Association of testosterone and dihydrotestosterone with externalizing behavior in adolescent boys and girls

Abstract

Background: While an association between androgens and different types of aggression has been well documented in male offenders, the influence of androgens on externalizing behavior in adolescents at risk for antisocial behavior has not been investigated so far.

Methods: Plasma levels of the main androgen metabolites testosterone (T) and 5α-dihydrotestosterone (DHT) were measured in $\text{N}\text{=87}$ fourteen-year-old (36 boys, 51 girls) from a prospective longitudinal study of children at risk. Externalizing behavior at age 8, 11 and 14 was assessed using the Achenbach Child Behavior Checklist (CBCL) and Teacher Report Form (TRF).

Results: Significant higher androgen levels (T, DHT) were found in male, but not in female adolescents with elevated scores of externalizing behavior. Moreover, boys with persistent externalizing behavior exhibited the highest levels of plasma androgens.

Conclusions: There is a link between T, DHT and externalizing behavior in male adolescents at risk for psychopathology. Due to the findings of highest androgen levels in boys with persistent externalizing behavior, a role of androgens in the development of disruptive or later antisocial disorders can be hypothesized.

Introduction

Although there is clear evidence from animal studies that androgens provide both organizational and activational effects on aggressive behavior (Brain and Haug, 1992), the available findings in humans are inconclusive (review by Archer, 1991, Rubinow and Schmidt, 1996). The human concept of ‘aggression’ or ‘aggressiveness’ comprises different facets of a complex behavior pattern subsuming various forms of disturbed social interactions like proactive, reactive, instrumental, verbal, physical, overt and covert kinds of aggression. Moreover, in studies establishing a positive link between androgens and aggression elements of violent, destructive, dominant, hostile, delinquent and antisocial behavior are involved as well (Mattson et al., 1980, Christiansen and Knussmann, 1987, Dabbs and Morris, 1990, Dabbs et al., 1991). In humans, far more than in animals, the manifestation of aggression is influenced by learning processes during socialization. Besides interindividual differences, types of aggressive behavior can be combined at one time and are changing in their occurrence over life span intraindividually. Especially in children and adolescents running through stages of social and biological development within a short time, aggressive behavior can vary considerably, although it has been shown that aggressiveness is one of the most stable personality traits during the course of life (Huesmann et al., 1984).

In child and adolescent psychiatry the term externalizing problems reflects one of the two main dimensions of psychopathology that have been detected in multivariate analyses of behavior problems in children and adolescents subsuming both delinquent and aggressive behavior (Achenbach, 1991). Higher levels of externalizing behavior in children and adolescents have been shown to predict violence and criminality in adulthood (Loeber and Hay, 1997).

Few studies provide evidence of androgen effects on child and adolescent behavior. Published findings are mainly confined to children from clinical samples and results are inconsistent (Susman et al., 1987, Olweus et al., 1988, Constantino et al., 1993, van Goozen et al., 1998, van Goozen et al., 2000). So far, longitudinal studies investigating the link between androgens and behavior outcomes in non-clinical samples are missing. Moreover, various androgen and epiandrosterone metabolites can display different and in part additive effects on brain organization and activation. Thus, it is reasonable to measure at least the concentration of testosterone (T) and 5alpha-dihydrotestosterone (DHT), both strongly effecting fetal and perinatal brain development and later brain function and plasticity ( Swerdloff et al., 1992, Rubinow and Schmidt, 1996, Fitch and Denenberg, 1998).

The aim of the present study was to investigate the influence of androgens on externalizing behavior in adolescents at risk for later antisocial development. Androgen levels, controlled for gender and Tanner status, were compared between groups defined by their intensity of aggressive and delinquent behavior as measured by parent and teacher ratings. Both, concurrent behavior as well as the persistence of behavior were considered.