Doctoral Dissertations

Date of Award

12-1998

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Sandra Thomas

Committee Members

Martha Alligood, Cheryl Travis, Sheila Bowman, R. Tom Ladd

Abstract

The primary purpose of this research was to explore the effects of early menarche on the psychological development, health, and well-being of young girls. Early menarche has been associated with a variety of undesirable outcomes including early coital debut, low educational attainment, cigarette, alcohol and drug use, and an increased risk of depression. These behaviors have clear social and health costs. The model developed for this research tested a mid-range theory derived from the work of Peplau and King. The theory proposed that individuals who experienced early menarche were at risk due to asynchrony of physiological and psychological development in the context of family and social environments that can foster or inhibit ego development Stated as a hypothesis: If a person is regarded as an personal system (King, 1981, Peplau, 1989) moving forward in the direction of constructive and satisfying personal and community living (Peplau, 1954); and if successful completion of a learning experience (an event that arises at or about a certain period in the life of an individual) is dependent upon the availability of tools developed in preceding developmental eras (King, 1981, Peplau, 1954), then a girl who reaches physical maturity before she has accomplished the tasks of late childhood will exhibit difficulties adjusting to puberty. The experience of early menarche represents a special application of the newly synthesized mid-range theory of asynchronous development. Self-reported measures of level of pubertal development, level of ego development, empathy, family warmth, interparental conflict, depression. and a modified version of the CDC Youth Risk Surveillance Survey were administered to 598 students in 6 middle schools (IRB, school system and parental permission as well as individual assent were obtained for all participants). A total of 336 female students completed surveys. The study provided preliminary support for the theory of asynchronous development. AMOS (a structural equation modeling software package) was used to test a model incorporating family warmth, biological factors, level of ego development and level of pubertal development as predictors for participation in health risk behaviors and manifestation of depressive symptoms. The model was able to explain 70 percent of the variance of the dependent variables. The study confirmed the role of early menarche as an identifiable risk factor for early coital debut, early tobacco use and drug use. In this sample, there was no association of early menarche and alcohol use. The trend towards earlier menarche that has been found by other authors was again noted. The positive influence of family warmth in increasing ego development and decreasing these risks should be of interest to parents, nurses, teachers, and all who work with young adolescents. These findings have important implications for the development of anticipatory guidance for parents, school systems and school age clients. Clarification of the factors important in mediating the observed relationship of early menarche and health risk behaviors can provide guidance in the development of intervention programs and future research.

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