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
"PERMISSION TO REPRODUCE THIS
MATERIAL HAS BEEN GRANTED BY
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Paper presented at the biennial meeting of the Society for Research in
Child Development, Baltimore, Marylard, April 24, 1987.
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.
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.
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
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
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
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.
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.
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.
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PUBERTAL STAGE 3 COHORT