Uniquely Associated Research Articles

Psychological and Physical Intimate Partner Aggression Are Associated with Broad and Specific Internalizing Symptoms during Pregnancy.

Background: Intimate partner violence (IPV) has serious consequences, particularly during high-risk periods such as pregnancy, which poses a significant risk to maternal mental health. However, it is unclear whether IPV presents a broad risk for psychopathology or is specific to distinct diagnoses or symptom dimensions (e.g., panic, social anxiety). Further, the relative impact of physical versus psychological aggression remains unclear. Methods: One hundred and fifty-nine pregnant couples completed surveys assessing psychological and physical intimate partner aggression unfolding in the couple relationship, as well as a range of internalizing symptoms. Results: Psychological and physical aggression were each associated with broad negative affectivity, which underlies mood and anxiety disorders; however, only psychological aggression demonstrated a unique association. Further, for pregnant women, aggression was uniquely associated with several symptom dimensions characteristic of PTSD. In contrast, men demonstrated a relatively heterogeneous symptom presentation in relation to aggression. Conclusion: The present study identifies unique symptom manifestations associated with IPV for couples navigating pregnancy and suggests psychological aggression can be more detrimental to mental health than physical aggression. To promote maternal perinatal mental health, clinicians should screen for covert forms of psychological aggression during pregnancy (e.g., raised voices, insults), trauma-related distress, and symptom elevations in women and their partners.

Emotion Dysregulation and Eating Disorder Symptoms: Examining Distinct Associations and Interactions in Adolescents

Emotion dysregulation has been posited as a key transdiagnostic factor of mental health difficulties, including eating disorders. However, how this transdiagnostic factor interacts with the disorder-specific factor of weight and shape concerns remains unclear. The current study examined whether emotion dysregulation is associated with eating disorder behaviors over and above the association between weight and shape concerns and whether these two factors interacted. The current study used data from two samples, a community sample of high school students (n = 2699), and a clinical sample of adolescents receiving outpatient treatment for an eating disorder (n = 149). Participants completed self-report measures on their eating behaviors, weight/shape concerns, and emotion dysregulation. Findings showed that emotion dysregulation had a unique association with engaging in binge eating and purging (community sample only). Weight and shape concerns were found to have a unique association with engaging in binge eating, fasting, purging, and driven exercise (community sample only). Additionally, weight and shape concerns moderated the association between emotion dysregulation and the probability of engaging in binge eating and driven exercise, whereby the strongest association between emotion dysregulation and these behaviors were observed among adolescents with the lowest levels of weight and shape concerns. Regarding the frequency of eating disorder behaviors, emotion dysregulation had a unique association with severity of binge eating and fasting. Weight and shape concerns were uniquely associated with severity of fasting and driven exercise (community sample only). Findings suggest that emotion dysregulation is a distinct factor of eating disorder behaviors among adolescents.

Relationships Between Emotion Regulation, Social Communication and Repetitive Behaviors in Autism Spectrum Disorder

The relationship between emotion regulation, social interaction and different types of restricted and repetitive behaviors is poorly understood. In the present study, structural equation modeling based on information about 239 individuals with autism was used to examine whether emotion regulation and social communication were associated with self-injury and stereotyped behaviors. Results showed that poor emotion regulation had a unique association with self-injury while difficulties with social communication was uniquely associated with stereotyped behaviors. Emotion regulation and social communication were strongly associated and self-injury and stereotyped behaviors moderately associated. This implies that these types of behaviors are often expressions of broader negative emotional states in autism. Treatments that help improve coping and social communication strategies may benefit individuals with autism.

Objective and perceived measures of tobacco marketing are uniquely associated with cigar use

BackgroundFew studies have examined associations between perceived and objective exposure to tobacco marketing and cigar use, which is the second most commonly used tobacco product by youth.MethodsWe used Geographic Ecological...

Examining the Structural and External Validity of the Adult Concentration Inventory for Assessing Sluggish Cognitive Tempo in Adults.

The Adult Concentration Inventory (ACI) is an adult self-report measure of sluggish cognitive tempo (SCT) developed following a meta-analysis identifying items distinguishing SCT from attention-deficit/hyperactivity disorder (ADHD) inattention. To date, only one study conducted in college students has examined the structural and external validity of the ACI. The current study evaluated the convergent and discriminative validity of the ACI in a community sample of adults, in addition to testing unique associations with internalizing symptoms, daily life executive functions, and sleep. Adults (N = 286; Mage = 44.45; 83.6% female) completed ratings of SCT, ADHD symptom dimensions, and external correlates. An a priori two-factor model with cross-loadings found 10 of the 16 SCT items to have high loadings on the SCT factor and low loadings on the ADHD inattention factor. SCT was uniquely associated with higher internalizing symptoms, time management and self-organization difficulties, poorer sleep quality, shorter sleep duration, lower sleep efficiency, and more daytime sleepiness. These findings replicate and extend support for the ACI in assessing SCT in adults.

Reflective functioning and empathy among mothers of school-aged children: Charting the space between.

Parental child-focused reflective functioning (RF)-understanding children's behavior as a function of mental states-and parental empathy-understanding, resonating with, and feeling concern for children's emotions-have each been linked to sensitive caregiving and children's attachment security in separate studies, but they have been neither directly compared nor have researchers tested whether they interact in predicting child outcomes. In this article, we offer theoretical perspectives regarding differences between the constructs, potential points of connection, and ways in which these constructs may function together. Then we test these ideas empirically with 2 samples of mothers of school-age children, exploring their unique and interactive associations with parenting sensitivity, children's attachment security, and children's emotion regulation. In Study 1, mothers (N = 105) watched their children completing a stressor task (i.e., an impossible puzzle); mothers then answered interview questions, from which separate teams coded state-like RF and empathy. In Study 2, mothers (N = 72) completed the Parent Development Interview, coded separately for trait-like parental RF and empathy. Results of the 2 studies converged, revealing moderate positive associations between parental RF and empathy. Further, both RF and empathy were positively associated with specific child outcomes (e.g., attachment security); also, there were unique patterns of association (e.g., parental empathy was uniquely associated with child physiological regulation [neuroendocrine reactivity]) and evidence that critical levels of both are important (e.g., for supportive parenting, accuracy of emotion judgment). Parental RF and empathy might be related to each other and to distinguishable capacities that contribute to attachment and related outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Use of different strategies to make one's bisexual+ identity visible: Associations with dimensions of identity, minority stress, and health.

Bisexual+ people (i.e., those who are attracted to more than one gender or regardless of gender) use a variety of strategies to make their identity visible to others, but little is known about the extent to which using different strategies is related to other dimensions of identity, minority stress, and health. To address this, we surveyed 715 bi+ people about their use of five different types of visibility strategies (direct communication, indirect communication, community engagement, gender-based visual displays, and public behavioral displays). Results indicated that people who used visibility strategies more often (aggregated across types) reported higher identity centrality and affirmation, and lower internalized bi-illegitimacy and internalized binegativity. However, they also reported more discrimination from heterosexual and gay/lesbian individuals and higher depression and anxiety. When we examined the unique associations between each of the five types of visibility strategies and our other variables, we found different patterns of associations for different strategies. For example, direct communication was uniquely associated with more discrimination from gay/lesbian individuals, while indirect communication, gender-based visual displays, and public behavioral displays were uniquely associated with more discrimination from heterosexual individuals. Only indirect communication was uniquely associated with higher depression and anxiety, while community engagement was uniquely associated with lower anxiety. Finally, public behavioral displays were uniquely associated with more alcohol use problems and a higher likelihood of cigarette use. These findings highlight the importance of examining the specific strategies that people use to make their bi+ identity visible in order to understand their experiences and health.

Linking Big Five Personality Domains and Facets to Alcohol (Mis)Use: A Systematic Review and Meta-Analysis.

The goal of this investigation was to synthesize (un)published studies linking Big Five personality domains and facets to a range of alcohol use outcomes. Meta-analyses were conducted to quantify the unique associations between alcohol use outcomes and each Big Five personality domains over and above other domains. Within each domain, meta-analyses also were conducted to examine the unique contribution of each personality facet in predicting alcohol use outcomes. Systematic literature reviews were performed in PsycINFO and PubMed using keywords related to alcohol use and personality. Peer-reviewed and unpublished studies were screened and coded for the meta-analyses. A total of 80 independent samples were subjected to correlated effects meta-regressions. Over and above other Big Five personality domains, both conscientiousness and agreeableness were negatively correlated with alcohol consumption, risky/hazardous drinking and negative drinking-related consequences. Facet-level analyses indicated that deliberation and dutifulness were uniquely associated with alcohol (mis)use over and above other conscientiousness facets, and compliance and straightforwardness were uniquely associated with alcohol (mis)use over and above other agreeableness facets. Extraversion-namely excitement seeking-was correlated with alcohol consumption, whereas neuroticism-namely impulsiveness and angry hostility-was correlated with negative drinking-related consequences. Personality characteristics are robust correlates of alcohol (mis)use. Examining relevant narrowband traits can inform mechanisms by which personality affects drinking behaviors and related problems, and ways to enhance clinical interventions for alcohol use disorder. Gaps in this literature and future research directions are discussed.

The distinct role of body image aspects in predicting eating disorder onset in adolescents after one year.

Recent research suggests specific body image aspects, namely weight/shape dissatisfaction, overvaluation of weight/shape, weight/shape preoccupation, and fear of weight gain, have distinct roles in eating disorder (ED) onset and maintenance. The aim of this study was to investigate unique associations between these body image aspects and ED onset, distress, and quality of life in a community sample of adolescents prospectively after 1 year. Adolescents (n = 1,327; 51% female; age range 11-19 years) who completed Waves 1 and 2 of the EveryBODY Study and did not meet criteria for an ED at Wave 1 completed measures of ED symptoms, distress, and quality of life impairment. Results showed that 18.2% of participants (70% female) met criteria for an ED at Wave 2. Only weight/shape dissatisfaction was prospectively associated with onset of any ED. No other body image aspect was uniquely associated with greater distress nor lower quality of life in longitudinal analyses. However, all body image aspects were independent correlates of ED diagnosis within Wave 2. These findings suggest that dissatisfaction might operate as a risk factor for ED development in adolescence, whereas overvaluation, preoccupation, and fear of weight gain could be more proximal markers of ED psychopathology. Therefore, these body image phenomena should be assessed as separate constructs as they may play unique roles in ED onset and classification. ED prevention efforts in adolescence may need to target dissatisfaction first, whereas a focus on other aspects of body image may be more important for early intervention programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The impact of clinical symptoms and endoscopic and histologic disease activity on health-related quality of life in patients with ulcerative colitis following treatment with multimatrix mesalazine

PurposeStudies of patients with ulcerative colitis (UC) report that reduced clinical symptoms and endoscopic activity predict better health-related quality of life (HRQoL). However, no study has examined the joint and unique associations of clinical and endoscopic activity with HRQoL, nor of histologic inflammation and HRQoL. These post hoc analyses evaluated whether reduced clinical, endoscopic, and histologic disease activity were uniquely associated with improved HRQoL for adults with active mild-to-moderate UC receiving once-daily 4.8 g/day multimatrix mesalazine for 8 weeks.MethodsAssessments at baseline and week 8 (i.e., treatment completion) included clinical and endoscopic activity (modified UC-Disease Activity Index), histology (Geboes scoring), and HRQoL (Short Inflammatory Bowel Disease Questionnaire [SIBDQ]; SF-12v2® Health Survey [SF-12v2]). Associations among each type of disease activity and HRQoL were examined by correlations and by mean changes in SIBDQ and SF-12v2 scores between disease activity subgroups (e.g., achievement of clinical remission; mucosal healing). Regression models estimated unique variance in HRQoL accounted by each type of disease activity.ResultsWithin the analysis sample (n = 717), patients with reduced clinical and endoscopic activity had significantly larger improvements in all HRQoL domains (p < 0.001), as did patients in both endoscopic and clinical remission compared to patients in endoscopic remission only (p < 0.05). Patients with histologic activity post-treatment scored significantly worse on all HRQoL domains than patients with no activity (p < 0.05). Correlations and regression models found that decreases in clinical and endoscopic activity were associated with improvements in HRQoL domain scores.ConclusionsClinical symptoms and mucosal health have separable, distinct impacts on UC patients’ HRQoL.

Mindfulness and engagement in COVID-19 preventive behavior.

The novel coronavirus disease 2019 (COVID-19) pandemic represents a significant risk to population health. Health organizations worldwide have recommended numerous preventive health behaviors to slow the spread of COVID-19. Yet, considerable variability exists in individual-level adherence to these recommendations. Mindfulness has been associated with greater engagement in health promotive behavior (e.g., physical activity, healthy eating), and may serve as an individual difference factor that encourages adherence. However, no study to date has examined the extent to which mindfulness is associated with preventive health behaviors during a global pandemic. The purpose of the present study was to assess the relations between mindfulness and recommended preventive health behaviors for COVID-19. A national U.S. sample (N=353; M age=41.47years, range: 19-84; 50.2% female) completed an online survey via Amazon's Mechanical Turk from April 3rd to 15th, 2020, including measures of mindfulness and frequency of avoiding touching one's face, handwashing, disinfecting/cleaning frequently used surfaces, social distancing, and self-quarantining. Personality, health risk, and demographic factors were also assessed to test the unique association between mindfulness and preventive health behaviors. Mindfulness was significantly correlated with greater engagement in all of the COVID-19 preventive health behaviors. However, when accounting for demographics, health risk, and personality, mindfulness was only uniquely associated with engagement in social distancing. This research highlights mindfulness as an individual-level characteristic associated with engagement in COVID-19 preventive health behavior and may inform future prevention efforts aimed at improving adherence to recommendations for curbing the spread of infectious disease.

Associations between self-rated physical Health and relationship satisfaction in couples with children.

The degree to which individual self-rated physical health and concordance of self-rated physical health between partners are associated with relationship satisfaction was examined in a community sample of 399 couples with children. Couples completed self-report assessments of physical health (general health and physical functioning) and relationship satisfaction. Results suggest unique associations between partners’ general health and their own relationship satisfaction. Further, higher between-partner concordance in physical functioning was uniquely associated with higher relationship satisfaction in women. Understanding associations between health and relationship processes is crucial and has implications for future research on couple-based interventions to promote physical health.

The Network Structure of Personality Pathology in Adolescence With the 100-Item Personality Inventory for DSM-5 Short-Form (PID-5-SF).

There is currently a lack of understanding of the structure of personality disorder (PD) trait facets. The network approach may be useful in providing additional insights, uncovering the unique association of each PD trait facet with every other facet. A unique feature of network analysis is centrality, which indicates the importance of the role a trait facet plays in the context of other trait facets. Using data from 1,940 community Dutch adolescents, we applied network analysis to the 25 trait facets from the 100-item Personality Inventory for DSM-5 Short-Form (PID-5-SF) to explore their associations. We found that some trait facets only seem to be core indicators of their pre-ordained domains, whereas we observed that other trait facets were strongly associated with trait facets outside of their hypothesized domains. Importantly, anxiousness and callousness were identified as highly central facets, being uniquely associated with many other trait facets. Future longitudinal network studies could therefore further examine the possibility of anxiousness and callousness as risk marker trait facets among other PD trait facets.

Gay-Specific and General Stressors Predict Gay Men's Psychological Functioning Over Time.

Gay men experience various stressors, including gay-specific stressors such as discrimination and internalized homonegativity as well as general stressors such as occupational and financial strain. While a robust literature has examined how gay-specific stressors are associated with negative mental health outcomes among gay men, less attention has been paid to the association between general stress and gay men's psychological functioning or to how different types of stressors may interact to affect functioning. The current study sought to address this gap by examining the unique and combined associations between gay-specific external stress (discrimination), gay-specific internal stress (rejection sensitivity, internalized homonegativity, sexual identity concealment), and general stressors (e.g., academic difficulties) and negative affect and alcohol use over time. A total of 147 self-identified gay men living in the greater New York City area participated in a baseline assessment and a 7-week diary study. Univariate and multivariate results revealed that gay-specific external stress, gay-specific internal stress, and general stress were each positively and uniquely associated with higher mean levels of and greater fluctuations in negative affect over time, and general stress was positively associated with greater fluctuations in alcohol use over time. Multiplicative analyses indicated that individuals reporting high levels of stress in multiple domains experienced particularly high mean levels of negative affect. These findings highlight the unique contribution of general stress to gay men's functioning over time and underscore the importance of considering multiple forms of stress (i.e., gay-specific and general stress) and their interactions to better understand gay men's psychological functioning.

Sluggish cognitive tempo and ADHD symptoms in relation to task-unrelated thought: Examining unique links with mind-wandering and rumination

Recent theoretical and empirical evidence highlights associations between attention-deficit/hyperactivity disorder (ADHD) symptoms and task-unrelated thought, including mind-wandering and rumination. However, it has been hypothesized that sluggish cognitive tempo (SCT), characterized by daydreaming and staring behaviors, may uniquely relate to task-unrelated thought. The purpose of the present study was to test whether SCT symptoms are associated with greater mind-wandering and rumination, and whether this association remains when controlling for ADHD and internalizing symptoms. Participants (N = 4679; 18–29 years; 69% female; 80.9% White) enrolled in six universities in the United States completed measures of SCT, ADHD symptoms, internalizing symptoms, and rumination, as well as two scales used to assess mind-wandering. Although ADHD symptoms were correlated with greater self-reported mind-wandering and rumination, relations with mind-wandering on the daydreaming frequency scale, reflective rumination, and brooding rumination were attenuated when controlling for SCT and internalizing symptoms. Above and beyond other psychopathology dimensions, SCT symptoms were uniquely associated with greater self-reported mind-wandering and both reflective and brooding rumination. Additionally, SCT symptoms were more strongly associated than other psychopathology dimensions with the mind-wandering measure of daydreaming frequency. Results provide the first empirical support for unique and robust associations between SCT symptoms and task-unrelated thought, while suggesting that the link between ADHD and mind-wandering may be less robust than previously suggested.

Gender Differences in Mindfulness, Self-Compassion, and Drinking to Cope in Undergraduates with Problematic Consumption

Undergraduate students show the highest rates of problematic alcohol consumption compared to any other non-clinical category of individuals, and coping-motivated drinking has been consistently shown to be the most problematic. The present study examines associations between mindfulness facets, self-compassion, and coping-motivated drinking, and how these associations differ by gender. Undergraduate problematic drinkers (N = 146) completed self-report measures assessing their motives for drinking (coping-depression, coping-anxiety, enhancement, social, conformity) and levels of dispositional mindfulness (observing, describing, acting with awareness, non-judging, non-reactivity) and self-compassion. Regression analyses revealed that for both genders, mindfulness facets and self-compassion were statistically significantly negatively associated with coping-depression, but not coping-anxiety. Non-judging was uniquely associated with coping-depression in women, but in men, non-reactivity was the sole unique association. Unexpectedly, describing was negatively associated with conformity-motivated drinking in women. Mindfulness and self-compassion based programs for undergraduate problematic drinkers may be most effective if they target students who drink to cope with depression and emphasize different skills depending on the student’s gender.

Sluggish Cognitive Tempo in Adolescents with and without ADHD: Differentiation from Adolescent-Reported ADHD Inattention and Unique Associations with Internalizing Domains.

A growing number of studies support the internal and external validity of youth self-reported sluggish cognitive tempo (SCT) symptoms. However, no study has examined SCT in adolescents without ADHD, examined whether adolescent self-reported SCT is distinct from adolescent self-reported ADHD inattention (ADHD-IN), or evaluated whether links between SCT and internalizing problems differ for adolescents with or without ADHD. The present study is the first to (1) determine the convergent and discriminant validity of self-reported SCT and ADHD-IN symptoms in both adolescents with and without ADHD, (2) test the invariance of SCT and ADHD-IN symptoms across ADHD and comparison groups, (3) examine SCT as uniquely related to a range of internalizing-relevant domains, and (4) evaluate if the association between SCT with internalizing correlates differs for adolescents with or without ADHD. Participants were adolescents (Mage=13years) with (n=162) and without (n=140) ADHD. Adolescents and parents completed measures of internalizing symptoms and emotion dysregulation; adolescents completed measures of rumination and suicidal ideation. Analyses indicated that 13 of the 15 SCT items demonstrated convergent and discriminant validity from ADHD-IN, and SCT and ADHD-IN demonstrated invariance across the ADHD and comparison groups and across sex. SCT, but not ADHD-IN, was uniquely associated with greater adolescent-reported internalizing symptoms and suicidal ideation. Both SCT and ADHD-IN were uniquely associated with adolescent-reported emotion dysregulation and parent-reported internalizing symptoms. Only ADHD-IN was uniquely associated with parent-reported emotion dysregulation. Findings support the differentiation of adolescent-reported SCT and ADHD-IN and demonstrate associations between SCT and increased internalizing problems in adolescents with and without ADHD.

SOCIAL TIES AND SUICIDAL IDEATION AMONG OLDER ADULTS REFERRED FOR A BEHAVIORAL HEALTH EVALUATION

The association between the quality and nature of social relationships and suicidal outcomes across the lifespan is well established. However, social ties are rarely assessed in primary care and other clinical settings where older adults at high risk for suicide-related outcomes are seen. This study examined the unique associations between three indices of social ties (i.e., perceived social support, frequency of negative social exchanges, and degree of social integration) and death/suicidal ideation among 3,261 older veterans (aged 65+) who completed a clinical mental health/substance use (MH/SU) assessment upon referral to a Primary Care-Mental Health Integration (PCMHI) program. Data on sociodemographics, MH/SU conditions (e.g., depression, anxiety, and substance use), perceived health, the three indices of social ties, and death/suicidal ideation were extracted from clinical interviews. Veterans were on average 70.8 years old (+6.5 years) and primarily male. Approximately half were married and 60.3% were non-Hispanic white. Forty percent reported death ideation or suicidal ideation, as measured by the Paykel Suicide Scale. Logistic regression analyses revealed that, adjusting for covariates, while perceived social support was associated with a greater risk of reporting death ideation relative to no ideation, both social support and frequency of negative exchanges were uniquely associated with greater risk of reporting suicidal ideation relative to no ideation. Social integration was unrelated to odds of death or suicidal ideation. Findings underscore the value of integrating assessments of multiple aspects of social ties into routine PCMHI practice, as doing so has the potential to enhance suicide screening and intervention efforts.

Prevalence and correlates of psychiatric comorbidities in children and adolescents with full and subthreshold avoidant/restrictive food intake disorder.

We aimed to characterize the current and lifetime prevalence of comorbid psychiatric diagnoses and suicidality in treatment- and nontreatment-seeking individuals with full and subthreshold avoidant/restrictive food intake disorder (ARFID). We also sought to examine unique associations between the three DSM-5 ARFID profiles (i.e., sensory sensitivity, fear of aversive consequences, and lack of interest in food or eating) and specific categories of psychiatric diagnoses and suicidality. We conducted structured clinical interviews with 74 children and adolescents with full or sub threshold ARFID to assess the presence of comorbid psychiatric diagnoses, suicidality, and the severity of each of the three ARFID profiles. Nearly half of the sample (45%) met criteria for a current comorbid psychiatric diagnosis, and over half (53%) met criteria for a lifetime comorbid diagnosis. A total of 8% endorsed current suicidality and 14% endorsed lifetime suicidality. Severity in the sensory sensitivity profile was uniquely associated with greater odds of comorbid disorders in the neurodevelopmental, disruptive, and conduct disorders category; the anxiety, obsessive-compulsive, and trauma-related disorders category; and the depressive and bipolar-related disorders category. Severity in the fear of aversive consequences profile was associated with greater odds of disorders in the anxiety, obsessive-compulsive, and trauma-related disorders category. Our findings underscore the severity of psychopathology among individuals with ARFID and related presentations, and also highlight the potential that shared psychopathology between specific ARFID profiles and other psychiatric disorders represent transdiagnostic constructs (e.g., avoidant behavior) that may be relevant treatment targets.

Pubertal Status and Age are Differentially Associated with Inflammatory Biomarkers in Female and Male Adolescents.

A better understanding of the maturational correlates of inflammatory activity during adolescence is needed to more appropriately study both normal and abnormal development. Inflammation is the immune system's first response to infection, injury, or psychological stress, and it has been shown to be elevated in individuals with both physical and psychological conditions. This study examined unique associations between (1) pubertal status and inflammatory biomarkers, and (2) age and inflammatory biomarkers, and whether these relationships differed by sex in a diverse sample of 155 adolescents (54.2% female, 45.8% male; Mage = 16.22) from a northeastern city in the US. A more advanced pubertal status was uniquely associated with lower levels of tumor necrosis factor alpha (TNF-α) and interleukin-8 (IL-8). Chronological age was uniquely associated with lower IL-8 levels. The association between pubertal status and C-reactive protein (CRP) levels differed by sex: more mature females had higher CRP, whereas pubertal status and CRP were not significantly associated in males. These findings highlight an important relation between pubertal development and inflammatory activity during adolescence.