Puberte Prekoksun Psikososyal Etkileri

Year 2022, Volume: 16 Issue: 2, 168 - 173, 16.03.2022

Mukaddes Turan Miral Nevin Hotun Şahin

https://doi.org/10.12956/tchd.884513

Abstract

Puberte prekoksta çocuk, yaşıtlarından çok daha önce fiziksel, psikolojik, sosyal ve bilişsel değişimi yaşayarak adaptasyon sağlamak zorunda kalır. Puberte prekoks bir yandan iskelet olgunlaşmasını hızlandırarak epifizlerin erken kapanmasına ve sonuçta erişkin boy kısalığına neden olur. Diğer yandan da seks steroidlerinin artışına neden olarak sekonder seks karakterlerinin erken gelişmesine, sonuç olarak da davranışsal ve psikososyal sorunlara yolaçar. Puberte prekokslu kızlar çevresel etkilere karşı daha kırılgan ve savunmasızdır. Puberte prekoksun aynı zamanda kız çocuğunun annesinde de psikososyal sorunlara neden olduğunu gösteren çalışmalar bulunmaktadır. Puberte prekoksta çocuğun; düşük benlik saygısı, içe kapanma, sosyal izolasyon, saldırganlık, stres, anksiyete, depresyon, okul sorunları, erken yaşta cinsel aktivite, cinsel istismar, madde kullanımı risklerinde artış, çocuğun annesinde ise anksiyete, stres, baskı ve suçluluk duygusunda artış olduğunu gösteren çalışmalar bulunmaktadır. Bu dönemde özellikle kız çocukları konusunda hassas davranılması, çocuk ile birlikte ebeveynlerin özellikle de annenin bakıma dahil edilmesi, hem pubertal değişikliklere hem de tedaviye adaptasyonu kolaylaştırır.

Keywords

anneler, kızlar, psikososyal yönleri, puberte prekoks

Psychosocial Effects of Precocious Puberty

Abstract

In precocious puberty, the child has to adapt by experiencing physical, psychological, social and cognitive changes long before her peers. On the one hand, precocious puberty accelerated skeletal maturation, causing premature closure of the epiphysis and consequently short adult stature. On the other hand, it causes an increase in sex steroids, leading to early development of secondary sex characters, and consequently behavioral and psychosocial problems. Girls with puberty precocious are more vulnerable and defenceless to environmental influences. There are studies showing that precocious puberty causes psychosocial problems but also in her mother. In puberty precocious there are studies indicating that the child has risk of early sexual activity, sexual abuse, substance use, low self-esteem, introversion, social isolation, aggression, stress, anxiety, depression, school problems, and her mother has anxiety, stress, pressure, guilt. This situation increases the disease burden. In this period, being sensitive to girls, including to care the parents, especially the mother, facilitates the adaptation to both pubertal changes and treatment.

Keywords

Girls, Mothers, Precocious puberty, Psychosocial aspects

References

• Ball JW, Bindler RM, Cowen KJ. Child Health Nursing Partnering with Children &Families (Second Edition, Chapter 32). Chicago: Pearson Education Limited. 2010;1266-8.
• Neyzi O, Ertuğrul T. Pediyatri (4. Baskı, Cilt 2). Istanbul: Nobel Tıp Kitabevleri. 2010:1608-13.
• Çayır Y, Çayır A. Birinci Basamakta Erken Puberteli Çocuğa Yaklaşım. Tıp Araştırmaları Dergisi 2013; 11:1-4.
• Abacı A, Çatlı G, Aydın M. Diagnosis and Treatment Guidelines in Child Health and Diseases. Türkiye Milli Pediatri Derneği Çocuk Endokinolojisi ve Diyabet Derneği Ortak Kılavuzu. 2014, Aralık.
• Kyle T. Essentials of Pediatric Nursing. (Capter 28) Philadelphia: Lippincott Williams & Wilkins. 2008: 944-945.
• Sørensen K, Mouritsen A, Aksglaede L, Hagen CP, Mogensen, SS, Juul A. Recent Secular Trends in Pubertal Timing: Implications for Evaluation and Diagnosis of Precocious Puberty. Horm Res Pediatr 2012;77: 137-45.
• Eklioğlu BS, Atabek ME, Akyürek N, Sarıkaya E. Endokrinoloji Polikliniğine Puberte Bulguları ile Başvuran Olguların Etiyolojik Dağılımı ve Klinik Özellikleri. Türkiye Çocuk Hast Derg 2016:10:233-6.
• Blumenthal H, Leen-Feldner EW, Babson KA, Gahr JL, Trainor CD, Frala JL. Elevated Social Anxiety Among Early Maturing Girls. Dev Psychol 2011; 47:1133–40.
• Lee S, Kim G. Factors Influencing the Quality of Life in Mothers of Children with Precocious Puberty. Child Health Nursing Resarch 2017; 23: 312-8.
• Schoelwer MJ, Donahue KL, Bryk K, Didrick P, Eugster EA. One-Year Follow-Up of Girls with Precocious Puberty and Their Mothers: Do Psychological Assessments Change Over Time or with Treatment?. Horm Res Paediatr 2017; 88: 347–53.
• Lee J, Kwak MJ, Ju HO. Effect of a Social Support Program for Mothers of Children with Precocious Puberty: A Preliminary Quasi-Experimental Study. J Pediatr Nurs 2019;46, e2-e9.
• Miral M, Şahin N. Precocious Puberty: Bakım ve Yönetim Editör; Nevin Şahin. Güncel Jinekoloji Hemşireliği. Ankara: Akademisyen Kitabevi 2019: 203-223.
• Negriff S, Susman EJ. Pubertal Timing, Depression, and Externalizing Problems: A Framework, Review, and Examination of Gender Differences. J Research on Adolescence 2011; 21: 717-46.
• Kim EY, Lee MI. Psychosocial Aspects in Girls With Idiopathic Precocious Puberty. Psychiatry Investig 2012; 9: 25-8.
• Mendle J, Turkheimer E, Emery RE. Detrimental Psychological Outcomes Associated with Early Pubertal Timing in Adolescent Girls. Dev Rev 2007; 27:151-71.
• Oktan V, Şahin M. Kız Ergenlerde Beden İmaji ile Benlik Saygısı Arasındaki İlişkinin İncelenmesi. Uluslararası İnsan Bilimleri Dergisi 2010;7: 543-556.
• Mercader-Yus E, Neipp-López M, Gómez-Méndez P, Vargas-Torcal F, Gelves-Ospina M, Puerta-Morales L, León-Jacobus A, Cantillo-Pacheco K, Mancera-Sarmientoa M. Anxiety, Self-esteem and Body Image in Girls with Precocious Puberty. Rev Colomb Psiquiatr 2018; 47: 229-36.
• Liao LM, Missenden K, Hallam RS, Conway GS. Experience of Early Pubertal Development: A Preliminary Analysis. Journal of Reproductive and Infant Psychology 2005; 23: 219-33.
• Purper-Ouakil D, Didillon A. Psychopathology Related to Women Pubertal Precocity. L’encephale 2016; 42: 453-7.
• Caspi A, Lynam DR, Moffitt ET, Silva PA. Unraveling Girls’ Delinquency: Biological, Dispositional, And Contextual Contributions to Adolescent Misbehavior. Developmental Psychology 1993; 29:19-30.
• Vicary JR, Klingaman LR, Harkness WL. Risk Factors Associated with Date Rape and Sexual Assault of Adolescent Girls. J Adolesc1995; 18: 289-306.
• Synovitz L, Chopak-Foss J. Precocious Puberty: Pathology, Related Risks, and Support Strategies. Open Journal of Preventive Medicine 2013; 3: 504-9.
• Copeland W, Shanahan L, Miller S, Costello EJ, Angold A, Maughan B. Outcomes of Early Pubertal Timing in Young Women: A Prospective Population-Based Study. Am J Psychiatry 2010;167:1218-25.
• Trepanier L, Juster RP, Marin MF, Plusquellec P, Francois N, Sindi S, et al. Early Menarche Predicts Increased Depressive Symptoms and Cortisol Levels in Quebec Girls Ages 11 To 13. Dev Psychopathol 2013;25:1017-27.
• Mrug S, Elliott MN, Davies S, Tortolero SR, Cuccaro P, Schuster MA. Early Puberty, Negative Peer Influence, and Problem Behaviors in Adolescent Girls. Pediatrics 2014; 133: 7-14.
• Tremblay L, Frigon JY. Precocious Puberty in Adolescent Girls: A Biomarker of Later Psychosocial Adjustment Problems. Child Psychiatry Hum Dev 2005; 36; 73-94.
• Hamilton JL, Hamlat EJ, Stange JP, Abramson LY, Alloy LB. Pubertal Timing and Vulnerabilities to Depression in Early Adolescence: Differential Pathways to Depressive Symptoms by Sex. JAdolesc 2014; 37: 165-74.
• Hayward C, Killen JD, Wilson DM, Hammer LD, Litt IF, Kraemer HC, et al. Psychiatric Risk Associated with Early Puberty in Adolescent Girls. J Am Acad Child Adolesc Psychiatry 1997; 36: 255-62.
• Klein K, Soliman AM, Grubb EB, Nisbet P. A Survey of Care Pathway and Health-Related Quality of Life Impact for Children with Central Precocious Puberty. Curr Med Res Opin 2020; 36: 411-8.
• Soon-Mi C, Hye-Young J. Experiences of Precocious Puberty in Primary School Girls with Hormone Therapeutics. J Korean Acad Soc Nurs Educ 2019;25: 459-70.
• Xhrouet-Heinrichs D, Lagrou K, Heinrichs C, Craen M, Dooms L, Malvaux P, et al. Longitudinal Study of Behavioral and Affective Patterns in Girls with Central Precocious Puberty During Long-Acting Triptorelin Therapy. Acta Paediatr 1997;86: 808-15.
• Yu R, Yang S, Hwang IT. Psychological Effects of Gonadotropin-Releasing Hormone Agonist Treatment in Girls with Central Precocious Puberty. J Pediatr Endocrinol Metab 2019;32:1071-5.
• Mul D, Versluis-den Bieman HJ, Slijper FM, Oostdijk W, Waelkens JJ, Drop SL. Psychological Assessments Before and After Treatment of Early Puberty in Adopted Children. Acta Pediatr 2001; 90: 965- 71.
• Kim EY. Long-Term Effects Of Gonadotropin-Releasing Hormone Analogs In Girls With Central Precocious Puberty. Korean J Pediatr 2015; 58: 1-7.
• Graber JA, Lewinsohn PM, Seeley JR, Brooks-Gunn J. Is Psychopathology Associated with The Timing of Pubertal Development? J Am Acad Child Adolesc Psychiatry 1997; 36: 1768–76.
• Kaltiala-Heino R, Rimpelä M, Rissanen A, Rantanen P. Early Puberty and Early Sexual Activity are Associated with Bulimic-Type Eating Pathology in Middle Adolescence. J Adolesc Health 2001; 28: 346-52.
• Ruuska J, Kaltiala-Heino R, Koivisto AM, Rantanen P. Puberty, Sexual Development and Eating Disorders in Adolescent Outpatients. Eur Child Adolesc Psychiatry 2003; 12: 214-20.
• Stice E, Presnell K, Bearman SK. Relation of Early Menarche to Depression, Eating Disorders, Substance Abuse, And Comorbid Psychopathology Among Adolescent Girls. Dev Psychol 2001;37:608–19.
• Tate DR. Literature Review of Early and Precocious Puberty in Girls. Southern Adventist Univeristy KnowledgeExchange@Southern 2013. Erişim: 22.02.2021. https://knowledge.e.southern.edu/gradnursing/30
• Graber JA, Seeley JR, Brooks-Gunn J, Lewinsohn PM. Is Pubertal Timing Associated with Psychopathology in Young Adulthood. J Am Acad Child Adolesc Psychiatry 2004;43:718–26.
• Wichstrom L. Predictors of Adolescent Suicide Attempts: A Nationally Representative Longitudinal Study of Norwegian Adolescents. J Am Acad Child Adolesc Psychiatry 2000; 39: 603-610.
• Deng F, Tao FB, Wan YH, Hao JH, Su PY, Cao YX. Early Menarche and Psychopathological Symptoms in Young Chinese Women. J Women’s Health 2011; 20: 207-13.
• Galatzer A, Beth-Halachmi N, Kauli R, Laron Z. Intellectual Function of Girls with Precocious Puberty. Pediatrics 1984;74: 246–9.
• Ehrhardt AA, Meyer-Bahlburg HF. Idiopathic Precocious Puberty in Girls: Long-Term Effects on Adolescent Behavior. Acta Endocrinol Suppl (Copenh). 1986;279: 247-253.
• Wojniusz S, Callens N, Sütterlin S, Andersson S, Schepper JD, Gies İ, et al. Cognitive, Emotional, and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty. Front Psychol 2016;7:1053.
• Mastroyannopovlov K, Stakkard P, Lewis M, Lenton S. The Impact of Childhood Non-Malignant Life-threatening Illness on Parents: Gender Differences and Prediction of Parental Adjustment. J Child Psychol Psychiatry 1997; 38: 823-9.
• Hanson MJ, Hanline MF. Parenting a Child with A Disabilities: A Longitudinal Study of Parental Stress and Adaptation. JEI 1994;14: 234-8.
• Sendler DJ, Szewczyk A. Psychosexological Evaluation of Children with Precocious Puberty: An Interview Study Focusing on Parental Perspective and Reasons for Delaying Treatment of Their Children. Pediatr Med 2019;2:15
• Schoelwer MJ, Donahue KL, Bryk K, Didrick P, Berenbaum SA, Eugster EA. Psychological Assessment of Mothers and Their Daughters at The Time of Diagnosis of Precocious Puberty. Int J Pediatr Endocrinol 2015;5:2-5.
• Deeb A, Akle M, Zaabi A, Siwji Z, Attia S, Suwaidi H, et al. Maternal Attitude Towards Delaying Puberty in Girls With and Without a Disability: A Questionnaire-Based Study From The United Arab Emirates. BMJ Paediatrics Open 2018;2:e000306.
• Miral M. Puberte Prekokslu Kızlar ve Annelerinde Roy Adaptasyon Modeline Dayalı Hemşirelik Destek Programının Etkileri (Doktora Tezi).İstanbul:İstanbul Üniversitesi-Cerrahpaşa 2019.