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      Pubertal timing and tempo and its prospective associations with behavioral problems


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          Objective The study aims to examine the prospective association and sex differences of pubertal timing and tempo with behavior problems.

          Methods Participants from two primary schools in grade 1–3 were selected through clustering convenience sampling method in Bengbu, Anhui Province was established since 2013 (T1), with informed consent, 2 084 students were recruited and follow-up surveys were conducted in 2015 (T2) 2017 (T3) and 2019 (T4) respectively. Demographic information non-suicidal self-injury (NSSI) suicidal ideation suicide plan suicide attempt and externalizing symptoms were collected through questionnaire investigation and pubertal development in boys and girls were evaluated by secondary sexual development (testicular volume for boys and breast development for girls). At T4, externalizing symptoms were evaluated by MacArthur Health & Behavior Questionnaire-Child (HBQ-C). Using SAS PROC NLMIXED to fit nonlinear growth model to estimate pubertal timimg and tempo. Puberty timing was classified into early on-time and delayed groups; and the puberty tempo into fast average and slow groups. Multivariable logistic regression model was used to analyze the predictive effects of modeling pubertal timing and tempo on multi-disciplinary behavior problems in adolescence boys and girls.

          Results There were 1 909 people with complete baseline and follow-up questionnaires and puberty development information. Reported rates of externalizing symptoms, NSSI, suicidal ideation, suicide plan suicide attempt and were 13.9% (265) 24.4% (466) 14.2% (271) 4.6% (88) and 2.3% (43) respectively. Logistic regression analysis results show that fast pubertal tempo increases the risk of externalization [ OR(95% CI) =2.85 (1.53-5.31) and NSSI [ OR(95% CI) =2.11(1.22-3.65)] for boys, and the risk of suicide attempt [ OR(95% CI) =2.99(1.07-8.35)] for girls. Slow tempo can reduce the risk of suicidal ideation and suicide plan for boys [ OR(95% CI) =0.40(0.18-0.87), 0.07(0.01- 0.67) ] , the externalizing symptoms and suicidal ideation for girls [ OR(95% CI) =0.33(0.13-0.81), 0.38(0.17-0.85)] . Early pubertal timing will increase the risk of suicide plan for boys [ OR(95% CI) =3.60 (1.04–12.43) ] , meanwhile late timing can reduce the risk of NSSI in girls [ OR(95% CI) =0.39(0.19-0.80) ].

          Conclusion The tempo of pubertal development may be a useful predictor of adolescent behavioral problems.


          【摘要】 目的 探讨青春期发育时相与发育速度对青少年行为问题的前瞻性预测效应, 及可能存在的性别差异。 方 法 于 2013 年 (T1) 方便选取安徽省蚌埠市 2 所小学一至三年级 2 084 名学生, 建立儿童青春期发育队列, 并分别于 2015 (T2)、2017 (T3) 和 2019 (T4) 开展 2 年一次的随访调査, 最终有效人数 1 909 人。问卷调査收集人口统计学信息、非自杀性 自伤行为 (non-suicidal self-injury, NSSI)、自杀意念、自杀计划、自杀企图与外化症状, 男女童的青春期发育分别采用男童睾 丸容积和女童乳房发育 Tanner 分期作为评估指标。T4时采用《 MacArthur 健康行为问卷儿童报告版》评估外化症状。基 于SAS软件的非线性生长模型 (nonlinear growth model, NLM) 分别拟合男女童青春期发育的时相与速度, 将青春期时相划 分为提前、适时、延迟组; 将青春期发育速度划分为快速、正常、缓慢组。采用多因素 Logistic 回归模型评价男女生青春期发 育时相与发育速度对随访期不同行为问题发生的预测效应。 结果 外化症状、NSSI、自杀意念、自杀计划和自杀企图报告 率分别为 13.9% (265 名) 、24.4%(466 名) 、14.2%(271 名) 、4.6% (88 名) 和 2.3% (43 名)。Logistic 回归分析结果提示, 青 春期发育速度过快会增加男童外化症状、NSSI [ OR值 (95% CI) 分别为 2.85(1.53~5.31), 2.11(1.22~3.65)] 和女童自杀企 图的发生风险 [ OR值 (95% CI)= 2.99(1.07~8.35)]。发育速度缓慢可以降低男童自杀意念与自杀计划[ OR值 (95% CI) 分 别为 0.40(0.18~0.87), 0.07(0.01 ~ 0.67)] 和女童外化症状和自杀意念的发生风险 [ OR值(95% CI) 分别为 0.33(0.13 ~ 0.81), 0.38(0.17~0.85)]。发育时相提前会增加男童自杀计划发生风险 [ OR值 (95% CI)= 3.60 (1.04~ 12.43)], 发育时相 延迟可以降低女童NSSI发生的可能性 [ OR值 (95% CI)=0.39(0.19~0.80)]。 结论 青春期发育速度可能是青少年行为问题的重要预测因素。

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          Author and article information

          Chinese Journal of School Health
          Chinese Journal of School Health (China )
          01 June 2020
          01 June 2020
          : 41
          : 6
          : 815-820
          [1] 1Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei (230032), China
          Author notes
          *Corresponding author: SUN Ying, E-mail: yingsun@ 123456ahmu.edu.cn
          © 2020 Chinese Journal of School Health

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

          Self URI (journal-page): http://www.cjsh.org.cn
          Journal Article

          Ophthalmology & Optometry,Pediatrics,Nutrition & Dietetics,Clinical Psychology & Psychiatry,Public health
          Puberty,Adolescent,Growth and development,Behavior,Follow-up studies,Regression analysis


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