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

## TL;DR

Early puberty in boys and girls is linked to increased risk of psychotic-like experiences later, with faster development in boys showing a stronger connection.

## Contribution

This study introduces sex-specific measures of pubertal timing and tempo to identify risk for psychotic-like experiences in youth.

## Key findings

- Earlier pubertal timing in both boys and girls is associated with elevated psychotic-like experiences.
- Faster pubertal tempo in boys is linked to increased psychotic-like experiences.
- Adrenarchal timing and tempo interact to influence psychotic-like experiences in boys.

## Abstract

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.

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.

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).

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.

Aberrant puberty is a putative risk factor for psychosis. Retrospective, cross-sectional, and single-sex indicators of puberty oversimplify this multiyear biopsychosocial process. In 11,718 youths from the ABCD (Adolescent Brain Cognitive Development) Study, we derived measures of pubertal timing and tempo. Using sex-specific negative binomial multilevel models, we demonstrated that early pubertal timing in boys and girls and fast tempo in boys only are associated with increased endorsement of psychotic-like experiences 3 years later. Findings suggest a central role of social and hormonal factors in the emergence of psychotic-like experiences, which can advance identification and prevention efforts for youth at greatest risk.

Aberrant puberty is a putative risk factor for psychosis. Retrospective, cross-sectional, and single-sex indicators of puberty oversimplify this multiyear biopsychosocial process. In 11,718 youths from the ABCD (Adolescent Brain Cognitive Development) Study, we derived measures of pubertal timing and tempo. Using sex-specific negative binomial multilevel models, we demonstrated that early pubertal timing in boys and girls and fast tempo in boys only are associated with increased endorsement of psychotic-like experiences 3 years later. Findings suggest a central role of social and hormonal factors in the emergence of psychotic-like experiences, which can advance identification and prevention efforts for youth at greatest risk.