CoChat
Sign Up
Cited by 411Child and Adolescent Psychosocial and Emotional DevelopmentNeural and Behavioral Psychology StudiesPsychology and Mental Health

Puberty Initiates Cascading Relationships Between Neurodevelopmental, Social, and Internalizing Processes Across Adolescence

Open access
Pfeifer, Jennifer H., Allen, Nicholas B.·2021·Biological Psychiatry
DOI 10.1016/j.biopsych.2020.09.002PMC PMC8494463
Open this paper in CoChat — free account

Abstract

Adolescence is a period of dramatic developmental transitions -- from puberty-related changes in hormones, bodies, and brains to an increasingly complex social world. The concurrent increase in the onset of many mental disorders has prompted the search for key developmental processes that drive changes in risk for psychopathology during this period of life. Hormonal surges and consequent physical maturation linked to pubertal development in adolescence are believed to impact multiple aspects of brain development, social cognition, and peer relations; each of which have also demonstrated associations with risk for mood and anxiety disorders. These puberty-related effects may combine with other non-pubertal influences on brain maturation to transform adolescents’ social perception and experiences, which in turn continue to shape both mental health and brain development through transactional processes. In this review, we focus on pubertal, neural, and social changes across the duration of adolescence that are known or believed to be related to adolescent-emergent disorders, specifically depression, anxiety, and deliberate self-harm (non-suicidal self-injury). We propose a theoretical model in which social processes (both social cognition and peer relations) are critical to understanding the way in which pubertal development drives neural and psychological changes that produce potential mental health vulnerabilities, particularly (but not exclusively) in adolescent girls.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review argues that pubertal development initiates cascading, transactional relationships among neural maturation, social cognition, peer relations, and internalizing problems (depression, anxiety, NSSI) across adolescence, with effects most pronounced in girls. The authors propose a conceptual model in which social processes are the critical mediator between puberty-driven neural change and mental health vulnerability.

Key findings

  • Girls' risk for depression rises to double or more that of boys during adolescence, peaking in mid-late adolescence; worry-related anxiety disorders (social anxiety, panic, general anxiety, PTSD) all increase from ages 13–18 and are diagnosed 2–3x more often in girls; NSSI increases in early adolescence and peaks in mid-to-late adolescence with gender disparities.
  • Rates of adolescent-emergent internalizing problems have been increasing worldwide, especially over the past decade and most notably among girls; the authors note increased treatment seeking or primary care diagnoses are unlikely explanations.
  • In girls, earlier pubertal timing and more rapid pubertal tempo (relative to same-age, same-sex peers) are associated with higher rates of depressive disorders, substance use disorders, eating disorders, and antisocial behavior.
  • Evidence for neural mediation is described as "initial proofs of concept": larger pituitary volumes mediated early pubertal timing–depressive symptoms and DHEA–social anxiety links; hippocampal structure mediated testosterone–depressive symptoms in girls; weak perigenual ACC connectivity at age 14 was associated with higher internalizing symptoms two years later (mediation not tested directly).

Methods

  • Design: narrative/theoretical review with a proposed conceptual model; no new empirical data are collected or analyzed.
  • Scope: synthesizes animal and human literature on puberty, brain development (sMRI, fMRI, DWI, rs-fcMRI), social cognition (self-perception, mentalizing), peer relations (rejection, close friendships, romantic/sexual relationships), and internalizing disorders; details of cited empirical studies are in Supplementary Material.
  • The model proposes direct and indirect effects of pubertal and neural changes on social processes and mental health, in contrast to contextual amplification theory, which casts puberty as a moderator; testable hypotheses include mediation, temporal sequencing, and specific path effects.

Limitations

  • Stated: pubertal-social-internalizing links have been studied more extensively in girls, calling for more work in boys; self-report puberty scales may be less precise for boys than girls; most neuroimaging studies of social cognition rely on chronological age rather than pubertal stage; nationally representative studies are typically limited to self-report and cannot examine hormonal contributions, while neuroimaging work often cannot contextualize associations across sex and ethnicity.
  • Stated: empirical evidence directly linking puberty to social cognition or its neural substrates remains limited, and most studies would benefit from replication in much larger samples.
  • Evident from the text: as a review, the proposed cascading/transactional model is largely untested — the authors note many hypotheses "require special types of designs (e.g., longitudinal) to be adequately evaluated," and several cited mediation findings are described as proofs of concept rather than established mechanisms.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.biopsych.2020.09.002

Cites

150 of 150 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 63 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    In a well-powered cross-sectional study of early adolescent girls, no association was observed between either age or puberty (self-reported stage or hormone levels) and vmPFC activation during self-evaluation.

    “However, we recently observed no association between either age or puberty (self-reported stage or hormone levels) and vmPFC activation during self-evaluation in a well-powered cross-sectional study of early adolescent girls.(77)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [77] Blakemore, 2008, The social brain in adolescence, Nat Rev Neurosci source

      Not checked in the free run.

  • Interpretationnone given

    The literature reviewed suggests there is a convincing pattern of associations between puberty, brain development, social processes (social cognition and peer relations), and adolescent-emergent internalizing disorders.

    “The literature reviewed above suggests there is a convincing pattern of associations between puberty, brain development, social processes (social cognition and peer relations) and adolescent-emergent internalizing disorders.”
    Quote in the paperNot a substantial claim
  • Premisecitation

    Gonadarcheal development fosters maturation into a sexual being, incorporating social processes such as negotiating sexual feelings, sensitivity to status, intimate friendships, and romantic relationships.

    “Meanwhile, gonadarcheal development fosters maturation into a sexual being, which incorporates a broader suite of social processes such as negotiating sexual feelings, sensitivity to status, intimate friendships, and romantic relationships.(34,135)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [34] Mendle, 2019, The psychology of puberty: What aren’t we studying that we should?, Child Dev Perspect source

      Not checked in the free run.

    • cites [135] Ge, 2009, In search of explanations for early pubertal timing effects on developmental psychopathology, Curr Dir Psychol Sci source

      Not checked in the free run.

  • Premisecitation

    Some features of romantic and sexual relationships (e.g., poor quality relationships, breakups) are strongly associated with adolescent mental health outcomes, ranging from depressive symptoms, particularly in girls, to self-harm and suicide risk.

    “Some features of romantic and sexual relationships (e.g., poor quality relationships, breakups) are strongly associated with adolescent mental health outcomes.(113) This ranges from depressive symptoms, particularly in girls,(109,114) to self-harm and suicide risk.(115–117)”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [113] Bagge, 2013, Quantifying the impact of recent negative life events on suicide attempts, J Abnorm Psychol source

      Not checked in the free run.

    • cites [109] Hughes, 2005, What’s love got to do with it? Exploring the impact of maintenance rules, love attitudes, and network support on friends with benefits relationships, West J Commun source

      Not checked in the free run.

    • cites [114] Price, 2016, Young love: Romantic concerns and associated mental health issues among adolescent help-seekers, Behav Sci source

      Not checked in the free run.

    • cites [115] Cheng, 2020, Feeling left out or just surprised? Neural correlates of social exclusion and overinclusion in adolescence, Cogn Affect Behav Neurosci source

      Not checked in the free run.

    • cites [116] Masten, 2009, Neural correlates of social exclusion during adolescence: Understanding the distress of peer rejection, Soc Cogn Affect Neurosci source

      Not checked in the free run.

    • cites [117] Masten, 2011, Subgenual anterior cingulate responses to peer rejection: A marker of adolescents’ risk for depression, Dev Psychopathol source

      Not checked in the free run.

  • Premisecitation

    Interpersonal stressors, particularly peer rejection, are prominently associated with self-harm.

    “and interpersonal stressors, particularly peer rejection, are prominently associated with self-harm.(91,92)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [91] Wang, 2009, School bullying among adolescents in the United States: Physical, verbal, relational, and cyber, J Adolesc Health source

      Not checked in the free run.

    • cites [92] Beeri, 2012, Social rejection by peers: A risk factor for psychological distress, Child Adolesc Ment Health source

      Not checked in the free run.

  • May combine two claims. 26
  • Classified as probably not a substantial claim. 16

  • May combine two claims.

    Premisecitation

    Adolescence is a period of significant vulnerability to the emergence of mental health disorders, particularly internalizing (mood and anxiety) disorders, especially in girls.

    “Adolescence is a period of significant vulnerability to the emergence of mental health disorders.(1) In particular, it is a critical window for the emergence of internalizing (i.e., mood and anxiety) disorders, especially in girls.(2,3)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [1] Kessler, 2007, Age of onset of mental disorders: A review of recent literature, Curr Opin Psychiatry source

      Not checked in the free run.

    • cites [2] Salk, 2017, Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms, Psychol Bull source

      Not checked in the free run.

    • cites [3] Hankin, 1998, Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study, J Abnorm Psychol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    During adolescence, girls' risk for depression rises to double or more than that of boys, a disparity that peaks in mid-late adolescence and persists across most of the remaining lifespan.

    “Meta-analyses show that during adolescence, girls’ risk for depression rises to double or more than that of boys -- a disparity in both symptoms and diagnoses that peaks in mid-late adolescence, and persists across most of the remaining lifespan (for a recent multinational meta-analysis, see (2)).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Salk, 2017, Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms, Psychol Bull source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    NSSI significantly increases in early adolescence, continues to emerge into mid-to-late adolescence, and exhibits peak prevalence and gender disparities there.

    “Meanwhile, NSSI significantly increases in early adolescence, but continues to emerge well into mid-to-late adolescence, where it exhibits peak prevalence and gender disparities.(12,13)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12] Hawton, 2012, Self-harm and suicide in adolescents, Lancet source

      Not checked in the free run.

    • cites [13] Moran, 2012, The natural history of self-harm from adolescence to young adulthood: A population-based cohort study, Lancet source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Most worry-related anxiety disorders have median ages of onset in mid-to-late adolescence; social anxiety, panic, general anxiety, and PTSD all increase from ages 13-18, and girls are diagnosed with these disorders 2-3 times more often than boys.

    “Most worry-related anxiety disorders also have median age of onsets in mid-to-late adolescence; social anxiety, panic, general anxiety, and post-traumatic stress disorders all increase from ages 13–18, and girls are also diagnosed with these disorders 2–3x more often than boys.(9–11)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [9] Beesdo, 2009, Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V, Psychiatr Clin North Am source

      Not checked in the free run.

    • cites [10] Beesdo-Baum, 2012, Developmental epidemiology of anxiety disorders, Child Adolesc Psychiatr Clin North Am source

      Not checked in the free run.

    • cites [11] Caouette, 2013, Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience, Dev Cogn Neurosci source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Development of secondary sexual characteristics impacts how adolescents are perceived by themselves and others, and may contribute to adultification, particularly for Black girls.

    “Additionally, development of secondary sexual characteristics impact how adolescents are perceived by themselves and others, and may contribute to adultification (when children are perceived as being older and less innocent), particularly for Black girls.(35,36)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [35] Forbes, 2010, Pubertal development and behavior: Hormonal activation of social and motivational tendencies, Brain Cogn source

      Not checked in the free run.

    • cites [36] Nielson, 2020, Great expectations: A critical review of and recommendations for the study of reward processing as a cause and predictor of depression [published online ahead of print Jun 17], Biol Psychiatry

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In girls, earlier pubertal timing and more rapid pubertal tempo relative to same-age, same-sex peers are associated with higher rates of depressive disorders, as well as substance use disorders, eating disorders, and antisocial behavior.

    “For example, in girls, earlier pubertal timing and more rapid pubertal tempo (relative to same-age, same-sex peers) is associated with higher rates of depressive disorders in particular, as well as substance use disorders, eating disorders, and antisocial behavior.(30–32)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [30] Marceau, 2011, Individual differences in boys’ and girls’ timing and tempo of puberty: Modeling development with nonlinear growth models, Dev Psychol source

      Not checked in the free run.

    • cites [31] Byrne, 2017, A systematic review of adrenarche as a sensitive period in neurobiological development and mental health, Dev Cogn Neurosci source

      Not checked in the free run.

    • cites [32] Suleiman, 2017, Becoming a sexual being: The “elephant in the room” of adolescent brain development, Dev Cogn Neurosci source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Rates of adolescent-emergent mental health problems (depressive and anxiety disorders, NSSI, and suicidal thoughts and behaviors) have been increasing worldwide, especially over the past decade, and most notably amongst girls.

    “Layered atop these well-known developmental trajectories, a series of new findings indicate that rates of these adolescent-emergent mental health problems (depressive and anxiety disorders, NSSI, and suicidal thoughts and behaviors) have been increasing worldwide -- especially over the past decade, and most notably amongst girls.(2,20–23)”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [2] Salk, 2017, Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms, Psychol Bull source

      Not checked in the free run.

    • cites [20] Haidt, 2020, Scrutinizing the effects of digital technology on mental health, Nature source

      Not checked in the free run.

    • cites [21] Keyes, 2019, Recent increases in depressive symptoms among US adolescents: Trends from 1991 to 2018, Soc Psychiatry Psychiatr Epidemiol source

      Not checked in the free run.

    • cites [22] Duffy, 2019, Trends in mood and anxiety symptoms and suicide-related outcomes among U.S. undergraduates, 2007–2018: Evidence from two national surveys, J Adolesc Health source

      Not checked in the free run.

    • cites [23] Twenge, 2019, Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017, J Abnorm Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    While these neural and social consequences of puberty for internalizing may be most pronounced in girls, they are still expected to impact boys.

    “While these neural and social consequences of puberty for internalizing may be most pronounced in girls, they are still expected to impact boys.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Social experiences across adolescence are not only predictive of concurrent and near-future mental health, but also part of a cascading series of developmental and risk processes that are at least in part driven by earlier biological and psychosocial changes.

    “In other words, social experiences across adolescence are not only predictive of concurrent and near-future mental health, but also part of a cascading series of developmental and risk processes that are at least in part driven by earlier biological and psychosocial changes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    In contrast to contextual amplification theory, which casts puberty in a moderating role, we propose direct and indirect effects of pubertal (and neural) changes on social processes and mental health.

    “Thus in contrast to contextual amplification theory(138) which casts puberty in a moderating role, we propose direct and indirect effects of pubertal (and neural) changes on social processes and mental health (see Figure 1).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [138] Odgers, 2020, Annual research review: Adolescent mental health in the digital age: Facts, fears, and future directions, J Child Psychol Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    Through such interactions this dynamic system can augment or buffer against risk for mood and anxiety disorders.

    “Through such interactions this dynamic system can augment or buffer against risk for mood and anxiety disorders.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Another central feature of our model is a consideration of how social, neural, and pubertal processes co-evolve across the duration of adolescence.

    “Another central feature of our model is a consideration of how social, neural, and pubertal processes co-evolve across the duration of adolescence (see Figure 2 for alignment of these processes with mental health trajectories).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Our model proposes that puberty dramatically alters adolescents' social perceptions and experiences with peers, via physical, neural, and interpersonal changes that reshape how adolescents see themselves and how they interact with others.

    “Our model proposes that puberty dramatically alters adolescents’ social perceptions and experiences with peers. It does so via physical, neural, and interpersonal changes that reshape how adolescents see themselves, and how they interact with others.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Internalizing disorders are associated specifically with pubertal processes rather than with age, suggesting the relationship is not due solely to psychosocial factors common to a chronologically defined stage of adolescence.

    “Internalizing disorders are known to be associated specifically with pubertal processes rather than with age, suggesting that the relationship is not due solely to psychosocial factors common to individuals at a chronologically-defined stage of adolescence.(25,26)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [25] Patton, 2007, Pubertal stage and deliberate self-harm in adolescents, J Am Acad Child Adolesc Psychiatry source

      Not checked in the free run.

    • cites [26] Patton, 2008, Predicting female depression across puberty: A two-nation longitudinal study, J Am Acad Child Adolesc Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    For adolescent girls, intentional social exclusion is a common form of relational aggression and a potent risk factor for internalizing problems.

    “For adolescent girls in particular, intentional social exclusion is a common form of relational aggression(93) and a potent risk factor for internalizing problems.(94)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [93] Narr, 2019, Close friendship strength and broader peer group desirability as differential predictors of adult mental health, Child Dev source

      Not checked in the free run.

    • cites [94] Havewala, 2019, Friendship quality moderates the relation between maternal anxiety and trajectories of adolescent internalizing symptoms, J Psychopathol Behav Assess source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Chronic relational victimization is a consistent predictor of adolescent depression, temporally preceding it in many longitudinal studies.

    “Similarly, chronic relational victimization is a consistent predictor of adolescent depression, temporally preceding it in many longitudinal studies,(90)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [90] Whitlock, 2006, Self-injurious behaviors in a college population, Pediatrics source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Peer rejection, close friendships, and romantic or sexual relationships represent highly salient/emerging developmental tasks in adolescence, reflecting the need to foster social connection with peers and minimize social rejection from them.

    “Together these represent highly salient/emerging developmental tasks in adolescence,(83) reflecting the need to foster social connection with peers and minimize social rejection from them.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83] Sheeber, 1997, Family support and conflict: Prospective relations to adolescent depression, J Abnorm Child Psychol source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisenone given

    Most neuroimaging studies of social cognition have relied on chronological age to track maturation rather than pubertal stage.

    “Furthermore, most neuroimaging studies of social cognition have relied on chronological age to track maturation rather than pubertal stage.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Taken together, the evidence suggests that close friendship quality is typically a protective factor against mental health problems in adolescence, but under certain conditions, close friendships may exacerbate internalizing problems in adolescent girls.

    “Taken together, the evidence suggests close friendship quality is typically a protective factor against mental health problems in adolescence, but under certain conditions, close friendships may exacerbate internalizing problems in adolescent girls.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Romantic and sexual relationships are frequently characterized as a salient consequence of puberty.

    “In contrast to its under-examined associations with brain development, romantic and sexual relationships are frequently characterized as a salient consequence of puberty.(132)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [132] Buss, 2019

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Although sexual reproduction can be considered the ultimate evolutionary target of pubertal development, reproductive success encompasses a much broader range of social processes than sexual reproductive capacity per se.

    “Importantly, although sexual reproduction can be considered the ultimate evolutionary target of pubertal development, reproductive success encompasses a much broader range of social processes than sexual reproductive capacity per se.(34,135)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [34] Mendle, 2019, The psychology of puberty: What aren’t we studying that we should?, Child Dev Perspect source

      Not checked in the free run.

    • cites [135] Ge, 2009, In search of explanations for early pubertal timing effects on developmental psychopathology, Curr Dir Psychol Sci source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    One recent study found that friendship buffers affective and neural responses to social exclusion in adolescents who experienced early adversity.

    “However, one recent study found that friendship buffers affective and neural responses to social exclusion in adolescents who experienced early adversity.(130)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [130] Carlson, 2007, The role of reciprocity in romantic relationships in middle childhood and early adolescence, Merrill-Palmer Q source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Another recent study showed that choosing to self-disclose about intimate information to a close friend was associated with increased activity in regions associated with social cognition and emotion regulation, including vmPFC, for adolescent girls.

    “Another recent study showed choosing to self-disclose about intimate information to a close friend was associated with increased activity in regions associated with social cognition and emotion regulation, including vmPFC, for adolescent girls.(131)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [131] Finkelstein, 1998, Effects of estrogen or testosterone on self-reported sexual responses and behaviors in hypogonadal adolescents, J Clin Endocrinol Metab

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Adolescent romantic relationships and behaviors are qualitatively different than the feelings pre-pubescent children can have towards their peers; testosterone and estradiol seem to underlie some of that romantic interest.

    “Adolescent romantic relationships and behaviors are qualitatively different than the feelings pre-pubescent children can have towards their peers;(110,133) testosterone and estradiol seem to underlie some of that romantic interest.(134)”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [110] Mirsu-Paun, 2017, How much does love really hurt? A meta-analysis of the association between romantic relationship quality, breakups and mental health outcomes in adolescents and young adults, J Relatsh Res

      Not checked in the free run.

    • cites [133] Sontag, 2008, Coping with social stress: Implications for psychopathology in young adolescent girls, J Abnorm Child Psychol source

      Not checked in the free run.

    • cites [134] Sontag, 2011, The role of peer stress and pubertal timing on symptoms of psychopathology during early adolescence, J Youth Adolesc source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Collectively, neuroimaging studies demonstrate consistent evidence of engagement in subgenual ACC, vlPFC, posterior midline regions, and ventral striatum during social exclusion; paradigms looking at anticipation/receipt of social evaluative feedback additionally elicit responses in amygdala and medial orbitofrontal cortex.

    “Collectively, these studies demonstrate consistent evidence of engagement in subgenual ACC (sgACC), vlPFC, posterior midline regions, and ventral striatum (for a meta-analysis, see (124)); the paradigms that look at anticipation/receipt of social evaluative feedback additionally elicit responses in amygdala and medial orbitofrontal cortex.(39,122,123,125)”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [124] Oppenheimer, 2020, Suicidal ideation among anxious youth: A preliminary investigation of the role of neural processing of social rejection in interaction with real world negative social experiences, Child Psychiatry Hum Dev source

      Not checked in the free run.

    • cites [39] Piekarski, 2017, Does puberty mark a transition in sensitive periods for plasticity in the associative neocortex?, Brain Res source

      Not checked in the free run.

    • cites [122] Nelson, 2011, The development of the ventral prefrontal cortex and social flexibility, Dev Cogn Neurosci source

      Not checked in the free run.

    • cites [123] Jankowski, 2018, Feeling left out: Depressed adolescents may atypically recruit emotional salience and regulation networks during social exclusion, Soc Cogn Affect Neurosci source

      Not checked in the free run.

    • cites [125] Brown, 2017, Differential neural processing of social exclusion and inclusion in adolescents with non-suicidal self-injury and young adults with borderline personality disorder, Front Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The anterior insula, part of the salience network, has been implicated in atypical responses to social exclusion in depression and anxiety, but the direction of effects has been mixed.

    “The anterior insula, part of the salience network, has also been implicated in atypical responses to social exclusion in depression(123,126) and anxiety,(127) but the direction of effects has been mixed.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [123] Jankowski, 2018, Feeling left out: Depressed adolescents may atypically recruit emotional salience and regulation networks during social exclusion, Soc Cogn Affect Neurosci source

      Not checked in the free run.

    • cites [126] Groschwitz, 2016, Differential neural processing of social exclusion in adolescents with nonsuicidal self-injury: An fMRI study, Psychiatry Res Neuroimaging source

      Not checked in the free run.

    • cites [127] Fritz, 2020, Mood and neural responses to social rejection do not seem to be altered in resilient adolescents with a history of adversity, Dev Psychopathol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Biological changes of adolescence do not cease when puberty concludes; the brain continues to exhibit change in structure and function across the entire duration of adolescence, reaching developmental asymptotes largely in the mid-twenties.

    “In addition, the biological changes of adolescence do not cease when puberty concludes; rather, the brain continues to exhibit change in structure and function across the entire duration of adolescence, reaching developmental asymptotes largely in the mid-twenties.(142)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [142] Uban, 2018, Biospecimens and the ABCD study: Rationale, methods of collection, measurement and early data, Dev Cogn Neurosci source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Despite the completion of many morphological changes associated with puberty-related development of secondary sexual characteristics, rendering self-report metrics ineffective, hormone levels continue to rise across the same extended period as brain development.

    “Despite the completion of many of the morphological changes associated with puberty-related development of secondary sexual characteristics, rendering self-report metrics ineffective, hormone levels continue to rise across the same extended period as brain development.(33)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [33] Epstein, 2017

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    These neural and social changes individually and together affect adolescent propensity for internalizing disorders, particularly for girls.

    “that individually and together affect adolescent propensity for internalizing disorders, particularly for girls.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationcitation

    Hormone levels may serve as a better index of maturation to incorporate during the latter half of adolescence, as well as a measure of individual differences relating to social changes and mental health.

    “In this respect, hormone levels may serve as a better index of maturation to incorporate during the latter half of adolescence, as well as a measure of individual differences relating to social changes and mental health.(42)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] van Duijvenvoorde, 2019, A three-wave longitudinal study of subcortical–cortical resting-state connectivity in adolescence: Testing age- and puberty-related changes, Human Brain Mapping source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisereasoning

    These ongoing increases in sex hormones are also believed to shape and refine neural circuitry as well as drive many late-maturing events not captured by categorical Tanner stages.

    “These ongoing increases in sex hormones are also believed to shape and refine neural circuitry as well as drive many late-maturing events not captured by categorical Tanner stages.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    There is a relative dearth of information relating close friendships to pubertal development, although one study found early-maturing girls to be more likely to experience dissolution of a friendship.

    “In contrast to this work on romantic/sexual relationships, there is a relative dearth of information relating close friendships to pubertal development, although one study found early-maturing girls to be more likely to experience dissolution of a friendship.(136)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [136] Hamlat, 2015, Pubertal timing, peer victimization, and body esteem differentially predict depressive symptoms in African American and Caucasian girls, J Early Adolesc source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisereasoning

    This limitation is counterbalanced by the ability of nationally representative studies to contextualize these associations across sex and ethnicity, something that most neuroimaging work has yet to be able to do.

    “This limitation is counterbalanced by the ability of nationally representative studies to contextualize these associations across sex and ethnicity, something that most neuroimaging work has yet to be able to do.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisereasoning

    Many studies relating puberty to mental health draw on large, nationally representative samples that are typically limited to self-report and thus unable to examine later contributions of hormonal changes.

    “While neuroimaging studies have increasingly assayed sex hormones, many studies relating puberty to mental health draw on large, nationally representative samples that are typically limited to self-report and thus unable to examine later contributions of hormonal changes.”
    Quote in the paperSubstantial claim
34 of 34

  • The paper relies on this without support.

    The associations reported in the reviewed literature reflect causal processes rather than solely correlational or confounded relationships.

    “The literature reviewed above suggests there is a convincing pattern of associations between puberty, brain development, social processes (social cognition and peer relations) and adolescent-emergent internalizing disorders.”

  • The paper relies on this without support.

    The measures used in the reviewed studies validly capture the constructs of puberty, social processes, and internalizing symptoms.

    “Most studies related brain structure or function to pubertal development when controlling for age, which is akin to modelling pubertal timing (i.e., pubertal stage relative to that of one’s same-age peers).”

  • The paper relies on this without support.

    The findings from the reviewed studies generalize to the broader adolescent population.

    “A trend we hope spreads widely is for studies to harmonize data collection efforts, with an aim to truly complement and inform each other.”

  • The paper relies on this without support.

    The literature reviewed is sufficiently comprehensive and representative to support the proposed integrative model.

    “The literature reviewed above suggests there is a convincing pattern of associations between puberty, brain development, social processes (social cognition and peer relations) and adolescent-emergent internalizing disorders.”

  • The paper relies on this without support.

    Peer relations are a major determinant of well-being and mental health in childhood and adolescence.

    “It is widely understood that peer relations are a major determinant of well-being and mental health in childhood and adolescence.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Females experience pubertal bodily changes earlier than males, which can provoke further downstream social changes.

    “For example, females experience pubertal bodily changes earlier than do males, which can provoke further downstream social changes20.”

    From Windows of developmental sensitivity to social media (2022) · cites this paper as [20]

    The Puberty section says secondary sexual characteristics can change how adolescents are perceived by themselves and others, and the Conceptual Model proposes that physical pubertal changes reshape social experiences. But the paper’s discussion of earlier timing in girls compares girls with same-age, same-sex peers; it does not establish that females experience bodily changes earlier than males. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Puberty is associated with increased vulnerability to anxiety, depression, and suicidal ideation.

    “In addition to the physiological changes associated with puberty, this developmental period is also associated with dramatic shifts in mental health risk, such as increased vulnerability to anxiety, depression, and suicidal ideation (9-11)”

    From Puberty Blocker, Leuprolide, Reduces Sex Differences in Rough-and-Tumble Play and Anxiety-like Behavior in Juvenile Rats (2024) · cites this paper as [9]

    The Abstract and “Growing Gender Disparities in Internalizing Disorders During Adolescence” describe increased adolescent vulnerability to depression and anxiety in the context of pubertal development. The review discusses non-suicidal self-injury and mentions suicide risk in relation to romantic relationships, but it does not establish increased vulnerability to suicidal ideation specifically during puberty. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Substantial biological changes in the social brain make adolescence a sensitive period for social development, self-perception, and social interaction.

    “It has been proposed that substantial biological changes in the social brain make adolescence a sensitive period for social development19, self-perception, and social interaction20.”

    From Windows of developmental sensitivity to social media (2022) · cites this paper as [20]

  • The increase in sex hormones at puberty plays a role in brain development, social outcomes, and mental health.

    “Evidence suggests that the increase in sex hormones at puberty plays a role in brain development, 114-117 social outcomes, 118 and mental health. 119-121”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [118]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Pfeifer, J. H., & Allen, N. B.
Affiliations
University of Oregon (US)
Corresponding author
Pfeifer, Jennifer H.
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2021-01
Volume
89
Issue
2
Pages
99-108
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/j.biopsych.2020.09.002
PMC
PMC8494463
OpenAlex
W3084100974
Semantic Scholar
3da6c2bf7e8aac212e5ca12f957136fa47d95dc9
Cited by
411
References
150
Citations by year
2026: 79 · 2025: 103 · 2024: 91 · 2023: 67 · 2022: 51 · 2021: 16 · 2020: 2 · 2014: 1
FWCI
2.66
Type
journal article
Language
en
Open access
Licence
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
Funders
National Institute of Mental Health (R01 MH104718)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords
puberty, adolescence, brain development, social cognition, peer relationships, internalizing disorders, depression, anxiety, self-harm, non-suicidal self-injury, mood disorders, anxiety disorders, adolescent girls, mental health risk
MeSH terms
Adolescent, Anxiety, Anxiety Disorders, Brain, Female, Humans, Psychopathology, Puberty

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review