"Early 'shake-up': how the pace of puberty affects adolescent self-esteem

Scientists from the University of Bristol analysed data from 6,644 adolescents (41% boys) from the Avon Longitudinal Study of Parents and Children (ALSPAC) to find out how the pace of puberty (age of peak growth velocity and, in girls, age of menarche) is associated with body dissatisfaction and self-esteem at 14 years. The study is published in BMJ Journals.

Methods and indicators

• Pubertal markers:

  • Age at Peak Height Velocity (aPHV) is the objectively calculated age of maximum growth in centimeters per year.

  • Age at Menarche (AAM) is the age at which girls begin their first menstruation.

• Body image and self-perception assessment:

  • Satisfaction and Dissatisfaction with Body Parts Scale - a scale of satisfaction with body parts.

  • Self-Image Profile is a scale of self-esteem and the feeling of “good” appearance.

• Adjustments were made for pre-pubertal body mass index and family socioeconomic status.

Main findings

1. Boys:

   • Late peak growth velocity (late aPHV) was associated with greater body dissatisfaction (b-value=0.13; 95% CI 0.09–0.18).

   • They probably feel like they are "left behind" in the midst of their "giant" peers.

2. Girls (aPHV):

   • Late aPHV was associated with less dissatisfaction, but the effect was attenuated after controlling for BMI (b=−0.03; 95% CI −0.07–0.01).

   • Indicates that part of the association is explained by body length and prepubertal weight.

3. Girls (AAM):

   • Late menarche was associated with lower levels of dissatisfaction (b=−0.06; 95% CI −0.09–−0.02).

   • Perhaps mature bodies are perceived more positively when menstruation starts later.

4. Self-perception (“I look good”) in girls:

   • After late aPHV, the odds of feeling “good about appearance” were higher (OR = 1.09; 95% CI 1.01–1.19).

   • However, the likelihood of feeling “different from others” is lower (OR = 0.91; 95% CI 0.83–1.00).

5. Boys' self-esteem in Self-Image Profile scores was not dependent on aPHV.

Conclusions and significance

• Boys vulnerable to late growth: Those who lag behind in puberty growth spurts experience more discomfort about their appearance.
• Benefits of late menarche in girls: Late puberty is associated with a more positive body image.
• Recommendations: Schools and adolescent clinics can develop targeted support programs that take into account the pace of puberty to reduce the risk of developing eating disorders and depression.

“Our study highlights that not only the physiological but also the social aspects of puberty influence the development of self-esteem in adolescents. Early interventions are needed, especially for boys whose maturation is delayed relative to their peers,” comments Dr. Dana Tarif, the study’s lead author.

The authors highlight four key points:

1. Differences in Body Image in Boys
   “We found that boys who experience their growth peak later than their peers are more likely to experience body dissatisfaction,” says Dr. Dana Tarif. “This points to the need for early emotional support for these adolescents.”

2. Protective effect of late menarche in girls
   “Late menarche was associated with more positive body image in girls,” adds co-author Professor Alison Brown. “This phenomenon may be related to less pressure from social norms in early adolescence.”

3. The Role of BMI and Growth Rate
   “Part of the growth effect in girls is explained by pre-pubertal body mass index,” says Dr. Tarif. “This highlights the importance of monitoring physical growth and nutrition before puberty.”

4. Need for targeted programmes
   “These findings suggest that schools and clinics should offer tailored support groups and educational modules that take into account the pace of puberty to improve adolescents’ psycho-emotional well-being,” concludes Prof. Brown.

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These findings will help educators, psychologists, and pediatricians develop preventive programs to support adolescents during years of rapid physiological and psychological change.