Early Menarche: Is it a Risk Factor for Depression,

Substance

Abuse, and Eating Disorders?

Facilitator: Ann Hung, Mental Health Board Intern June 8 th , 2011

Agenda

1. Early puberty 2. Biological, environmental, and nutritional aspects 3. Stress hypotheses 4. Negative psychosocial outcomes:    Depression Substance Use Eating Pathology 5. Limitations of research and implications for clinical practice

Puberty

 Are girls developing earlier than before?  (Herman-Giddens et al., 1997; Walvoord, 2010)  Pubarche, thelarche & menarche  Ethnic differences in onset of puberty  (Obeidallah et al., 2000; Chumlea et al., 2003)

Biological and Environmental Antecedents

 Biological  genes (Brooks-Gunn & Warren, 1988)  Environmental    poverty father absence (Surbey, 1990; Deardorff et al., 2011) family conflict  Nutrition and Obesity (Kaplowitz et al., 2001; Davidson et al., 2003)

Stress Hypotheses

(Caspi & Moffitt, 1991)

1. Stressful Change 2. Off-time 3. Early-Timing

Caspi & Moffitt, 1991

5 0 15 10 Behavior Problems as a function of age at menarche 25 20 <12 12-13 13-14 14-15 13 Age 15

Depression

 Theoretical Underpinnings   physical changes hormonal changes  Comorbidity with other disorders (Patton et al., 1996; Hayward et al., 1996; Graber et al., 2004)  Results among racial minorities   (Hayward et al., 1999) (Ge et al., 2003)

Eating Pathology

 Two central mechanisms (Stice & Shaw, 2002)   dieting negative affect  Mixed findings re. early menarche on eating pathology  Other factors leading to eating disorders

Precursors and Consequences of Body Dissatisfaction

Substance Use

 Early maturers → increased risk of substance use (Dick et al., 2000)  Association of girls with older peers (Magnusson et al., 1986; Moffitt et al., 2001)  Means for self-medication  Racial Differences  cigarette use (Negriff et al., 2010)

Limitations of Current Literature

 Lack of follow-up reports  Retrospective data  Measurement criterion  Dearth of racially diverse samples

Implications for Clinical Practice

 Spending more time on body dissatisfaction   sociocultural ideals of thinness critical consumers of mass media  Intervention programs targeted during the most developmentally challenging and stress inducing times  Informational programs for parents  5 th vital sign

References

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References cont.

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