Journal of Adolescence 37 (2014) 905e913
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Early menarche, depressive symptoms, and coping strategies nica Alcala -Herrera a, b, 1, Ma. Luisa Marva n b, * Vero noma de M Coordination of Psychophysiology, Universidad Nacional Auto exico, Av. Universidad 3004, Col Copilco-Universidad, Del. n, 04510, M Coyoaca exico D.F., Mexico Institute of Psychological Research, Universidad Veracruzana, M exico, Av. Dr. Luis Castelazo Ayala s/n Col. Industrial Animas, C.P. 91190 Xalapa, Ver., Mexico a
b
a b s t r a c t Keywords: Menarche Early menarche Early maturers Depressive symptoms Coping strategies
During the time around menarche, young women must make many emotional and social adjustments to adapt to a new life stage. We compared depressive symptomatology and coping strategies between early and average maturer Mexican adolescents girls. The relationships between elapsed time since menarche and both depressive symptomatology and coping strategies were also studied. Three hundred eighty post-menarcheal students from 11 to 15 years completed the Children's Depression Scale and the Children's Situational Coping Scale. Early maturers showed more depressive symptoms than their peers, but they reported having used fewer non-productive coping strategies. Early maturers who experienced menarche one to three years previously reported more non-productive coping strategies than those who had experienced menarche four to six years ago. However, no differences were found in the results of the average maturers depending on the time elapsed since menarche. These findings are discussed in light of the psychosocial context of early maturers. © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Puberty is the period at the beginning of adolescence that is characterized by sexual maturation. Although there is a wide range of normal ages, visible physical changes associated with puberty typically begin at age 10 to 11 and usually are complete by age 15 to 17 in girls. In boys, these changes appear later, usually around 12 years, and are complete by age 16 to 17. In contrast with puberty, which refers to a period of physical transition, adolescence is the period of psychological and social transition between childhood and adulthood. It typically encompasses a larger period of time and its limits are less well defined since they depend mainly on social factors (Reyes, 2012). During this period, sex hormones regulate some brain functions, such as the modulation of the limbic-cortical circuits, which leads to the acquisition of adult cognition and the establishment of information pathways to promote social development in the individuals (Romer, 2010; Vigil et al., 2011). Adolescence is characterized by new psychosocial challenges that adolescents must face. Some examples are competition with peers, learning to balance the desire for immediate gratification with an understanding of the importance of long-term goals and consequences, the rapid succession physical changes, the management of sexuality, the parenteadolescent relationship, the development of self, and the expanding network of social relationships (Dahl, 2004; Liu, Chen, & Peng, 2012).
gicas, Universidad Veracruzana, Av. Dr. Luis Castelazo Ayala s/n Col. Industrial Animas, * Corresponding author. Instituto de Investigaciones Psicolo Xalapa, Ver. 91190, Mexico. Tel.: þ52 (228) 841 89 00x13210. n). E-mail addresses: [email protected] (V. Alcal a-Herrera), [email protected] (Ma.L. Marva 1 Tel.: þ52 (55) 56 22 22 30, þ52 (228) 841 89 00x13210. http://dx.doi.org/10.1016/j.adolescence.2014.06.007 0140-1971/© 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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These challenges are often confusing leading adolescents to erratic behaviors and difficulty in controlling their impulses (Vigil et al., 2011), exposing themselves to unnecessary risks such as participating in delinquent activities, drug consumption, or having unprotected sex, among others. Psychological gender-related experiences during adolescence Adolescence is a period of vulnerability to depression, possibly due to the impact of greater exposure to negative life events, particularly those involving difficulties with peer and family relationships (Sawyer, Pfeiffer, & Spence, 2009). Females show more depressive symptoms than male adolescents (Fatiregun & Kumapayi, 2014; Hilt & Nolen-Hoeksema, 2009). Nolen-Hoeksema and collaborators stated that this gender difference is caused by the combination of two factors: a) girls apparently face more new challenges in early adolescence than boys; and b) girls are more likely than boys to carry risk factors for depression even before early adolescence, but these risk factors lead to depression only in the face of challenges that increase in prevalence in early adolescence (Nolen-Hoeksema & Girgus, 1994; Nolen-Hoeksema, Larson, & Grayson, 1999). From the 1990s to the present, researchers have agreed that depression is a complex combination of high negative emotions and low positive emotions. However, depressive affect (e.g., loneliness, sadness, low self-esteem) and positive feelings and experiences (e.g., satisfaction, happiness, pleasure) are not merely opposite ends of the same continuum, but represent two distinct aspects of a more general construct of depression (Forbes & Dahl, 2005; Lindahl & Archer, 2013; Tisher, Lang-Takac, & Lang, 1992). Although females show more depressive affect than do male adolescents (Lindahl & Archer, 2013; Tisher et al., 1992), researchers who have compared positive feelings and experiences between female and male adolescents, have not found gender differences (Eryilmaz, 2009; Forbes, Williamson, Ryan, & Dahl, 2004). Another gender-related difference in adolescence is that girls tend to rate negative life events as more stressful than do boys (Mezulis, Shibley-Hyde, Simonson, & Charbonneau, 2011), and girls also show more altered responses to adversity, including a propensity to adopt self-blaming coping styles (Nolen-Hoeksema, Wisco, & Lyubomirky, 2008; Patton & Viner, 2007). It is important to notice there is no one way of coping with stressful situations but rather many, and although coping strategies are neither ‘good’ nor ‘bad’ (because different situations call for different strategies), they can be considered in terms of their effectiveness and differentiated as productive or non-productive (Stewart & Sun, 2007). Menarche Because menarche (the first menstruation), is considered the major landmark of puberty for girls, we were interested in studying some psychosocial variables related to the timing of menarche. Unlike the other gradual changes that accompany puberty in girls, menarche is sudden and conspicuous; it is a memorable event for most women since it symbolizes the end of childhood (Chang, Hayter, & Wu, 2010). Since the 1980s, various authors have pointed out that menarche not only involves a biological transformation in girls' bodies, but also demands emotional and social adjustments (Brooks-Gunn & Ruble, 1980; Gaudineau et al., 2010; Koff, Rierdan, & Jacobson, 1981; Walvoord, 2010), and the timing of menarche's occurrence has a great influence on these adjustments (Allison & Hyde, 2013; Ge & Natsuaki, 2009). The age that menarche occurs varies substantially between women across different cultures, but studies reporting the timing of menarche worldwide are very scarce. Thomas, Ranaud, & Benefice (2001), collected data on 67 countries, and found that the earliest age of menarche was 12.0 (Congo and Greece) and the latest was 16.2 years (Nepal). However, rigorous comparisons between the results of different studies of menarcheal timing are complicated due to methodological problems, such as: (a) lack of uniformity in research designs, (b) different sample characteristics such as ages or socioeconomic status of participants included, (c) the use of prospective or retrospective reporting protocols, and (d) different statistical analyses. In Mexico, where the current study was conducted, several authors have studied the timing of menarche. Ages ranged chiga, Mejía, Marrod between 12.06 and 12.64 years (Are an, & Mesa, 1999; García-Baltazar, Figueroa-Perea, Reyes-Zapata, rez-Palacios, 1993; Me ndez, Valencia, & Melendez, 2006). However, these studies were carried out during the Brindis, & Pe 1990s and more recent data is not available. Early menarche Some girls experience menarche earlier or later than their peers. Although nutrition and genetic heritage play an important role in determining age at menarche (Currie et al., 2012; Dvornyk & Waqar-ul-Haq, 2012), psychosocial factors have also been associated with differences in menarcheal timing. Researchers agree that menarche occurs at an earlier age among girls raised in stressful family circumstances (Boynton-Jarrett & Harville, 2012; Jean et al., 2011). Menarche can be a lonelier and more difficult adjustment period for early maturing girls when compared to those maturing on-time because the former often lack same-age models of behavior (Allison & Hyde, 2013). Moreover, early maturers have less time to acquire, assimilate and strengthen adaptive and coping skills to ensure an effective transition from childhood to adolescence, thus leading to developmental asynchrony between physical, cognitive and social maturity (Allison & Hyde, 2013; Negriff, Hillman, & Dorn, 2011). However, as far as we know, no researchers have examined the relationship between early menarche and coping strategies.
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Early menarche increases the likelihood of social victimization (Craig, Pepler, Connolly, & Henderson, 2001). For example, the fact that a boy suspects that a girl has had her first menses, especially if she is unusually young, may provide an opportunity for the boy to practice male dominance by ridiculing or oppressing her. Early menarche is also a risk factor for sexual harassment because the emergence of visible secondary sexual characteristics may elicit the attention and interest of opposite-sex individuals (Allison & Hyde, 2013). The gap between physical and psychosocial maturity in early maturers may increase risk for psychopathology (Ge & Natsuaki, 2009). In a literature review of the detrimental psychological outcomes associated with early menarche, Mendle, Turkheirmer, and Emergy (2007) concluded that early maturers manifest higher levels of depressive symptomatology than average maturers; more recent studies have confirmed these results (Black & Klein, 2012; Joinson, Heron, & Lewis, 2011). The most common explanations for these findings are related to physical changes associated with puberty. For example, when girls mature physically earlier than their peers, they may find it difficult to establish friendships with other girls who have not developed at a similar rate. Another example is that due to their early physical development, older persons may unjustifiably perceive these girls as having greater maturity and therefore force them to face certain challenges before they are emotionally or cognitively prepared to do so e which might cause negative affect, fear, and/or confusion (Mendle et al., 2007). It is important to notice that until now, depressive symptomatology in early maturers has been measured using questionnaires that only comprise depressive affect items. None of the questionnaires used measured positive feelings and experiences. It has even been suggested that early menarche may predispose girls to other emotional problems, such as: social isolation (Copeland et al., 2010), self-harming behaviors (Deng et al., 2011), eating disorders (McNicholas, Dooley, McNamara, & Lennon, 2012), substance abuse (Richards & Oinonen, 2011), and anxiety (Zehr, Culbert, Sisk, & Klump, 2007). However, not all studies support a causal relationship between early menarche and these suggested predispositions (Mendle, Leve, Ryzir, Natsuaki, & Ge, 2011; Natsuaki, Leve, & Mendle, 2011) and further research is needed before reaching a definitive conclusion. A possible explanation for the relation between early menarche and behavioral and emotional problems could be related to the Social Deviance Hypothesis proposed by Petersen & Taylor, which states that girls who reach puberty at a different time than their peers are out of synchrony with the normative experiences during a developmental period that is characterized by heightened vulnerabilities. As a result, these girls are anticipated to be at greater risk for adjustment difficulties due, in part, to their perceived lack of shared experiences with others (e.g., talking about typical feminine issues such as menstrual hygiene or attraction to persons of the opposite-sex). Another possible explanation is related to the Stage Termination Hypothesis proposed by Peskin & Livson, which states that early menarche does not allow girls sufficient time for the acquisition and consolidation of adaptive skills. According to this hypothesis, the early maturers' physical changes may elicit difficulties in adjusting to developmental pressures (e.g., moving into older mixed-sex peer groups or entering romantic relationships among others) because older individuals may view the girls as more emotionally, socially and cognitively advanced than, in fact, they are (Carter, Jaccard, Silverman, & Pina, 2009).
The current study Early maturers reach adolescence in a disadvantaged situation compared to their peers and may be at increased risk for emotional problems. Therefore, early maturers may feel pressured to hurriedly devise coping strategies to adequately face their changed situation. The objective of this study was to compare depressive symptomatology (high depressive affect and few positive feelings or experiences) and coping strategies between early and average maturering Mexican adolescent girls. The relationships between elapsed time since menarche and both depressive symptomatology and coping strategies were also studied. We expected that: 1) Early maturer participants are more likely than average maturers to have depressive symptomatology, 2) Early maturers use different coping strategies than their peers, and 3) Depressive symptomatology and coping strategies used by participants depend on elapsed time since menarche.
Methodology Study setting Appointments were set up with the principals of 13 mixed-gender public schools in Mexico City (the capital of the country) to explain the objective of the study, and ask them to request their school board's permission to conduct the study. The school boards of five elementary and four middle schools agreed. These schools were located in eight different municipal delegations in the center, south, west and east of the city. The schools were in neighborhoods characterized by residents of middle or lower socioeconomic status. Upon agreement, the conditions under which researchers could conduct the study were established. The project was explained to teachers who in turn, sent parents a document explaining the nature of the study and asking their consent for their daughters' participation. After the consents were collected, a schedule was established to apply the survey.
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Sample recruitment Participants were recruited by the schools' teachers, who asked all female students who had begun menstruating and who were attending from fifth grade of elementary school to third grade of middle school (equivalent to fifth through ninth grades in USA and Europe), if they wanted to be part of a research project about adolescence. Teachers stressed that participation was voluntary, that there would be no reprisals for not participating, that the results would be used exclusively for the research project, and that neither the teachers nor the girls' parents would know the answers given by each participant. The inclusion criterion to be eligible for the study was that the adolescents were post-menarcheal and had presented their menarche one year ago or earlier. The exclusion criteria were that adolescents had needed psychological support for treating depressive symptoms (no adolescent reported this condition), that they were not in good health, and that they had reached menarche at 13 years old or later. We established the last criterion because, as is described in the Results section, average maturers were considered those adolescents who had reached menarche at the age of 11 or 12 years old, and early maturers were those who had reached menarche at 8, 9 or 10 years. There were too few girls to compose a group of late maturers (girls reaching menarche at 13 years old or later) since the oldest participants were only 15 years old. Four hundred thirty-six students were invited to participate; four of them did not accept, the parents of 13 did not provide consent to participate, and 39 were excluded for the reasons mentioned above. Thus, the final sample was composed of 380 participants whose ages ranged from 11 to 15 years (mean ¼ 13.44, SD ¼ 11.04). The sociodemographic characteristics of these participants are shown in Table 1. According to the total number of female students who attend these grades in public schools in Mexico City, our sample size had a confidence level of 95% with a margin of error of 5%.
Procedure The study was approved by the corresponding board of the Institute of Psychological Research, Universidad Veracruzana. Two female researchers went to the schools to survey the students on the scheduled day between September 2012 and January 2013. When the researchers arrived at the schools, the students were in a designated classroom in which the survey, which was to be completed online, would take place. To assure privacy, students were seated so they were unable to see each other's computer. Participants were told they could withdraw at any point if they decided not to complete the survey. They were also told again that the information they were going to provide was strictly confidential. The fact that there were no wrong or right answers to the questions was emphasized. Finally, the students were told that their responses were going to be analyzed by people who did not know them.
Table 1 Socio-demographic characteristics of participants. Early maturers (n ¼ 94)
Mean current age (years):
Average maturers (n ¼ 286)
M
SD
M
SD
13.41
1.07
13.44
0.89
n
%
n
%
Age at menarche (years): 8 9 10 11 12
5 19 70 e e
5.3 20.2 74.5
e e e 148 138
51.7 48.3
Time elapsed since menarche (years): 1 2 3 4 5 6
5 11 26 25 21 6
5.3 11.7 27.7 26.6 22.3 6.4
106 101 63 14 2 0
37.1 35.3 22.0 4.9 0.7
Scholastic level: Grades 5e7 Grades 8e9
30 64
27.7 72.3
58 228
30.3 69.7
Participant lives with her: Father and mother Only mother Only father Neither parent
70 21 2 1
74.4 22.3 2.1 1.0
210 69 5 2
73.4 24.1 1.7 0.7
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The researchers provided the participants with a link to the survey posted on Survey Monkey.com, and explained how to complete the questionnaires. Additional aid was provided if needed. The questionnaires were completed in two sessions and a total time of between 40 and 80 min was required by the participants. The adolescents responded to the survey as part of a more extensive research project about menstruation, in which both emotional reactions to menarche and attitudes towards menstruation were also explored. When the project was completed, we returned to the schools to give the directive boards feedback concerning the main results of the study. Measures Participants were initially asked to answer some questions concerning socio-demographic data, their age, the people they were living with, and any health conditions. They were also asked about age at menarche using the question: When was the first time you got your period? Participants reported their age in years. Afterwards, the following questionnaires were applied: Children's Depression Scale: Depressive symptoms were measured using the Spanish version of the Children's Depression Scale (CDS) developed by Lang & Tisher in 1978 (Tisher et al., 1992) and adapted into Spanish by TEA editorial (Lang & Tisher, 1997). This scale is directed to children aged 8e16 years old. It was chosen because instead of being derived from adult depression definitions or manual diagnostics, it was developed from an empirical definition of childhood depression by summarizing the features reported in the literature together with consistent signs in children who had been diagnosed with depression (Tisher et al., 1992). Furthermore, unlike other depression scales for children and adolescents, the CDS includes items to measure both depressive affect and positive feelings and experiences. CDS is a 5-point Likert scale with options ranging from (1)-strongly disagree to (5)-strongly agree. It includes 66 items that comprise eight factors. Six of these factors measure depressive affect: 1) Affective response: feeling and mood of the respondent (Cronbach's alpha in the current study ¼ .84, score range: 8e40); 2) Social problems: difficulties encountered in social interaction, feelings of isolation and loneliness (Cronbach's alpha ¼ .84, score range: 8e40); 3) Self-esteem: respondent's attitudes, concepts and feeling in relation to her own worth and value (Cronbach's alpha ¼ .86, score range: 8e40); 4) Preoccupation with own sickness and death: respondent's dreams and fantasies in relation to disease or to death (Cronbach's alpha ¼ .78, score range: 7e35); 5) Guilt: respondent's self-blame (Cronbach's alpha ¼ .77, score range: 8e40); and 6) Miscellaneous depressive items: depressive statements which could not be grouped with any of the above (Cronbach's alpha ¼ .72, score range: 9e45). The other two CDS factors measure positive feelings and experiences: 1) Pleasure/enjoyment: presence of enjoyment and happiness in the respondent's life, or her capacity to experience them (Cronbach's alpha ¼ .74, score range: 8e40); and 2) Miscellaneous positive items: positive items not included in Pleasure/enjoyment subscale (Cronbach's alpha ¼ .64, score range: 10e50). The total CDS reliability was .92 using the Cronbach's alpha coefficient. High scores in all subscales indicate a higher index of depressive symptoms. This includes both depressive affect and positive feelings/experiences subscales since the two positive subscales are rated inversely. Children's Situational Coping Scale: Coping strategies were measured using the Children's Situational Coping Scale (CSCS), which was developed in Spain by Morales-Rodríguez (2008). This scale was chosen because it evaluates coping strategies in different situations within the four most common daily contexts: family, health, academic, and peers. Following the scale directions, participants were asked about coping strategies they had used during the last year according to a 3 point scale: never (1), sometimes (2) and frequently (3). Coping strategies were grouped in two factors: a) Non-productive strategies: to ignore the problem, cognitive avoidance, aggressive behavior, and/or keeping to one's self; and b) Problem focused coping: Active solution, seeking information and guidance, positive focus, and/or seeking social support (Cronbach's Alpha in the current study .79 and .80 respectively). Since the CSCS was designed in Spain, minor changes were made to account for language differences between Mexico and Spain. Then, 18 experts on the topic reviewed the questionnaire after which it was piloted with 15 students from 11 to 15 years old who were invited to discuss any items they considered difficult to understand. The questionnaire was reviewed accordingly, and the resultant form was then tested with 679 students from five schools who did not participate in the current study and whose ages also ranged between 11 and 15 years. The discriminant capacity of each item was calculated using the extreme groups method, comparing the scores on each item obtained by the 27% of participants who scored highest and the 27% who scored lowest on the entire questionnaire (Anastasi & Urbina, 1998). Then, a factorial analysis with oblimin rotation was conducted. Results of both KaisereMeyereOlkin and Bartlett tests were similar to those found in Spain in the four everyday contexts evaluated. The temporal stability (testeretest) of the CSCS was calculated applying the questionnaire again six months after the first application. Stability across the two administrations was satisfactory (r ¼ .97), and there were no significant changes between the first and second applications. Finally, internal consistency was satisfactory at both Time 1 and Time 2 (Cronbach's alpha ¼ . 83 and .78 respectively). Data analyses Analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 15.0. Participants were divided into two groups, early and average maturers, according to the median and mode of participants' age at menarche, as well as a literature review.
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Affective depressive and positive feelings/experiences were analyzed as two distinct aspects of depressive symptoms. Multivariate analyses of variance (MANOVAs) were conducted to compare the CDS scores between early and average maturers. First, the six depressive affect subscales were the dependent variables (DVs); and then, the two positive feelings and experiences subscales were the DVs. Two additional MANOVAs were conducted to compare the CSCS scores between early and average maturers. In the first, non-productive coping strategies in each of the four contexts evaluated were the DVs, while in the second, problem focused strategies in the same four contexts were the DVs. In order to know if the elapsed time between menarche and participation in this survey affects depressive symptomatology and coping strategies, both early and average maturers were subdivided into two subgroups using the median split method: a) “less time since menarche” (below the median), and b) “more time since menarche” (above the median). MANOVAs were conducted to compare the scores of both depressive affect and positive feelings/experiences CDS subscales between these two subgroups of participants. MANOVAs were also conducted to compare the scores of both non-productive and problem focused coping strategies between the same two subgroups of participants. These analyses were done first for the early maturers and then for the average maturers. Results Considering that most of the participants had reached menarche at the age of 11 (38.9%) or 12 years old (36.3%), we decided that early maturers were those girls whose menarche occurred before 11 years (n ¼ 94), and average maturers were those who reached menarche at 11 or 12 years old (n ¼ 286). When participants were subdivided according the elapsed time between menarche, the subgroups of early maturers were conformed by: a) Participants who had 1e3 years since menarche (n ¼ 42) and b) participants who had 4e6 years since menarche (n ¼ 52). On the other hand, when average maturers were subdivided, the subgroups were: a) participants who had 1 year since menarche (n ¼ 106) and b) participants who had 2e5 years since menarche (n ¼ 180). Depressive symptoms Comparing depressive affect subscales of the CDS between early and average maturers, the MANOVA test was significant. Early maturers scored higher than average maturers (M ¼ 26.19 and 24.06, respectively), Pillai's Trace F (6, 373) ¼ 2.14, p < .05. When tests of between-subjects effects were analyzed, we found that early maturers scored higher than their peers on the “Affective Response”, “Social Problems”, “Self-Esteem”, “Guilt”, and “Miscellaneous Depressive” subscales, but not on the “Preoccupation with Sickness and Death” subscale (Table 2). On the other hand, when the positive feelings and experiences subscales of the CDS were compared between early and average maturers, the MANOVA test was not significant (Table 2). When early maturers were subdivided according to the elapsed time since their menarche, the results of the subgroups “less time since menarche” and “more time since menarche” were compared. There were no significant differences between these subgroups in the CDS scores on either the depressive affect or the positive feelings and experiences subscales. Neither were there any significant differences in the CDS scores when the average maturers were subdivided in the same way. Coping strategies Statistical analyses of coping strategies were significant only for non-productive strategies.
Table 2 Depressive symptoms in early maturers and average maturers. Early maturers
Average maturers
N ¼ 94
N ¼ 286
M
SD
M
SD
Depressive affect: Affective response Social problems Self esteem Preoccupation with sickness and death Guilt Miscellaneous depressive
25.03 26.28 24.34 22.21 26.11 33.18
6.64 7.00 6.66 5.59 6.35 5.05
22.68 23.99 22.16 20.89 23.98 30.69
7.69** 7.46** 7.87* 6.33 6.66** 6.63**
Positive feelings and experiences: Pleasure/Enjoyment Miscellaneous positive
17.27 23.91
5.22 5.88
16.51 23.80
5.11 5.94
*p < .05; **p < .01.
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Early maturers reported having used fewer non-productive strategies than their peers (M ¼ 1.76 and 2.05, respectively), Pillai's Trace (F (4,375) ¼ 15.61, p < .0001). The tests of between-subjects effect indicated that early maturers scored higher than their average maturers peers in the four everyday contexts explored: family, health, academic, and peers (Table 3). When early maturers were divided according to the elapsed time since their menarche, the MANOVA test showed that early maturers belonging to the subgroup “less time since menarche,” as compared to those belonging to the subgroup “more time since menarche,” had used more non-productive coping strategies (M ¼ 1.86 and 1.68, respectively), Pillai's Trace (F (4,89) ¼ 3.65, p < .01). The tests of between-subjects effect indicated that this difference occurred in three of the four everyday contexts evaluated: family, academic, and peers (Table 4). However, there were no significant differences when “less time since menarche” and “more time since menarche” subgroups of average maturers were compared. Discussion The results indicate important differences between early and average maturers. Early maturers showed more depressive symptomatology than their peers, which is consistent with earlier studies (Black & Klein, 2012; Deng et al., 2011; Joinson et al., 2011), and which has been attributed mainly to the advanced physical changes experienced by early maturers for their age (Mendle et al., 2007). When the results were analyzed according to the elapsed time since their menarche, the increment of depressive symptoms in early maturers persisted four to six years after menarche, which is consistent with an earlier study (Joinson et al., 2011).None-the-less, it will be important to investigate the more long-term effects of early menarche on depressive symptomatology. Although there was a significant difference between early and average maturers in depressive affect, positive feelings and experiences were similar in both groups of participants. Thus, early maturers are as capable as their peers of experiencing happiness (e.g., “In my family we all had so much fun”) and of enjoying daily life (e.g. “I enjoy the things I do”). In adolescents, positive affect serves to initiate and maintain relationships with friends, parents, and romantic partners (Forbes & Dahl, 2005), and it is considered a protective factor to depression (Lindahl & Archer, 2013). Increasing happiness may help lessen the pain of negative life events and foster adaptive coping strategies leading to creative problem solving and to seeking activities that make the individual feel good (Layous, Chancellor, & Sonja, 2014). Another of our results was that early maturers reported having used fewer non-productive coping strategies than their peers in the four everyday contexts evaluated: family, health, academic, and peers. It may be that due to experiencing menarche before 11 years, these girls had to confront more difficult situations than their peers, which may have forced them to learn to use fewer non-productive coping strategies to solve these situations. When adolescents face a stressful situation, they evaluate the situation, its consequences, and what resources are available to deal with it. After they give a response, the outcome is assessed and another response may follow loading to a feedback loop that determines whether the used strategies are likely to be tried again or rejected depending on the effectiveness of the outcome. Effective coping, in turn, enhances confidence in one's own capacity to resolve difficult situations (Frydenberg, 2008; Frydenberg & Lewis, 2009). When early maturers were divided according to the elapsed time since their menarche, those belonging to the subgroup “less time since menarche” reported having used more non-productive coping strategies in contexts involving family, academic and peer problems than did the subgroup “more time since menarche.” In contrast, there were no significant differences between the same subgroups of the average maturers regarding their use of non-productive coping strategies. Several possible explanations were considered for these results. First, according to the Maturation Disparity Hypothesis proposed by Ge and Natsuaki in 2009, early maturers experience puberty under more disadvantaged conditions than their peers because of the gap between their physical and psychosocial maturity. With the passing of time, they learn to use fewer non-productive coping strategies, whereas average maturers, who have not been exposed to the same conditions, may not have had the need to change their coping strategies. A second possible explanation is related to the elapsed time since menarche per se. At the moment of the survey, early maturers of the subgroup “more time since menarche” presumably looked not so different from their peers because the average maturers had already reached a stage of physical development similar to that of the early maturers. Moreover, by the time of the survey, early maturers had perhaps already attained synchronization between their
Table 3 Non-productive coping strategies in early maturers and average maturers.
Context: Family Health School Peers **p < .01; ***p < .001.
Early maturers
Average maturers
N ¼ 94
N ¼ 286
M
SD
M
SD
1.71 1.75 1.64 1.94
0.42 0.51 0.41 0.51
2.03 2.04 2.03 2.09
.44*** .59*** .57*** .49**
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Table 4 Non-productive coping strategies in early maturers according to time elapsed since menarche. Less time since menarche
More time since menarche
N ¼ 42
Context: Family Health School Peers
N ¼ 52
M
SD
M
SD
1.81 1.82 1.74 2.07
0.45 0.49 0.42 050
1.63 1.69 1.57 1.84
0.38* 0.51 0.38* 0.50*
*p < .05.
physical and psychosocial development. A third explanation is related to the fact that the subgroup “more time since menarche” of early maturers had experienced their menarche more years previous to the study than had the same subgroup of average maturers (4e6 and 2e5 years respectively). Thus, average maturers may not have had enough time to identify those coping strategies that had not proven effective when facing challenges of adolescence. Finally, some limitations of the present study should be taken into consideration First, we do not have information about possible environmental stressors before and after the menarche of participants, nor is information available concerning their family's structure or its cultural and economic background, the participants' schooling environment, or their exposure to social media e all of which might act as confounding variables. Other possible confounding cognitive factors may be the participants' language ability, working memory or executive functions. Another limitation is that early maturers were not asked about how they felt in relation to their speedy physical development. Further, we had to exclude participants who reached their menarche at 13 or more years. In spite of these limitations, the study has some possible clinical and educational implications. Our findings could be helpful in making parents, teachers and caregivers aware that early maturers need special support to resolve adverse life events and to diminish the gap between their physical and psychosocial maturity. Helping early maturers to adopt positive coping strategies and optimistic thinking styles, through both preventive intervention and/or in therapy, might reduce their risk for depression. According to Lewis and Frydenberg (2004) any attempt to improve the coping ability of adolescents should focus on minimizing their reliance on non-productive coping, in contrast to attempts concentrating only on improving adolescents' use of problem solving strategies. Finally, it is important to identify both predisposing and protective factors, as well as moderating and/or mediating variables, that may lead to non-productive coping and to depression in this population. Acknowledgments The authors wish to thank Arely Robles, Ana Padilla, Ma. Merced Gaitan, Patricia Cortes and Juan Martínez, who assisted us in the collection of data. References Allison, C., & Hyde, J. (2013). Early menarche: confluence of biological and contextual factors. Sex Roles, 68, 55e64. http://dx.doi.org/10.1007/s11199-0119993-5. gicos (7a. ed.). Me xico: Pearson Educacio n. Anastasi, A., & Urbina, S. (1998). Tests psicolo chiga, J., Mejía, M. R., Marrod lisis comparativo de la edad media de la menarquia en poblacio n mexicana. Anales Are an, M. D., & Mesa, M. S. (1999). Ana Museo de Am erica, 7, 257e266. Black, S., & Klein, D. (2012). Early menarcheal age and risk for later depressive symptomatology: the role of childhood depressive symptoms. Journal Youth Adolescence, 41, 1142e1150. http://dx.doi.org/10.1007/s10964-012-9758-7. Boynton-Jarrett, R., & Harville, E. (2012). A prospective study of childhood social hardships and age at menarche. Annals of Epidemiology, 22, 731e737. http:// dx.doi.org/10.1016/j.annepidem.2012.08.005. Brooks-Gunn, J., & Ruble, D. (1980). Menarche. The interaction of physiological, cultural, and social factors. In A. J. Dan, E. A. Graham, & C. P. Beech (Eds.), The menstrual cycle (Vol. II); (pp. 141e159). New York: Springer. Carter, R., Jaccard, J., Silverman, W., & Pina, A. (2009). Pubertal timing and its link to behavioral and emotional problems among ‘at-risk’ African American adolescent girls. 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Adolescencias entre muros: escuela secundaria y la construccio Richards, M., & Oinonen, K. (2011). Age at menarche is associated with divergent alcohol use patterns in early adolescence an early adulthood. Journal of Adolescence, 34, 1065e1076. http://dx.doi.org/10.1016/j.adolescence.2010.11.001. Romer, D. (2010). Adolescent risk taking, impulsivity, and brain development implications for prevention. Developmental Psychobiology, 52(3), 263e276. http://dx.doi.org/10.1002/dev.20442. Sawyer, M., Pfeiffer, S., & Spence, S. (2009). Life events, coping and depressive symptoms among young adolescents. A one-year prospective study. Journal of Affective Disorders, 117, 48e54. http://dx.doi.org/10.1016/j.jad.2008.12.013. Stewart, D., & Sun, J. (2007). Resilience and depression in children: mental health promotion in primary schools in China. International Journal of Mental Health Promotion, 9(4), 37e46. http://dx.doi.org/10.1080/14623730.2007.9721847. Thomas, F., Renaud, F., & Benefice, E. (2001). International variability of ages at menarche and menopause: patterns and main determinants. Human Biology, 73(02), 271e290. Tisher, M., Lang-Takac, E., & Lang, M. (1992). The Children's Depression Scale: review of Australian and overseas experience. Australian Journal of Psychology, 44(1), 27e35. http://dx.doi.org/10.1080/00049539208260159. s, M. E., Molina, C. T., Switzer, B. E., & Klaus, H. (2011). Endocrine modulation of the adolescent brain: a review. Journal of Vigil, P., Orellana, R. F., Corte Pediatric and Adolescent Gynecology, 1e8. http://dx.doi.org/10.1016/j.jpag.2011.01.061. Walvoord, E. (2010). The timing of puberty: is it changing? Does it matter? Journal of Adolescent Health, 47, 433e439. http://dx.doi.org/10.1016/j.jadohealth. 2010.05.018. Zehr, J., Culbert, K., Sisk, C., & Klump, K. (2007). An association of early puberty with disordered eating and anxiety in a population of undergraduate women and men. 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Early menarche, depressive symptoms, and coping strategies nica Alcala -Herrera a, b, 1, Ma. Luisa Marva n b, * Vero noma de M Coordination of Psychophysiology, Universidad Nacional Auto exico, Av. Universidad 3004, Col Copilco-Universidad, Del. n, 04510, M Coyoaca exico D.F., Mexico Institute of Psychological Research, Universidad Veracruzana, M exico, Av. Dr. Luis Castelazo Ayala s/n Col. Industrial Animas, C.P. 91190 Xalapa, Ver., Mexico a
b
a b s t r a c t Keywords: Menarche Early menarche Early maturers Depressive symptoms Coping strategies
During the time around menarche, young women must make many emotional and social adjustments to adapt to a new life stage. We compared depressive symptomatology and coping strategies between early and average maturer Mexican adolescents girls. The relationships between elapsed time since menarche and both depressive symptomatology and coping strategies were also studied. Three hundred eighty post-menarcheal students from 11 to 15 years completed the Children's Depression Scale and the Children's Situational Coping Scale. Early maturers showed more depressive symptoms than their peers, but they reported having used fewer non-productive coping strategies. Early maturers who experienced menarche one to three years previously reported more non-productive coping strategies than those who had experienced menarche four to six years ago. However, no differences were found in the results of the average maturers depending on the time elapsed since menarche. These findings are discussed in light of the psychosocial context of early maturers. © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Puberty is the period at the beginning of adolescence that is characterized by sexual maturation. Although there is a wide range of normal ages, visible physical changes associated with puberty typically begin at age 10 to 11 and usually are complete by age 15 to 17 in girls. In boys, these changes appear later, usually around 12 years, and are complete by age 16 to 17. In contrast with puberty, which refers to a period of physical transition, adolescence is the period of psychological and social transition between childhood and adulthood. It typically encompasses a larger period of time and its limits are less well defined since they depend mainly on social factors (Reyes, 2012). During this period, sex hormones regulate some brain functions, such as the modulation of the limbic-cortical circuits, which leads to the acquisition of adult cognition and the establishment of information pathways to promote social development in the individuals (Romer, 2010; Vigil et al., 2011). Adolescence is characterized by new psychosocial challenges that adolescents must face. Some examples are competition with peers, learning to balance the desire for immediate gratification with an understanding of the importance of long-term goals and consequences, the rapid succession physical changes, the management of sexuality, the parenteadolescent relationship, the development of self, and the expanding network of social relationships (Dahl, 2004; Liu, Chen, & Peng, 2012).
gicas, Universidad Veracruzana, Av. Dr. Luis Castelazo Ayala s/n Col. Industrial Animas, * Corresponding author. Instituto de Investigaciones Psicolo Xalapa, Ver. 91190, Mexico. Tel.: þ52 (228) 841 89 00x13210. n). E-mail addresses: [email protected] (V. Alcal a-Herrera), [email protected] (Ma.L. Marva 1 Tel.: þ52 (55) 56 22 22 30, þ52 (228) 841 89 00x13210. http://dx.doi.org/10.1016/j.adolescence.2014.06.007 0140-1971/© 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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These challenges are often confusing leading adolescents to erratic behaviors and difficulty in controlling their impulses (Vigil et al., 2011), exposing themselves to unnecessary risks such as participating in delinquent activities, drug consumption, or having unprotected sex, among others. Psychological gender-related experiences during adolescence Adolescence is a period of vulnerability to depression, possibly due to the impact of greater exposure to negative life events, particularly those involving difficulties with peer and family relationships (Sawyer, Pfeiffer, & Spence, 2009). Females show more depressive symptoms than male adolescents (Fatiregun & Kumapayi, 2014; Hilt & Nolen-Hoeksema, 2009). Nolen-Hoeksema and collaborators stated that this gender difference is caused by the combination of two factors: a) girls apparently face more new challenges in early adolescence than boys; and b) girls are more likely than boys to carry risk factors for depression even before early adolescence, but these risk factors lead to depression only in the face of challenges that increase in prevalence in early adolescence (Nolen-Hoeksema & Girgus, 1994; Nolen-Hoeksema, Larson, & Grayson, 1999). From the 1990s to the present, researchers have agreed that depression is a complex combination of high negative emotions and low positive emotions. However, depressive affect (e.g., loneliness, sadness, low self-esteem) and positive feelings and experiences (e.g., satisfaction, happiness, pleasure) are not merely opposite ends of the same continuum, but represent two distinct aspects of a more general construct of depression (Forbes & Dahl, 2005; Lindahl & Archer, 2013; Tisher, Lang-Takac, & Lang, 1992). Although females show more depressive affect than do male adolescents (Lindahl & Archer, 2013; Tisher et al., 1992), researchers who have compared positive feelings and experiences between female and male adolescents, have not found gender differences (Eryilmaz, 2009; Forbes, Williamson, Ryan, & Dahl, 2004). Another gender-related difference in adolescence is that girls tend to rate negative life events as more stressful than do boys (Mezulis, Shibley-Hyde, Simonson, & Charbonneau, 2011), and girls also show more altered responses to adversity, including a propensity to adopt self-blaming coping styles (Nolen-Hoeksema, Wisco, & Lyubomirky, 2008; Patton & Viner, 2007). It is important to notice there is no one way of coping with stressful situations but rather many, and although coping strategies are neither ‘good’ nor ‘bad’ (because different situations call for different strategies), they can be considered in terms of their effectiveness and differentiated as productive or non-productive (Stewart & Sun, 2007). Menarche Because menarche (the first menstruation), is considered the major landmark of puberty for girls, we were interested in studying some psychosocial variables related to the timing of menarche. Unlike the other gradual changes that accompany puberty in girls, menarche is sudden and conspicuous; it is a memorable event for most women since it symbolizes the end of childhood (Chang, Hayter, & Wu, 2010). Since the 1980s, various authors have pointed out that menarche not only involves a biological transformation in girls' bodies, but also demands emotional and social adjustments (Brooks-Gunn & Ruble, 1980; Gaudineau et al., 2010; Koff, Rierdan, & Jacobson, 1981; Walvoord, 2010), and the timing of menarche's occurrence has a great influence on these adjustments (Allison & Hyde, 2013; Ge & Natsuaki, 2009). The age that menarche occurs varies substantially between women across different cultures, but studies reporting the timing of menarche worldwide are very scarce. Thomas, Ranaud, & Benefice (2001), collected data on 67 countries, and found that the earliest age of menarche was 12.0 (Congo and Greece) and the latest was 16.2 years (Nepal). However, rigorous comparisons between the results of different studies of menarcheal timing are complicated due to methodological problems, such as: (a) lack of uniformity in research designs, (b) different sample characteristics such as ages or socioeconomic status of participants included, (c) the use of prospective or retrospective reporting protocols, and (d) different statistical analyses. In Mexico, where the current study was conducted, several authors have studied the timing of menarche. Ages ranged chiga, Mejía, Marrod between 12.06 and 12.64 years (Are an, & Mesa, 1999; García-Baltazar, Figueroa-Perea, Reyes-Zapata, rez-Palacios, 1993; Me ndez, Valencia, & Melendez, 2006). However, these studies were carried out during the Brindis, & Pe 1990s and more recent data is not available. Early menarche Some girls experience menarche earlier or later than their peers. Although nutrition and genetic heritage play an important role in determining age at menarche (Currie et al., 2012; Dvornyk & Waqar-ul-Haq, 2012), psychosocial factors have also been associated with differences in menarcheal timing. Researchers agree that menarche occurs at an earlier age among girls raised in stressful family circumstances (Boynton-Jarrett & Harville, 2012; Jean et al., 2011). Menarche can be a lonelier and more difficult adjustment period for early maturing girls when compared to those maturing on-time because the former often lack same-age models of behavior (Allison & Hyde, 2013). Moreover, early maturers have less time to acquire, assimilate and strengthen adaptive and coping skills to ensure an effective transition from childhood to adolescence, thus leading to developmental asynchrony between physical, cognitive and social maturity (Allison & Hyde, 2013; Negriff, Hillman, & Dorn, 2011). However, as far as we know, no researchers have examined the relationship between early menarche and coping strategies.
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Early menarche increases the likelihood of social victimization (Craig, Pepler, Connolly, & Henderson, 2001). For example, the fact that a boy suspects that a girl has had her first menses, especially if she is unusually young, may provide an opportunity for the boy to practice male dominance by ridiculing or oppressing her. Early menarche is also a risk factor for sexual harassment because the emergence of visible secondary sexual characteristics may elicit the attention and interest of opposite-sex individuals (Allison & Hyde, 2013). The gap between physical and psychosocial maturity in early maturers may increase risk for psychopathology (Ge & Natsuaki, 2009). In a literature review of the detrimental psychological outcomes associated with early menarche, Mendle, Turkheirmer, and Emergy (2007) concluded that early maturers manifest higher levels of depressive symptomatology than average maturers; more recent studies have confirmed these results (Black & Klein, 2012; Joinson, Heron, & Lewis, 2011). The most common explanations for these findings are related to physical changes associated with puberty. For example, when girls mature physically earlier than their peers, they may find it difficult to establish friendships with other girls who have not developed at a similar rate. Another example is that due to their early physical development, older persons may unjustifiably perceive these girls as having greater maturity and therefore force them to face certain challenges before they are emotionally or cognitively prepared to do so e which might cause negative affect, fear, and/or confusion (Mendle et al., 2007). It is important to notice that until now, depressive symptomatology in early maturers has been measured using questionnaires that only comprise depressive affect items. None of the questionnaires used measured positive feelings and experiences. It has even been suggested that early menarche may predispose girls to other emotional problems, such as: social isolation (Copeland et al., 2010), self-harming behaviors (Deng et al., 2011), eating disorders (McNicholas, Dooley, McNamara, & Lennon, 2012), substance abuse (Richards & Oinonen, 2011), and anxiety (Zehr, Culbert, Sisk, & Klump, 2007). However, not all studies support a causal relationship between early menarche and these suggested predispositions (Mendle, Leve, Ryzir, Natsuaki, & Ge, 2011; Natsuaki, Leve, & Mendle, 2011) and further research is needed before reaching a definitive conclusion. A possible explanation for the relation between early menarche and behavioral and emotional problems could be related to the Social Deviance Hypothesis proposed by Petersen & Taylor, which states that girls who reach puberty at a different time than their peers are out of synchrony with the normative experiences during a developmental period that is characterized by heightened vulnerabilities. As a result, these girls are anticipated to be at greater risk for adjustment difficulties due, in part, to their perceived lack of shared experiences with others (e.g., talking about typical feminine issues such as menstrual hygiene or attraction to persons of the opposite-sex). Another possible explanation is related to the Stage Termination Hypothesis proposed by Peskin & Livson, which states that early menarche does not allow girls sufficient time for the acquisition and consolidation of adaptive skills. According to this hypothesis, the early maturers' physical changes may elicit difficulties in adjusting to developmental pressures (e.g., moving into older mixed-sex peer groups or entering romantic relationships among others) because older individuals may view the girls as more emotionally, socially and cognitively advanced than, in fact, they are (Carter, Jaccard, Silverman, & Pina, 2009).
The current study Early maturers reach adolescence in a disadvantaged situation compared to their peers and may be at increased risk for emotional problems. Therefore, early maturers may feel pressured to hurriedly devise coping strategies to adequately face their changed situation. The objective of this study was to compare depressive symptomatology (high depressive affect and few positive feelings or experiences) and coping strategies between early and average maturering Mexican adolescent girls. The relationships between elapsed time since menarche and both depressive symptomatology and coping strategies were also studied. We expected that: 1) Early maturer participants are more likely than average maturers to have depressive symptomatology, 2) Early maturers use different coping strategies than their peers, and 3) Depressive symptomatology and coping strategies used by participants depend on elapsed time since menarche.
Methodology Study setting Appointments were set up with the principals of 13 mixed-gender public schools in Mexico City (the capital of the country) to explain the objective of the study, and ask them to request their school board's permission to conduct the study. The school boards of five elementary and four middle schools agreed. These schools were located in eight different municipal delegations in the center, south, west and east of the city. The schools were in neighborhoods characterized by residents of middle or lower socioeconomic status. Upon agreement, the conditions under which researchers could conduct the study were established. The project was explained to teachers who in turn, sent parents a document explaining the nature of the study and asking their consent for their daughters' participation. After the consents were collected, a schedule was established to apply the survey.
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Sample recruitment Participants were recruited by the schools' teachers, who asked all female students who had begun menstruating and who were attending from fifth grade of elementary school to third grade of middle school (equivalent to fifth through ninth grades in USA and Europe), if they wanted to be part of a research project about adolescence. Teachers stressed that participation was voluntary, that there would be no reprisals for not participating, that the results would be used exclusively for the research project, and that neither the teachers nor the girls' parents would know the answers given by each participant. The inclusion criterion to be eligible for the study was that the adolescents were post-menarcheal and had presented their menarche one year ago or earlier. The exclusion criteria were that adolescents had needed psychological support for treating depressive symptoms (no adolescent reported this condition), that they were not in good health, and that they had reached menarche at 13 years old or later. We established the last criterion because, as is described in the Results section, average maturers were considered those adolescents who had reached menarche at the age of 11 or 12 years old, and early maturers were those who had reached menarche at 8, 9 or 10 years. There were too few girls to compose a group of late maturers (girls reaching menarche at 13 years old or later) since the oldest participants were only 15 years old. Four hundred thirty-six students were invited to participate; four of them did not accept, the parents of 13 did not provide consent to participate, and 39 were excluded for the reasons mentioned above. Thus, the final sample was composed of 380 participants whose ages ranged from 11 to 15 years (mean ¼ 13.44, SD ¼ 11.04). The sociodemographic characteristics of these participants are shown in Table 1. According to the total number of female students who attend these grades in public schools in Mexico City, our sample size had a confidence level of 95% with a margin of error of 5%.
Procedure The study was approved by the corresponding board of the Institute of Psychological Research, Universidad Veracruzana. Two female researchers went to the schools to survey the students on the scheduled day between September 2012 and January 2013. When the researchers arrived at the schools, the students were in a designated classroom in which the survey, which was to be completed online, would take place. To assure privacy, students were seated so they were unable to see each other's computer. Participants were told they could withdraw at any point if they decided not to complete the survey. They were also told again that the information they were going to provide was strictly confidential. The fact that there were no wrong or right answers to the questions was emphasized. Finally, the students were told that their responses were going to be analyzed by people who did not know them.
Table 1 Socio-demographic characteristics of participants. Early maturers (n ¼ 94)
Mean current age (years):
Average maturers (n ¼ 286)
M
SD
M
SD
13.41
1.07
13.44
0.89
n
%
n
%
Age at menarche (years): 8 9 10 11 12
5 19 70 e e
5.3 20.2 74.5
e e e 148 138
51.7 48.3
Time elapsed since menarche (years): 1 2 3 4 5 6
5 11 26 25 21 6
5.3 11.7 27.7 26.6 22.3 6.4
106 101 63 14 2 0
37.1 35.3 22.0 4.9 0.7
Scholastic level: Grades 5e7 Grades 8e9
30 64
27.7 72.3
58 228
30.3 69.7
Participant lives with her: Father and mother Only mother Only father Neither parent
70 21 2 1
74.4 22.3 2.1 1.0
210 69 5 2
73.4 24.1 1.7 0.7
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The researchers provided the participants with a link to the survey posted on Survey Monkey.com, and explained how to complete the questionnaires. Additional aid was provided if needed. The questionnaires were completed in two sessions and a total time of between 40 and 80 min was required by the participants. The adolescents responded to the survey as part of a more extensive research project about menstruation, in which both emotional reactions to menarche and attitudes towards menstruation were also explored. When the project was completed, we returned to the schools to give the directive boards feedback concerning the main results of the study. Measures Participants were initially asked to answer some questions concerning socio-demographic data, their age, the people they were living with, and any health conditions. They were also asked about age at menarche using the question: When was the first time you got your period? Participants reported their age in years. Afterwards, the following questionnaires were applied: Children's Depression Scale: Depressive symptoms were measured using the Spanish version of the Children's Depression Scale (CDS) developed by Lang & Tisher in 1978 (Tisher et al., 1992) and adapted into Spanish by TEA editorial (Lang & Tisher, 1997). This scale is directed to children aged 8e16 years old. It was chosen because instead of being derived from adult depression definitions or manual diagnostics, it was developed from an empirical definition of childhood depression by summarizing the features reported in the literature together with consistent signs in children who had been diagnosed with depression (Tisher et al., 1992). Furthermore, unlike other depression scales for children and adolescents, the CDS includes items to measure both depressive affect and positive feelings and experiences. CDS is a 5-point Likert scale with options ranging from (1)-strongly disagree to (5)-strongly agree. It includes 66 items that comprise eight factors. Six of these factors measure depressive affect: 1) Affective response: feeling and mood of the respondent (Cronbach's alpha in the current study ¼ .84, score range: 8e40); 2) Social problems: difficulties encountered in social interaction, feelings of isolation and loneliness (Cronbach's alpha ¼ .84, score range: 8e40); 3) Self-esteem: respondent's attitudes, concepts and feeling in relation to her own worth and value (Cronbach's alpha ¼ .86, score range: 8e40); 4) Preoccupation with own sickness and death: respondent's dreams and fantasies in relation to disease or to death (Cronbach's alpha ¼ .78, score range: 7e35); 5) Guilt: respondent's self-blame (Cronbach's alpha ¼ .77, score range: 8e40); and 6) Miscellaneous depressive items: depressive statements which could not be grouped with any of the above (Cronbach's alpha ¼ .72, score range: 9e45). The other two CDS factors measure positive feelings and experiences: 1) Pleasure/enjoyment: presence of enjoyment and happiness in the respondent's life, or her capacity to experience them (Cronbach's alpha ¼ .74, score range: 8e40); and 2) Miscellaneous positive items: positive items not included in Pleasure/enjoyment subscale (Cronbach's alpha ¼ .64, score range: 10e50). The total CDS reliability was .92 using the Cronbach's alpha coefficient. High scores in all subscales indicate a higher index of depressive symptoms. This includes both depressive affect and positive feelings/experiences subscales since the two positive subscales are rated inversely. Children's Situational Coping Scale: Coping strategies were measured using the Children's Situational Coping Scale (CSCS), which was developed in Spain by Morales-Rodríguez (2008). This scale was chosen because it evaluates coping strategies in different situations within the four most common daily contexts: family, health, academic, and peers. Following the scale directions, participants were asked about coping strategies they had used during the last year according to a 3 point scale: never (1), sometimes (2) and frequently (3). Coping strategies were grouped in two factors: a) Non-productive strategies: to ignore the problem, cognitive avoidance, aggressive behavior, and/or keeping to one's self; and b) Problem focused coping: Active solution, seeking information and guidance, positive focus, and/or seeking social support (Cronbach's Alpha in the current study .79 and .80 respectively). Since the CSCS was designed in Spain, minor changes were made to account for language differences between Mexico and Spain. Then, 18 experts on the topic reviewed the questionnaire after which it was piloted with 15 students from 11 to 15 years old who were invited to discuss any items they considered difficult to understand. The questionnaire was reviewed accordingly, and the resultant form was then tested with 679 students from five schools who did not participate in the current study and whose ages also ranged between 11 and 15 years. The discriminant capacity of each item was calculated using the extreme groups method, comparing the scores on each item obtained by the 27% of participants who scored highest and the 27% who scored lowest on the entire questionnaire (Anastasi & Urbina, 1998). Then, a factorial analysis with oblimin rotation was conducted. Results of both KaisereMeyereOlkin and Bartlett tests were similar to those found in Spain in the four everyday contexts evaluated. The temporal stability (testeretest) of the CSCS was calculated applying the questionnaire again six months after the first application. Stability across the two administrations was satisfactory (r ¼ .97), and there were no significant changes between the first and second applications. Finally, internal consistency was satisfactory at both Time 1 and Time 2 (Cronbach's alpha ¼ . 83 and .78 respectively). Data analyses Analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 15.0. Participants were divided into two groups, early and average maturers, according to the median and mode of participants' age at menarche, as well as a literature review.
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Affective depressive and positive feelings/experiences were analyzed as two distinct aspects of depressive symptoms. Multivariate analyses of variance (MANOVAs) were conducted to compare the CDS scores between early and average maturers. First, the six depressive affect subscales were the dependent variables (DVs); and then, the two positive feelings and experiences subscales were the DVs. Two additional MANOVAs were conducted to compare the CSCS scores between early and average maturers. In the first, non-productive coping strategies in each of the four contexts evaluated were the DVs, while in the second, problem focused strategies in the same four contexts were the DVs. In order to know if the elapsed time between menarche and participation in this survey affects depressive symptomatology and coping strategies, both early and average maturers were subdivided into two subgroups using the median split method: a) “less time since menarche” (below the median), and b) “more time since menarche” (above the median). MANOVAs were conducted to compare the scores of both depressive affect and positive feelings/experiences CDS subscales between these two subgroups of participants. MANOVAs were also conducted to compare the scores of both non-productive and problem focused coping strategies between the same two subgroups of participants. These analyses were done first for the early maturers and then for the average maturers. Results Considering that most of the participants had reached menarche at the age of 11 (38.9%) or 12 years old (36.3%), we decided that early maturers were those girls whose menarche occurred before 11 years (n ¼ 94), and average maturers were those who reached menarche at 11 or 12 years old (n ¼ 286). When participants were subdivided according the elapsed time between menarche, the subgroups of early maturers were conformed by: a) Participants who had 1e3 years since menarche (n ¼ 42) and b) participants who had 4e6 years since menarche (n ¼ 52). On the other hand, when average maturers were subdivided, the subgroups were: a) participants who had 1 year since menarche (n ¼ 106) and b) participants who had 2e5 years since menarche (n ¼ 180). Depressive symptoms Comparing depressive affect subscales of the CDS between early and average maturers, the MANOVA test was significant. Early maturers scored higher than average maturers (M ¼ 26.19 and 24.06, respectively), Pillai's Trace F (6, 373) ¼ 2.14, p < .05. When tests of between-subjects effects were analyzed, we found that early maturers scored higher than their peers on the “Affective Response”, “Social Problems”, “Self-Esteem”, “Guilt”, and “Miscellaneous Depressive” subscales, but not on the “Preoccupation with Sickness and Death” subscale (Table 2). On the other hand, when the positive feelings and experiences subscales of the CDS were compared between early and average maturers, the MANOVA test was not significant (Table 2). When early maturers were subdivided according to the elapsed time since their menarche, the results of the subgroups “less time since menarche” and “more time since menarche” were compared. There were no significant differences between these subgroups in the CDS scores on either the depressive affect or the positive feelings and experiences subscales. Neither were there any significant differences in the CDS scores when the average maturers were subdivided in the same way. Coping strategies Statistical analyses of coping strategies were significant only for non-productive strategies.
Table 2 Depressive symptoms in early maturers and average maturers. Early maturers
Average maturers
N ¼ 94
N ¼ 286
M
SD
M
SD
Depressive affect: Affective response Social problems Self esteem Preoccupation with sickness and death Guilt Miscellaneous depressive
25.03 26.28 24.34 22.21 26.11 33.18
6.64 7.00 6.66 5.59 6.35 5.05
22.68 23.99 22.16 20.89 23.98 30.69
7.69** 7.46** 7.87* 6.33 6.66** 6.63**
Positive feelings and experiences: Pleasure/Enjoyment Miscellaneous positive
17.27 23.91
5.22 5.88
16.51 23.80
5.11 5.94
*p < .05; **p < .01.
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Early maturers reported having used fewer non-productive strategies than their peers (M ¼ 1.76 and 2.05, respectively), Pillai's Trace (F (4,375) ¼ 15.61, p < .0001). The tests of between-subjects effect indicated that early maturers scored higher than their average maturers peers in the four everyday contexts explored: family, health, academic, and peers (Table 3). When early maturers were divided according to the elapsed time since their menarche, the MANOVA test showed that early maturers belonging to the subgroup “less time since menarche,” as compared to those belonging to the subgroup “more time since menarche,” had used more non-productive coping strategies (M ¼ 1.86 and 1.68, respectively), Pillai's Trace (F (4,89) ¼ 3.65, p < .01). The tests of between-subjects effect indicated that this difference occurred in three of the four everyday contexts evaluated: family, academic, and peers (Table 4). However, there were no significant differences when “less time since menarche” and “more time since menarche” subgroups of average maturers were compared. Discussion The results indicate important differences between early and average maturers. Early maturers showed more depressive symptomatology than their peers, which is consistent with earlier studies (Black & Klein, 2012; Deng et al., 2011; Joinson et al., 2011), and which has been attributed mainly to the advanced physical changes experienced by early maturers for their age (Mendle et al., 2007). When the results were analyzed according to the elapsed time since their menarche, the increment of depressive symptoms in early maturers persisted four to six years after menarche, which is consistent with an earlier study (Joinson et al., 2011).None-the-less, it will be important to investigate the more long-term effects of early menarche on depressive symptomatology. Although there was a significant difference between early and average maturers in depressive affect, positive feelings and experiences were similar in both groups of participants. Thus, early maturers are as capable as their peers of experiencing happiness (e.g., “In my family we all had so much fun”) and of enjoying daily life (e.g. “I enjoy the things I do”). In adolescents, positive affect serves to initiate and maintain relationships with friends, parents, and romantic partners (Forbes & Dahl, 2005), and it is considered a protective factor to depression (Lindahl & Archer, 2013). Increasing happiness may help lessen the pain of negative life events and foster adaptive coping strategies leading to creative problem solving and to seeking activities that make the individual feel good (Layous, Chancellor, & Sonja, 2014). Another of our results was that early maturers reported having used fewer non-productive coping strategies than their peers in the four everyday contexts evaluated: family, health, academic, and peers. It may be that due to experiencing menarche before 11 years, these girls had to confront more difficult situations than their peers, which may have forced them to learn to use fewer non-productive coping strategies to solve these situations. When adolescents face a stressful situation, they evaluate the situation, its consequences, and what resources are available to deal with it. After they give a response, the outcome is assessed and another response may follow loading to a feedback loop that determines whether the used strategies are likely to be tried again or rejected depending on the effectiveness of the outcome. Effective coping, in turn, enhances confidence in one's own capacity to resolve difficult situations (Frydenberg, 2008; Frydenberg & Lewis, 2009). When early maturers were divided according to the elapsed time since their menarche, those belonging to the subgroup “less time since menarche” reported having used more non-productive coping strategies in contexts involving family, academic and peer problems than did the subgroup “more time since menarche.” In contrast, there were no significant differences between the same subgroups of the average maturers regarding their use of non-productive coping strategies. Several possible explanations were considered for these results. First, according to the Maturation Disparity Hypothesis proposed by Ge and Natsuaki in 2009, early maturers experience puberty under more disadvantaged conditions than their peers because of the gap between their physical and psychosocial maturity. With the passing of time, they learn to use fewer non-productive coping strategies, whereas average maturers, who have not been exposed to the same conditions, may not have had the need to change their coping strategies. A second possible explanation is related to the elapsed time since menarche per se. At the moment of the survey, early maturers of the subgroup “more time since menarche” presumably looked not so different from their peers because the average maturers had already reached a stage of physical development similar to that of the early maturers. Moreover, by the time of the survey, early maturers had perhaps already attained synchronization between their
Table 3 Non-productive coping strategies in early maturers and average maturers.
Context: Family Health School Peers **p < .01; ***p < .001.
Early maturers
Average maturers
N ¼ 94
N ¼ 286
M
SD
M
SD
1.71 1.75 1.64 1.94
0.42 0.51 0.41 0.51
2.03 2.04 2.03 2.09
.44*** .59*** .57*** .49**
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Table 4 Non-productive coping strategies in early maturers according to time elapsed since menarche. Less time since menarche
More time since menarche
N ¼ 42
Context: Family Health School Peers
N ¼ 52
M
SD
M
SD
1.81 1.82 1.74 2.07
0.45 0.49 0.42 050
1.63 1.69 1.57 1.84
0.38* 0.51 0.38* 0.50*
*p < .05.
physical and psychosocial development. A third explanation is related to the fact that the subgroup “more time since menarche” of early maturers had experienced their menarche more years previous to the study than had the same subgroup of average maturers (4e6 and 2e5 years respectively). Thus, average maturers may not have had enough time to identify those coping strategies that had not proven effective when facing challenges of adolescence. Finally, some limitations of the present study should be taken into consideration First, we do not have information about possible environmental stressors before and after the menarche of participants, nor is information available concerning their family's structure or its cultural and economic background, the participants' schooling environment, or their exposure to social media e all of which might act as confounding variables. Other possible confounding cognitive factors may be the participants' language ability, working memory or executive functions. Another limitation is that early maturers were not asked about how they felt in relation to their speedy physical development. Further, we had to exclude participants who reached their menarche at 13 or more years. In spite of these limitations, the study has some possible clinical and educational implications. Our findings could be helpful in making parents, teachers and caregivers aware that early maturers need special support to resolve adverse life events and to diminish the gap between their physical and psychosocial maturity. Helping early maturers to adopt positive coping strategies and optimistic thinking styles, through both preventive intervention and/or in therapy, might reduce their risk for depression. 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