title: Comparison of puberty and psychosocial adjustment between Taiwanese adolescent females with and without diabetes.
abstract: OBJECTIVE
  The aims of this study were to (1) determine the differences in puberty and psychosocial adjustment among Taiwanese adolescent females with and without type 1 diabetes mellitus, and (2) examine the interaction between pubertal timing and diabetes in relation to its effect on adolescent's psychosocial adjustment.
  
  
  BACKGROUND
  Rapid physical and sexual changes during puberty elicit a wide array of psychosocial adjustments. The effects of pubertal changes among adolescent females with type 1 diabetes mellitus on psychosocial adjustment are unknown. Design.  This study used a comparative, case-controlled design. A total of 82 adolescent females, aged 10-17, were recruited for the study. Forty-one adolescents with type 1 diabetes mellitus were age-matched to 41 adolescents without type 1 diabetes mellitus.
  
  
  METHODS
  Adolescents' psychosocial adjustment, including internalising and externalising behaviours, was assessed using the Child Behaviour Checklist (parental report) and the Youth Self-Report (individual self-report). The self-reported Pubertal Development Scale was used to measure adolescents' puberty, including onset of menses, age at menarche and pubertal timing.
  
  
  RESULTS
  When compared to their counterparts, adolescent females with type 1 diabetes mellitus reported a delayed menarche and a delayed puberty. Females with type 1 diabetes mellitus had significantly greater internalising and externalising behaviours than their counterparts according to parental reports. Onset of menses and adolescent self-reported psychosocial adjustment were not different between the two groups. Interaction analyses showed that the association between pubertal timing and internalising behaviours was related to the presence of diabetes. According to parental reports, early pubertal timing had positive effects on internalising behaviours for adolescent females with type 1 diabetes mellitus not for adolescent females without type 1 diabetes mellitus.
  
  
  CONCLUSIONS
  A multi-informant approach is suggested when health care professionals assess adolescent psychosocial adjustment. Health care professionals must provide female teenagers with information and opportunities to discuss the impact of type 1 diabetes mellitus on their puberty and psychosocial adjustment.
authors.affiliation: Department of Nursing, School of Medicine, National Cheng Kung University, Tainan, Taiwan. yuht12@mail.ncku.edu.tw
authors.forename: Yu-Yun Alice
authors.initials: YY
authors.lastname: Hsu
authors.forename: Lorah D
authors.initials: LD
authors.lastname: Dorn
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D011627:Puberty