Early Menarche: Is it a Risk Factor
for Depression, Substance Abuse,
and Eating Disorders?
Facilitator: Ann Hung, Mental Health Board Intern
June 8th, 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
Total Behavior Problem Score (RBPC)
Caspi & Moffitt, 1991
Behavior Problems as a function of age at menarche
25
20
<12
12-13
13-14
14-15
15
10
5
0
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

5th vital sign
References
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