Early Pubertal Development Is a Risk Factor for Psychotic-Like Experiences in Boys and Girls

Abstract

Background: Puberty has long been identified as a risk factor for psychosis, although retrospective, cross-sectional, and single-sex indicators of puberty have limited our ability to pinpoint biopsychosocial mechanisms contributing to risk. The current study determined whether individual differences in the timing (onset) and tempo (pace) of pubertal development conferred risk for psychotic-like experiences (PLEs) in youth across biological sex. Methods: Data included 11,758 youths (6134 boys and 5624 girls) from the ABCD (Adolescent Brain Cognitive Development) Study (average age = 9.9 years at baseline, 12.9 years at 3-year follow-up). Pubertal timing and tempo (overall, adrenarche, gonadarche) were derived from sex-specific linear mixed-effects models using the Pubertal Development Scale. Sex-specific negative binomial multilevel models estimated effects of categorical and continuously measured pubertal timing and tempo and their interaction on year-3 PLEs per the Prodromal Questionnaire-Brief Child. Results: In both sexes, earlier pubertal timing was associated with elevated PLEs (βs = 0.23 to 0.31), and later pubertal timing was associated with fewer PLEs (βs = -0.22 to -0.52) relative to on-time peers. In boys only, faster pubertal tempo was associated with fewer PLEs relative to on-track peers (βs = -0.21 to -0.30). Analyses with continuous pubertal timing and tempo demonstrated an association between earlier adrenarchal timing and more PLEs in girls only (β = -0.21) and an interaction between adrenarchal timing and tempo in boys only (β = -0.80). Conclusions: Early pubertal timing in both sexes and faster pubertal tempo in males increases PLEs. Understanding the unique experiences associated with a youth's pubertal maturation, particularly adrenarche, can advance identification and prevention efforts for children and adolescents at greatest clinical risk.