Do Self-Reported and Actigraph Sleep Mediate the Association between Pubertal Development and Internalizing Symptoms?

• In Event: Pubertal Change, Deficient Sleep, and Mental Health Problems: Understanding This Slow Moving Trainwreck

Abstract

Pubertal onset is linked with physical and psychological changes, including increased eveningness preference, delayed sleep-wake patterns, as well as increased risk for internalizing problems (Costello et al., 2011; Gradisar et al., 2011; Randler et al., 2009). The biopsychosocial and contextual model of sleep in adolescence posits that sleep is an integral factor in adolescent development (Becker et al., 2015), yet no known studies have examined sleep as a mediator between pubertal development and internalizing symptoms. Several studies, though, suggest that earlier pubertal timing is cross-sectionally and prospectively associated with sleep-wake behaviors (i.e., shorter sleep durations; Diao et al., 2020; Hoyt et al., 2018). There is also support for prospective associations between poorer sleep and higher internalizing symptoms in adolescence (Nunes et al., 2020). As such, gender-stratified mediation models examined whether pubertal development predicted internalizing symptoms indirectly through both self-reported (sleep disturbances) and actigraphy-detected sleep (duration, midpoint variability).

Participants were twin children (N=818; 51% female; 56.5% non-Hispanic White; 25.7% Hispanic/Latino) and their primary caregivers (Lemery-Chalfant et al., 2019). Analyses included the 10-year (785 children; Mage=10.88, SD=1.15) and 11-year (628 children; Mage=11.63, SD=1.04) study waves. Twins and primary caregivers completed the Pubertal Development Scale (Petersen et al., 1988). Pubertal development composites were computed and standardized separately for boys and girls (Conley et al., 2012). Twins wore wrist-based accelerometers (Ambulatory Monitoring, Inc, Ardsley, NY USA) for approximately 7 consecutive nights (M= 6.81, SD = .86). Twins completed the Children’s Report of Sleep Patterns (Meltzer et al., 2013) where higher scores on the sleep disturbances subscale indicated greater disturbances. The Berkeley Puppet Interview (Armstrong & Goldstein, 2003) captured internalizing symptoms at age 11. Covariates included age, sex, race/ethnicity, family socioeconomic status, body mass index, vacation (participated during summer/holiday break), and age 10 internalizing symptoms. Multigroup multilevel mediation models were conducted for each sleep mediator, separately for boys and girls, and adjusted for the nesting of twins within families.

For boys, longer sleep duration predicted higher internalizing symptoms (b = .17, p = .02; Figure 1a). For girls, greater pubertal development predicted lower internalizing symptoms (b = -.24, p = .01; Figure 1b). Midpoint variability models were non-significant. There was a significant indirect effect of pubertal development on internalizing through sleep disturbances for boys (b = .03, SE = .02, 95% CI = .003, .069), but not for girls (Figure 1e, 1f).
While greater pubertal development predicted lower internalizing symptoms for girls, sleep disturbances mediated this relation in boys. This opposes extant research that has consistently linked greater pubertal development with risk for internalizing in girls, but many studies have focused on pubertal timing rather than pubertal status, and examined internalizing symptoms in later adolescence (Alloy et al., 2016; Pfeifer & Allen, 2021). Sleep may be a potential malleable factor for youth, especially boys, undergoing pubertal development to prevent subsequent onset of internalizing symptomatology. Future studies should consider longitudinal analyses across all pubertal stages, as well as examine other potential mediators (e.g., rumination; Mendle et al., 2020) in the puberty-internalizing problem relation.

Authors

• Emma Lecarie, Arizona State University
  Presenting Author

• Leah D Doane, Arizona State University

• Mary Davis, Arizona State University

• Kathryn Lemery-Chalfant, Arizona State University