The Health Behavior Study
Puberty is a critical and dynamic period of development for optimal bone accrual and normal reproductive function. In fact, girls accumulate nearly 50% of bone mineral content in puberty. Enhancing bone mass accrual in puberty optimizes peak mass and decreases the risk of osteoporosis and its ensuing late life problems. Osteoporosis is a major public health problem for the elderly but the pathway to osteoporosis is determined multifactorially and begins early in life.
The Health Behavior Study is a longitudinal study examining the effects of moods and behaviors (e.g smoking, depressive symptoms) on reproductive and bone health. We enrolled 262 girls ages 11-17, in the study. Girls are seen annually for 4 years. We gather a variety of information about smoking history, reproductive health, mood and behavior, and dexa scans to measure bone mineral density and content. In addition to annual visits, participants also complete follow-up phone interviews at three month intervals. The purpose of these interviews is to update mood, behavior, and menstrual cycle (reproductive health) information. We are interested in studying the combined impact of timing of puberty, substance use, and depression/anxiety on bone and reproductive health in adolescent girls.
Status of the study: As of October 2008 all participants completed the second annual visit and over half have completed the third visit. Although funding through the NIH ended 1/31/09, study visits are continuing. Many of our hypotheses are supported by the findings in the publications listed below. One particularly intriguing finding is shown in our first paper listed below where high depressive symptoms and anxiety were associated with lower bone mineral density and content. This relationship has been shown in the adult population but not in adolescents; a population that may be at risk if accrual of bone is hampered during the important time of puberty. Dr. Dorn hopes to continue visits up to Year 6 in order to follow all girls through their time of peak accrual of bone. A grant for this continuation is currently under review at the NIH. The new grant will also focus on the potential mechanism involved in this relationship of moods and bone health. Knowing this may enhance intervention and prevention efforts for poor bone health.
This research is supported by Grant Number R01 DA 16402, National Institute of Drug Abuse, NIH. PI: Lorah D. Dorn, Ph.D. and U.S.P.H.S. Grant Number M01 RR 08084, General Clinical Research Centers Program, National Center for Research Resources, NIH.
Publications
Dorn, L.D., Susman, E.J., Pabst, S.R., Huang, B., Kalkwarf, H.J., & Grimes, S. (2008). The
association of depressive symptoms and anxiety with bone mass and
density in ever smoking and never smoking adolescent girls. Archives of Pediatrics and Adolescent Medicine,
162(12),1181-1188. This paper found that high depressive symptoms and
anxiety were associated with lower bone mineral density and content.
Smokers had higher depression and anxiety than nonsmokers. Subgroup
analyses suggested that in smokers higher anxiety was related to lower
bone mineral content.
Dorn, L.D., Negriff, S., Huang, B., Pabst, S., Hillman., J., Braverman, P., & Susman, E.J. (2009). Menstrual Symptoms in Adolescent Girls: Association with Smoking, Depressive Symptoms and Anxiety. Journal of Adolescent Health,
44, 237-243. This paper found that high depressive symptoms and anxiety
were related to more menstrual symptoms. Smokers had more menstrual
symptoms than nonsmokers and the association between depressive
symptoms/anxiety and menstrual symptoms was stronger for smokers.
Pabst, S.R., Negriff, S., Huang, B., Susman. E.J., & Dorn, L.D. (in press). Depression and anxiety in adolescent females: The impact of sleep preference and body mass index.Journal of Adolescent Health.This
paper found that evening chronotype (having an evening sleep
preference, e.g. going to bed later) was related to higher depressive
symptoms and anxiety. This effect was stronger in overweight girls. The
combination of evening chronotype and being overweight appears to have
the strongest association on the emotional health of adolescent
females.
Marklein, E., Negriff, S., & Dorn, L.D. (in press). Pubertal timing, substance use, and peer smoking.Prevention Science.
This paper found that late pubertal timing was associated with more
alcohol use. Also having more friends that were regular smokers was
related to the girl’s use of cigarettes, alcohol, and marijuana. Having
friends that smoke strongly influences an adolescent’s use of
substances.
Negriff, S. & Dorn, L.D. (in press). Morningness-Eveningness and menstrual symptoms in adolescent girls.Journal of Psychosomatic Research.
This paper found that evening chronotype (having an evening sleep
preference, e.g. going to bed late) was associated with more menstrual
symptoms and shorter duration of menses. Girls with evening sleep
preference experience more menstrual symptoms than girls with morning
preference.
