Original article
Depression and Anxiety in Adolescent Females: The Impact of Sleep Preference and Body Mass Index

https://doi.org/10.1016/j.jadohealth.2008.11.012Get rights and content

Abstract

Purpose

To examine the differences in depressive symptoms and anxiety between (a) normal weight and overweight, and (b) morning type and evening type (sleep chronotype) adolescent girls. The interaction of sleep chronotype and weight and depressive symptoms and anxiety were also examined.

Method

The design consisted of a cross-sectional study of 264 adolescent females (mean age = 14.9 ± 2.2, range 11–17 years). Sleep chronotype, depressive symptoms, and anxiety were obtained by self-report questionnaire. The mean of three measurements of height and weight was used to calculate the body mass index (BMI). BMI was plotted on the CDC BMI-for-age growth charts to obtain percentile ranking. Participants were categorized into two groups according to BMI percentile: normal weight (<85th percentile) and overweight (≥85th percentile).

Results

Compared with normal-weight females, overweight females were more likely to be non-Caucasian, lower socioeconomic status, have more advanced pubic hair and breast stages, and earlier age at menarche. No differences were observed with respect to sleep chronotype, depressive symptoms, and trait anxiety between normal weight and overweight females. Evening chronotype was associated with more depressive symptoms (β = −.65, p < .01) and higher trait anxiety (β = −.22, p < .05). Evening chronotype was associated with more depressive symptoms in both normal-weight and overweight females. However, the association was stronger in overweight females.

Conclusions

Individually, sleep and weight impact physical and mental health during adolescence. The combination of evening chronotype and overweight appears to have the strongest association on the emotional health of adolescent females. Further investigations are needed to provide potential biological mechanisms for this relationship.

Section snippets

Sample and procedures

The current cross-sectional study examines baseline data from a 3-year cross-sequential study [28], [29] examining the effects of health behaviors (i.e., cigarette smoking, depression, and anxiety) on growth and development (R01DA16402). Adolescent females ages 11, 13, 15, and 17 were recruited from a mid-Western, urban teen health center and the surrounding community to complete screening questionnaires on health behaviors. The screening questionnaires were administered by phone or in person

Descriptive statistics for demographic and primary variable

The total sample mean age was 14.9 (SD = 2.2) years, and mean SES was 37.4 (SD = 13.6). More participants were Caucasian (62.1%) or African American (32.6%) than other ethnicities or those reporting mixed race (5.3%). Descriptive statistics for the demographic and primary variables are listed in Table 1.

Demographic and primary variable group differences between normal-weight and overweight females

The results indicated significant differences between normal-weight females and overweight females for minority status, SES, pubic hair stage, breast stage, age at menarche, and BMI (Table 2).

Discussion

To our knowledge, this is the first study to examine depressive symptoms and anxiety by sleep chronotype and BMI group in adolescent females. As expected, differences between normal-weight and overweight females were observed. Overweight females were more likely to be non-Caucasion and have a number of risk factors for various health and developmental problems, such as more mature pubertal stage, and lower SES.

The association between body mass index and psychological well-being across the life

Acknowledgments

Financial support was from a grant received by Dr. Lorah D. Dorn (R01DA16402) from the National Institute on Drug Abuse. The study was also supported by USPHS GCRC Grant #M01 RR 08084 from the National Center for Research Resources, NIH. No other support was received by any of the authors.

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      Given the profusion of research supporting a relationship between chronotype and depression, and as depression is highly related to anxiety, a new line of research has begun investigating the relationship between chronotype and anxiety. Some work has found that holding an evening preference is related to elevations in symptoms of anxiety (Díaz-Morales, 2016; Hsu et al., 2012; Lemoine et al., 2013; Pabst et al., 2009; Park et al., 2015; Prat and Adan, 2013) whereas other work has not found a relationship between anxiety and an evening preference (Alvaro et al., 2017,2014; Antypa et al., 2015). In samples of late adolescents and adults (i.e., college students, adult psychiatric patients, and youth/adult community members), an evening preference has been concurrently related to elevated levels of anxiety, via symptoms (Hsu et al., 2012; Prat and Adan, 2013), diagnoses (Lemoine et al., 2013) and a related construct, anxious temperament (Hsu et al., 2012).

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