexual changes in adolescents due to the developmental process differentiate the approach to adolescents with gender dysphoria (GD) from the approach to adults. In this article, two adolescents who applied for GD and followed up for a long time are presented. The first case was assigned male at birth and defined herself as female. At the age of fifteen, a gonadotropin-releasing hormone analog was started for puberty suppression, and sex hormone was started in the follow-up. The second case's assigned sex was female and defined himself as male. At the age of sixteen years and six months, puberty suppressive treatment was started, followed by sex hormones. Both cases were able to continue their psychosocial development without any problems after the psychiatric and physical treatments they could reach on time. Although GD in adolescents cannot be resolved with puberty suppression alone, it creates time to resolve the acute problems and to search for appropriate treatment approaches in the future. Puberty suppression partially relieves and prevents the exacerbation of the dysphoria experienced by the youth diagnosed as GD, and creates time to search appropriate treatment approaches in the follow-up. Through these two cases, it is aimed to introduce the gender affirmation processes of adolescents with GD, to discuss the medical interventions in adolescence and the psychosocial effects of the process on individuals. Keywords: Gender dysphoria, gender incongruence, adolescence, gender affirmation process, puberty supression, puberty blockers.

Puberty Blockers for Children: Can They Consent?

Gender dysphoria is a persistent distress about one's assigned gender. Referrals regarding gender dysphoria have recently greatly increased, often of a form that is rapid in onset. The sex ratio has changed, most now being natal females. Mental health issues pre-date the dysphoria in most. Puberty blockers are offered in clinics to help the child avoid puberty. Puberty blockers have known serious side effects, with uncertainty about their long-term use. They do not improve mental health. Without medication, most will desist from the dysphoria in time. Yet over 90% of those treated with puberty blockers progress to cross-sex hormones and often surgery, with irreversible consequences. The brain is biologically and socially immature in childhood and unlikely to understand the long-term consequences of treatment. The prevailing culture to affirm the dysphoria is critically reviewed. It is concluded that children are unable to consent to the use of puberty blockers.

¿Aislamiento social preventivo, o aislamiento endogámico? Acerca de sus efectos en los trabajos psíquicos de una adolescente durante la pandemia / Preventive lockdown or endogamous lockdown? Its effects on the psychic work of anadolescent during the pandemic / Isolement social préventif ou isolement consanguin? Sur ses effets sur le travail psychique d'unadolescent pendant la pandémie / Isolamento social preventivo ou isolamento endogâmico? Reflexões sobre seus efeitos no atendimento psicoterápico com uma adolescente durante a pandemia

La pandemia por COVID-19 llevó a un nuevo orden mundial. El afuera se convirtió en un espacio vedado, la premisa principal fue la convivencia absoluta con una familia o la soledad del hogar, aparecieron el temor al contagio y la muerte que nos comunicaban a diario. El aislamiento como condición llevó a la virtualidad como posibilidad de conectarnos con otros, de explorar desde dentro y de sobrellevar de algún modo el encierro. La virtualidad como dispositivo de encuentro atravesó todas las áreas, incluida la salud, mediante la teleconsulta o videollamada se sostuvieron los tratamientos o bien se iniciaron otros. En el presente trabajo se analizarán las sesiones virtuales con una joven que llega a tratamiento psicoanalítico por pedido de su madre, con el fin de entrecruzar la sintomatología que permite la apertura de una demanda propia y los trabajos psíquicos adolescentes desde el interior de su cuarto AU

The COVID-19 pandemic led to a new world order. The outside became a barred territory and the main premise was full-time coexistence with all the household members or a life in the solitude of the household. The fear of contagion and death appeared as a result of daily reports. Isolation as a condition led to virtual communication as a way to connect with others, to explore from the inside and somehow endure lockdown. The virtual realm as a meeting point was used across all areas, including healthcare ⎯oldtreatments continued and new treatments started through teleconsultations or video calls. The present paper analyzes the virtual sessions of a young girl starting psychoanalytic treatment at the request of her mother in order to intertwine the symptoms enabling a personal demand and adolescent psychic work from inside her room AU

La pandémie de COVID-19 a conduit à un nouvel ordre mondial. L'extérieur se convertit en un espace clos, la prémisse principale devenait la coexistence absolue avec une famille ou la solitude du foyer, laissant apparaitre quotidiennement la peur de la contagion et de la mort. L'isolement en tant que condition a conduit à la virtualité en tant quepossibilité de se connecter aux autres, d'explorer de l'intérieur et de faire face d'une manière ou d'une autre à l'enfermement. La virtualité comme dispositif de rencontre traversait tous les domaines, y compris celui de la santé : grâce à la téléconsultation ou à l'appel vidéo, certains traitements pouvaient être maintenus tandis que d'autres modalités pouvaient apparaitre.Dans le présent travail, les séances virtuelles avec une jeune femme qui vient en cure psychanalytique à la demande de sa mère seront analysées, afin de croiser la symptomatologie que permet l'ouverture de son propre processus et le travail psychique adolescent depuis l'intérieur de sa chambre AU

A pandemia da COVID-19 levou a uma nova ordem mundial. A vida externa virou espaço proibido, a prioridade principal foi a convivência absoluta com a família ou a solidão da casa. Aparecerem o temor ao contágio e a morte que nos comunicavam diariamente. O isolamento como condição fez com que a virtualidade se tornasse possibilidade de conectarmos com os outros, de explorarmos a vida a partir de dentro e de suportarmos de algum modo o fato de estarmos isolados. O envolvimento virtual por meio de plataformas de comunicação digital abrangeu todas as áreas, incluindo a saúde: mediante as consultas online e as vídeos chamadas, alguns continuaram os tratamentos, outros iniciaram naquele novo formato. No presente trabalho são analisadas as sessões virtuais com uma adolescente que iniciou o tratamento psicanalítico a pedido de sua mãe, entrelaçando a sintomatologia que permite a abertura de uma demanda própria e os trabalhos psíquicos adolescentes desde o interior de seu quarto AU

Family environmental antecedents of pubertal timing in girls and boys: A review and open questions.

Across nonhuman species, pubertal timing is affected by the social environment, with consequences for reproductive success and behavior. In human beings, variations in pubertal timing have not been systematically examined in relation to social environmental antecedents, although their psychological consequences are well documented. This paper focuses on links in human beings between pubertal timing and the childhood social environment, with several sections: A review of studies relating pubertal timing to the family context, a key aspect of the social environment; challenges in studying the issue; and opportunities for future work that takes advantage of and creates links with evidence in other species. The review shows that pubertal timing in girls is accelerated by adversity in aspects of the early family social context, with effects small in size; data in boys are not sufficient to enable conclusions. Inferences from existing studies are limited by variations in conceptualizations and measurement of relevant aspects of puberty and of the family social environment, and by methodological issues (e.g., reliance on existing data, use of retrospective reports, nonrandom missing data). Open questions remain about the nature, mechanisms, and specificity of the links between early family social environment and pubertal timing (e.g., form of associations, consideration of absence of positive experiences, role of timing of exposure). Animal studies provide a useful guide for addressing these questions, by delineating potential hormonal mechanisms that underlie links among social context, pubertal timing, and behavior, and encouraging attention to aspects of the social environment outside the family, especially peers.

Elucidating early pubertal timing effects on disordered eating symptoms in young adult women.

INTRODUCTION: Early pubertal timing increases risk for disordered eating (DE) in females, but the extent to which associations persist after puberty and are relevant to all types of DE symptoms is unclear. Factors that link pubertal timing and DE also remain unknown, although leading theories posit that adiposity and body-focused psychosocial factors play a key role. Thus, this study examined pubertal timing effects on several types of DE symptoms in young adult women and evaluated whether body mass index (BMI), pressures for thinness, thin-ideal internalization, and/or history of weight-based teasing account for such associations. METHODS: This study included a racially and ethnically diverse sample of 342 female college students (Mage = 20.44, SD = 3.46). Women retrospectively reported their age at onset of menses, which served as the pubertal timing indicator, and completed self-report questionnaires on DE symptoms, perceived pressures for thinness, thin-ideal internalization, and history of weight-based teasing. BMI was calculated from height/weight measurements. RESULTS: Earlier pubertal timing was associated with body dissatisfaction and binge eating, but not other DE symptoms (dieting, excessive exercise, muscle building) in young adult women. BMI accounted for pubertal timing effects on body dissatisfaction, whereas none of the examined factors explained pubertal timing effects on binge eating. CONCLUSIONS: Earlier pubertal timing may exert long-term effects on only some DE symptoms in women, and the etiologic factors underlying pubertal timing effects on DE outcomes may differ across symptom types.

The associations among racial discrimination, pubertal timing, neighborhoods, and mental health among U.S. Mexican boys.

The present study addressed gaps in puberty and weathering research by examining the relation between peer racial discrimination, pubertal timing, internalizing and externalizing symptoms, and neighborhood context among a longitudinal sample of U.S. Mexican boys. Using three waves of data (N = 383; mean ages: 10.3-15.8 years), we examined the weathering hypothesis: Whether peer racial discrimination experiences in late childhood predicted earlier pubertal timing in adolescence and subsequent mental health problems. We also examined whether variability in youths' neighborhood contexts qualified these associations. Consistent with the weathering hypothesis, exposure to peer racial discrimination in 5th grade, predicated earlier pubertal timing in the 7th grade, which, in turn, predicted increases in internalizing symptoms in the 10th grade. However, this pattern only applied to boys residing in neighborhoods with higher levels of Latinx concentration in 5th grade. Additionally, early timing in the 7th grade predicted increases in externalizing symptoms, but this association was significant only when boys lived in neighborhoods that were lower on Latinx concentration. There was evidence of weathering in context with specific implications for internalizing symptoms, and that neighborhood Latinx concentration was both inhibiting and promoting at unique places in the hypothesized model. The findings advance existing understandings of weathering patterns and individual variation in pubertal timing among U.S. Mexican boys. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multimethod assessment of pubertal timing and associations with internalizing psychopathology in early adolescent girls.

Early pubertal timing has consistently been associated with internalizing psychopathology in adolescent girls. Here, we aimed to examine whether the association between timing and mental health outcomes varies by measurement of pubertal timing and internalizing psychopathology, differs between adrenarcheal and gonadarcheal processes, and is stronger concurrently or prospectively. We assessed 174 female adolescents (age 10.0-13.0 at Time 1) twice, with an 18-month interval. Participants provided self-reported assessments of depression/anxiety symptoms and pubertal development, subjective pubertal timing, and date of menarche. Their parents/guardians also reported on the adolescent's pubertal development and subjective pubertal timing. We assessed salivary dehydroepiandrosterone (DHEA), testosterone, and estradiol levels and conducted clinical interviews to determine the presence of case level internalizing disorders. From these data, we computed 11 measures of pubertal timing at both time points, as well as seven measures of internalizing psychopathology, and entered these in a Specification Curve Analysis. Overall, earlier pubertal timing was associated with increased internalizing psychopathology. Associations were stronger prospectively than concurrently, suggesting that timing of early pubertal processes might be especially important for later risk of mental illness. Associations were strongest when pubertal timing was based on the Tanner Stage Line Drawings and when the outcome was case-level Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) depression or Hierarchical Taxonomy of Psychopathology (HiTOP) distress disorders. Timing based on hormone levels was not associated with internalizing psychopathology, suggesting that psychosocial mechanisms, captured by timing measures of visible physical characteristics might be more meaningful determinants of internalizing psychopathology than biological ones in adolescent girls. Future research should precisely examine these psychosocial mechanisms. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Puberty, depressive symptoms, and neighborhood context among African American and Caribbean Black males.

OBJECTIVE: Previous empirical research on pubertal development among Black boys is limited. The present study examined the ethnic-racial composition of neighborhoods as a moderator in the relation between pubertal indicators and depressive symptoms among a nationally representative sample of African American and Caribbean Black boys. METHOD: The present study utilized the male sample (N = 559) from the National Survey of American Life Adolescent sample (Jackson et al., 2004). The sample consists of 395 African American and 164 Caribbean Black boys ages 13-17 years who completed measures of relative pubertal timing, voice changes, pubic hair growth, and depressive symptoms. RESULTS: The results indicate that Black boys with early developing hair growth who lived in neighborhoods with higher percentages of Black residents had higher depressive symptoms compared to their early developing counterparts in neighborhoods with fewer Black residents. African American males with early developing hair growth had higher depressive symptoms compared to Caribbean Black males with early developing hair growth regardless of neighborhood context. CONCLUSION: Early pubertal timing is a risk for African American boys' mental health regardless of neighborhood context. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pubertal stress recalibration and later social and emotional adjustment among adolescents: The role of early life stress.

The current study investigated whether recalibration of the hypothalamic-pituitary -adrenocortical (HPA) axis stress response in youth who had previously experienced early life stress (ELS) would predict socioemotional adjustment in a follow-up assessment approximately 2-4 years later when youth were 12- to 21-years old. The sample consisted of previously institutionalized (PI) (N = 96) youth and a comparison non-adopted (NA) group (N = 117). Youth were 16 years old on average at the time of the follow-up assessment. Parent and youth-reported measures were used to assess youth's internalizing symptoms and emotion regulation. Parent-reported measures were used to assess youth's externalizing symptoms. We tested whether showing cortisol increases (vs. not) across the peripubertal period was associated with later social and emotional adjustment differently for PI and NA youth. Significant interactions emerged showing that for PI youth only, increases in cortisol reactivity across the peripubertal period was associated with poorer subsequent socioemotional functioning.

Gonadal and adrenal hormones interact with pubertal maturation to predict depressive symptoms in a group of high-school females.

Adolescent females are at elevated risk for the development of depression. In this study, we addressed two questions: Are pubertal hormones associated with adolescent mental health? Might this association depend on pubertal development? We tested the hypothesis that estradiol, which has been associated with adolescent social sensitivity, might interact with pubertal stage to predict depression risk at three time points in ninth and tenth grade. Hormones and pubertal development were measured ninth-grade females. Linear regression analyses were used to predict fall ninth-grade (N = 79), spring ninth-grade (N = 76), and spring tenth-grade (N = 67) Children's Depression Inventory (CDI) scores. The hypothesized model was not statistically significant, but exploratory analyses revealed that two- and three-way interactions incorporating estradiol, puberty (stage and perceived onset), and cortisol predicted current and future CDI scores. Our exploratory model did not predict changes in CDI but did account for future (spring of ninth grade) CDI scores. Specifically, estradiol was positively correlated with fall and spring ninth-grade depressive symptoms in participants with high cortisol who also reported earlier stages and later perceived onset of pubertal development. These findings suggest that hormones associated with sensitivity to the social environment deserve consideration in models of adolescent depression risk.

Characteristics of "chunibyo" identified by a questionnaire.

BACKGROUND: "Chunibyo" is a term that represents a distinctive, transient mental state during puberty in Japan, but its characteristics and precise definition have not been standardized. Increased awareness of chunibyo could lead to a better environment for those who experience it. This study aimed to identify the characteristics of and problems related to chunibyo using an anonymous questionnaire. MATERIALS AND METHODS: An anonymous online questionnaire was conducted in February 2021 in Japan. In total, 314 volunteers completed the anonymous online questionnaire. Respondents were divided into the chunibyo group (n = 122) and the non-chunibyo group (n = 192), and the questionnaire responses were compared between the two groups. Furthermore, the responses were compared between the chunibyo with problems subgroup (n = 82) and the other subgroup (n = 232). The main outcome was the identification of the chunibyo group based on the responses to the item "I have experienced chunibyo" or "I have been told that I exhibited chunibyo". RESULTS: The median age of the chunibyo group was 31 years old; this group was predominantly male (n = 79, 64.8%) and had a relatively high proportion of respondents with any problems (n = 82, 67.2%). The chunibyo group had higher proportions of respondents who felt that academic tests did not reflect their true worth (n = 58 (47.5%) vs. n = 66 (35.4%), p = 0.024), who felt uncomfortable in the world (n = 77 (61.1%) vs. n = 67 (34.9%), p<0.001), and who had an imaginary/fantasy friend or boyfriend/girlfriend (n = 39 (32.0%) vs. n = 10 (5.2%), p<0.001). The results were similar between the chunibyo with problems subgroup and the other subgroup. Eighty respondents (25.4%) had negative impressions of chunibyo, whereas twenty-one respondents (6.7%) had positive impressions. CONCLUSIONS: This study is the first to report the characteristics of chunibyo by collecting the experiences and thoughts of people who experienced chunibyo.

Promoting Healthy Sexuality for Children and Adolescents With Disabilities.

This clinical report updates a 2006 report from the American Academy of Pediatrics titled "Sexuality of Children and Adolescents With Developmental Disabilities." The development of a healthy sexuality best occurs through appropriate education, absence of coercion and violence, and developmental acquisition of skills to navigate feelings, desires, relationships, and social pressures. Pediatric health care providers are important resources for anticipatory guidance and education for all children and youth as they understand their changing bodies, feelings, and behaviors. Yet, youth with disabilities and their families report inadequate education and guidance from pediatricians regarding sexual health development. In the decade since the original clinical report was published, there have been many advancements in the understanding and care of children and youth with disabilities, in part because of an increased prevalence and breadth of autism spectrum disorder as well as an increased longevity of individuals with medically complex and severely disabling conditions. During this same time frame, sexual education in US public schools has diminished, and there is emerging evidence that the attitudes and beliefs of all youth (with and without disability) about sex and sexuality are being formed through media rather than formal education or parent and/or health care provider sources. This report aims to provide the pediatric health care provider with resources and tools for clinical practice to address the sexual development of children and youth with disabilities. The report emphasizes strategies to promote competence in achieving a healthy sexuality regardless of physical, cognitive, or socioemotional limitations.

Barriers to Puberty Talk between Mothers and Daughters: A Qualitative Study.

OBJECTIVE: The aim of the present study is to explain the barriers to puberty talk between mothers and daughters. METHODS: In the present study, the conventional content analysis method was used. The present study was conducted from September 2018 to August 2019 in Iran. The study population consisted of mothers and adolescent girls. The data was collected using purposeful sampling method. The sample consisted of 4 mothers and 6 girls that were interviewed using semistructured interviews. Data collection continued until data saturation was achieved. Data analysis was conducted as described by Graneheim et al. using NVivo 11 software. RESULTS: In the present study, after exploring the views of the participants about barriers to puberty talk between mothers and daughters, one dominant theme emerged. Puberty talk is seen as an "inappropriate talk with a girl." There were several subthemes, including "lack of mother's awareness regarding the school role, the busy schedule of the mother, and the adoption of alternatives to mother's talk with girls". CONCLUSIONS: Different sociocultural factors affect puberty talk between mothers and adolescent girls. It is important that mothers and policy makers take these barriers into account.