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ED 282 639 

PS 016 606 


Nottelmann, Editha D.; And Others 

Concurrent and Predictive Relations between Hormone 
Levels and Social-Emotional Functioning in Early 
24 Apr 87 

12p.; Paper presented at the Biennial Meeting of the 
Society for Research in Child Development (Baltimore, 
MD, April 23-26, 1987) . 
Reports - Research/Technical (143) — 
Speeches/Conference Papers (150) 




MFOl/PCOl Plus Postage. 

♦Adolescents; *Emotional Development; *Physiology; 
♦Predictor Variables; Sex Differences; *Social 

*Early Adolescents; *Hormones 



Hormone levels and changes in hormone levels were 
evaluated three times across a 1-year period as concurrent and 
predictive correlates of the socio-emotional functioning of 56 boys 
10- to 14-years-old and 52 girls 9- to 14-years-old who represented 
the five stages of Tanner's criteria of pubertal development. The 
hormone measures were serum levels of gonadotropins, sex steroids, 
adrenal androgens, and corticosteroid. An additional measure was 
testosterone-estradiol binding globulin. The measures of adolescent 
social-emotional functioning were based on adolescent questionnaire 
and interview self-reports on psychological functioning (impulse 
control, emotional tone, body- and self-image, and self-esteem); 
social functioning (social relationships, morals, family 
relationships, and social competence); and anxiety, depression, and 
affective/neurotic symptoms. Concurrent hormone-behavior relations 
were more likely to replicate for boys than for girls. Concurrent 
relations were stronger than predictive relations for boys, but of 
similar strength for girls. The best predictor of social-emotional 
functioning at Time 3, for boys, was timing of maturation based on 
pubertal stage at Time 1 and, for girls, the rate of change in 
hormone levels from Time 1 to Time 3. (RH) 


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Concurrent and Predictive Relations between Hormone Levels 
and Soclal-*Emotlonal Functioning In Early Adolescence 


Edltha D. Nottelmann 

Laboratory of Develomental Psychology 
National Institute of Mental Health 

Elizabeth J* Susman 
The Pennsylvania State University 

Gale Inof f-Gerraaln 

Laboratory of Develomental Psychology 
National Institute of Mental Health 

George P. Chrousos 

Developmental Endocrinology Branch 
National Institute of Child Health and Human Development 






Paper presented at the biennial meeting of the Society for Research in 
Child Development, Baltimore, Marylard, April 24, 1987. 



Nottelmann SRCD87 

My paper, and Gale Incff -Germain's presentation, are based on a short-term 
longitudinal study carried out collaboratively at NIMH by Elizabeth Susman, 
Gale Inoff-G'^rmain, Lorah Dorn, and me with endocrinologists at NICHD, George 
Chrousos, Gordon Cutler, and Lynn Loriaux. We began data collection in 1982 
and logged in the last hormone values early last year. 

I/hat we set out to do in this study was to examine relations between 
psychological functioning and pubertal status — pubertal status based on 
hormone levels as well as on physical stage of pubertal development — in a 
sample of normal pubertal-age boys and girls. 

At the outset, we knew that hormones influence physical maturation. We 
also knew, based on prior evidence, that physical maturity status is likely to 
influence social-emotional adjustment in early adolescence. The major interest, 
therefore, was to explore at a descriptive level, what was more or less unknown: 
whether ther;* are relations between hormones and adjustment across the pubertal 

Our first cross-sectional analyses revealed that there indeed are signifi- 
cant hormone-behavior relations in normal pubertal-age adolescents; and that 
these relations tend to be stronger and more consistent for boys than for 
girls. In further cross-sectional analyses, and also in longitudinal analyses, 
we are finding support for these first results. I will present findings in 
summary form and offer some interpretations. 

To begin with, q brief description of the study. Our sample comprises 56 
boys and 52 girls, enrolled by age and pubertal stage. At the time of entry 
into the study, the age range was 10 to 14 years for hoys and 9 to 14 years 
for girls. The adolescents represented all five stages of pubertal development 
(Tanner criteria). They were seen three times across a one-year period, at 
6-month intervals, for assessments of physical maturity and endocrine status. 

Nottelmann SRCD87'-2 

6-month intervals, for assessments of physical maturity and endocrine status, 
as well as psychological assessments. 

In addition, to pubertal stage based on genital stago for boys and breast 
stage for girls — the measures relevant to this presentation — our physical 
maturity measures included pubic hair stage (Tanner criteria) and h<&igbt and 
weight for both boys and girls; and, additionally for boys, testicular volume. 

Our hormone measures included serum hormone level determinations for 
hormones of the hypothalamic-pituitary-gonadal axis (gonadal axis) and the 
hypothalamic-pituitary-adrenal axis (the adrenal axis)* 

For the gonadal axis, we assessed gonadotropins, luteinizing and follicle 
stimulating hormone (LH and FSH), and two sex steroids, testosterone (X) and 
estradiol (£2)* For the adrenal axis, we assessed three adrenal androgens^ 
dehydroepiandrosterone (DHEA), its sulfate (DHEAS), and androstenedione ( 4A). 
Also assessed, but not relevant here, were Cortisol (F), another adrenal axis 
hormone, and two binding globulins, one f'»r testosterone and estradiol (XeBG) 
and one for Cortisol (CBG). 

Why these particular hormones for a study of pubertal hormone-behavior 
relations? This figure shows schematically hormone levels of the two axes by 
chronological age, the adrenal axis at the top and the gonadal axis at the 
bottom. The adrenal axis hormones begin to rise at adrenarche, typically 
between the ages of 6 and 8, but, as you can see, they continue to rise gradually 
throughout puberty and reach asymptote in late adolescence. The gonadal axis 
hormones begin to rise later, with the onset of puberty, typically between the 
ages of 9 and 13; first, the gonadotropins; followed by the sex steroids. The 
sex steroids rise steeply and tend to re'^^rh asymptote around mid-adolescence. . 
It is this rise of gonadal axis hormones that is thought to play a role in 
adjustment and behavior problems in early adolescence. 

Nottelmann SRCD87-3 

Now, for a quick look at the Time 1 hormone levels by r^ubertrl stage: 
gonadotropins, LH and FSH: our data suggest that generally gonadotropin levels 
rise 2" to 3-fold; sex steroids, testosterone and estradiol: on average, our 
data suggest that testosterone levels of boys rise about 10- to 18-fold, and 
that estradiol levels of girls rise about 6- to 8-fold; adrenal androgens 
DHEa, DHEAS, and andro£<ten.edicT.c:: our data suggest that generally adrenal 
androgen levels rise 2- to 3-fold. 

Dev«*lopmentally , pubertal changes at the physical and hormonal levels are 
interrelated. Specifically, at each assessment, (a) the various i.idicos of 
ihysical maturity generally were highly correlated; (b) hormone level inter- 
correlations generally were moderate; and (c) hormone levels v/ere moderately 
correlated with the physical maturity measures, and with chronological age. 

Our behavioral measures include adolescent self-report, parent report, 
and observational data. The set of findings on which I am reporting involve 
adolescent social-emctional functioning in terms of self- and parent-reports, 
using scales from the Offer Self-image Questionnaire for Adolescents, the 
Perceived Competence Scale for Children, and the Child Behavior Checklist. 

In general, we found self-image to improve, competence and stlf-esteera to 
increase, and behavior problems to decrease across the year of the study. For 
the sake of brevity, I will use the term "adjustment" tc refer collectively 
to these measures. 

We examined hormone-adjustment relations by multiple regression analysis. 
In general, our findings suggest that rising hormone levels and advances in 
physical pubertal development have positive Implications for the adjustment of 
boys and negative implications for the adjustment of girls. This conclusion 
is based not only on relations involving absolute hormone levels. Because our 
sample of boys and girls spans 4 to 5 years In age and all stages of pubertal 

Nottelmann SRCD87-4 

development, we also explored v.he effect of two important aspects of puberty 
on hormone-adjustment relations: timing of puberty and rate of maturation. 

On the timing issue: We know from the external physical changes that 
the age at onset of normal puberty is idiosyncratic; and that, physiologically, 
a wide range in the timing of puberty is defined as normal. We do not know 
whether nariier or later activation of the gonadal axis, the timing of the 
rise in pubertal hormones, has effects on behavior that are independent from 
the effects of physical changes. We do know that the rise in gonadotropin 
levels, which signals the onset of puberty, precedes external physical changes 
and that the riee in sex steroids also follows the initial rise in gonadotropins. 
Our study was not designed for intensive examination of the effects of the 
onset of puberty. However, we explored the timing issue by examining hormone- 
behavior relations with statistical control for the variance that hormone . 
levels share with chronological age. This was done by entering age at the 
first step into the regression equation. 

On the rate issue: The rate at which adolescents progress through the 
various stages of pubertal development, as defined by external physical changes, 
also is idiosyncratic. Some children mature very rapidly, moving through all 
pubertal stages within one tr. two years; others may take three, four, or even 
five years to reach the last stage of pubertal development. In our sample, we 
found the rate of physical maturation to be greater for boys than for girls. 
Of the boys, only 20Z had not advanced in genital stage across the year that 
they were studied, about 40Z had advanced one stage, and another 40% had advanced 
two or more stages. Of the girls, 30Z were still at the same breast stage one 
year later, about 60Z had advanced one stage, and only lOZ had advanced more 
than one stage. 

As we have no developmental "norms" for hormone levels we examined rate 
of hormone level change by pubertal stage. We stratified each Time 1 pubertal 

Nottelmann SRCD87-5 

stage 1, 2, and 3 cohort into subgroups by rate of physical pubertal change 
across the year of the study; that is, by no change, change of one stage, 
change of two stages, etc. We then looked at change in hormone levels in 
these subgroups. For many of the hormones, we found that adolescents in a 
cohort who subsequently advanced in physical pubertal stage not only had a 
greater increase in hormone levels. They also had hJ.gher hormone levels to 
begin with than adolescents of the same cohort with no pubertal stape change 
across the year. This bar graph, which shows testosterone levels tor the 
Pubertal Stage 3 cohort of boys, illustrates the rate issue for hormones. It 
shows testosterone levels for Time 1, Time 2, and Time 3 for the whole cohort, 
followed by three subgroups identified by rate of physical change, none, one 
stage, and two stages. Boys who advanced more pubertal stages across the year 
already had higher testosterone levels at Time 1 than boys of the same pubertal 
stage cohort who did not advance in pubertal stage. Apparently, wi thin-stage 
hormone level differences reflect, in part, individual differences in rate of 

We explored the rate issue by examining hormone-behavior relations with 
statistical control for the variance that hormone levels share with pubertal 
stage, as well as with control for both chronological age and pubertal stage 
(i.e., timing and rate of maturation). 

Given this background, here is a summary of our findings. Most relations 
involved adrenal and gonadal axis hormones: for boys, primarily adrenal androgens 
and sex steroids; for girls, primarily adrenal androgens and gonadotropins. 

Starting with boys, the general pattern of concurrent and predictive 
relations \r±th adjustment indicates that better adjustment was associated with 
lower adrenal androgen levels (primarily androstenedione) and higher sex steroid 
levels. On average, these hormone levels accounted for between 15 and 25 
percent of the variance in adjustment. Recall that the various hormone levels 

Nottelmann SRCD87-6 

increase during puberty. According to individual and pubertal s.age hormone 
profiles, it is the ascendance or predominance of gonadal axis over adrenal 
axis hormones, or more mature endocrine status, that was associated with better 

When we controlled hormone l.vels for age and/or pubertal stage, hormone 
levels continued to be significantly related to most adjustment measurer. In 
many cases, chronological age accounted for additional variance (together with 
hormone levels, for up to 45Z). indicating that the hormone correlates associated 
With better adjustment held in particular for boys of more mature endocrine 
status and relatively lower age. These findings suggest also that, for boys, 
a faster rate of increase in hormone levels has positive implications. 

The predictive Tiae 1 and Time 2 hormone correlates associated with better 
adjustment at Time 3 were primarily lower adrenal androgen (androstenedione) 
levels. However, the best predictor of better adjustment at Time 3 was the 
Time 1 and Time 2 combination of lower age and higher pubertal stage, which 
may be conceptualized as earlier maturation. 

Turning to girls, the general pattern of concurrent and predictive relations 
With adjustment indicates that better adjustment was associated primarily with 
lower adrenal androgen levels (androstenedione) and lower gonadotropin levels; 
and. in a few instances, with lower sex steroid (esc.adiol) levels. On average, 
these hormone levels, typical for girls at lower pubertal stages, accounted 
for between 10 and 15X of the variance in a.justme.t. According to individual 
and pubertal stage hormone profiles, relatively low gonadotropin and adrenal 
androren levels Zn our sample differentiated pubertal stage 1 to 3 groups from 
pubertal stage 4 and 5 groups. (Menarchial status dichotomizes the girls in 
our sample into the same groupings.) The hormone-behavior relations findings 
for girls, therefore, may be due to threshold or saturation effects, with 
hormone influence, becoming salient only during the later stages of puberty. 


Nottelraann SRCD87-7 

Concurrent hormone levels controlled for age usually were not related to 
adjustment, which suggests that concurrent hormone correlates reflect primarily 
developmental or maturational variation. However, hormone levels controlled 
for pubertal stage, or for both age and stage, and hormone levels controlled 
for both age and stage continued to be related to adjustment. This set of 
find_ igs suggests that, for girls, a slower rate of increase in hormone levels 
has positive implications. 

The predictive Time 1 and Time 2 hormone correlates associated with better 
adjustment at Time 3 also wete primarily lower gonadotropin levels and both 
higher and lower adrenal androgen levels (lower androstenedione and higher 
DHEA or DHEAS levels) — again, primarily hormone levels typical for girls in 
the lower pubertal stages. These relations generally held for hormone levels 
controlled for age and/or pubertal stage. 

Overall, for both boys and girls, concurrent hormone-adjustment relations 
were fewer at each successive assessment. As the sample as a whole matured 
across the one-year period, endocrinologically and physically, the correlates 
were not always the same, but formed a consistent pattern. 

In summary, in a sample of normal adolescents, the rise in pubertal hormone 
levels was associated with better social-emotional adjustment for boys, especially 
for boys for whom puberty began relatively early. In contrast, the rise in 
pubertal hormones was more likely to be associated with poorer social-emotional 
adjustment for girls. 

Our thoughts on sex differences for hormone-behavior relations findings 
will be covered by Gale Inof f-Germain. I will touch briefly on directionality 
and on the generality of our findings. 

Our findings are correlational. We do not dismiss the possibility of 
bidirectional influences. Just as hormones may affect adjustment, adjustment 
may affect the endocrine system. George Chrousos, one of our collaborators. 

Nottelmann SRCD87-8 

whose research focuses on the adrenal axis, for example, has suggested that 
the higher adrenal androgen levels that are associated with poorer adjustment 
may, in part, reflect increased adrenal function in response to psychological 
stress. Increased adienal function, usually indicated by high Cortisol 
levels, and perhaps also oy high androstenedione levels, may, in turn, suppress 
gonadal axis activation and thereby delay the onset of puberty and/or affect 
the rate of pubertal maturation. An example of such effects in the extreme is 
social dwarfism. At a subtle level, such effects may operate also in a sample 
of normal adolescents. This hypothesis obviously needs to be tested in a 
longitudinal study of prepubertal children. 

As to the generality of our findings, we studied a sample of normal boys 
and girls, across ages 9 to 15. Certain of our findings are not expected to 
hold in samples of older adolescents, in narrower pubertal stage or age .samples, 
or in special population samples. Obviously, our work needs to be extended 
.nd replicated, and we hope that many of you will join in the enterprise. 

o 10 


Nottelmann SRCD87-9 

Selected References 

cross. R, T.. . nu.e. P. m. (1980). The effect of earl, versus late physical 
maturity on adolescent behavior. Pedlatr. Cl.n. ..... 27. 71-77. 

Marshall. W. A. . i Tanner. J. M. (1969^ v«^^»... . . 

M. Uyb9). Variations in the pattarn of pubertal 

changes in girls. Arch. Pis. Chnn 44. 291-303. 
Mar^hall. w. A. . . Xa„„e.. M. (1,70). Variation. i„ p,„e.„ of pubertal 

Changes in boys. Arch. Pis. Chnn . 45. 13-23. 
Nottel„a„, E. sus,a„. ... x„o«-Cet^i„. 0.. Cutlet. 0. B. . .t. . r.tia„, 
D. U. . Chtousos. 0. P. (1,37). Develop^entel ptocease, 1„ early adolesoe„ce = 
ReUtlonahips between adolescent edjuafent proble»a and ohronologlo age 
pubertal stage, and puberty-related aeru. hormone level. Journal o, Pediatrlca 
110 . 473-480. ' 

»ottel.ann. 0.. Sua,an. E. ... ^rn. U „. . lno„-Cer^l„. 0. . Urlaux. . 
Cutler. G. ... Jr.. , Chrouaos. 0. P. (1,87). Develop^ntal procesaea In 
early adolesoence= Relations chronologlo age. pubertal stage, height 
weight, and aeru. levela of gonadotropina. se. steroids, and adrenal androgens. 
Journal of Adolescent Hp«1rh r.^^^ g. 246-260.