Puberty

Pubertal Timing

The onset of puberty can vary by as many as 4–5 years among healthy individuals, with recognized sex and race/ethnicity differences. Pubertal timing reflects a strong genetic component, with other factors such as childhood weight, nutrition, stress, and epigenetic programming having additional effects. Early timing of puberty has often been shown to be associated with or be a risk factor for negative mental and physical health, including depression, anxiety, risky behaviors, and cardiometabolic outcomes. There are a number of proposed mechanisms, including direct influences of underlying sex hormones on brain development, that occur at different times during puberty and in turn may affect neuropsychological function and behavioral changes. Additionally, adults or peers who notice external pubertal changes often respond differently to the adolescent, which may indirectly affect outcomes via stress or low self-esteem. The tempo of puberty (progression to the established milestones after entry into puberty) may also have implications for adolescent development.

Puberty Measurement

Puberty can be studied directly through hormone concentrations or indirectly through pubertal staging, as the hormones influence the degree of physical development. Classical empirical work by James M. Tanner and colleagues in the middle of the 20th century established five graded categories of both adrenarche (pubic hair) and gonadarche (breast development for girls and testicular volume for boys), and Tanner staging (1 = prepubertal; 5 = full maturity) remains a primary system for measuring puberty. A physical examination is the gold standard, but other studies utilize drawings, photographs, or descriptions of the five stages to solicit parental or self-reports. The Pubertal Development Scale is currently the most widely used pubertal questionnaire. This measure includes some of the early pubertal changes (e.g., breast development) as well as developmental markers that become evident in mid- to late adolescence, such as facial hair and voice change for boys and menarche for girls. It is important to consider the outcome variable of interest when selecting a measure of puberty.

See also Adolescence; Anxiety; Demographics