How changes in pubertal status and chronological age shape individual depressive symptoms by sex: testing a pathoplasty model.

Depressive symptoms increase during puberty and females experience higher rates of depression compared to males. However, it is unclear whether the increase in depressive severity is due to general increases in all symptoms, or whether there are specific symptoms that are more prominently influenced by pubertal development. Therefore, we examined whether pubertal status and chronological age exert pathoplastic effects (i.e., differential influences on disorder expression) on depressive symptoms. To isolate pathoplastic effects, we controlled for overall depression severity. Data came from 7,362 participants spanning ages 10-18 in the Avon Longitudinal Study of Parents and Children. Depression was assessed via the Short Mood and Feelings Questionnaire. Pubertal status was measured through self- and parent-reports of pubic hair, breast, and gonadal development, and voice changes in male participants. Pubertal changes correlated with overall depression severity in females, but not in males. Certain symptoms were more prominently influenced by pubertal indicators and chronological age, supporting pathoplastic effects. In females, within-person breast development was associated with increases in the symptoms I hated myself and nobody really loved me and decreases in the symptom felt lonely. Pubic hair development was associated with higher levels of miserable/unhappy and I hated myself. In males, within-person testes development was associated with increases of the symptom felt tired. Voice changes were associated with increases in the symptom felt lonely. Chronological age was associated with multiple symptoms, beyond the effects of puberty. Pubertal changes and age independently shape depressive symptoms in different ways by sex.