Pathways to Teenage Female Depression: the Role Testosterone Plays in the Association between Ecological Stress and Adolescent Depression Outcomes in Girls during Late Puberty Open Access

Frazier, Tyralynn (2014)

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Purpose: This study examined free testosterone and the possible moderating effect of stress in the testosterone-depression association, in girls during late-puberty. Methods: Participants included 267 girls who were recruited through the Student Information Management System of public school systems of 11 counties in western North Carolina. A total of 1104 biological and stress exposure measures were taken between the ages of 9 and 16. Due to the stratified nature of the sample, the Generalized Estimating Equation (GENMOD procedure) in SAS was used in the moderation model. Late-Puberty was assessed based on age defined as between 13-16, and blood spots were used to determine levels of free testosterone. Environmental stress was defined as a set of adolescent risk factors with known associations with negative behavioral and health outcomes. Birth weight (normal birth weight greater than or equal to 2500g and low birth weight less than 2500g), was measured as a potential confounder or effect modifier. Results: Regression analysis revealed that in normal birth weight girls ages 13-16 (94% of the sample), stress does moderate the relationship between testosterone and depression. In the presence of little or no stress, there exists no significant relationship between testosterone levels and depression. Stress has a multiplicative effect such that the association between testosterone levels and probability of depression increase substantially with increases in exposure to environmental stress. For low birth weight girls, the odds of having depression was much higher than for normal weight girls (OR: 13.5, p-value: 0.002), but the low birth weight sample was too small to assess the effect of stress. Conclusions: These findings suggest that the interactions between stress exposure and testosterone levels are important to consider when evaluating pathways towards elevations in depression among girls during late-adolescence.

Table of Contents


The Stress System 2

Identifying Safety 9

Perceptions and Survival 9

Stress and the Adolescent Transition 14

The Brain 15 The Body 17


Manuscript Chapter 19

Background 19

Methods 21

Results 25

Discussion 29


Summary, Public Health Implications and Possible Future Directions 31

Works Cited 33

Figures and Tables 36

Appendices 1 45

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