Pubertal Timing and Suicidal Behavior in Early Adolescence

• In Event: 3-087 - Developmental Perspectives on Adolescent Self-Injurious Thoughts and Behaviors

Integrative Statement

Suicidal behavior, including suicidal ideation (SI) and suicide attempts (SAs), increases dramatically in early adolescence (Nock et al., 2013). Studies on risk factors specific to this developmental period, such as pubertal timing, are scarce. Compared to adolescents with on-time pubertal timing, those who mature earlier are at higher risk for behavioral and emotional problems (Kaltiala-Heino et al., 2003). However, no prior studies have examined the prospective association of pubertal timing with SI and SAs among early adolescents. We examine these associations in a clinical sample of girls and a representative sample of early adolescents and expect that early pubertal timing will be associated with an early onset of SI, and future SI and SAs.

Methods
Our clinical sample included 59 girls, ages 12–19, from diverse ethnic backgrounds (64% Latina/Hispanic), who disclosed SI or an SA in two hospitals, and participated in two study sessions, 1/2–3 months apart. Girls were asked about age of onset of SI and the age of first menarche.

Our representative sample involved a subsample of 1,318 early adolescents (55.1% girls), 12 to 14 years old, from the Add Health Study, assessed twice (1994/95 and 1996). Four gender-specific puberty items were standardized and summed. The total score was standardized by age to calculate pubertal timing. Adolescents reported past-year SI and SA twice. Analyses were weighted.

Results
Clinical sample: The correlation between age of menarche and onset of suicidal ideation was 0.36 (p = .01). Thirteen girls (22%) started thinking about suicide the year before menarche and 46 (78%) during the same year or after menarche. In the latter group, age of menarche was significantly associated with age of onset of SI (B (SE) = 0.77 (0.18), p < .01) after adjusting for prior/concurrent onset of self-injury, race/ethnicity, and hospital.

Representative sample: The prevalence of SI and SA at wave 2 was 11.2% and 4.2%, respectively. Pubertal timing was associated SI and SAs a year later, adjusting for race/ethnicity and baseline poverty, depressive symptoms, and suicidal behavior. For each unit of increase in pubertal timing, the odds (95% CI) of SI and SAs increased 1.10 (1.09-1.10) and 1.28 (1.47-1.48), respectively, for girls. For boys, the odds (95% CI) of SI increased 1.24 (1.23-1.24) and of SAs increased 2.12 (2.09-2.13) (unadjusted model).

Discussion
As hypothesized, pubertal timing emerged as an important physiological marker of future suicidal behavior among early adolescents, especially among boys. Our findings partially align with two studies that found that different pubertal milestones predicted future SA among older adolescents. Our studies help clarify the role of pubertal timing on suicidal behavior during the apex of the pubertal maturation. Furthermore, our findings support the early timing hypothesis that posits that children who mature earlier than their peers have less time to develop the cognitive/emotional skills necessary to navigate the social pressures and experiences associated with sexual maturity (Petersen & Taylor, 1980). The distress derived from the discordance between physical development and emotional/cognitive skills may exacerbate underlying vulnerabilities and increase risk of suicidal behavior.

Authors

• Ana Ortin, Hunter College
  Presenting Author

• Regina Miranda, Hunter College and The Graduate Center, City University of New York
  Non-Presenting Author