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<article
    xmlns:mml="http://www.w3.org/1998/Math/MathML"
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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">OJP</journal-id>
      <journal-title-group>
        <journal-title>Open Journal of Psychology</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2771-2370</issn>
      <issn pub-type="ppub"></issn>
      <publisher>
        <publisher-name>Science Publications</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.31586/ojp.2025.1141</article-id>
      <article-id pub-id-type="publisher-id">OJP-1141</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Article</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>
          Puberty Onset and Positive Urgency Explain Diminished Returns of Family Income on Tobacco and Marijuana Use
        </article-title>
      </title-group>
      <contrib-group>
<contrib contrib-type="author">
<name>
<surname>Assari</surname>
<given-names>Shervin</given-names>
</name>
<xref rid="af1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Najand</surname>
<given-names>Babak</given-names>
</name>
<xref rid="af2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zare</surname>
<given-names>Hossein</given-names>
</name>
<xref rid="af3" ref-type="aff">3</xref>
<xref rid="af4" ref-type="aff">4</xref>
</contrib>
      </contrib-group>
<aff id="af1"><label>1</label> Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States</aff>
<aff id="af2"><label>2</label> Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA, United States</aff>
<aff id="af3"><label>3</label> Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States</aff>
<aff id="af4"><label>4</label> University of Maryland Global Campus (UMGC), Adelphi, MD, United States</aff>
<aff id="af5"><label>5</label></aff>
      <pub-date pub-type="epub">
        <day>16</day>
        <month>01</month>
        <year>2025</year>
      </pub-date>
      <volume>5</volume>
      <issue>1</issue>
      <history>
        <date date-type="received">
          <day>12</day>
          <month>08</month>
          <year>2024</year>
        </date>
        <date date-type="rev-recd">
          <day>26</day>
          <month>10</month>
          <year>2024</year>
        </date>
        <date date-type="accepted">
          <day>19</day>
          <month>11</month>
          <year>2024</year>
        </date>
        <date date-type="pub">
          <day>16</day>
          <month>01</month>
          <year>2025</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>&#xa9; Copyright 2025 by authors and Trend Research Publishing Inc. </copyright-statement>
        <copyright-year>2025</copyright-year>
        <license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
          <license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p>
        </license>
      </permissions>
      <abstract>
        <bold>Background: </bold>Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral risks, these benefits may not be equally protective for Black youth due to the phenomenon of Minorities' Diminished Returns (MDRs). MDRs suggest that higher family income does not offer the same protective effects for Black youth as it does for White youth, potentially leading to earlier puberty and increased substance use among high-income Black adolescents.<bold> </bold><bold>Objective: </bold>This study aimed to investigate whether early puberty onset and associated positive urgency (impulsivity) mediate the relationship between family income and the initiation of tobacco and marijuana use over a six-year follow-up period among adolescents. Additionally, the study examined whether the effects of family income on early puberty onset differ by race, testing the hypothesis that high-income Black youth would experience earlier puberty onset compared to their high-income White peers.<bold> </bold><bold>Methods: </bold>Data were sourced from the Adolescent Brain Cognitive Development (ABCD) Study. Participants were 9-10-year-old adolescents at baseline, followed over a period of six years. Structural equation modeling (SEM) was used to assess whether early puberty onset mediated the effects of family income on substance use behaviors. Interaction terms between race and family income were included to test whether the impact of family income varies by race.<bold> </bold><bold>Results: </bold>Early puberty onset and associated positive urgency partially explained the relationship between family income and the initiation of tobacco and marijuana use. High-income Black youth showed earlier puberty onset compared to their White counterparts. Earlier puberty onset then predicted higher positive urgency. These factors, in turn, were linked to higher rates of tobacco and marijuana initiation. <bold>Conclusions: </bold>This study provides additional evidence that the benefits of high family income do not extend equally to Black adolescents, particularly regarding delaying puberty onset and its consequences for substance use.
      </abstract>
      <kwd-group>
        <kwd-group><kwd>Puberty</kwd>
<kwd>Puberty Timing</kwd>
<kwd>Early Puberty Onset</kwd>
<kwd>Substance Use</kwd>
<kwd>Socioeconomic Status</kwd>
<kwd>Racial Disparities</kwd>
<kwd>Adolescence</kwd>
<kwd>Tobacco Use</kwd>
<kwd>Marijuana Use</kwd>
</kwd-group>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec1">
<title>Introduction</title><p>Puberty is a critical developmental milestone that encompasses a series of physiological, emotional, and cognitive changes, often reshaping a young individual&#x26;#x02019;s identity, social dynamics, and behavior [
<xref ref-type="bibr" rid="R1">1</xref>]. These developmental shifts during adolescence are closely linked to health-related behaviors, including the initiation and escalation of substance use, such as tobacco, marijuana, and alcohol [
<xref ref-type="bibr" rid="R2">2</xref>]. Earlier onset of puberty has been associated with an increased risk of engaging in risky behaviors, suggesting that the timing of puberty may have significant implications for adolescent health and well-being. The timing of puberty, however, is not solely determined by biological factors; it is heavily influenced by the social environment, socioeconomic status (SES) indicators such as family income, and exposure to various stressors, all of which intersect with race and gender.</p>
<p>Lower SES (e.g. family income) has long been associated with earlier onset of puberty, a phenomenon often linked to evolutionary adaptations. In environments characterized by adversity, earlier puberty may have provided an evolutionary advantage, allowing individuals to achieve reproductive maturity more quickly [
<xref ref-type="bibr" rid="R3">3</xref>]. This "adaptive response" to stressful conditions, however, may come at a cost in contemporary societies, where earlier puberty is linked to adverse behavioral and health outcomes, including a heightened risk of substance use and emotional challenges such as depression. Additionally, research consistently shows that girls, compared to boys, tend to experience puberty earlier, highlighting the role of sex as a significant factor in developmental timing. The interplay between SES, stress, and sex has important implications for social epidemiology, as these factors shape trajectories of health and behavior, including vulnerability to substance use during adolescence.</p>
<p>Race, as both a social and structural determinant, further complicates the relationship between SES indicators such as family income and early puberty onset. Black and other minoritized populations are disproportionately exposed to stressors like economic instability, neighborhood disadvantage, and food insecurity&#x26;#x02014;factors that are known to accelerate puberty. However, race not only influences exposure to these stressors but also affects the degree to which individuals benefit from protective resources like higher SES. This phenomenon, referred to as Minorities' Diminished Returns (MDRs) [
<xref ref-type="bibr" rid="R4">4</xref>,<xref ref-type="bibr" rid="R5">5</xref>], suggests that Black and other racialized groups often experience weaker positive effects of SES compared to their White counterparts. As a result, even in high-income families, Black children may not fully reap the developmental benefits of increased family income. For example, higher family income, often associated with delayed puberty and reduced behavioral risks for White youth, may not yield the same protective effects for Black youth due to ongoing exposure to racialized stress and discrimination.</p>
<p>One of the mechanisms by which low income and earlier puberty onset may elevate the risk for initiating tobacco and marijuana use is through their impact on impulsivity and inhibitory control. Low family income and earlier puberty are both linked to reductions in inhibitory control and increases in impulsivity, making adolescents more prone to risky behaviors. Positive urgency, a specific domain of impulsivity, is characterized by a tendency to act impulsively in response to intense positive emotions. This heightened impulsivity may lead to greater vulnerability to substance use, as adolescents with lower inhibitory control and higher positive urgency may struggle to resist engaging in high-risk behaviors like experimenting with tobacco and marijuana. The reduced capacity to regulate impulses in these contexts underscores the importance of addressing underlying social and developmental factors when aiming to mitigate substance use initiation in vulnerable groups.</p>
<p>This study aims to explore these complex dynamics using the Adolescent Brain Cognitive Development (ABCD) Study [
<xref ref-type="bibr" rid="R6">6</xref>,<xref ref-type="bibr" rid="R7">7</xref>,<xref ref-type="bibr" rid="R8">8</xref>,<xref ref-type="bibr" rid="R9">9</xref>,<xref ref-type="bibr" rid="R10">10</xref>,<xref ref-type="bibr" rid="R11">11</xref>,<xref ref-type="bibr" rid="R12">12</xref>,<xref ref-type="bibr" rid="R13">13</xref>,<xref ref-type="bibr" rid="R14">14</xref>], a large and diverse sample that allows for a nuanced examination of the interactions between SES, race, and early puberty onset. Specifically, this study investigates whether early puberty onset mediates the relationship between family income and substance use behaviors, and whether the influence of family income on early puberty onset varies by race. We also hypothesized that early puberty onset effect on tobacco /marijuana initiation would be in part mediated via positive urgency. We hypothesize that, consistent with the MDRs framework, high-income Black youth will still experience earlier puberty compared to their high-income White peers, despite similar family income levels. This persistence of early puberty onset among high-income Black youth may lead to elevated risks of substance use, underscoring the need to consider both race and family income in understanding adolescent health disparities.</p>
</sec><sec id="sec2">
<title>Methods</title><title>2.1. Study Design and Participants</title><p>This study utilized data from the Adolescent Brain Cognitive Development (ABCD) Study [
<xref ref-type="bibr" rid="R6">6</xref>,<xref ref-type="bibr" rid="R7">7</xref>,<xref ref-type="bibr" rid="R8">8</xref>,<xref ref-type="bibr" rid="R9">9</xref>,<xref ref-type="bibr" rid="R10">10</xref>,<xref ref-type="bibr" rid="R11">11</xref>,<xref ref-type="bibr" rid="R12">12</xref>,<xref ref-type="bibr" rid="R13">13</xref>,<xref ref-type="bibr" rid="R14">14</xref>], the largest long-term study of brain development and child health in the United States. The ABCD Study follows over 11,000 children from diverse racial, ethnic, and economic backgrounds, starting at ages 9 to 10 years old, with annual follow-up assessments. The study is designed to provide a comprehensive understanding of cognitive, emotional, and social development during adolescence. Data were collected across 21 research sites in the United States using a multi-site, longitudinal cohort design. The dataset includes a wide range of measures, such as neuroimaging, cognitive assessments, substance use behaviors, and detailed demographic information.</p>
<title>2.2. Measures</title><p><bold>Independent Variable: Family Income</bold>: Family income was assessed based on parent-reported annual household income levels. Family income was categorized into several levels to examine its impact on various developmental and behavioral outcomes. Higher family income was hypothesized to be associated with a reduced likelihood of early puberty onset and lower substance use, with potential variations by race.</p>
<p><bold>Mediator 1: Early Puberty Onset by Age 9/10</bold>: Early puberty onset by age 9/10 was assessed using Tanner stage criteria, a validated measure of physical changes that mark the onset of puberty. This study focused on early puberty onset as a mediator in the relationship between family income and substance use. Higher Tanner scores indicated a more advanced stage of pubertal development by ages 9 to 10, identifying individuals with earlier onset of puberty.</p>
<p><bold>Mediator 2: Positive Urgency</bold>: Positive urgency, a trait linked to impulsive behavior under positive emotional states, was measured using the Urgency-Premeditation-Perseverance-Sensation Seeking-Positive Urgency (UPPS-P) Scale [
<xref ref-type="bibr" rid="R32">32</xref>]. This scale was used to assess impulsivity driven by positive emotions, which may increase the risk of engaging in substance use. Positive urgency was examined as a mediator to explore its role in the pathway from early puberty onset to substance use.</p>
<p><bold>Dependent Variables: Substance Use (Tobacco and Marijuana)</bold>: Substance use was captured through self-reported data on tobacco and marijuana use. Participants reported any initiation of tobacco or marijuana use over the past six years, allowing for the tracking of substance use behaviors from early to mid-adolescence. The validity of these self-reports was enhanced by additional questions regarding frequency and context of use.</p>
<p><bold>Moderator: Race</bold><bold>:</bold><bold> </bold>Race was self-identified and was limited to Black (coded as 1) or White (Coded as 0, and the reference category). </p>
<p><bold>Covariates</bold>: Demographic factors, including age, sex, ethnicity, and family structure (e.g., married or single-parent households), were included as covariates. These variables were controlled for in the analysis to account for their potential influence on early puberty onset and substance use.</p>
<title>2.3. Statistical Analysis</title><p>Structural equation modeling (SEM) was conducted to examine the proposed relationships between family income, early puberty onset by age 9/10, positive urgency, and substance use. SEM was selected for its ability to manage complex pathways, mediations, and interactions, providing a detailed understanding of direct, indirect, and moderation effects. In this analysis, early puberty onset and positive urgency were tested as mediators in the relationship between family income and the initiation of substance use (tobacco and marijuana). Interaction terms were included to explore whether the effects of family income on early puberty onset differed by race, focusing on the framework of Minorities' Diminished Returns (MDRs).</p>
<p>Model fit was assessed using established indices, including the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI), and the Root Mean Square Error of Approximation (RMSEA). Statistical significance was set at p &lt; 0.05. All statistical analyses were performed using Stata 15.0 software.</p>
<title>2.4. Institutional Review Board (IRB) Approval</title><p>The ABCD Study received ethical approval from the Institutional Review Boards (IRBs) at University of California San Diego as well as other participating Universities, ensuring adherence to ethical standards in research with human subjects. All participants and their legal guardians provided informed consent or assent, following appropriate ethical protocols for minors. Participant privacy and confidentiality were strictly maintained throughout the study, in compliance with federal guidelines and institutional policies. This secondary analysis of ABCD data was exempt from review.</p>
</sec><sec id="sec3">
<title>Results</title><p>Table 1 presents results from a structural equation model analyzing the Minorities' Diminished Returns (MDRs) of family income on the initiation of tobacco and marijuana use. The analysis includes pathways through which family income influences early puberty onset and positive urgency. </p>
<p>Higher family income is associated with a later onset of puberty (B = -0.049, SE = 0.018, 95% CI = -0.083, -0.014, p = 0.005). Latino ethnicity has a small but significant positive association with earlier puberty (B = 0.024, SE = 0.011, 95% CI = 0.001, 0.046, p = 0.039). Race (Black) does not show a significant direct effect on puberty onset (B = 0.021, SE = 0.033, 95% CI = -0.043, 0.085, p = 0.518). However, the interaction between race (Black) and family income significantly predicts earlier puberty (B = 0.062, SE = 0.029, 95% CI = 0.005, 0.118, p = 0.032). Being from a married family does not significantly influence pubertal onset (B = -0.020, SE = 0.013, 95% CI = -0.046, 0.006, p = 0.124). Age has a significant positive association with pubertal onset by age 9/10 (B = 0.113, SE = 0.011, 95% CI = 0.092, 0.134, p &lt; 0.001). Male gender is negatively associated with earlier puberty onset (B = -0.082, SE = 0.011, 95% CI = -0.103, -0.061, p &lt; 0.001). </p>
<table-wrap id="tab1">
<label>Table 1</label>
<caption>
<p><b> </b>Summary of Structural equation modeling (SEM) on Minorities' Diminished Returns (MDRs) of family income on tobacco/marijuana use initiation via Minorities' Diminished Returns (MDRs) of family income on early puberty onset and positive urgency</p>
</caption>

<table>
<thead>
<tr>
<th align="center"></th>
<th align="center">&#x00026;nbsp;</th>
<th align="center">&#x00026;nbsp;</th>
<th align="center">B</th>
<th align="center">SE</th>
<th align="center">95% CI</th>
<th align="center"></th>
<th align="center">p</th>
<th align="center"></th>
</tr>
</thead>
<tbody>
<tr>
<td align="center"></td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Age </td>
<td align="center">&#x02192;</td>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">0.113</td>
<td align="center">0.011</td>
<td align="center">0.092</td>
<td align="center">0.134</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Male </td>
<td align="center">&#x02192;</td>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">-0.082</td>
<td align="center">0.011</td>
<td align="center">-0.103</td>
<td align="center">-0.061</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Family Income</td>
<td align="center">&#x02192;</td>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">-0.049</td>
<td align="center">0.018</td>
<td align="center">-0.083</td>
<td align="center">-0.014</td>
<td align="center">0.005</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Ethnicity (Latino)</td>
<td align="center">&#x02192;</td>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">0.024</td>
<td align="center">0.011</td>
<td align="center">0.001</td>
<td align="center">0.046</td>
<td align="center">0.039</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Race (Black)</td>
<td align="center">&#x02192;</td>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">0.021</td>
<td align="center">0.033</td>
<td align="center">-0.043</td>
<td align="center">0.085</td>
<td align="center">0.518</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Race (Black) x Family Income</td>
<td align="center">&#x02192;</td>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">0.062</td>
<td align="center">0.029</td>
<td align="center">0.005</td>
<td align="center">0.118</td>
<td align="center">0.032</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Married Family</td>
<td align="center">&#x02192;</td>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">-0.020</td>
<td align="center">0.013</td>
<td align="center">-0.046</td>
<td align="center">0.006</td>
<td align="center">0.124</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center"></td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">&#x02192;</td>
<td align="center">Positive Urgency</td>
<td align="center">0.056</td>
<td align="center">0.012</td>
<td align="center">0.032</td>
<td align="center">0.080</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Age</td>
<td align="center">&#x02192;</td>
<td align="center">Positive Urgency</td>
<td align="center">0.134</td>
<td align="center">0.003</td>
<td align="center">0.127</td>
<td align="center">0.141</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Male</td>
<td align="center">&#x02192;</td>
<td align="center">Positive Urgency</td>
<td align="center">0.091</td>
<td align="center">0.011</td>
<td align="center">0.070</td>
<td align="center">0.112</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Family Income</td>
<td align="center">&#x02192;</td>
<td align="center">Positive Urgency</td>
<td align="center">-0.044</td>
<td align="center">0.015</td>
<td align="center">-0.074</td>
<td align="center">-0.014</td>
<td align="center">0.005</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Ethnicity (Latino)</td>
<td align="center">&#x02192;</td>
<td align="center">Positive Urgency</td>
<td align="center">0.026</td>
<td align="center">0.011</td>
<td align="center">0.004</td>
<td align="center">0.048</td>
<td align="center">0.019</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Race (Black)</td>
<td align="center">&#x02192;</td>
<td align="center">Positive Urgency</td>
<td align="center">0.158</td>
<td align="center">0.031</td>
<td align="center">0.098</td>
<td align="center">0.219</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Race (Black) x Family Income</td>
<td align="center">&#x02192;</td>
<td align="center">Positive Urgency</td>
<td align="center">-0.072</td>
<td align="center">0.027</td>
<td align="center">-0.126</td>
<td align="center">-0.018</td>
<td align="center">0.009</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center">&#x00026;nbsp;</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Pubertal Onset by Age 9/10</td>
<td align="center">&#x02192;</td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">0.039</td>
<td align="center">0.013</td>
<td align="center">0.013</td>
<td align="center">0.064</td>
<td align="center">0.003</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Positive Urgency</td>
<td align="center">&#x02192;</td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">0.041</td>
<td align="center">0.015</td>
<td align="center">0.012</td>
<td align="center">0.069</td>
<td align="center">0.006</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Age </td>
<td align="center">&#x02192;</td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">0.039</td>
<td align="center">0.004</td>
<td align="center">0.030</td>
<td align="center">0.047</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Male </td>
<td align="center">&#x02192;</td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">-0.020</td>
<td align="center">0.012</td>
<td align="center">-0.044</td>
<td align="center">0.004</td>
<td align="center">0.098</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Family Income</td>
<td align="center">&#x02192;</td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">-0.162</td>
<td align="center">0.018</td>
<td align="center">-0.197</td>
<td align="center">-0.128</td>
<td align="center">0.000</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Ethnicity (Latino)</td>
<td align="center">&#x02192;</td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">-0.018</td>
<td align="center">0.013</td>
<td align="center">-0.043</td>
<td align="center">0.007</td>
<td align="center">0.156</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Race (Black)</td>
<td align="center">&#x02192;</td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">-0.231</td>
<td align="center">0.036</td>
<td align="center">-0.301</td>
<td align="center">-0.160</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
<tr>
<td align="center">Race (Black) x Family Income</td>
<td align="center"><bold>&#x02192;</bold><bold></bold></td>
<td align="center">Tobacco/ Marijuana</td>
<td align="center">0.175</td>
<td align="center">0.032</td>
<td align="center">0.113</td>
<td align="center">0.238</td>
<td align="center">&lt; 0.001</td>
<td align="center"></td>
</tr>
<tr>
<td align="center" colspan="8">
<hr />
</td>
</tr>
</tbody>
</table>
</table-wrap><p></p>
<p>Puberty onset by age 9/10 is significantly associated with an increase in positive urgency (B = 0.056, SE = 0.012, 95% CI = 0.032, 0.080, p &lt; 0.001). Family income has a negative effect on positive urgency (B = -0.044, SE = 0.015, 95% CI = -0.074, -0.014, p = 0.005), while Latino ethnicity is positively associated with positive urgency (B = 0.026, SE = 0.011, 95% CI = 0.004, 0.048, p = 0.019). Black race is associated with higher positive urgency (B = 0.158, SE = 0.031, 95% CI = 0.098, 0.219, p &lt; 0.001), and the interaction between race (Black) and family income shows a negative effect on positive urgency (B = -0.072, SE = 0.027, 95% CI = -0.126, -0.018, p = 0.009). Age is a strong predictor of positive urgency (B = 0.134, SE = 0.003, 95% CI = 0.127, 0.141, p &lt; 0.001), and males have higher positive urgency (B = 0.091, SE = 0.011, 95% CI = 0.070, 0.112, p &lt; 0.001). </p>
<p>Early puberty onset predicts increased likelihood of substance use (B = 0.039, SE = 0.013, 95% CI = 0.013, 0.064, p = 0.003). Positive urgency also contributes to higher substance use risk (B = 0.041, SE = 0.015, 95% CI = 0.012, 0.069, p = 0.006). Higher family income is associated with reduced substance use (B = -0.162, SE = 0.018, 95% CI = -0.197, -0.128, p &lt; 0.001). The interaction between race (Black) and family income is positively associated with substance use (B = 0.175, SE = 0.032, 95% CI = 0.113, 0.238, p &lt; 0.001). Latino ethnicity does not significantly affect substance use (B = -0.018, SE = 0.013, 95% CI = -0.043, 0.007, p = 0.156). In contrast, being Black is associated with significantly lower substance use (B = -0.231, SE = 0.036, 95% CI = -0.301, -0.160, p &lt; 0.001). Age positively predicts substance use (B = 0.039, SE = 0.004, 95% CI = 0.030, 0.047, p &lt; 0.001), while being male has a marginally non-significant protective effect (B = -0.020, SE = 0.012, 95% CI = -0.044, 0.004, p = 0.098).</p>
<fig id="fig1">
<label>Figure 1</label>
<caption>
<p>Summary of Structural equation modeling (SEM) on Minorities' Diminished Returns (MDRs) of family income on tobacco/marijuana use initiation via Minorities' Diminished Returns (MDRs) of family income on early puberty onset and positive urgency (<b>Note:</b> Tob: tobacco; Marij: Marijuana, Married HH: Married Household; Urgency: Positive Urgency)</p>
</caption>
<graphic xlink:href="1141.fig.001" />
</fig></sec><sec id="sec4">
<title>Discussion</title><p>The primary aim of this study was to examine the relationship between family income, early puberty onset, and substance use among adolescents, with a particular focus on potential racial differences. Using the Adolescent Brain Cognitive Development (ABCD) Study's diverse sample, we tested whether early puberty onset mediates the effects of family income on substance use behaviors, including tobacco and marijuana. Additionally, we sought to determine whether race moderates the influence of family income on early puberty onset, exploring the hypothesis that high-income Black youth would exhibit earlier puberty compared to their White peers, aligning with the framework of Minorities' Diminished Returns (MDRs) [
<xref ref-type="bibr" rid="R15">15</xref>,<xref ref-type="bibr" rid="R16">16</xref>,<xref ref-type="bibr" rid="R17">17</xref>,<xref ref-type="bibr" rid="R18">18</xref>,<xref ref-type="bibr" rid="R19">19</xref>,<xref ref-type="bibr" rid="R20">20</xref>].</p>
<p>Our findings supported all initial hypotheses. Early puberty onset was a significant mediator in the relationship between SES and substance use behaviors, specifically tobacco and marijuana. While higher SES indicators such as family income were generally associated with later puberty and lower substance use in the full sample, these effects were not uniform across racial groups. Black adolescents from high-income families demonstrated earlier puberty than their White counterparts, which was linked to increased rates of tobacco and marijuana use over a six-year follow-up period. These results align with the MDRs framework, suggesting weaker protective effects of high SES for Black youth.</p>
<p>Socioeconomic status (SES) indicators such as family income plays a central role in determining health and behavioral outcomes during adolescence. Typically, higher SES indicators such as family income are associated with delayed puberty and reduced likelihood of engaging in substance use, largely due to greater access to resources, less exposure to stress, and a safer social environment. In our study, higher family income was generally protective against early puberty onset and subsequent substance use, which is consistent with prior research. However, the differential impact of family income by race highlights the limitations of assuming uniform benefits across diverse populations.</p>
<p>A significant interaction emerged between family income and race, where Black adolescents from higher SES backgrounds experienced earlier puberty compared to their White counterparts of similar family income. This pattern suggests that the advantages typically conferred by higher family income may not extend fully to Black youth. These findings reflect broader patterns of racial disparities in health outcomes, where Black individuals often face additional stressors and barriers, even at similar levels of economic resources. Factors such as racial discrimination, exposure to chronic stress, and neighborhood characteristics may play critical roles in explaining why family income effects differ by race.</p>
<p>The observed racial differences in the impact of family income align with the concept of Minorities' Diminished Returns (MDRs) [
<xref ref-type="bibr" rid="R21">21</xref>,<xref ref-type="bibr" rid="R22">22</xref>,<xref ref-type="bibr" rid="R23">23</xref>,<xref ref-type="bibr" rid="R24">24</xref>,<xref ref-type="bibr" rid="R25">25</xref>], which posits that the protective benefits of many SES indicators are attenuated for minoritized groups. Several root causes likely contribute to these diminished returns, including systemic racism, differential access to high-quality education and healthcare, exposure to greater psychosocial stress, and the challenges of navigating predominantly White or affluent spaces [
<xref ref-type="bibr" rid="R4">4</xref>,<xref ref-type="bibr" rid="R5">5</xref>]. These structural and contextual factors diminish the potential health benefits associated with higher family income among Black adolescents, making it harder for economic resources alone to fully protect against early puberty onset and its consequences [
<xref ref-type="bibr" rid="R31">31</xref>].</p>
<p>Early puberty has been linked to various mental and behavioral risks for adolescents, as the rapid biological and hormonal changes may outpace their emotional and cognitive development [
<xref ref-type="bibr" rid="R33">33</xref>,<xref ref-type="bibr" rid="R34">34</xref>,<xref ref-type="bibr" rid="R35">35</xref>]. Adolescents who experience early puberty are often at an increased risk of developing mental health issues such as depression, anxiety, and low self-esteem [
<xref ref-type="bibr" rid="R36">36</xref>,<xref ref-type="bibr" rid="R37">37</xref>,<xref ref-type="bibr" rid="R38">38</xref>]. The early onset of puberty can also expose adolescents to heightened social pressures, including bullying, peer rejection, or premature engagement in adult-like behaviors [
<xref ref-type="bibr" rid="R39">39</xref>,<xref ref-type="bibr" rid="R40">40</xref>]. Behaviorally, early-maturing adolescents are more likely to engage in risky behaviors, such as substance use, early sexual activity, and delinquent behavior, potentially as a way to navigate or cope with these social pressures [
<xref ref-type="bibr" rid="R41">41</xref>,<xref ref-type="bibr" rid="R42">42</xref>,<xref ref-type="bibr" rid="R43">43</xref>]. Additionally, early puberty is associated with spending more time in higher-risk contexts and forming connections with riskier peer groups, further amplifying their vulnerability to adverse outcomes [
<xref ref-type="bibr" rid="R44">44</xref>,<xref ref-type="bibr" rid="R45">45</xref>,<xref ref-type="bibr" rid="R46">46</xref>,<xref ref-type="bibr" rid="R47">47</xref>,<xref ref-type="bibr" rid="R48">48</xref>]. These risks are often compounded by environmental factors, such as familial stress, peer influences, or cultural expectations, underscoring the importance of providing supportive and protective environments for early-maturing youth [
<xref ref-type="bibr" rid="R49">49</xref>,<xref ref-type="bibr" rid="R50">50</xref>].</p>
<title>4.1. Implications</title><p>These findings have significant implications for public health interventions and policies. Efforts to reduce substance use among adolescents may need to account for the differential impacts of SES by race, particularly in addressing the unique vulnerabilities of Black youth from high-income families. Interventions should consider not only socioeconomic factors but also the broader social and environmental contexts, including racism and discrimination, that shape adolescent development. Strategies that address structural inequalities, improve neighborhood conditions, and promote racial equity are crucial to mitigating the risk of early puberty onset and substance use among Black youth.</p>
<title>4.2. Limitations</title><p>This study has several limitations. First, while the ABCD dataset provides a diverse and large sample, self-reported data on substance use and family income may be subject to biases, including social desirability and recall biases. We only investigated family income and did not investigate other SES indicators such as wealth. Additionally, the cross-sectional nature of some measurements limits the ability to draw causal conclusions. Although we examined early puberty onset as a mediator, other unmeasured factors such as family dynamics, neighborhood characteristics, or genetic influences may also play a role. Lastly, the generalizability of these findings may be limited to populations similar to those in the ABCD study.</p>
<title>4.3. Future Research Directions</title><p>Future research should further explore the mechanisms underlying the MDRs [
<xref ref-type="bibr" rid="R26">26</xref>,<xref ref-type="bibr" rid="R27">27</xref>,<xref ref-type="bibr" rid="R28">28</xref>,<xref ref-type="bibr" rid="R29">29</xref>,<xref ref-type="bibr" rid="R30">30</xref>] of a wide range of SES indicators on early puberty onset and substance use, with a focus on identifying modifiable factors that could reduce these disparities. Longitudinal studies examining the impact of structural and contextual factors&#x26;#x02014;such as exposure to discrimination, neighborhood characteristics, and school environments&#x26;#x02014;would provide deeper insights into the pathways linking SES, early puberty onset, and substance use among different racial groups. Additionally, qualitative studies may shed light on the lived experiences of high-income Black adolescents, offering a nuanced understanding of how racialized stress affects developmental outcomes.</p>
</sec><sec id="sec5">
<title>Conclusions</title><p>In conclusion, this study provides compelling evidence that the benefits of high family income do not extend equally to Black adolescents, particularly regarding delaying puberty onset and its consequences for substance use. The MDRs framework highlights the need to move beyond simplistic understandings of family SES as a uniform protective factor, emphasizing the importance of context, race, and systemic inequalities. Addressing these disparities requires comprehensive and culturally sensitive approaches that consider the unique challenges faced by minoritized populations, aiming to reduce racial inequities in adolescent development and health outcomes.</p>
<p></p>
<p><bold>Authors&#x26;#x02019; Funding</bold></p>
<p>Part of Hossein Zare&#x26;#x000a0;effort comes from the NIMHD U54MD000214. Shervin Assari is supported by funds provided by The Regents of the University of California, Tobacco-Related Diseases Research Program, Grant Number no T32IR5355.  No funders had any role in the design of the current manuscript or in the analyses or&#x26;#x000a0;interpretation of the data.</p>
<p></p>
<p><bold>ABCD&#x26;#x000a0;Funding:&#x26;#x000a0;</bold></p>
<p>Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). This is a multisite, longitudinal study designed to recruit more than 10,000 children age 9&#x26;#x02013;10 and follow them over 10 years into early adulthood. The opinions, findings, and conclusions herein are those of the authors and not necessarily represent The Regents of the University of California, or any of its programs. The ABCD Study<sup>&#x26;#x000ae;</sup>&#x26;#x000a0;is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041048, U01DA050989, U01DA051016, U01DA041022, U01DA051018, U01DA051037, U01DA050987, U01DA041174, U01DA041106, U01DA041117, U01DA041028, U01DA041134, U01DA050988, U01DA051039, U01DA041156, U01DA041025, U01DA041120, U01DA051038, U01DA041148, U01DA041093, U01DA041089, U24DA041123, U24DA041147. A full list of supporters is available at&#x26;#x000a0;https://abcdstudy.org/federal-partners.html. A listing of participating sites and a complete listing of the study investigators can be found at&#x26;#x000a0;https://abcdstudy.org/consortium_members/. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in the analysis or writing of this report. This manuscript reflects the views of the authors and may not reflect the opinions or views of the NIH or ABCD consortium investigators.</p>
<p></p>
</sec>
  </body>
  <back>
    <ref-list>
      <title>References</title>
      
<ref id="R1">
<label>[1]</label>
<mixed-citation publication-type="other">Dorn LD, Dahl RE, Woodward HR, Biro F. Defining the boundaries of early adolescence: A user's guide to assessing pubertal status and pubertal timing in research with adolescents. Applied Developmental Science. 2006;10(1):30-56.
</mixed-citation>
</ref>
<ref id="R2">
<label>[2]</label>
<mixed-citation publication-type="other">Hummel A, Shelton KH, Heron J, Moore L, van den Bree MB. A systematic review of the relationships between family functioning, pubertal timing and adolescent substance use. Addiction. 2013;108(3):487-96.
</mixed-citation>
</ref>
<ref id="R3">
<label>[3]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Caldwell CH. Race, socioeconomic status, and sex hormones among male and female American adolescents. Reproductive Medicine. 2020;1(2):8.
</mixed-citation>
</ref>
<ref id="R4">
<label>[4]</label>
<mixed-citation publication-type="other">Assari S. Health disparities due to diminished return among black Americans: Public policy solutions. Social Issues and Policy Review. 2018;12(1):112-45.
</mixed-citation>
</ref>
<ref id="R5">
<label>[5]</label>
<mixed-citation publication-type="other">Assari S. Unequal Gain of Equal Resources across Racial Groups. Int J Health Policy Manag. 2018;7(1):1-9.
</mixed-citation>
</ref>
<ref id="R6">
<label>[6]</label>
<mixed-citation publication-type="other">Alcohol Research: Current Reviews Editorial S. NIH's Adolescent Brain Cognitive Development (ABCD) Study. Alcohol Res. 2018;39(1):97.
</mixed-citation>
</ref>
<ref id="R7">
<label>[7]</label>
<mixed-citation publication-type="other">Casey BJ, Cannonier T, Conley MI, Cohen AO, Barch DM, Heitzeg MM, et al. The Adolescent Brain Cognitive Development (ABCD) study: Imaging acquisition across 21 sites. Dev Cogn Neurosci. 2018;32:43-54.
</mixed-citation>
</ref>
<ref id="R8">
<label>[8]</label>
<mixed-citation publication-type="other">Compton WM, Dowling GJ, Garavan H. Ensuring the Best Use of Data: The Adolescent Brain Cognitive Development Study. JAMA Pediatrics. 2019;173(9):809-10.
</mixed-citation>
</ref>
<ref id="R9">
<label>[9]</label>
<mixed-citation publication-type="other">Dick AS, Lopez DA, Watts AL, Heeringa S, Reuter C, Bartsch H, et al. Meaningful associations in the adolescent brain cognitive development study. NeuroImage. 2021;239:118262.
</mixed-citation>
</ref>
<ref id="R10">
<label>[10]</label>
<mixed-citation publication-type="other">Hagler Jr DJ, Hatton S, Cornejo MD, Makowski C, Fair DA, Dick AS, et al. Image processing and analysis methods for the Adolescent Brain Cognitive Development Study. Neuroimage. 2019;202:116091.
</mixed-citation>
</ref>
<ref id="R11">
<label>[11]</label>
<mixed-citation publication-type="other">Hatton S. Preview of the Adolescent Brain Cognitive Development (ABCD) Study Release 3.0. Biological Psychiatry. 2020;87(9):S110-S1.
</mixed-citation>
</ref>
<ref id="R12">
<label>[12]</label>
<mixed-citation publication-type="other">Jernigan TL, Brown SA, Dowling GJ. The Adolescent Brain Cognitive Development Study. J Res Adolesc. 2018;28(1):154-6.
</mixed-citation>
</ref>
<ref id="R13">
<label>[13]</label>
<mixed-citation publication-type="other">Lisdahl KM, Sher KJ, Conway KP, Gonzalez R, Feldstein Ewing SW, Nixon SJ, et al. Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods. Dev Cogn Neurosci. 2018;32:80-96.
</mixed-citation>
</ref>
<ref id="R14">
<label>[14]</label>
<mixed-citation publication-type="other">Luciana M, Bjork JM, Nagel BJ, Barch DM, Gonzalez R, Nixon SJ, et al. Adolescent neurocognitive development and impacts of substance use: Overview of the adolescent brain cognitive development (ABCD) baseline neurocognition battery. Developmental cognitive neuroscience. 2018;32:67-79.
</mixed-citation>
</ref>
<ref id="R15">
<label>[15]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Caldwell CH: A dream deferred: African American women's diminished socioeconomic re-turns of postponing childbearing from teenage to adulthood. Reproductive Medicine 2020, 1(2):62-76.
</mixed-citation>
</ref>
<ref id="R16">
<label>[16]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Thomas A, Cobb RJ, Hudson D, Curry TJ, Nicholson HL, Jr., Cuevas AG, Mistry R et al: Pa-rental Educational Attainment, the Superior Temporal Cortical Surface Area, and Reading Ability among American Children: A Test of Marginalization-Related Diminished Returns. Children (Basel) 2021, 8(5).
</mixed-citation>
</ref>
<ref id="R17">
<label>[17]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Caldwell CH, Bazargan M: Minorities' Diminished Returns of Parental Educational Attainment on Ado-lescents' Social, Emotional, and Behavioral Problems. Children 2020, 7(5):49.
</mixed-citation>
</ref>
<ref id="R18">
<label>[18]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Caldwell CH, Bazargan M: Parent Education and Future Transition to Cigarette Smoking: Latinos' Dimin-ished Returns. Front Pediatr 2020, 8:457.
</mixed-citation>
</ref>
<ref id="R19">
<label>[19]</label>
<mixed-citation publication-type="other">Assari S, Caldwell C, Bazargan M: Parental educational attainment and relatives' substance use of American youth: Hispan-ics Diminished Returns. J Biosci Med (Irvine) 2020, 8(2):122-134.
</mixed-citation>
</ref>
<ref id="R20">
<label>[20]</label>
<mixed-citation publication-type="other">Assari S, Caldwell CH, Mincy R: Family socioeconomic status at birth and youth impulsivity at age 15; Blacks' diminished return. Children 2018, 5(5):58.
</mixed-citation>
</ref>
<ref id="R21">
<label>[21]</label>
<mixed-citation publication-type="other">Assari S, Cobb S, Saqib M, Bazargan M: Diminished returns of educational attainment on heart disease among Black Ameri-cans. The open cardiovascular medicine journal 2020, 14:5.
</mixed-citation>
</ref>
<ref id="R22">
<label>[22]</label>
<mixed-citation publication-type="other">Assari S, Mistry R: Diminished Return of Employment on Ever Smoking Among Hispanic Whites in Los Angeles. Health Eq-uity 2019, 3(1):138-144.
</mixed-citation>
</ref>
<ref id="R23">
<label>[23]</label>
<mixed-citation publication-type="other">Assari S, Najand B, Sheikhattari P: Household income and subsequent youth tobacco initiation: Minorities' Diminished Re-turns. Journal of Medicine, Surgery, and Public Health 2024, 2:100063.
</mixed-citation>
</ref>
<ref id="R24">
<label>[24]</label>
<mixed-citation publication-type="other">Assari S, Sheikhattari P, Zare H: Blacks' Diminished Returns of Parental Education on Household Income: A Study of College Students in the US. Open Journal of Educational Research 2024, 4(4):187-196.
</mixed-citation>
</ref>
<ref id="R25">
<label>[25]</label>
<mixed-citation publication-type="other">Assari S, Zare H: Household Income and Offspring Education Explain Blacks' Diminished Returns of Parental Educa-tion. Open Journal of Psychology 2024, 4(1):18-29.
</mixed-citation>
</ref>
<ref id="R26">
<label>[26]</label>
<mixed-citation publication-type="other">Assari S, Zare H: Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Re-turns. Global Journal of Epidemiology and Infectious Disease 2024, 4(1):34-43.
</mixed-citation>
</ref>
<ref id="R27">
<label>[27]</label>
<mixed-citation publication-type="other">Barsha RAA, Assari S, Hossain MB, Apata J, Sheikhattari P: Black Americans' Diminished Return of Educational Attainment on Tobacco Use in Baltimore City. J Racial Ethn Health Disparities 2023, 10(6):3178-3187.
</mixed-citation>
</ref>
<ref id="R28">
<label>[28]</label>
<mixed-citation publication-type="other">Boyce S, Darvishi M, Marandi R, Rahmanian R, Akhtar S, Patterson J, Assari S: Review Paper Racism-Related Diminished Returns of Socioeconomic Status on Adolescent Brain and Cognitive Development.
</mixed-citation>
</ref>
<ref id="R29">
<label>[29]</label>
<mixed-citation publication-type="other">Assari S, Bazargan M: Parental Educational Attainment and Black-White Adolescents' Achievement Gap: Blacks' Diminished Returns. Open Journal of Social Sciences 2020, 8(3):282-297.
</mixed-citation>
</ref>
<ref id="R30">
<label>[30]</label>
<mixed-citation publication-type="other">Zare H, Assari S: Non-hispanic Black Americans' diminished protective effects of educational attainment and employment against cardiometabolic diseases: NHANES 1999-2016. Austin journal of public health and epidemiology 2021, 8(4).
</mixed-citation>
</ref>
<ref id="R31">
<label>[31]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Caldwell CH. Race, Socioeconomic Status, and Sex Hormones among Male and Female American Adolescents. Reprod Med (Basel). 2020 Sep;1(2):108-121. doi: 10.3390/reprodmed1020008.
</mixed-citation>
</ref>
<ref id="R32">
<label>[32]</label>
<mixed-citation publication-type="other">Lynam DR, Smith GT, Whiteside SP, Cyders MA. The UPPS-P: Assessing Five Personality Pathways to Impulsive Behavior. West Lafayette, IN: Purdue University; (2006).
</mixed-citation>
</ref>
<ref id="R33">
<label>[33]</label>
<mixed-citation publication-type="other">Laube C, Fuhrmann D. Is early good or bad? Early puberty onset and its consequences for learning. Current Opinion in Be-havioral Sciences. 2020 Dec 1;36:150-6.
</mixed-citation>
</ref>
<ref id="R34">
<label>[34]</label>
<mixed-citation publication-type="other">Sun Y, Liu H, Mu C, Liu P, Hao C, Xin Y. Early puberty: a review on its role as a risk factor for metabolic and mental disor-ders. Frontiers in Pediatrics. 2024 Sep 12;12:1326864.
</mixed-citation>
</ref>
<ref id="R35">
<label>[35]</label>
<mixed-citation publication-type="other">Herman ME, PA G, Bourdony C, Slora E, Wasserman R. Early puberty: a cautionary tale. Pediatrics. 2001 Mar 1;107(3):609-10.
</mixed-citation>
</ref>
<ref id="R36">
<label>[36]</label>
<mixed-citation publication-type="other">James J, Ellis BJ, Schlomer GL, Garber J. Sex-specific pathways to early puberty, sexual debut, and sexual risk taking: Tests of an integrated evolutionary-developmental model. Developmental psychology. 2012 May;48(3):687.
</mixed-citation>
</ref>
<ref id="R37">
<label>[37]</label>
<mixed-citation publication-type="other">Golub MS, Collman GW, Foster PM, Kimmel CA, Rajpert-De Meyts E, Reiter EO, Sharpe RM, Skakkebaek NE, Toppari J. Public health implications of altered puberty timing. Pediatrics. 2008 Feb 1;121(Supplement_3):S218-30.
</mixed-citation>
</ref>
<ref id="R38">
<label>[38]</label>
<mixed-citation publication-type="other">Dimler LM, Natsuaki MN. The effects of pubertal timing on externalizing behaviors in adolescence and early adulthood: A meta-analytic review. Journal of Adolescence. 2015 Dec 1;45:160-70.
</mixed-citation>
</ref>
<ref id="R39">
<label>[39]</label>
<mixed-citation publication-type="other">Haynie DL. Contexts of risk? Explaining the link between girls' pubertal development and their delinquency involvement. Social Forces. 2003 Sep 1;82(1):355-97.
</mixed-citation>
</ref>
<ref id="R40">
<label>[40]</label>
<mixed-citation publication-type="other">Reynolds BM, Juvonen J. The role of early maturation, perceived popularity, and rumors in the emergence of internalizing symptoms among adolescent girls. Journal of youth and adolescence. 2011 Nov;40:1407-22.
</mixed-citation>
</ref>
<ref id="R41">
<label>[41]</label>
<mixed-citation publication-type="other">Lee JM. Growing Up Too Fast? An Examination of Pubertal Timing and Childhood Social Wariness in the Development of Adolescent Depression. The University of North Carolina at Greensboro; 2023.
</mixed-citation>
</ref>
<ref id="R42">
<label>[42]</label>
<mixed-citation publication-type="other">Delevich K, Wilbrecht L. Role of puberty on adult behaviors. InOxford research encyclopedia of neuroscience 2020 Jul 30.
</mixed-citation>
</ref>
<ref id="R43">
<label>[43]</label>
<mixed-citation publication-type="other">Kretsch N, Harden KP. Pubertal development and peer influence on risky decision making. The Journal of Early Adolescence. 2014 Apr;34(3):339-59.
</mixed-citation>
</ref>
<ref id="R44">
<label>[44]</label>
<mixed-citation publication-type="other">Markey CN, Markey PM, Tinsley BJ. Personality, puberty, and preadolescent girls' risky behaviors: Examining the predictive value of the five-factor model of personality. Journal of Research in Personality. 2003 Oct 1;37(5):405-19.
</mixed-citation>
</ref>
<ref id="R45">
<label>[45]</label>
<mixed-citation publication-type="other">Cozzi D, Vinel V. Risky, early, controversial. Puberty in medical discourses. Social Science &#x00026; Medicine. 2015 Oct 1;143:287-96.
</mixed-citation>
</ref>
<ref id="R46">
<label>[46]</label>
<mixed-citation publication-type="other">Collado A, MacPherson L, Kurdziel G, Rosenberg LA, Lejuez CW. The relationship between puberty and risk taking in the real world and in the laboratory. Personality and individual differences. 2014 Oct 1;68:143-8.
</mixed-citation>
</ref>
<ref id="R47">
<label>[47]</label>
<mixed-citation publication-type="other">Downing J, Bellis MA. Early pubertal onset and its relationship with sexual risk taking, substance use and anti-social behav-iour: a preliminary cross-sectional study. BMC public health. 2009 Dec;9:1-1.
</mixed-citation>
</ref>
<ref id="R48">
<label>[48]</label>
<mixed-citation publication-type="other">Donovan A, Assari S, Grella C, Shaheen M, Richter L, Friedman TC. Early Life Stress and Pubertal Predictors of Subsequent Substance Use in a National Diverse Sample of Adolescents: Sex and Substance Type Matter. Drug and Alcohol Dependence. 2025 Jan 13:112551.
</mixed-citation>
</ref>
<ref id="R49">
<label>[49]</label>
<mixed-citation publication-type="other">Donovan A, Assari S, Shaheen M, Grella C, Richter L, Friedman TC. 8256 Early Life Stress and Pubertal Predictors of Youth Substance Use Initiation: Does Sex Moderate the Relationship Between ELS, Puberty, and Substance Use Initiation?. Journal of the Endocrine Society. 2024 Oct;8(Supplement_1):bvae163-1194.
</mixed-citation>
</ref>
<ref id="R50">
<label>[50]</label>
<mixed-citation publication-type="other">Donovan A, Assari S, Grella C, Shaheen M, Richter L, Friedman TC. Early Life Stress and Pubertal Predictors of Subsequent Substance Use in a National Diverse Sample of Adolescents: Sex and Substance Type Matter. Drug and Alcohol Dependence. 2025 Jan 13:112551.
</mixed-citation>
</ref>
<ref id="R1">
<label>[1]</label>
<mixed-citation publication-type="other">Dorn LD, Dahl RE, Woodward HR, Biro F. Defining the boundaries of early adolescence: A user's guide to assessing pubertal status and pubertal timing in research with adolescents. Applied Developmental Science. 2006;10(1):30-56.
</mixed-citation>
</ref>
<ref id="R2">
<label>[2]</label>
<mixed-citation publication-type="other">Hummel A, Shelton KH, Heron J, Moore L, van den Bree MB. A systematic review of the relationships between family functioning, pubertal timing and adolescent substance use. Addiction. 2013;108(3):487-96.
</mixed-citation>
</ref>
<ref id="R3">
<label>[3]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Caldwell CH. Race, socioeconomic status, and sex hormones among male and female American adolescents. Reproductive Medicine. 2020;1(2):8.
</mixed-citation>
</ref>
<ref id="R4">
<label>[4]</label>
<mixed-citation publication-type="other">Assari S. Health disparities due to diminished return among black Americans: Public policy solutions. Social Issues and Policy Review. 2018;12(1):112-45.
</mixed-citation>
</ref>
<ref id="R5">
<label>[5]</label>
<mixed-citation publication-type="other">Assari S. Unequal Gain of Equal Resources across Racial Groups. Int J Health Policy Manag. 2018;7(1):1-9.
</mixed-citation>
</ref>
<ref id="R6">
<label>[6]</label>
<mixed-citation publication-type="other">Alcohol Research: Current Reviews Editorial S. NIH's Adolescent Brain Cognitive Development (ABCD) Study. Alcohol Res. 2018;39(1):97.
</mixed-citation>
</ref>
<ref id="R7">
<label>[7]</label>
<mixed-citation publication-type="other">Casey BJ, Cannonier T, Conley MI, Cohen AO, Barch DM, Heitzeg MM, et al. The Adolescent Brain Cognitive Development (ABCD) study: Imaging acquisition across 21 sites. Dev Cogn Neurosci. 2018;32:43-54.
</mixed-citation>
</ref>
<ref id="R8">
<label>[8]</label>
<mixed-citation publication-type="other">Compton WM, Dowling GJ, Garavan H. Ensuring the Best Use of Data: The Adolescent Brain Cognitive Development Study. JAMA Pediatrics. 2019;173(9):809-10.
</mixed-citation>
</ref>
<ref id="R9">
<label>[9]</label>
<mixed-citation publication-type="other">Dick AS, Lopez DA, Watts AL, Heeringa S, Reuter C, Bartsch H, et al. Meaningful associations in the adolescent brain cognitive development study. NeuroImage. 2021;239:118262.
</mixed-citation>
</ref>
<ref id="R10">
<label>[10]</label>
<mixed-citation publication-type="other">Hagler Jr DJ, Hatton S, Cornejo MD, Makowski C, Fair DA, Dick AS, et al. Image processing and analysis methods for the Adolescent Brain Cognitive Development Study. Neuroimage. 2019;202:116091.
</mixed-citation>
</ref>
<ref id="R11">
<label>[11]</label>
<mixed-citation publication-type="other">Hatton S. Preview of the Adolescent Brain Cognitive Development (ABCD) Study Release 3.0. Biological Psychiatry. 2020;87(9):S110-S1.
</mixed-citation>
</ref>
<ref id="R12">
<label>[12]</label>
<mixed-citation publication-type="other">Jernigan TL, Brown SA, Dowling GJ. The Adolescent Brain Cognitive Development Study. J Res Adolesc. 2018;28(1):154-6.
</mixed-citation>
</ref>
<ref id="R13">
<label>[13]</label>
<mixed-citation publication-type="other">Lisdahl KM, Sher KJ, Conway KP, Gonzalez R, Feldstein Ewing SW, Nixon SJ, et al. Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods. Dev Cogn Neurosci. 2018;32:80-96.
</mixed-citation>
</ref>
<ref id="R14">
<label>[14]</label>
<mixed-citation publication-type="other">Luciana M, Bjork JM, Nagel BJ, Barch DM, Gonzalez R, Nixon SJ, et al. Adolescent neurocognitive development and impacts of substance use: Overview of the adolescent brain cognitive development (ABCD) baseline neurocognition battery. Developmental cognitive neuroscience. 2018;32:67-79.
</mixed-citation>
</ref>
<ref id="R15">
<label>[15]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Caldwell CH: A dream deferred: African American women's diminished socioeconomic re-turns of postponing childbearing from teenage to adulthood. Reproductive Medicine 2020, 1(2):62-76.
</mixed-citation>
</ref>
<ref id="R16">
<label>[16]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Thomas A, Cobb RJ, Hudson D, Curry TJ, Nicholson HL, Jr., Cuevas AG, Mistry R et al: Pa-rental Educational Attainment, the Superior Temporal Cortical Surface Area, and Reading Ability among American Children: A Test of Marginalization-Related Diminished Returns. Children (Basel) 2021, 8(5).
</mixed-citation>
</ref>
<ref id="R17">
<label>[17]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Caldwell CH, Bazargan M: Minorities' Diminished Returns of Parental Educational Attainment on Ado-lescents' Social, Emotional, and Behavioral Problems. Children 2020, 7(5):49.
</mixed-citation>
</ref>
<ref id="R18">
<label>[18]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Caldwell CH, Bazargan M: Parent Education and Future Transition to Cigarette Smoking: Latinos' Dimin-ished Returns. Front Pediatr 2020, 8:457.
</mixed-citation>
</ref>
<ref id="R19">
<label>[19]</label>
<mixed-citation publication-type="other">Assari S, Caldwell C, Bazargan M: Parental educational attainment and relatives' substance use of American youth: Hispan-ics Diminished Returns. J Biosci Med (Irvine) 2020, 8(2):122-134.
</mixed-citation>
</ref>
<ref id="R20">
<label>[20]</label>
<mixed-citation publication-type="other">Assari S, Caldwell CH, Mincy R: Family socioeconomic status at birth and youth impulsivity at age 15; Blacks' diminished return. Children 2018, 5(5):58.
</mixed-citation>
</ref>
<ref id="R21">
<label>[21]</label>
<mixed-citation publication-type="other">Assari S, Cobb S, Saqib M, Bazargan M: Diminished returns of educational attainment on heart disease among Black Ameri-cans. The open cardiovascular medicine journal 2020, 14:5.
</mixed-citation>
</ref>
<ref id="R22">
<label>[22]</label>
<mixed-citation publication-type="other">Assari S, Mistry R: Diminished Return of Employment on Ever Smoking Among Hispanic Whites in Los Angeles. Health Eq-uity 2019, 3(1):138-144.
</mixed-citation>
</ref>
<ref id="R23">
<label>[23]</label>
<mixed-citation publication-type="other">Assari S, Najand B, Sheikhattari P: Household income and subsequent youth tobacco initiation: Minorities' Diminished Re-turns. Journal of Medicine, Surgery, and Public Health 2024, 2:100063.
</mixed-citation>
</ref>
<ref id="R24">
<label>[24]</label>
<mixed-citation publication-type="other">Assari S, Sheikhattari P, Zare H: Blacks' Diminished Returns of Parental Education on Household Income: A Study of College Students in the US. Open Journal of Educational Research 2024, 4(4):187-196.
</mixed-citation>
</ref>
<ref id="R25">
<label>[25]</label>
<mixed-citation publication-type="other">Assari S, Zare H: Household Income and Offspring Education Explain Blacks' Diminished Returns of Parental Educa-tion. Open Journal of Psychology 2024, 4(1):18-29.
</mixed-citation>
</ref>
<ref id="R26">
<label>[26]</label>
<mixed-citation publication-type="other">Assari S, Zare H: Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Re-turns. Global Journal of Epidemiology and Infectious Disease 2024, 4(1):34-43.
</mixed-citation>
</ref>
<ref id="R27">
<label>[27]</label>
<mixed-citation publication-type="other">Barsha RAA, Assari S, Hossain MB, Apata J, Sheikhattari P: Black Americans' Diminished Return of Educational Attainment on Tobacco Use in Baltimore City. J Racial Ethn Health Disparities 2023, 10(6):3178-3187.
</mixed-citation>
</ref>
<ref id="R28">
<label>[28]</label>
<mixed-citation publication-type="other">Boyce S, Darvishi M, Marandi R, Rahmanian R, Akhtar S, Patterson J, Assari S: Review Paper Racism-Related Diminished Returns of Socioeconomic Status on Adolescent Brain and Cognitive Development.
</mixed-citation>
</ref>
<ref id="R29">
<label>[29]</label>
<mixed-citation publication-type="other">Assari S, Bazargan M: Parental Educational Attainment and Black-White Adolescents' Achievement Gap: Blacks' Diminished Returns. Open Journal of Social Sciences 2020, 8(3):282-297.
</mixed-citation>
</ref>
<ref id="R30">
<label>[30]</label>
<mixed-citation publication-type="other">Zare H, Assari S: Non-hispanic Black Americans' diminished protective effects of educational attainment and employment against cardiometabolic diseases: NHANES 1999-2016. Austin journal of public health and epidemiology 2021, 8(4).
</mixed-citation>
</ref>
<ref id="R31">
<label>[31]</label>
<mixed-citation publication-type="other">Assari S, Boyce S, Bazargan M, Caldwell CH. Race, Socioeconomic Status, and Sex Hormones among Male and Female American Adolescents. Reprod Med (Basel). 2020 Sep;1(2):108-121. doi: 10.3390/reprodmed1020008.
</mixed-citation>
</ref>
<ref id="R32">
<label>[32]</label>
<mixed-citation publication-type="other">Lynam DR, Smith GT, Whiteside SP, Cyders MA. The UPPS-P: Assessing Five Personality Pathways to Impulsive Behavior. West Lafayette, IN: Purdue University; (2006).
</mixed-citation>
</ref>
<ref id="R33">
<label>[33]</label>
<mixed-citation publication-type="other">Laube C, Fuhrmann D. Is early good or bad? Early puberty onset and its consequences for learning. Current Opinion in Be-havioral Sciences. 2020 Dec 1;36:150-6.
</mixed-citation>
</ref>
<ref id="R34">
<label>[34]</label>
<mixed-citation publication-type="other">Sun Y, Liu H, Mu C, Liu P, Hao C, Xin Y. Early puberty: a review on its role as a risk factor for metabolic and mental disor-ders. Frontiers in Pediatrics. 2024 Sep 12;12:1326864.
</mixed-citation>
</ref>
<ref id="R35">
<label>[35]</label>
<mixed-citation publication-type="other">Herman ME, PA G, Bourdony C, Slora E, Wasserman R. Early puberty: a cautionary tale. Pediatrics. 2001 Mar 1;107(3):609-10.
</mixed-citation>
</ref>
<ref id="R36">
<label>[36]</label>
<mixed-citation publication-type="other">James J, Ellis BJ, Schlomer GL, Garber J. Sex-specific pathways to early puberty, sexual debut, and sexual risk taking: Tests of an integrated evolutionary-developmental model. Developmental psychology. 2012 May;48(3):687.
</mixed-citation>
</ref>
<ref id="R37">
<label>[37]</label>
<mixed-citation publication-type="other">Golub MS, Collman GW, Foster PM, Kimmel CA, Rajpert-De Meyts E, Reiter EO, Sharpe RM, Skakkebaek NE, Toppari J. Public health implications of altered puberty timing. Pediatrics. 2008 Feb 1;121(Supplement_3):S218-30.
</mixed-citation>
</ref>
<ref id="R38">
<label>[38]</label>
<mixed-citation publication-type="other">Dimler LM, Natsuaki MN. The effects of pubertal timing on externalizing behaviors in adolescence and early adulthood: A meta-analytic review. Journal of Adolescence. 2015 Dec 1;45:160-70.
</mixed-citation>
</ref>
<ref id="R39">
<label>[39]</label>
<mixed-citation publication-type="other">Haynie DL. Contexts of risk? Explaining the link between girls' pubertal development and their delinquency involvement. Social Forces. 2003 Sep 1;82(1):355-97.
</mixed-citation>
</ref>
<ref id="R40">
<label>[40]</label>
<mixed-citation publication-type="other">Reynolds BM, Juvonen J. The role of early maturation, perceived popularity, and rumors in the emergence of internalizing symptoms among adolescent girls. Journal of youth and adolescence. 2011 Nov;40:1407-22.
</mixed-citation>
</ref>
<ref id="R41">
<label>[41]</label>
<mixed-citation publication-type="other">Lee JM. Growing Up Too Fast? An Examination of Pubertal Timing and Childhood Social Wariness in the Development of Adolescent Depression. The University of North Carolina at Greensboro; 2023.
</mixed-citation>
</ref>
<ref id="R42">
<label>[42]</label>
<mixed-citation publication-type="other">Delevich K, Wilbrecht L. Role of puberty on adult behaviors. InOxford research encyclopedia of neuroscience 2020 Jul 30.
</mixed-citation>
</ref>
<ref id="R43">
<label>[43]</label>
<mixed-citation publication-type="other">Kretsch N, Harden KP. Pubertal development and peer influence on risky decision making. The Journal of Early Adolescence. 2014 Apr;34(3):339-59.
</mixed-citation>
</ref>
<ref id="R44">
<label>[44]</label>
<mixed-citation publication-type="other">Markey CN, Markey PM, Tinsley BJ. Personality, puberty, and preadolescent girls' risky behaviors: Examining the predictive value of the five-factor model of personality. Journal of Research in Personality. 2003 Oct 1;37(5):405-19.
</mixed-citation>
</ref>
<ref id="R45">
<label>[45]</label>
<mixed-citation publication-type="other">Cozzi D, Vinel V. Risky, early, controversial. Puberty in medical discourses. Social Science &#x00026; Medicine. 2015 Oct 1;143:287-96.
</mixed-citation>
</ref>
<ref id="R46">
<label>[46]</label>
<mixed-citation publication-type="other">Collado A, MacPherson L, Kurdziel G, Rosenberg LA, Lejuez CW. The relationship between puberty and risk taking in the real world and in the laboratory. Personality and individual differences. 2014 Oct 1;68:143-8.
</mixed-citation>
</ref>
<ref id="R47">
<label>[47]</label>
<mixed-citation publication-type="other">Downing J, Bellis MA. Early pubertal onset and its relationship with sexual risk taking, substance use and anti-social behav-iour: a preliminary cross-sectional study. BMC public health. 2009 Dec;9:1-1.
</mixed-citation>
</ref>
<ref id="R48">
<label>[48]</label>
<mixed-citation publication-type="other">Donovan A, Assari S, Grella C, Shaheen M, Richter L, Friedman TC. Early Life Stress and Pubertal Predictors of Subsequent Substance Use in a National Diverse Sample of Adolescents: Sex and Substance Type Matter. Drug and Alcohol Dependence. 2025 Jan 13:112551.
</mixed-citation>
</ref>
<ref id="R49">
<label>[49]</label>
<mixed-citation publication-type="other">Donovan A, Assari S, Shaheen M, Grella C, Richter L, Friedman TC. 8256 Early Life Stress and Pubertal Predictors of Youth Substance Use Initiation: Does Sex Moderate the Relationship Between ELS, Puberty, and Substance Use Initiation?. Journal of the Endocrine Society. 2024 Oct;8(Supplement_1):bvae163-1194.
</mixed-citation>
</ref>
<ref id="R50">
<label>[50]</label>
<mixed-citation publication-type="other">Donovan A, Assari S, Grella C, Shaheen M, Richter L, Friedman TC. Early Life Stress and Pubertal Predictors of Subsequent Substance Use in a National Diverse Sample of Adolescents: Sex and Substance Type Matter. Drug and Alcohol Dependence. 2025 Jan 13:112551.
</mixed-citation>
</ref>
    </ref-list>
  </back>
</article>