Sonya Negriff

Menstrual Symptoms in Adolescent Girls: Association with Smoking, Depressive Symptoms, and Anxiety

PURPOSE Dysmenorrhea affects quality of life and contributes to absenteeism from school and work, thereby diminishing opportunities for successful psychosocial and cognitive development during adolescence. In adults, depression, anxiety, and smoking have an impact on menstrual cycles and dysmenorrhea. Associations between these problems have not been examined in adolescents. The purpose of this study was to examine relations between depressive symptoms and anxiety with menstrual symptoms. Smoking was examined as a moderator of this association. METHODS This study enrolled 154 postmenarcheal girls from a sample of 207 girls age 11, 13, 15, and 17 years (mean = 15.4 years [+/-1.9]). Self-reported measures included the Menstrual Symptom Questionnaire (MSQ), Childrens Depression Inventory, State-Trait Anxiety Inventory, and smoking behavior. Generalized linear regression modeled MSQ outcomes separately for depressive symptoms and anxiety. RESULTS More depressive symptoms/anxiety were related to higher numbers of menstrual symptoms (r = 0.23-0.44, p < .05). Smoking status (ever) was related to higher MSQ scores. Moderating effects of smoking and depressive symptoms or anxiety on menstrual symptoms were consistent across most MSQ factors where effects were stronger in never smokers. CONCLUSION This is the first study in adolescents showing smoking status and depressive symptoms/anxiety are related to menstrual symptoms, and that the impact of depressive symptoms/anxiety on menstrual symptoms is stronger in never smokers. The dynamic and complex nature of smoking, moods, and dysmenorrhea cannot be disentangled without longitudinal analyses. Efforts to reduce menstrual symptoms should begin at a young gynecological age and include consideration of mood and smoking status.

Depression and Anxiety in Adolescent Females: The Impact of Sleep Preference and Body Mass Index

PURPOSE To examine the differences in depressive symptoms and anxiety between (a) normal weight and overweight, and (b) morning type and evening type (sleep chronotype) adolescent girls. The interaction of sleep chronotype and weight and depressive symptoms and anxiety were also examined. METHOD The design consisted of a cross-sectional study of 264 adolescent females (mean age = 14.9 +/- 2.2, range 11-17 years). Sleep chronotype, depressive symptoms, and anxiety were obtained by self-report questionnaire. The mean of three measurements of height and weight was used to calculate the body mass index (BMI). BMI was plotted on the CDC BMI-for-age growth charts to obtain percentile ranking. Participants were categorized into two groups according to BMI percentile: normal weight (<85th percentile) and overweight (> or =85th percentile). RESULTS Compared with normal-weight females, overweight females were more likely to be non-Caucasian, lower socioeconomic status, have more advanced pubic hair and breast stages, and earlier age at menarche. No differences were observed with respect to sleep chronotype, depressive symptoms, and trait anxiety between normal weight and overweight females. Evening chronotype was associated with more depressive symptoms (beta = -.65, p < .01) and higher trait anxiety (beta = -.22, p < .05). Evening chronotype was associated with more depressive symptoms in both normal-weight and overweight females. However, the association was stronger in overweight females. CONCLUSIONS Individually, sleep and weight impact physical and mental health during adolescence. The combination of evening chronotype and overweight appears to have the strongest association on the emotional health of adolescent females. Further investigations are needed to provide potential biological mechanisms for this relationship.

Morningness/Eveningness, pubertal timing, and substance use in adolescent girls

The purpose of this study was to examine the associations between Morningness/Eveningness (M/E; a measure of sleep-wake preference) and alcohol, cigarette, and marijuana use as well as the interaction of M/E and pubertal timing. The data represent baseline measures from a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health in 262 adolescent girls (11-17 years). The primary measures used for this study were pubertal timing (measured by age at menarche), the Morningness/Eveningness scale, and substance use (alcohol, cigarettes, and marijuana). Multiple group path modeling showed that there was a significant interaction between pubertal timing and M/E on cigarette use. The direction of the parameter estimates indicated that for the early and on-time groups, Evening preference was associated with more cigarette use. For the late timing group the association was not significant. The results point to the need to consider sleep preference as a characteristic that may increase risk for substance use in adolescents.

Exposure to peer delinquency as a mediator between self-report pubertal timing and delinquency: a longitudinal study of mediation.

This study examined exposure to peer delinquency as a mediator between pubertal timing and self-reported delinquency longitudinally and whether this mediational model was moderated by either gender or maltreatment experience. Data were obtained from Time 1, 2, and 3 of a longitudinal study of maltreatment and development. At Time 1 the sample comprised 454 children aged 9-13 years. Analyses via structural equation modeling supported full mediation. Gender did not moderate this mediational relationship, but maltreatment experience did. The results show that early maturing males and females are both at risk for being exposed to peers that may draw them into delinquent behavior. In addition, the mechanism linking early pubertal timing to delinquency differs depending on maltreatment experience.

Overweight and Obesity among Maltreated Young Adolescents.

PURPOSE (1) To identify and compare rates of body mass index (BMI)≥ 85% (overweight/obesity) and BMI ≥ 95% (obesity) in maltreated versus comparison young adolescents; (2) to determine whether demographic/psychological characteristics are related to high BMI; (3) to determine whether type of maltreatment is related to high BMI in maltreated young adolescents. METHODS We compared a sample of maltreated young adolescents to a comparison sample of adolescents from the same neighborhood. The maltreated sample (n=303) of young adolescents (ages 9-12) came from referrals from the county child welfare department in Los Angeles, CA from new cases of maltreatment opened in specified zip codes. A comparison sample (n=151) was recruited from the same zip codes. The total sample (both maltreated and comparison) was 77% Black or Hispanic and 23% White or biracial with 53% males and 47% females. A stepwise logistic regression was used to examine predictors of high BMI with demographic/psychological covariates and maltreatment group. The maltreated young adolescents were selected and the logistic model included all covariates as well as an interaction between gender and each maltreatment type (neglect, sexual, and physical abuse). RESULTS Maltreated young adolescents were similar to comparison adolescents in obesity prevalence (27.1% and 34.4%, respectively), although comparison young adolescents were 1.7 times more likely to have overweight/obesity than the maltreated young adolescents (95% CI=1.13-2.76). No demographic variables predicted high BMI. For the comparison young adolescents, depression slightly increased the odds of overweight/obesity (OR=1.08, 95% CI=1.01-1.15). Being neglected reduced the odds of being in the overweight/obesity and obesity group when combining genders. For females, but not males, sexual and physical abuse slightly reduced the odds of obesity. CONCLUSIONS Both the maltreated and comparison young adolescents had a high prevalence of overweight and obesity, which puts them at risk for health problems. Maltreatment reduced the odds of having a high BMI for adolescents in this study, which is opposite to research in adults. Further exploration of the mechanism of how maltreatment is related to weight as adolescents age, with specific emphasis on differences between genders, is needed.

The Relationship Between Pubertal Timing and Delinquent Behavior in Maltreated Male and Female Adolescents

This study examined the relationship between pubertal timing and delinquent behavior across two time points in a sample of 303 maltreated and 151 comparison adolescents aged between 9 and 13 years at enrollment. The first aim was to examine the relationship between pubertal timing and delinquency for the total sample and then to test for gender differences using multiple group models. The second aim was to examine the interaction effect of pubertal timing and maltreatment on delinquency as well as gender differences for this interaction effect. Results showed that earlier pubertal timing was related to higher delinquency and this relationship was not significantly different for males and females. Maltreatment did not moderate the relationship between pubertal timing and delinquency for the total sample; however, there was evidence of a three-way interaction. These findings highlighted the need to examine contextual factors that may affect the amplification and direction of these relationships.

Morningness/Eveningness and menstrual symptoms in adolescent females.

OBJECTIVE Two types of sleep preference have been supported in the literature. Morning types awaken early and are refreshed upon waking, whereas Evening types rise later and have more erratic sleep schedules. Sleep affects menstrual functioning in adult women. However, there is scant research on the association between sleep preference and menstrual functioning in adolescents. Thus, the present study examined the association between sleep preference and menstrual functioning in 210 adolescent girls (11-17 years old). METHODS Data represent baseline measures from a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health. Measures included the Menstrual Symptom Questionnaire (MSQ), regularity and duration of menstrual cycles, and the Morningness/Eveningness scale (measuring sleep preference). MSQ factor scores were used in analyses: abdominal pain, negative affect/somatic complaints, back pain, and anxiety/fatigue. RESULTS The results from hierarchical linear regression analyses showed significant associations between Evening preference and more symptoms of abdominal pain (P<.01), negative affect/somatic complaints (P<.01), anxiety/fatigue (P<.01), and shorter menses (P<.05). CONCLUSION Adolescent girls with Evening preference experience more menstrual symptoms than those with Morning preference. Future research should include sleep preference in studies of health and behavior particularly in adolescence when there is a normative shift toward Evening preference.

Longitudinal Relations between Depressive Symptoms and Externalizing Behavior in Adolescence: Moderating Effects of Maltreatment Experience and Gender.

Among the explanations for the high rates of co-occurrence between depressive symptoms and externalizing behavior is the possibility of direct causal associations between the two symptom groups. However, the mechanisms by which co-occurrence arises may not be the same across etiologically significant variables. A gender-balanced sample of 303 adolescents (ages 9–12 at the first assessment) with carefully assessed histories of maltreatment experience and 151 demographically matched nonmaltreated adolescents were assessed over the period of 1 year. Multiple-group cross-lagged panel analyses assessed the equivalence of longitudinal relations between depressive symptoms and externalizing behavior for gender/maltreatment status groups. Consistent with previous findings, the results suggest that girls, particularly maltreated girls, who exhibit early externalizing behavior are at high risk for the development of subsequent depressive symptoms.

The measurement of menstrual symptoms Factor structure of the menstrual symptom questionnaire in adolescent girls

This study examined the factor structure of the Menstrual Symptom Questionnaire (MSQ) in a sample of 210 adolescent girls (11—17 years). Such an examination has not been carried out with an adolescent sample. In addition, the definitions of menstrual disorders have evolved since the creation of the MSQ. Exploratory factor analysis supported a three factor structure indicating abdominal pain, negative affect/somatic complaints, and back pain. Partial correlations indicated all three MSQ factors were correlated with depressive symptoms, but only the negative affect factor was correlated with trait anxiety. Future research should explore potential associations in multiple areas of functioning as menstrual symptoms may alter healthy developmental processes during adolescence.

Characterizing the sexual abuse experiences of young adolescents

The purpose of this descriptive study was to: (a) compare the demographics of maltreated youth initially labeled as sexually abused by the Department of Child and Family Services (DCFS) to maltreated youth classified as sexually abused using current and past case records, (b) identify differences in sexual abuse experiences and types of perpetrators between boys and girls, and (c) provide a detailed description of the sexual abuse experiences for boys and girls. Participants were youth ages 9-12 years old with a recent maltreatment allegation. The Maltreatment Case Record Abstraction Instrument (MCRAI) was used to code child welfare records of 303 maltreated youth of whom 60 experienced sexual abuse. Perpetrators were classified by gender into four categories (biological parent, parental figure, relative, and unrelated) and type of abuse was classified into three categories (penetrative, contact without penetration, and non-contact). Using Chi-Square tests, perpetrator categories and sexual abuse types were compared by child gender for significant differences. Only 23 (38.3%) of the 60 sexually abused youth were labeled as sexually abused in the most recent DCFS report when they entered the study. About three-quarters of the sexually abused youth experienced non-penetrative physical contact, 40% experienced penetration, and 15% experienced sexual abuse without physical contact. Most youth (91.7%) were victimized by a male, and 21.7% were abused by a female. Youth experienced a large range of sexual abuse experiences, the details of which may be important for exploration of consequences of childhood sexual abuse.