Skip to main content

Pubertal neuromaturation, stress sensitivity, and psychopathology


Normal adolescent development is often accompanied by transient emotional and behavioral problems. For most individuals with postpubertal-onset adjustment problems, there is a resolution by early adulthood and relative stability through the adult life span. But for a minority, adjustment problems escalate during adolescence and portend the development of serious mental illness in adulthood. In this article, we explore adolescent behavioral changes and neurodevelopmental processes that might contribute to stress sensitivity and vulnerability for the emergence of the mental disorders. Of particular interest is the role that hormonal changes might play in the expression of genetic vulnerabilities for psychopathology. Drawing on recent findings from clinical research and behavioral neuroscience, we describe the ways in which postpubertal hormones might alter brain function and, thereby, behavior. It is concluded that there are both activational and organization effects of hormones on the adolescent brain, and these contribute to developmental discontinuities in behavioral adjustment. Implications for adult psychopathology and preventive intervention are discussed.

Corresponding author
Address correspondence and reprint requests to: Elaine F. Walker, Department of Psychology, Emory University, Atlanta, GA 30322; E-mail:
Hide All


Allen, M. T., & Matthews, K. A. (1997). Hemodynamic responses to laboratory stressors in children and adolescents: The influences of age, race, and gender. Psychophysiology 34, 329339.
Angold, A., Costello, E. J., & Worthman, C. M. (1998). Puberty and depression: The roles of age, pubertal status and pubertal timing. Psychological Medicine 28, 5161.
Angold, A., & Rutter, M. (1992). Effects of age and pubertal status on depression in a large clinical sample. Development and Psychopathology 4, 528.
Arnett, J. J. (1999). Adolescent storm and stress, reconsidered. American Psychologist 54, 317326.
Arnold, A. P., & Breedlove, S. M. (1985). Organizational and activational effects of sex steroids on brain and behavior: A reanalysis. Hormones & Behavior 19, 469498.
Benes, F. M. (2003a). Schizophrenia, II: Amygdalar fiber alteration as etiology? American Journal of Psychiatry, 160, 1053.
Benes, F. M. (2003b). Why does psychosis develop during adolescence and early adulthood? Current Opinion in Psychiatry 16, 317319.
Blumberg, H. P., Martin, A., Kaufman, J., Leung, H., Skudlarski, P., Lacadie, C., Fulbright, R. K., Gore, J. C., Charney, D. S., Krystal, J. H., & Peterson, B. S. (2003). Frontostriatal abnormalities in adolescents with bipolar disorder: Preliminary observations from functional MRI. American Journal of Psychiatry 160, 13451347.
Birmaher, B., & Heydl, P. (2001). Biological studies in depressed children and adolescents. International Journal of Neuropsychopharmacology 4, 149157.
Booth, A., Johnson, D. R., Granger, D. A., Crouter, A. C., & McHale, S. (2003). Testosterone and child and adolescent adjustment: The moderating role of parent–child relationships. Developmental Psychology 39, 8598.
Brooks–Gunn, J. (1988). Antecedents and consequences of variations in girls' maturational timing. Journal of Adolescent Health Care 9, 365373.
Buchanan, C. M., Eccles, J. S., & Becker, J. B. (1992). Are adolescents the victims of raging hormones? Evidence for activational effects of hormones on moods and behavior at adolescence. Psychological Bulletin 111, 62107.
Buske–Kirschbaum, A., Jobst, S., Wustmans, A., Kirschbaum, C., Rauh, W., & Hellhammer, D. (1997). Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis. Psychosomatic Medicine 59, 419426.
Caspi, A., & Moffitt, T. E. (1991). Individual differences are accentuated during periods of social change: The sample case of girls at puberty. Journal of Personality and Social Psychology 61, 157168.
Chambers, R. A., Taylor, J. R., & Potenza, M. N. (2003). Developmental neurocircuitry of motivation in adolescence: A critical period of addiction vulnerability. American Journal of Psychiatry 160, 10411052.
Charmandari, E., Kino, T., Souvatzoglou, E., & Chrousos, G. P. (2003). Pediatric stress: Hormonal mediators and human development. Hormone Research, 59, 161179.
Chen, E., Matthews, K. A., & Boyce, W. T. (2002). Socioeconomic differences in children's health: How and why do these relationships change with age? Psychological Bulletin 128, 295329.
Cicchetti, D., & Rogosch, F. A. (2002). A developmental psychopathology perspective on adolescence. Journal of Consulting & Clinical Psychology 70, 620.
Cyranowski, J. M., Frank, E., Young, E., & Shear, K. (2000). Adolescent onset of the gender difference in lifetime rates of major depression. Archives of General Psychiatry 57, 2127.
Davies, P. S., Collins, D. L., Gregory, J. R., & Clarke, P. C. (1996). Parents' and childrens' reactions to taking blood in a nutrition study. Archives of Disease in Childhood 75, 309313.
Dorn, L. D., & Chrousos, G. P. (1997). Neurobiology of stress: Understanding regulation of affect during female biological transitions. Seminars in Reproductive Endocrinology 15, 2945.
Dorn, L. D., Hitt, S. F., & Rotenstein, D. (1999). Biopsychological and cognitive differences in children with premature vs. on-time adrenarche. Archives of Pediatric & Adolescent Medicine 153, 137146.
Durston, S., Hulshoff Pol, H. E., Casey, B. J., Giedd, J. N., Buitelaar, J. K., & van Engeland, H. (2001). Anatomical MRI of the developing human brain: What have we learned? Journal of the American Academy of Child & Adolescent Psychiatry 40, 10121020.
Fadalti, M., Petraglia, F., Luisi, S., Bernardi, F., Casarosa, E., Ferrari, E., Luisi, M., Saggese, G., Genazzani, A. R., & Bernasconi, S. (1999). Changes of serum allopregnanolone levels in the first 2 years of life and during pubertal development. Pediatric Research 46, 323327.
Faloia, E., Camilloni, M. A., Giacchetti, G., & Mantero, F. (2000). Adipose tissue as an endocrine organ? A review of some recent data. Eating & Weight Disorders 5, 116123.
Flinn, M. V., & England, B. G. (1997). Social economics of childhood glucocorticoid stress response and health. American Journal of Physical Anthropology 102, 3353.
Galdos, P., & van Os, J. (1995). Gender, psychopathology, and development: From puberty to early adulthood. Schizophrenia Research 14, 105112.
Gest, S. D., Reed, M. J., & Masten, A. S. (1999). Measuring developmental changes in exposure to adversity: A life chart and rating scale approach. Development and Psychopathology 11, 171192.
Goldsmith, H. H., & Lemery, K. S. (2000). Linking temperamental fearfulness and anxiety symptoms: A behavior–genetic perspective. Biological Psychiatry 48, 11991209.
Goodyer, I., Herbert, J., Moor, S., & Altham, P. (1991). Cortisol hypersecretion in depressed school-aged children and adolescents. Psychiatry Research 37, 237244.
Goodyer, I. M., Herbert, J., Tamplin, A., & Altham, P. M. (2000). Recent life events, cortisol, dehydroepiandrosterone and the onset of major depression in high-risk adolescents. British Journal of Psychiatry 177, 499504.
Goodyer, I. M., Park, R. J., & Herbert, J. (2001). Psychosocial and endocrine features of chronic first-episode major depression in 8–16 year olds. Biological Psychiatry 50, 351357.
Goodyer, I. M., Park, R. J., Netherton, C. M., & Herbert, J. (2001). Possible role of cortisol and dehydroepiandrosterone in human development and psychopathology. British Journal of Psychiatry 179, 243249.
Graber, J. A., & Brooks–Gunn, J. (1996). Transitions and turning points: Navigating the passage from childhood through adolescence. Developmental Psychology 32, 768776.
Graber, J. A., Brooks–Gunn, J., & Warren, M. P. (1995). The antecedents of menarcheal age: Heredity, family environment, and stressful life events. Child Development 66, 346359.
Granger, D. A., Weisz, J. R., McCracken, J. T., Ikeda, S. C., & Douglas, P. (1996). Reciprocal influences among adrenocortical activation, psychosocial processes, and the behavioral adjustment of clinic-referred children. Child Development 67, 32503262.
Grilo, C. M., Becker, D. F., Edell, W. S., & McGlashan, T. H. (2001). Stability and change of DSM-III-R personality disorder dimensions in adolescents followed up 2 years after psychiatric hospitalization. Comprehensive Psychiatry 42, 364368.
Guercio, G., Rivarola, M. A., Chaler, E., Maceiras, M., & Belgorosky, A. (2003). Relationship between the growth hormone/insulin-like growth factor-I axis, insulin sensitivity, and adrenal androgens in normal prepubertal and pubertal girls. Journal of Clinical Endocrinology & Metabolism 88, 13891393.
Hayward, C., Killen, J. D., Wilson, D. M., Hammer, L. D., Litt, I. F., Kraemer, H. C., Haydel, F., Varady, A., & Taylor, C. B. (1997). Psychiatric risk associated with early puberty in adolescent girls. Journal of the American Academy of Child & Adolescent Psychiatry 36, 255262.
Hessl, D., Glaser, B., Dyer–Friedman, J., Blasey, C., Hastie, T., Gunnar, M., & Reiss, A. L. (2002). Cortisol and behavior in fragile X syndrome. Psychoneuroendocrinology 27, 855872.
Jacobson, K. C., Prescott, C. A., & Kendler, K. S. (2002). Sex differences in the genetic and environmental influences on the development of antisocial behavior. Development and Psychopathology 14, 395416.
Kagan, J., Reznick, J. S., & Snidman, N. (1988). Biological Bases of childhood shyness. Science 240, 167171.
Kawata, M. (1995). Roles of steroid hormones and their receptors in structural organization in the nervous system. Neuroscience Research 24, 146.
Keenan, P. A., & Soleymani, R. M. (2001). Gonadal steroids and cognition. In R. Tarter & M. Butters (Eds.), Medical neuropsychology: The impact of disease on behavior. Critical Issues in Neuropsychology (pp. 181197). New York: Plenum Press.
Keks, N. A., Copolov, D. L., Mackie, B., Stuart, G. W., Singh, B. S., McGorry, P. D., & Coffey, C. (1991). Comparison of participants and nonparticipants in a neuroendocrine investigation of psychosis. Acta Psychiatrica Scandinavica 83, 373376.
Kellogg, C. K., Awatramani, G. B., & Piekut, D. T. (1998). Adolescent development alters stressor-induced Fos immunoreactivity in rat brain. Neuroscience 83, 681689.
Kenny, F. M., Gancayco, G. P., Heald, F. P., & Hung, W. (1966). Cortisol production rate in adolescent males in different stages of sexual maturation. Journal of Clinical Endocrinology 26, 12321236.
Kenny, F. M., Preeyasombat, C., & Migeon, C. J. (1966). Cortisol production rate II: Normal infants, children and adults. Pediatrics 37, 3442.
Kiess, W., Meidert, A., Dressendorfer, R. A., Scheiver, K., Kessler, U., & Konig, A. (1995). Salivary cortisol levels throughout childhood and adolescence: Relation with age, pubertal stage and weight. Pediatric Research 37, 502506.
Kim, K., & Smith, P. K. (1998). Childhood stress, behavioral symptoms and mother–daughter pubertal development. Journal of Adolescence 21, 231240.
Kirschbaum, C., Kudielka, B. M., Gaab, J., Schommer, N. C., & Hellhammer, D. H. (1999). Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamus–pituitary–adrenal axis. Psychosomatic Medicine 61, 154162.
Klump, K. L., McGue, M., & Iacono, W. G. (2003). Differential heritability of eating attitudes and behaviors in prepubertal versus pubertal twins. International Journal of Eating Disorders 33, 287292.
Knutsson, U., Dahlgren, J., Marcus, C., Rosberg, S., Bronnegard, M., Stierna, P., & Albertsson–Wiklund, K. (1997). Circadian cortisol rhythms in healthy boys and girls: Relationship with age, growth, body composition and pubertal development. Journal of Clinical Endocrinology & Metabolism 82, 536540.
L'Allemand, D., Penhoat, A., Lebrethon, M. C., Ardevol, R., Baehr, V., Oelkers, W., & Saez, J. M. (1996). Insulin-like growth factors enhance steroidogenic enzyme and corticotropin receptor messenger ribonucleic acid levels and corticotropin steroidogenic responsiveness in cultured human adrenocortical cells. Journal of Clinical Endocrinology & Metabolism 81, 38923897.
Lupien, S. J., Wilkinson, C. W., Briere, S., Menard, C., Ng, Y., Kin, N. M., & Nair, N. P. (2002). The modulatory effects of corticosteroids on cognition: Studies in young human populations. Psychoneuroendocrinology 27, 401416.
Lyons, M. J., Ture, W. R., Eisen, S. A., Goldberg, J., Meyer, J., Faraone, S. V., Eaves, L. J., & Tsuang, M. T. (1995). Differential heritability of adult and juvenile antisocial traits. Archives of General Psychiatry 52, 906915.
Malina, R. M. (1983). Menarche in athletes: A synthesis and hypothesis. Annals of Human Biology 10, 124.
Mann, D. R., Johnson, A. O., Gimpel, T., & Castracane, V. D. (2003). Changes in circulating leptin, leptin receptor, and gonadal hormones from infancy until advanced age in humans. Journal of Clinical Endocrinology & Metabolism 88, 33393345.
Matthews, K. A., Gump, B. B., Block, D. R., & Allen, M. T. (1997). Does background stress heighten or dampen children's cardiovascular responses to acute stress? Psychosomatic Medicine 59, 488496.
McBurnett, K., Lahey, B. B., Rathouz, P. J., & Rolf, L. (2000). Low salivary cortisol and persistent aggression in boys referred for disruptive behavior. Archives of General Psychiatry 57, 3843.
McCrae, R. R., Costa, P. T., Jr., Ostendorf, F., Angleitner, A., Hrebickova, M., Avia, M. D., Sanz, J., Sanchez–Bernardos, M. L., Kusdil, M. E., Woodfield, R., Saunders, P. R., & Smith, P. B. (2000). Nature over nurture: Temperament, personality, and life span development. Journal of Personality & Social Psychology 78, 173186.
McGue, M., Bacon, S., & Lykken, D. T. (1993). Personality stability and change in early adulthood: A behavioral genetic analysis. Developmental Psychology 29, 96109.
Mesce, K. A. (2002). Metamodulation of the biogenic amines: Second-order modulation by steroid hormones and amine cocktails. Brain, Behavior & Evolution 60, 339349.
Miller, E. M., & Shields, S. A. (1980). Skin conductance response as a measure of adolescents' emotional reactivity. Psychological Reports 46, 587590.
Muller, M., Holsboer, F., & Keck, M. E. (2002). Genetic modification of corticosteroid receptor signalling: Novel insights into pathophysiology and treatment strategies of human affective disorders. Neuropeptides 36, 117131.
Neugarten, B. L. (1979). Time, age, and the life cycle. American Journal of Psychiatry 136, 887894.
Neumann, C. S., Grimes, K., Walker, E. F., & Baum, K. (1995). Developmental pathways to schizophrenia: Behavioral subtypes. Journal of Abnormal Psychology 104, 558566.
Nottelmann, E. D., Susman, E. J., Dorn, L. D., Inoff–Germain, G., Loriaux, D. L., Cutler, G. B., Jr., & Chrousos, G. P. (1987). Developmental processes in early adolescence: Relations among chronological age, pubertal stage, height, weight, and serum levels of gonadotropins, sex steroids, and adrenal androgens. Journal of Adolescent Health Care 8, 246260.
Patton, G. C., Hibbert, M. E., Carlin, J., Shao, Q., Rosier, M., Caust, J., & Bowes, G. (1997). Menarche and the onset of depression and anxiety in Victoria, Australia. Journal of Epidemiology & Community Health 50, 661666.
Paus, T., Zijdenbos, A., Worsley, K., Collins, D. L., Blumenthal, J., Giedd, J. N., Rapoport, J. L., & Evans, A. C. (1999). Structural maturation of neural pathways in children and adolescents: In vivo study. Science 283, 19081911.
Petrill, S. A. (2003). The development of intelligence: Behavioral genetic approaches. In R. Sternberg & J. Lautrey (Eds.), Models of intelligence: International perspectives (pp. 8189). Washington, DC: American Psychological Association.
Pine, D. S. (2003). Developmental psychobiology and response to threats: Relevance to trauma in children and adolescents. Biological Psychiatry 53, 796808.
Post, R. M. (2002). Do the epilepsies, pain syndromes, and affective disorders share common kindling-like mechanisms? Epilepsy Research 50, 203219.
Rice, F., Harold, G. T., & Thapar, A. (2003). Negative life events as an account of age-related differences in the genetic aetiology of depression in childhood and adolescence. Journal of Child Psychology & Psychiatry & Allied Disciplines 44, 977987.
Rieder, J., & Coupey, S. M. (1999). Update on pubertal development. Current Opinion in Obstetrics & Gynecology 11, 457462.
Roberts, B. W., Caspi, A., & Moffitt, T. E. (2001). The kids are alright: Growth and stability in personality development from adolescence to adulthood. Journal of Personality & Social Psychology 81, 670683.
Saito, R., Toyama, H., Uemura, K., Ishii, K., Senda, M., & Uchiyama, A. (2001). Quantitative estimation of brain atrophy and function with PET and MRI two-dimensional projection images. Kaku Igaku–Japanese Journal of Nuclear Medicine 38, 201209.
Schmidt, M., Enthoven, L., van der Mark, M., Levine, S., de Kloet, E. R., & Oitzl, M. S. (2003). The postnatal development of the hypothalamic–pituitary–adrenal axis in the mouse. International Journal of Developmental Neuroscience 21, 125132.
Schmidt, P. J., Nieman, L. K., Danaceau, M. A, Adams, L. F., & Rubinow, D. R. (1998). Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. New England Journal of Medicine 338, 209216.
Schneider, W. (2002). Memory development in childhood. In U. Goswami (Ed)., Blackwell handbook of childhood cognitive development (pp. 236256). Malden, MA: Blackwell.
Silberg, J. L., Pickles, A., Rutter, M., Hewitt, J., Simonoff, E., Maes, H., Carbonneau, R., Murrelle, L., Foley, D., & Eaves, L. (1999). The influence of genetic factors and life stress on depression among adolescent girls. Archives of General Psychiatry 56, 225232.
Snieder, H., van Doornen, L. J., & Boomsma, D. I. (1997). The age dependency of gene expression for plasma lipids, lipoproteins, and apolipoproteins. American Journal of Human Genetics 60, 638650.
Steiner, H., & Levine, S. (1988). Family environment of adolescents and coping in the hospital. Psychoneuroendocrinology 13, 333338.
Stevens, J. R. (2002). Schizophrenia: Reproductive hormones and the brain. American Journal of Psychiatry 159, 713719.
Stoffel–Wagner, B. (2001). Neurosteroid metabolism in the human brain. European Journal of Endocrinology 145, 669679.
Susman, E. J., Dorn, L. D., & Chrousos, G. P. (1991). Negative affect and hormone levels in young adolescents: Concurrent and predictive perspectives. Journal of Youth and Adolescence 20, 167190.
Susman, E. J., Dorn, L. D., Inoff–Germain, G., Nottelmann, E. D., & Chrousos, G. P. (1997). Cortisol reactivity, distress behavior, and behavioral and psychological problems in young adolescents: A longitudinal perspective. Journal of Research on Adolescence 7, 81105.
Susman, E. J., Nottelmann, E. D., Dorn, L. D., Inoff–Germain, G., & Chrousos, G. P. (1989). Physiological and behavioral aspects of stress in adolescence. In G. Chrousos & P. Gold (Eds.), Mechanisms of physical and emotional stress (pp. 341352). New York: Plenum Press.
Susman, E. J., Nottelmann, E. D., Inoff–Germain, G. E., Dorn, L. D., & Chrousos, G. P. (1987). Hormonal influences on aspects of psychological development during adolescence. Journal of Adolescent Health Care 8, 492504.
Tamm, L., Menon, V., & Reiss, A. L. (2002). Maturation of brain function associated with response inhibition. Journal of the American Academy of Child & Adolescent Psychiatry 41, 12311238.
Tornhage, C. J. (2002). Reference values for morning salivary cortisol concentrations in healthy school-aged children. Journal of Pediatric Endocrinology & Metabolism 15, 197204.
Udry, J. R., Billy, J. G., Morris, N. M., Groff, T. R., & Raj, M. H. (1985). Serum androgenic hormone motivate sexual behavior in adolescent boys. Fertility & Sterility 43, 9094.
Udry, J. R., & Talbert, L. M. (1988). Sex hormone effects on personality at puberty. Journal of Personality & Social Psychology 54, 291295.
van Oel, C. J., Sitskoorn, M. M., Cremer, M. P., & Kahn, R. (2002). School performance as a premorbid marker for schizophrenia: A twin study. Schizophrenia Bulletin 28, 401414.
Veldhuis, J. D. (1996). Neuroendocrine mechanisms mediating awakening of the human gonadotropic axis in puberty. Pediatric Nephrology 10, 304317.
Viken, R. J., Rose, R. J., Kaprio, J., & Koskenvuo, M. (1994). A developmental genetic analysis of adult personality: Extraversion and neuroticism from 18 to 59 years of age. Journal of Personality & Social Psychology 66, 722730.
Wajs–Kuto, E., De Beeck, L. O., Rooman, R. P., & Caju, M. V. (1999). Hormonal changes during the first year of oestrogen treatment in constitutionally tall girls. European Journal of Endocrinology 141, 579584.
Walker, E., & Bollini, A. M. (2002). Pubertal neurodevelopment and the emergence of psychotic symptoms. Schizophrenia Research 54, 1723.
Walker, E. F., & Diforio, D. (1997). Schizophrenia: A neural diathesis-stress model. Psychological Review 104, 667685.
Walker, E. F., Walder, D. J., & Reynolds, F. (2001). Developmental changes in cortisol secretion in normal and at-risk youth. Development and Psychopathology 13, 721732.
Warren, M., & Brooks–Gunn, J. (1989). Mood and behavior at adolescence: Evidence for hormonal factors. Journal of Clinical Endocrinology & Metabolism 69, 7783.
Weber, A., Clark, A. J., Perry, L. A., Honour, J. W., & Savage, M. O. (1997). Diminished adrenal androgen secretion in familial glucocorticoid deficiency implicates a significant role for ACTH in the induction of adrenarche. Clinical Endocrinology 46, 431437.
Weise, M., Eisenhofer, G., & Merke, D. P. (2002). Pubertal and gender-related changes in the sympathoadrenal system in healthy children. Journal of Clinical Endocrinology & Metabolism 87, 50385043.
Wingo, M. K. (2002). The adolescent stress response to a naturalistic driving stressor. Dissertation Abstracts International: Section B: The Sciences & Engineering, 63, 1082 (Transaction Periodicals Consortium, Rutgers University).
Wolkowitz, O., Epel, E., & Reus, V. (2001). Stress hormone-related psychopathology: Pathophysiological and treatment implications. World Journal of Biological Psychiatry 2, 115143.
Yung, A. R., Phillips, L. J., Yuen, H. P., Francey, S. M., McFarlane, C. A., Hallgren, M., & McGorry, P. D. (2003). Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophrenia Research 60, 2132.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Development and Psychopathology
  • ISSN: 0954-5794
  • EISSN: 1469-2198
  • URL: /core/journals/development-and-psychopathology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed