Quality of Life Research

, Volume 20, Issue 2, pp 237–242 | Cite as

Biological maturation as a confounding factor in the relation between chronological age and health-related quality of life in adolescent females

  • Sean P. Cumming
  • Fiona B. Gillison
  • Lauren B. Sherar
Brief Communication



To examine the potential confounding effect of biological maturation on the relations between chronological age and health-related quality of life in adolescent British females.


Biological maturation, chronological age, and health-related quality of life were assessed in 366 British female students in years 7–10 (M = 13.0 years, SD = 0.8). The Kid-Screen 10 was used to assess health-related quality of life. Percentage of predicted adult height attained at measurement was used as an estimate of biological maturation.


Pearson product moment correlation demonstrated a statistically significant inverse relation between chronological age and health-related quality of life. This relation was, however, attenuated and non-significant once biological maturation was controlled for.


Researchers studying health-related quality of life in youth should consider and/or control for the potential confounding effect of biological maturation.


Growth Maturation Age Girls Health-related quality of life 



This research was supported by Grant #SG-46063 from The British Academy, entitled ‘Relations Between Biological Maturation, Exercise Behavior, and Psychological Health in British Adolescents’. Sean P. Cumming and Fiona B. Gillison are part of the Sport and Exercise Science Research Group, School for Health, University of Bath, UK; Lauren Sherar is part of the College of Kinesiology, University of Saskatchewan, Canada. Correspondence concerning this article should be sent to Sean P. Cumming, School for Health, University of Bath, Bath, United Kingdom, BA2 7AY.


  1. 1.
    WHOQOL Group. (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine, 41, 1403–1409.CrossRefGoogle Scholar
  2. 2.
    Williams, J., Wake, M., Hesketh, K., Maher, E., & Waters, E. (2005). Health-related quality of life of overweight and obese children. Journal of the American Medical Association, 293(1), 70–76.CrossRefPubMedGoogle Scholar
  3. 3.
    Sawyer, M. G., Reynolds, K. E., Couper, J. J., French, D. J., Kennedy, D., & Martin, J. (2004). Health-related quality of life in children and adolescents with chronic illness—a two year prospective study. Quality of Life Research, 13(7), 1309–1319.CrossRefPubMedGoogle Scholar
  4. 4.
    Gillison, F., & Skevington, S. (2006). Assessing children’s quality of life in health and social services: Meeting challenges and adding value. Journal of Children’s Services, 1(2), 42–51.Google Scholar
  5. 5.
    Bisegger, C., Cloetta, B., Von Rueden, U., Abel, T., & Ravens-Sieberer, U. (2005). Health-related quality of life: Gender differences in childhood and adolescence. Sozial- und Praventivmedizin, 50(5), 281–291.CrossRefPubMedGoogle Scholar
  6. 6.
    Williams, P. G., Holmbeck, G. N., & Greenley, R. N. (2002). Adolescent health psychology. Journal of Consulting and Clinical Psychology, 70(3), 828–842.CrossRefPubMedGoogle Scholar
  7. 7.
    Zullig, K. J., Valois, R. F., Huebner, E. S., Oeltmann, J. E., & Drane, J. W. (2001). Relationship between perceived life satisfaction and adolescents’ substance abuse. Journal of Adolescent Health, 29(4), 279–288.CrossRefPubMedGoogle Scholar
  8. 8.
    Baxter-Jones, A. D. G., Eisenmann, J. C., & Sherar, L. B. (2005). Controlling for maturation in pediatric exercise science. Pediatric Exercise Science, 17(1), 18–30.Google Scholar
  9. 9.
    Malina, R. M., Bouchard, C., & Bar-Or, O. (2004). Growth maturation and physical activity. Champaign, IL: Human Kinetics.Google Scholar
  10. 10.
    Malina, R. M. (2008). Biocultural factors in developing physical activity levels. In S. J. H. Biddle & A. L. Smith (Eds.), Youth physical activity and sedentary behavior: Challenges and solutions (pp. 141–166). Champaign, IL: Human Kinetics.Google Scholar
  11. 11.
    Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. Journal of the American Medical Association, 289(14), 1813–1819.CrossRefPubMedGoogle Scholar
  12. 12.
    Friedlander, S. L., Larkin, E. K., Rosen, C. L., Palermo, T. M., & Redline, S. (2003). Decreased quality of life associated with obesity in school-aged children. Archives of Pediatrics and Adolescent Medicine, 157(12), 1206–1211.CrossRefPubMedGoogle Scholar
  13. 13.
    Swallen, K. C., Reither, E. N., Haas, S. A., & Meier, A. M. (2005). Overweight, obesity, and health-related quality of life among adolescents: The national longitudinal study of adolescent health. Pediatrics, 115(2), 340–347.CrossRefPubMedGoogle Scholar
  14. 14.
    Niven, A. G., Fawkner, S. G., Knowles, A., & Stephenson, C. (2007). Maturational differences in physical self-perceptions and the relationship with physical activity in early adolescent girls. Pediatric Exercise Science, 19, 472–480.PubMedGoogle Scholar
  15. 15.
    Graber, J. A., Brooks-Gunn, J., & Warren, M. P. (1999). The vulnerable transition: Puberty and the development of eating pathology and negative mood. Womens Health Issues, 9(2), 107–114.CrossRefPubMedGoogle Scholar
  16. 16.
    Kaltiala-Heino, R., Marttunen, M., Rantanen, P., & Rimpela, M. (2003). Early puberty is associated with mental health problems in middle adolescence. Social Science and Medicine, 57(6), 1055–1064.CrossRefPubMedGoogle Scholar
  17. 17.
    Laitinen-Krispijn, S., Van der Ende, J., Hazebroek-Kampschreur, A. A. J. M., & Verhulst, F. C. (1999). Pubertal maturation and the development of behavioural and emotional problems in early adolescence. Acta Psychiatrica Scandinavica, 99(1), 16–25.CrossRefPubMedGoogle Scholar
  18. 18.
    Dick, D. M., Rose, R. J., Viken, R. J., & Kaprio, J. (2000). Pubertal timing and substance use: Associations between and within families across late adolescence. Developmental Psychology, 36(2), 180–189.CrossRefPubMedGoogle Scholar
  19. 19.
    Costello, E. J., Sung, M., Worthman, C., & Angold, A. (2007). Pubertal maturation and the development of alcohol use and abuse. Drug and Alcohol Dependence, 88, S50–S59.CrossRefPubMedGoogle Scholar
  20. 20.
    Brown, J. D., Halpern, C. T., & L’Engle, K. L. (2005). Mass media as a sexual super peer for early maturing girls. Journal of Adolescent Health, 36(5), 420–427.CrossRefPubMedGoogle Scholar
  21. 21.
    Palacio-Vieira, J. A., Villalonga-Olives, E., Valderas, J. M., Espallargues, M., Herdman, M., Berra, S., et al. (2008). Changes in health-related quality of life (HRQoL) in a population-based sample of children and adolescents after 3 years of follow-up. Quality of Life Research, 17(10), 1207–1215.CrossRefPubMedGoogle Scholar
  22. 22.
    Benjet, C., & Hernandez-Guzman, L. (2002). A short-term longitudinal study of pubertal change, gender, and psychological well-being of Mexican early adolescents. Journal of Youth and Adolescence, 31(6), 429–442.CrossRefGoogle Scholar
  23. 23.
    Malina, R. M. (1995). Anthropometry. In P. J. Maud & C. Foster (Eds.), Physiological assessment of human fitness (pp. 205–219). Champaign, IL: Human Kinetics.Google Scholar
  24. 24.
    Perini, T. A., de Oliveira, G. L., dos Santos Ornellas, J., & de Oliveira, F. P. (2005). Technical error of measurement in anthropometry. Revista Brasileira de Medicina do Esporte, 11(1), 86–90.CrossRefGoogle Scholar
  25. 25.
    Ravens-Sieberer, U., Auquier, P., Erhart, M., Gosch, A., Rajmil, L., Bruil, J., et al. (2007). The KIDSCREEN-27 quality of life measure for children and adolescents: Psychometric results from a cross-cultural survey in 13 European countries. Quality of Life Research, 16(8), 1347–1356.CrossRefPubMedGoogle Scholar
  26. 26.
    Khamis, H. J., & Roche, A. F. (1994). Predicting adult stature without using skeletal age—the Khamis–Roche method. Pediatrics, 94(4), 504–507.PubMedGoogle Scholar
  27. 27.
    Khamis, H. J., & Roche, A. F. (1995). Predicting adult stature without using skeletal age—the Khamis–Roche method (vol 94, p 504, 1994). Pediatrics, 95(3), 457.Google Scholar
  28. 28.
    Epstein, L., Valoski, A. M., Kalarchian, M. A., & McCurley, J. (1995). Do children lose and maintain weight easier than adults? A comparison of child and parent weight changes from six months to ten years. Obesity Research, 3, 411–417.PubMedGoogle Scholar
  29. 29.
    Cumming, S. P., Standage, M., Gillison, F., & Malina, R. M. (2008). Sex differences in exercise behavior during adolescence: is biological maturation a confounding factor? Journal of Adolescent Health, 42(5), 480–485.CrossRefPubMedGoogle Scholar
  30. 30.
    Cole, T. J., Bellizzi, M. C., Flegal, K. M., & Dietz, W. H. (2000). Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal, 320(7244), 1240–1243.CrossRefPubMedGoogle Scholar
  31. 31.
    Fisher, R. A. (1915). Frequency distribution of the values of the correlation coefficient in samples from an indefinitely large population. Biometrika, 10(4), 507–521.Google Scholar
  32. 32.
    Sherar, L. B., Cumming, S. P., Eisenmann, J. C., Baxter-Jones, A. D. G., & Malina, R. M. (2010). Adolescent biological maturity and physical activity: Biology meets behaviour. Pediatric Exercise Science, 22(3), 173–183.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Sean P. Cumming
    • 1
  • Fiona B. Gillison
    • 1
  • Lauren B. Sherar
    • 2
  1. 1.University of BathBathUK
  2. 2.The University of SaskatchewanSaskatoonCanada

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