Introduction a long-term decreasing trend of about 0.21 years

Introduction

Adolescence is a critical period in the life span of an individual
which is characterized by rapid pace in physical growth accompanied by psychological
and social changes leading to adulthood. Though
the biological determinants of adolescence are fairly universal, the duration
and defining characteristics of this period may vary across time, cultures, and
socioeconomic situations. The onset of puberty is a significant milestone for
young girls which delineate transition from childhood to womanhood. The most
striking event in the whole process of female puberty is considered as the
onset of menstruation.  

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The
timing of onset of puberty seems to be decreasing all over the world. In Europe
the average onset of puberty in girls was 12.5 in 1980 and it had fallen to
10.5 years by 2010. (Jones, 2013)

A study conducted across Indian states found a long-term decreasing trend of about 0.21 years in menarcheal age between the oldest and the
youngest cohorts. Over the past four decades the mean menarcheal age varied
from 16.50 years to 12.43 years across various subgroups of Indian women. (Pathak et al, 2014).  A survey conducted in Maharastra among 742
urban girls between 9 and 16 years found mean meanarcheal age of   12.62±1.05
years
(Dambhare et al, 2012).

Early physical development is
considered as one of the risk factor for variety of physical and psychological
problems in girls. The
underlying reasons for the elevated risk of psychopathology in early-maturing
girls are unclear. One possibility is that the increased pubertal hormones may
be responsible for creating the distress. (Steingraber, 2007)

Fast changes in body
size and contour from preadolescence to adolescence brought about by early
menarche can generate anxiety among young adolescents. The stressors of early
puberty and associated adolescence changes may be overwhelming for the young
girl. As a result, early puberty has a negative impact on their psychosocial
health of the young girls. (Fraser, 2017). High prevalence of worry, depression
and low self esteem are also reported to be associated with early process of
physical maturation (Oldehinkel et al, 2011).
 

Earlier pubertal onset has
been associated with increased anxiety, depression, substance abuse,
eating disorders, body dissatisfaction, delinquency, risky sexual behavior,
abortion and poor academic achievements compared with on-time or later
maturation. In addition to these, psychosomatic symptoms including abdominal
pain, sleep disturbances, headache, breathlessness, tremors, and heart
palpitations are seen more among early matured adolescence to than with their
counter peers. (Mendle et al (2007)

Developmental insecurity and
early adolescence go hand in hand. For most young people, puberty is the enemy
of self esteem. It changes
how they look at a time when physical appearance becomes more important for
social acceptance and social standing.

 Early
pubertal maturation contributes to emotional outburst and conduct problems placing
them at high risk for deviant behavior where the psychological development may
often be lagging behind (Pillai et al, 2008)

 Huerta &Brizuela-Gamiño (2002) evaluated the relationship between pubertal status and
symptoms of depression, stress, anxiety, stress perception and self-esteem
among  971 girls  of  8 to 16 years old based on Tanner staging. ANOVA
was used to compare the mean psychological symptoms scores with the girls’
pubertal development. The mean age of the sample was 12.5±2.4 years.  The results showed symptoms of severe
depression (3%), severe anxiety (2.1%) while 20%  subjects perceived severe stress. The symptoms
were highest in girls at Tanner stage V (p < 0.001) whereas the self-esteem decreased as the Tanner stage increased (p<0.001). A study was conducted among 7488 adolescents from 16 to 20 years old using self-administered questionnaire. Data from participants reporting early or late timing of puberty were compared with those reporting average timing of maturation. Early maturing girls reported a higher rate of dissatisfaction with body image (OR=1.32) and functional symptoms (OR=1.52) and reported engaging in sexual activity more often (OR=1.93). (Michaud et al, 2006) Adolescent-girl health determines the health of future generation. They are not only the health of future citizens but also the future mothers of the nation. Current age of physical maturation has declined but psychosocial maturity may now lag behind the physical development. Puberty begins prior to the usual onset of adolescence can put a girl at serious disadvantage. It is necessary that health care providers must deal with the current trends and effects of early onset of puberty on health of early maturing girls as it may affect the future progress of the society.   OBJECTIVES To identify psychosocial problems among preadolescent girls with early onset of puberty Materials & Methods A quantitative approach and explorative descriptive design was used. From preadolescent population, girls between 10-12 years who attained menarche were identified by a preliminary survey. Using a purposive sampling, 100 subjects studying in 5th, 6th and 7th standards of 4 private schools from urban and rural areas of Kottayam District of Kerala were included in the study. Using an investigator prepared, validated and reliability (0.96) tested questionnaire with 4 point rating scale was used for data collection. The tool had 12items on demographic profile, 70 items on psychosocial problems in 8 areas namely anxiety, depression, behaviour problem, eating, disorders, substance abuse, sexual abuse and self-esteem. Each item was rated against 4 options; never', 'sometimes' and 'often' and 'always' assigning a score of 1 to 4 respectively. The score ranged from 70 to 280. Ethical clearance from institutional ethical committee and formal permission from Head of the schools were obtained. Parental consent and preadolescent girls' assent were taken before the data collection. The purpose and the procedures of the study were explained and confidentiality of the data was assured. Data was collected through self administered questionnaire technique. Results and Discussion Psychosocial problems of preadolescent girls students were identified in various aspects using the standardized tool.