Testosterone and its effects on human male adolescent mood and behavior: a systematic review

Do testosterone and cortisol levels moderate aggressive responses to peer victimization in adolescents?

Aggressive reactions to peer victimization may be tempered by hormone levels. Grounded on the dualhormone hypothesis (DHH), which proposes that testosterone (T) is associated with aggressive behavior only when cortisol (C) is low, this study assessed whether the combination of T and C moderated adolescents' aggressive responses to peer victimization. The study involved 577 adolescents (50.4% girls, aged 12-17 years), who completed measures of online and offline victimization and perpetration of aggressive behavior in three waves over the course of one year. Moreover, they provided salivary samples to measure T and C levels. Multilevel analyses showed a three-way interaction between T, C, and victimization levels for both online and offline aggressive behaviors. In both cases, the adolescents with high T and high C or low T and low C responded with more aggressive behaviors when victimized or provoked by peers. The T/C ratio was only associated with aggressive behavior in the girls' sample. The results are opposite to those predicted by the DHH, but they are consistent with the findings of other studies that examined aggressive behaviors as reactions to provocations. These results suggest that some combinations of T and C predict higher aggressive reactions to peer victimization.

An overview on androgen-mediated actions in skeletal muscle and adipose tissue

Androgens are a class of steroid hormones primarily associated with male sexual development and physiology, but exert pleiotropic effects in either sex. They have a crucial role in various physiological processes, including the regulation of skeletal muscle and adipose tissue homeostasis. The effects of androgens are mainly mediated through the androgen receptor (AR), a ligand-activated nuclear receptor expressed in both tissues. In skeletal muscle, androgens via AR exert a multitude of effects, ranging from increased muscle mass and strength, to the regulation of muscle fiber type composition, contraction and metabolic functions. In adipose tissue, androgens influence several processes including proliferation, fat distribution, and metabolism but they display depot-specific and organism-specific effects which differ in certain context. This review further explores the potential mechanisms underlying androgen-AR signaling in skeletal muscle and adipose tissue. Understanding the roles of androgens and their receptor in skeletal muscle and adipose tissue is essential for elucidating their contributions to physiological processes, disease conditions, and potential therapeutic interventions.

Association of urinary sex hormones with mood and behavior changes in a community adolescent cohort

OBJECTIVE

To examine the contribution of variation in sex hormone excretion to mood and behavioral changes in adolescent females and males.

DESIGN

Prospective, longitudinal observational cohort study.

METHODS

Participants were 342 volunteers aged 10-12 years living in rural Australia. Urinary estradiol and testosterone levels measured by liquid chromatography-mass spectrometry were obtained at three-month intervals for three years. Integrated measures (area-under-curve) of urinary steroid excretion summarised as absolute and variability during each 12-month period of the study. Psychosocial data were gathered annually with the primary outcome of depressive symptomatology. Secondary outcomes were the other subscales of the Youth Self-Report, impulsive-aggression, sleep habits, and self-harm.

RESULTS

277 (158 male) participants contributed data over the full duration of the study and could be included in the analyses. In females, analyses of absolute urine hormone levels found no relationship between estradiol and any outcome, but higher testosterone was significantly associated with depression and poorer sleep. Greater variability of both urine estradiol and testosterone was associated with lower total psychopathology, anxious/depressed and social problems scores. Greater variability in urine estradiol was associated with lower attention problems and impulsive aggression in females. In males, higher testosterone and estradiol levels were associated with rule-breaking, and poorer sleep, and no associations were found for gonadal hormone variability for males.

CONCLUSIONS

Longitudinal measurement of both iso-sexual and contra-sexual gonadal hormones contributes to a more nuanced view of the impact of sex steroids on mood and behavior in adolescents. These findings may enlighten the understanding of the impact of sex steroids during normal male and female puberty with implications for hormone replacement therapies as well as management of common mood and behavioral problems.

Biobehavioral mechanisms underlying testosterone and mood relationships in peripubertal female adolescents

The pubertal transition is characterized by pronounced sex hormone fluctuation, refinement of affective neural circuitry, and an increased risk of depression in female adolescents. Sex hormones, including testosterone, exert modulatory effects on frontal-limbic brain networks and are associated with emotion dysregulation and depressive symptoms. Weekly changes in hormones predict affective symptoms in peripubertal female adolescents, particularly in the context of stress; however, the biobehavioral mechanisms underlying hormone change and mood relationships during the pubertal transition have yet to be determined and was the objective of the present study. Forty-three peripubertal female adolescents (ages 11-14) collected 8-weekly salivary hormone (estrone, testosterone) samples and mood assessments to evaluate hormone-mood relationships, followed by a biobehavioral testing session with psychosocial stress and EEG. Within-person correlations between weekly hormone changes and corresponding mood were performed to determine individual differences in mood sensitivity to weekly hormone change. Increased frontal theta activity indexing emotion reactivity, reduced cortisol reactivity, and reduced vagal efficiency predicted the strength of the relationship between testosterone and mood. Further, testosterone-sensitivity strength was associated with the enhancement of negative affect following stress testing. Results identify divergent frontal theta and stress responses as potential biobehavioral mechanisms underlying mood sensitivity to peripubertal testosterone fluctuation.

Hair androgen concentrations and depressive disorders in adolescents from the general population

Although the link between androgens and depression is well established in adults, the effects of cofactors on this association are less clearly understood, particularly in youth. Epidemiological cohort study of adolescents in Dresden, Germany. Analyses comprised data of 985 individuals assessed at baseline and of 512 individuals at 1-year follow-up. We investigated multivariable regression models for cross-sectional and longitudinal associations of hair testosterone, dehydroepiandrosterone (DHEA), and their cortisol ratios with 12-month diagnoses of major depressive disorder (MDD) and MDD without any anxiety disorder assessed with standardized diagnostic interview (DIA-X-5), and with dimensional depression scores (PHQ-9, PROMIS), separately for males and females. The potential moderating effect of social support was determined. Cross-sectional analyses yielded inverse associations of testosterone and DHEA with MDD and MDD without any anxiety disorders in males. In cross-sectional and longitudinal analyses, baseline ratio cortisol/DHEA was significantly, inversely associated to PROMIS-depression in males. Only cross-sectional associations for ratio cortisol/DHEA and PROMIS-depression remained significant after Bonferroni-Holm correction. No robust associations were observed in female participants. Social support exerted no consistent moderating effect on the investigated association. The present observational cohort study showed no consistent association of hair androgen concentrations with depressive disorders in adolescents. However, findings provide some support for the association between the cortisol/DHEA ratio and depression in males. Longitudinal research designs in large samples are needed to understand the interplay between androgens, depression, and developmental and social factors in youth.

Peripheral Inflammatory Markers in Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder at Adolescent Age

Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are associated with immune dysregulation. We aimed to estimate the pro- and anti-inflammatory activity/balance in ASD and ADHD patients at a little-studied adolescent age with respect to sex. We evaluated 20 ASD patients (5 girls, average age: 12.4 ± 1.9 y), 20 ADHD patients (5 girls, average age: 13.4 ± 1.8 y), and 20 age- and gender-matched controls (average age: 13.2 ± 1.9 y). The evaluated parameters included (1) white blood cells (WBCs), neutrophils, monocytes, lymphocytes, platelets, platelet distribution width (PDW), mean platelet volume, and derived ratios, as well as (2) cytokines-interferon-gamma, interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, tumor necrosis factor-alpha (TNF-α), and derived profiles and ratios. ASD adolescents showed higher levels of WBC, monocytes, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10, macrophages (M)1 profile, and anti-inflammatory profile than the controls, with ASD males showing higher monocytes, IL-6 and IL-10, anti-inflammatory profile, and a lower T-helper (Th)1/Th2+T-regulatory cell ratio than control males. The ADHD adolescents showed higher levels of PDW, IL-1β and IL-6, TNF-α, M1 profile, proinflammatory profile, and pro-/anti-inflammatory ratio than the controls, with ADHD females showing a higher TNF-α and pro-/anti-inflammatory ratio than the control females and ADHD males showing higher levels of IL-1β and IL-6, TNF-α, and M1 profile than the control males. Immune dysregulation appeared to be different for both neurodevelopmental disorders in adolescence.

Reduction of aggressive behaviour following hypothalamic deep brain stimulation: Involvement of 5-HT1A and testosterone

BACKGROUND

Aggressive behaviour (AB) may occur in patients with different neuropsychiatric disorders. Although most patients respond to conventional treatments, a small percentage continue to experience AB despite optimized pharmacological management and are considered to be treatment-refractory. For these patients, hypothalamic deep brain stimulation (pHyp-DBS) has been investigated. The hypothalamus is a key structure in the neurocircuitry of AB. An imbalance between serotonin (5-HT) and steroid hormones seems to exacerbate AB.

OBJECTIVES

To test whether pHyp-DBS reduces aggressive behaviour in mice through mechanisms involving testosterone and 5-HT.

METHODS

Male mice were housed with females for two weeks. These resident animals tend to become territorial and aggressive towards intruder mice placed in their cages. Residents had electrodes implanted in the pHyp. DBS was administered for 5 h/day for 8 consecutive days prior to daily encounters with the intruder. After testing, blood and brains were recovered for measuring testosterone and 5-HT receptor density, respectively. In a second experiment, residents received WAY-100635 (5-HT_1A antagonist) or saline injections prior to pHyp-DBS. After the first 4 encounters, the injection allocation was crossed, and animals received the alternative treatment during the next 4 days.

RESULTS

DBS-treated mice showed reduced AB that was correlated with testosterone levels and an increase in 5-HT1_A receptor density in the orbitofrontal cortex and amygdala. Pre-treatment with WAY-100635 blocked the anti-aggressive effect of pHyp-DBS.

CONCLUSIONS

This study shows that pHyp-DBS reduces AB in mice via changes in testosterone and 5-HT1_A mechanisms.

Added value of neurotechnology for forensic psychiatric and psychological assessment

The attention for neuroscience in relation to criminal behavior is growing rapidly, and research shows that neurobiological factors have added value to the understanding of psychological and social factors in explaining delinquency. There is evidence that neurotechnology can be used in criminal justice and may be of relevance for forensic psychiatric and psychological assessment. However, the question is whether scientific knowledge of neurobiological factors is applicable in daily practice of forensic assessment. Incorporation of basic technologies, e.g., psychophysiology (heart rate, skin conductance, wearables), hormonal measures (cortisol, testosterone), and neuropsychological testing might be evident, since they can be applied relatively easy. Moreover, a body of research shows the additive value of these technologies in this field. In addition, first steps are taken to apply these technologies in individual diagnostics, treatment, and risk assessment. Complex neurotechnologies like functional MRI (e.g., brain reading) and EEG show potential to be applicable in criminal justice, once it is known what additional information these indices offer for individual cases.

A dual-system, machine-learning approach reveals how daily pubertal hormones relate to psychological well-being in everyday life

The two studies presented in this paper seek to resolve mixed findings in research linking activity of pubertal hormones to daily adolescent outcomes. In study 1 we used a series of Confirmatory Factor Analyses to compare the fit of one and two-factor models of seven steroid hormones (n = 994 participants, 8084 samples) of the HPA and HPG axes, using data from a field study (https://www.icpsr.umich.edu/web/ICPSR/studies/38180) collected over ten consecutive weekdays in a representative sample of teens starting high school. In study 2, we fit a Bayesian model to our large dataset to explore how hormone activity was related to outcomes that have been demonstrated to be linked to mental health and wellbeing (self-reports of daily affect and stress coping). Results reveal, first that a two-factor solution of adolescent hormones showed good fit to our data, and second, that HPG activity, rather than the more often examined HPA activity, was associated with improved daily affect ratios and stress coping. These findings suggest that field research, when it is combined with powerful statistical techniques, may help to improve our understanding of the relationship between adolescent hormones and daily measures of well-being.

Individual's Reproductive Strategies Moderates the Association Between Facial Width-to-Height and Risk-Taking Propensity

Previous research has yielded mixed findings on the relationship between facial width-to-height ratio (fWHR), an androgen-dependent feature, and risk-taking propensity. We argue that mixed findings might result from overlooked variables. Given that risk-taking propensity might be ultimately linked to a search for mating opportunities, we analyze if reproductive strategies moderate the relationship between fWHR and risk-taking propensity. Our results, obtained from a sample of 434 male participants, show a positive association between fWHR and recreational and social risk-taking only for men who are more motivated to focus on mating effort over offspring survival. This finding aligns with research arguing that risk-taking may be a mating strategy since being social and recreational risk-prone might illustrate physical and psychological qualities and improve one's ability to attract mates. Our results support the notion that risk-taking might be a domain-specific construct. Overall, our research is in line with recent findings suggesting that the impact of testosterone exposure on risk-taking propensity is best understood when considering the role of contextual variables. Consequently, we add to previous research that studies related to risk-taking propensity should account for reproductive strategies.

Psychobiological Correlates of Aggression in Female Adolescents with Borderline Personality Disorder

INTRODUCTION

Aggressive behavior in reaction to threats, frustration, or provocation is prevalent in borderline personality disorder (BPD). This study investigated aggressive behavior and its biological correlates in adolescents with BPD.

METHODS

Twenty-one female adolescents with a DSM-IV BPD diagnosis and 25 sex- and age-matched healthy controls participated in the Taylor Aggression Paradigm (TAP), a laboratory-based experiment measuring aggressive behavior in the interpersonal context. Heart rate was measured and saliva samples were taken throughout the experiment.

RESULTS

Multilevel mixed-effects linear regression analyses revealed no significant group difference in aggressive behavior induced by the TAP. Additionally, the two groups did not differ in cortisol, testosterone, and heart rate responses to the aggression induction. The BPD group showed a significant cortisol increase in the time preceding the start of the TAP in contrast to the healthy control group, in whom a significant heart rate increase from baseline to the first block of the TAP was observed.

DISCUSSION

There was no evidence, either at the phenomenological or the biological level, of increased task-induced aggression in adolescents with BPD. The results may indicate that adolescents with BPD experienced fearful stress in anticipation of the experimental task in contrast to healthy controls who showed an adaptive response of the autonomic nervous system necessary to deal with the upcoming demand.

Psychobiological risk factors for suicidal thoughts and behaviors in adolescence: a consideration of the role of puberty

Suicide is the second leading cause of death among adolescents. While clinicians and researchers have begun to recognize the importance of considering multidimensional factors in understanding risk for suicidal thoughts and behaviors (STBs) during this developmental period, the role of puberty has been largely ignored. In this review, we contend that the hormonal events that occur during puberty have significant effects on the organization and development of brain systems implicated in the regulation of social stressors, including amygdala, hippocampus, striatum, medial prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex. Guided by previous experimental work in adults, we also propose that the influence of pubertal hormones and social stressors on neural systems related to risk for STBs is especially critical to consider in adolescents with a neurobiological sensitivity to hormonal changes. Furthermore, facets of the pubertal transition, such as pubertal timing, warrant deeper investigation and may help us gain a more comprehensive understanding of sex differences in the neurobiological and psychosocial mechanisms underlying adolescent STBs. Ultimately, advancing our understanding of the pubertal processes that contribute to suicide risk will improve early detection and facilitate the development of more effective, sex-specific, psychiatric interventions for adolescents.

Cardiovascular Health of Youth During Gender-Affirming Testosterone Treatment: A Review

PURPOSE

Many birth-assigned female/transgender male and nonbinary people (identified as masculine spectrum here) begin gender-affirming testosterone therapy by the age of 24 years. Few data inform assessment of cardiovascular health of masculine spectrum youth as a specific subgroup of the 1.5 million transgender people in the United States. The purpose of this review is to help youth-serving practitioners consider, understand, and evaluate cardiovascular health in adolescent and young adult masculine spectrum patients receiving gender-affirming testosterone treatment.

METHODS

This is a narrative review intended to synthesize a broad body of clinical and research literature.

RESULTS

Common cardiovascular health changes associated with testosterone include increased red blood cell mass and likely insignificant changes in high-density lipoprotein and low-density lipoprotein levels. Changes in heart mass, heart electrophysiology, and endothelial reactivity are likely, based on extrapolation of data from adults. Testosterone may have indirect effects on cardiovascular health through influences on depression, anxiety, stress, and anorexia nervosa as well as on behaviors such as tobacco use.

CONCLUSIONS

Testosterone contributes importantly to the cardiovascular health and well-being of masculine spectrum gender-diverse youth. We need to do a better job of supporting these young people with data on cardiovascular health over the life span.

Longitudinal Changes After Amygdala Surgery for Intractable Aggressive Behavior: Clinical, Imaging Genetics, and Deformation-Based Morphometry Study-A Case Series

BACKGROUND

Intractable aggressive behavior (iAB) is a devastating behavioral disorder that may affect psychiatric patients. These patients have reduced quality of life, are more challenging to treat as they impose a high caregiver burden and require specialized care. Neuromodulatory interventions targeting the amygdala, a key hub in the circuitry of aggressive behavior (AB), may provide symptom alleviation.

OBJECTIVE

To Report clinical and imaging findings from a case series of iAB patients treated with bilateral amygdala ablation.

METHODS

This series included 4 cases (3 males, 19-32 years old) who underwent bilateral amygdala radiofrequency ablation for iAB hallmarked by life-threatening self-injury and social aggression. Pre- and postassessments involved full clinical, psychiatric, and neurosurgical evaluations, including scales quantifying AB, general agitation, quality of life, and magnetic resonance imaging (MRI).

RESULTS

Postsurgery assessments revealed decreased aggression and agitation and improved quality of life. AB was correlated with testosterone levels and testosterone/cortisol ratio in males. No clinically significant side effects were observed. Imaging analyses showed preoperative amygdala volumes within normal populational range and confirmed lesion locations. The reductions in aggressive symptoms were accompanied by significant postsurgical volumetric reductions in brain areas classically associated with AB and increases in regions related to somatosensation. The local volumetric reductions are found in areas that in a normal brain show high expression levels of genes related to AB (eg, aminergic transmission) using gene expression data provided by the Allen brain atlas.

CONCLUSION

These findings provide new insight into the whole brain neurocircuitry of aggression and suggest a role of altered somatosensation and possible novel neuromodulation targets.

Role of insulin-like growth factor 1, sex and corticosteroid hormones in male major depressive disorder

BACKGROUND

Hormones of the hypothalamic-pituitary-gonadal (HPG), hypothalamic-pituitary-adrenal (HPA), and hypothalamic-pituitary-somatotropic (HPS) axes are potentially involved in major depressive disorder (MDD), but these hormones have not been simultaneously investigated in male patients with MDD. We investigated the association between male MDD symptoms and estradiol, testosterone, cortisol, dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF1).

METHODS

Serum estradiol, testosterone, cortisol, DHEAS, and IGF1 levels were measured in 54 male patients with MDD and 37 male controls and were compared with clinical factors. We investigated the associations between hormone levels and Hamilton Depression Rating Scale (HAM-D) scores. The correlations among hormones were also investigated.

RESULTS

Patients had significantly lower estradiol levels than controls (22.4 ± 8.4 pg/mL vs. 26.1 ± 8.5 pg/mL, P = 0.040). Serum estradiol levels were negatively correlated with HAM-D scores (P = 0.000094) and positively correlated with Global Assessment of Functioning scores (P = 0.000299). IGF1 levels and the cortisol:DHEAS ratio were higher in patients than in controls (IGF1: 171.5 ± 61.8 ng/mL vs. 144.1 ± 39.2 ng/mL, P = 0.011; cortisol:DHEAS ratio: 0.07 ± 0.05 vs. 0.04 ± 0.02, P = 0.001). DHEAS levels were lower in patients than in controls (227.9 ± 108.4 μg/dL vs. 307.4 ± 131.2 μg/dL, P = 0.002). IGF1, cortisol:DHEAS ratio, and DHEAS were not significantly correlated with HAM-D scores. Cortisol and testosterone levels were not significantly different between patients and controls. Serum estradiol levels were positively correlated with DHEAS levels (P = 0.00062) in patients, but were not significantly correlated with DHEAS levels in controls.

CONCLUSION

Estradiol may affect the pathogenesis and severity of patients with MDD in men, and other hormones, such as those in the HPA and HPS axes, may also be involved in male MDD. Additionally, a correlation between estradiol and DHEAS may affect the pathology of MDD in men.

Hearing the unheard voice-puberty experiences of young Pakistani men: A qualitative study

INTRODUCTION

Puberty experiences of male adolescents can have significant impacts on physical and psychological health outcomes. This qualitative study explored the puberty experiences of young males in Pakistan, as there are limited accounts of what shapes these puberty experiences, especially for adolescent males living in a restrictive culture.

METHODS

Twenty-two young Pakistani men (aged 18-21 years) from two urban sites in Karachi participated in individual face-to-face (n=19) and Skype (n=3) interviews. Qualitative thematic analysis was conducted using an inductive approach to identity and examine the patterns emerging from the data.

RESULTS

Participants described puberty as a challenging phase for which they were unprepared with a combination of various socio-cultural factors exposing them to negative impacts. As a result, young men expressed feelings of anxiety, embarrassment and isolation. Societal and gender norms around masculinity, sexuality and the roles and responsibilities of young men had a significant impact on how participants experienced puberty. While negative reactions towards puberty were dominant, participants described adopting coping strategies (e.g. social support) to help them deal with negative experiences.

CONCLUSIONS

Findings highlight the significance of culturally appropriate puberty education and various facilitating factors that may improve the puberty experiences for future young men. While extending current literature, this study also identifies key factors that could inform the development of health promotion programmes, which may aid adolescent males' puberty transition and positively influence their long-term health, well-being and identity.

Evaluation of Shoulder and Knee Isokinetic Strength Profile Among Elite Adolescent Badminton Players

CONTEXT

Badminton continues to be a highly competitive sport where training is introduced at an early age and load has intensified. This exposes players to a greater risk of injuries, in particular when assessing related training outcomes such as strength, agonist-antagonist ratio, and bilateral deficit among adolescents where age- and sex-associated growth and development should be considered.

OBJECTIVE

To evaluate strength profile of the upper and lower limbs among adolescent elite Malaysian badminton players.

DESIGN

Cross-sectional study.

SETTING

Laboratory.

PARTICIPANTS

Forty-eight asymptomatic athletes (24 males and 24 females) were grouped into early and late adolescence (13-14 y old and 15-17 y old, respectively).

MAIN OUTCOME MEASURE(S)

Strength (absolute and normalized) of the external/internal rotators of the shoulder and flexor/extensor of the knee and strength derivatives, conventional strength ratio (CSR), dynamic control ratio (DCR), and bilateral deficits were measured.

RESULTS

Males showed greater strength in all strength indices (P < .05). The older group had greater strength compared to younger for most of the upper and lower limb indices (P < .05); these effects diminished when using normalized data. For females, there was no age group effect in the shoulder and knee strength. All players displayed lower shoulder and knee normative values for CSR and DCR. Dominant and non-dominant knee strength were comparable between sex and age groups.

CONCLUSIONS

For males, growth and maturation had a greater contribution to strength gained compared to training, whereas for females, growth, maturation, and training did not improve strength. The normalized data indicated that training did not improve all indices measured apart from external rotator strength in females. All players also displayed lower normative values of CSR and DCR. These results suggest that training in elite adolescent Malaysian badminton players lacks consideration of strength gain and injury risk factors.

Size Matters: The CAG Repeat Length of the Androgen Receptor Gene, Testosterone, and Male Adolescent Depression Severity

There is a distinct increase in the prevalence of depression with the onset of puberty. The role of peripubertal testosterone levels in boys in this context is insufficiently understood and may be modulated by a functional polymorphism of the androgen receptor gene (AR), a variable number of CAG repeats. Moreover, there is preliminary evidence that the relationship between testosterone, CAG repeat length, and the severity of depressive symptoms may differ between subclinical and overt depression, but this has neither been studied in a clinical sample of adolescents with depression nor compared between subclinical and overt depression in an adequately powered study. To investigate the relationship between free testosterone, CAG repeat length of the AR, depression status (subclinical vs. overt), and the severity of depressive symptoms, 118 boys treated as in- or daycare patients at a single psychiatric hospital were studied. Of these, 73 boys had at least mild depressive symptoms according to the Beck Depression Inventory-II (BDI-II > 13). Higher-order moderation analysis in the multiple regression framework revealed a constant relationship between free testosterone and depression severity irrespective of the number of CAG repeats in adolescents with a BDI-II score ≤ 13. In adolescents with a BDI-II score > 13, however, there was a significant negative relationship between free testosterone and BDI-II score in patients with <19 CAG repeats and a significant positive relationship regarding free testosterone and BDI-II score in those with more than 28 CAG repeats, even when considering important covariates. These results suggest that the effects of testosterone on mood in male adolescents with depression depend on the genetic make-up of the AR as well as on depression status. This complex relationship should be considered by future studies addressing mental health issues against an endocrine background and may, moreover, contribute to tailored treatment concepts in psychiatric medicine, especially in adults.

Gender Role, But Not Sex, Shapes Humans' Susceptibility to Emotion

It is unknown whether the famous sex-related difference in emotion processing is accounted for by biological sex, gender role, or their interaction. To clarify the issue, in Study 1 we recorded event-related potentials in response to negative and positive images of diverse intensities when 47 masculine (26 males) and 47 feminine (22 males) subjects performed a non-emotional task. The occipital P1 and N1 amplitudes were larger in women than in men, while feminine subjects showed larger N1 amplitudes than masculine subjects, regardless of sex. Moreover, feminine subjects showed enhanced frontocentral N2 (210-270 ms) amplitudes for highly and mildly negative than for neutral stimuli, while masculine subjects showed an emotion effect only for highly negative stimuli. The feminine-specific effect for mildly negative stimuli was positively correlated to the feminine score, and this correlation was located to the anterior cingulate and the superior and medial frontal gyri. Furthermore, feminine but not masculine subjects showed enhanced parietal P3 (330-560 ms) amplitudes for highly and mildly positive than for neutral stimuli, an effect positively related to the feminine score and localized to the precuneus, posterior cingulate, and superior temporal gyrus. Machine learning analyses verified that single-trial N2 and P3 amplitudes of feminine subjects reliably discriminated the intensity of negative and positive stimuli, respectively. For ecological considerations, in Study 2 we used an observational approach (n = 300) and confirmed that feminine gender role, rather than biological sex, predicted individual differences in daily experience of emotion-related psychopathological symptoms. These findings provide solid evidence for the critical impact of gender role rather than sex on emotional susceptibility.

Androgens During Infancy, Childhood, and Adolescence: Physiology and Use in Clinical Practice

We provide an in-depth review of the role of androgens in male maturation and development, from the fetal stage through adolescence into emerging adulthood, and discuss the treatment of disorders of androgen production throughout these time periods. Testosterone, the primary androgen produced by males, has both anabolic and androgenic effects. Androgen exposure induces virilization and anabolic body composition changes during fetal development, influences growth and virilization during infancy, and stimulates development of secondary sexual characteristics, growth acceleration, bone mass accrual, and alterations of body composition during puberty. Disorders of androgen production may be subdivided into hypo- or hypergonadotropic hypogonadism. Hypogonadotropic hypogonadism may be either congenital or acquired (resulting from cranial radiation, trauma, or less common causes). Hypergonadotropic hypogonadism occurs in males with Klinefelter syndrome and may occur in response to pelvic radiation, certain chemotherapeutic agents, and less common causes. These disorders all require testosterone replacement therapy during pubertal maturation and many require lifelong replacement. Androgen (or gonadotropin) therapy is clearly beneficial in those with persistent hypogonadism and self-limited delayed puberty and is now widely used in transgender male adolescents. With more widespread use and newer formulations approved for adults, data from long-term randomized placebo-controlled trials are needed to enable pediatricians to identify the optimal age of initiation, route of administration, and dosing frequency to address the unique needs of their patients.

Bumpy and Smoother Pathways of Puberty Hormone Change: A Novel Way to Define Gonadal Hormone Trajectories in Adolescents

CONTEXT

The study of gonadal hormone effects on adolescent wellbeing has been limited by logistical challenges. Urine hormone profiling offers new opportunities to understand the health and behavioral implications of puberty hormones.

OBJECTIVE

To characterize pubertal change in urinary testosterone and estradiol among male and female adolescents, respectively.

DESIGN

Three-year prospective cohort study.

SETTING

Australian regional community.

PARTICIPANTS

282 (163 male) normally developing adolescents aged 11.8 ± 1.0 years at baseline.

MAIN OUTCOME MEASURE

Quarterly urine measurements of testosterone and estradiol (mass spectrometry); annual anthropometric assessment and Tanner stage (TS) self-report.

RESULTS

Two-class sigmoidal and quadratic growth mixture models (centered on age at TS3) were identified as best-fit for describing testosterone (male) and estradiol (female) change. Classes 1 (male: 63%; female: 82%) and 2 (male: 37%; female: 18%) were respectively named the "stable" and "unstable" trajectories, characterized by different standard deviation of quarterly hormone change and magnitude of hormone peaks and troughs (all P < 0.001). Compared with class 1 (stable), class 2 males were taller at baseline (154 vs 151 cm), reported earlier and faster TS progression (P < 0.01), and showed higher serum testosterone levels at baseline and 3 years (P ≤ 0.01). Class 2 females exhibited smaller height and weight gains over the 3 years and had higher baseline serum estradiol (249 vs 98 pmol/L; P = 0.002) than class 1.

CONCLUSIONS

Adolescents showed 2 distinct urinary gonadal hormone trajectories, characterized by stability of change over time, which were not associated with consistent anthropometric differences. Results provide a methodology for studying gonadal hormone impacts on other aspects of biopsychosocial wellbeing. Identification of potential "at-risk" hormone groups would be important for planning supportive interventions.

Saliva oxytocin, cortisol, and testosterone levels in adolescent boys with autism spectrum disorder, oppositional defiant disorder/conduct disorder and typically developing individuals

The aim of the current study was to compare levels of oxytocin, cortisol, and testosterone in adolescents with either autism spectrum disorder (ASD), or oppositional defiant disorder (ODD)/conduct disorder (CD), and in typically developing individuals (TDI), and relate hormone levels to severity and subtype of aggression and callous-unemotional (CU) traits. Saliva concentrations of oxytocin, cortisol, and testosterone were assessed in 114 male participants (N = 49 ASD, N = 37 ODD/CD, N = 28 TDI,) aged 12-19 years (M = 15.4 years, SD = 1.9). The ASD and the ODD/CD groups had significantly lower levels of oxytocin than the TDI group, and the ODD/CD group had significantly higher levels of testosterone than the ASD group. There were no group effects on cortisol levels. Group differences remained for oxytocin after correcting for the influence of CU traits, but were not significant after controlling for aggression. Results for testosterone became non-significant after correction for either CU traits or aggression. Across groups, higher levels of CU traits were related to higher levels of cortisol and testosterone, however, proactive and reactive aggression were unrelated to all three hormonal levels. The current findings show that, regardless of cognitive ability or comorbid disorders, the diagnostic groups (ASD, ODD/CD) differ from each other by their hormonal levels, with the ASD group characterized by relative low level of oxytocin, and the ODD/CD group by a relative low level of oxytocin and high level of testosterone. These group effects were partly driven by differences in CU traits between the groups.

Effect of pre-season training phase on anthropometric, hormonal and fitness parameters in young soccer players

The aims of the study were to investigate 1) the effect of 8 weeks of PSP training on anthropometrics, salivary hormones and fitness parameters in youth soccer players, 2) the correlations between fitness and hormonal parameters, and 3) the impact of the experience of the coach and his methodology of training on these parameters. Weight, height, BMI, pubertal development (PDS), salivary Cortisol (sC), salivary Testosterone (sT), salivary sDHEAS, intermittent tests (VO_2max), and countermovement jump test (CMJ) modifications of 35 youth soccer players (age: 14±0 yrs; BMI: 20.8±1.8 k/m²) from two Italian clubs (“Lupa Frascati” -LF-; “Albalonga” -AL) were analysed. A significant (p<0.05) time by club effect was observed in sC (F_(1,31) = 9.7, ES = 1.13), sT (F_(1,31) = 4.2, ES = 0.74), CMJ (F_(1,28) = 26.5, ES = 1.94), and VO_2max (F_(1,28) = 8.5, ES = 1.10). Statistical differences (p<0.05) in weight (F_(1,32) = 25.5, ES = 0.11), sC (F_(1,31) = 32.1, ES = 1.43), sT/sC ratio (F_(1,31) = 10.1, ES = 0.97), sDHEAS/sC ratio (F_(1,31) = 6.3, ES = 0.70), and VO_2max (F_(1,28) = 64.3, ES = 1.74) were found within time factor. Between clubs, differences (p<0.05) in sC (F_(1,32) = 8.5, ES = 1.17), sT (F_(1,31) = 4.2, ES = 0.74), CMJ (F_(1,28) = 26.5, ES = 1.50), and VO_2max (F_(1,28) = 8.5, ES = 1.10) were found. CMJ was inversely correlated with sDHEAS (r = -0.38) before PSP, while Δ of CMJ showed significant correlations with Δ of sC (r = 0.43) and ΔVO_2max was inversely correlated with ΔBMI (r = -0.54) and ΔsC (r = -0.37) in all subjects. Considering each single club, ΔVO_2max showed correlations with ΔBMI (r = -0.45) in AL, while ΔCMJ showed correlations with ΔPDS (r = 0.72) in LF club. Since the PSP is often limited training time to simultaneously develop physical, technical and tactical qualities, an efficient method to distribute the training load is important in youth soccer players to increase the performance and to avoid injuries.

A Biobehavioral Validation of the Taylor Aggression Paradigm in Female Adolescents

This research assessed the behavioral, emotional, endocrinological and autonomic reactivity to the laboratory Taylor Aggression Paradigm (TAP) in a sample of healthy female adolescents. Twenty participants were induced with the TAP to behave aggressively (aggression group) and 20 age-matched participants were not induced to behave aggressively (control group). Regression analysis revealed that the aggression group displayed significant higher levels of aggressive behavior compared to the control group (χ² (2) = 255.50, p < 0.0001). Aggressive behavior was not related to self-reported measures of trait aggression, impulsiveness or psychopathy features. Regarding the biological responses, regression analysis on cortisol, missed the set level of significance (χ² (1) = 3.73, p = 0.054), but showed significant effects on heart rate as a function of aggression induction (χ² (1) = 5.81, p = 0.016). While aggression induction was associated with increased autonomic arousal (heart rate), the interpretation of the effects on cortisol warrant caution, given existing differences between groups at baseline and overly elevated cortisol attributable to the general experimental procedures and not the TAP per se. No differences were found with respect to testosterone. In summary, the present study lends preliminary support for the validity of the TAP and its use in female adolescents on a behavioral and autonomic level.

Testosterone is not associated with traits of optimism or pessimism: Observational evidence from the prospective DETECT study

Background

Previous experimental research on testosterone (T) and psychological traits is inconclusive. Thus, we performed the first large-scale observational study of the association between T and dispositional optimism / pessimism.

Methods

We used prospective data from 6,493 primary-care patients (3,840 women) of the DETECT study (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment), including repeated immunoassay-based measurement of serum T and optimism / pessimism assessed by the revised Life-Orientation Test (LOT-R). Cross-sectional and longitudinal associations of baseline T and one-year change in T with optimism and pessimism were investigated using age- and multivariable-adjusted regression models.

Results

Cross-sectional analyses showed no association of T with optimism or pessimism in both sexes. Longitudinal analyses also showed no association of baseline T with optimism or pessimism at four-year follow-up. Multivariable analyses of total LOT-R score yielded similarly non-significant results (β-coefficient per unit change in T for men: -0.01 (95% CI: -0.24–0.22), women: 0.08 (-0.03–0.20)). Furthermore, change in T was not related to optimism or pessimism at four-year follow-up.

Conclusions

The present observational study of a large-scale prospective sample showed no association of T with optimism or pessimism. Integrating further experimental and interventional evidence from alternative methodological approaches would strengthen this conclusion and establish stronger evidence about the potential hormonal basis of psychological traits.

The association between aggression and risk of Internet gaming disorder in Korean adolescents: the mediation effect of father-adolescent communication style

OBJECTIVES

Open and supportive communication between parents and children is known to reduce adolescents' delinquent behavior. Recently, the risk of Internet gaming disorder (IGD) has been increasing in adolescents. The purpose of this study was to investigate the mediating effects of parent-child communication styles on the relationship between adolescent aggressiveness and risk of IGD.

METHODS

Participants in this study were 402 first-year students from 4 middle schools in Seoul who enrolled in the Internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE) and completed baseline assessment in 2016. The structural equation model was constructed based on an aggression questionnaire, the Internet game use-elicited symptom screen, a mother-child communication inventory, and a father-child communication inventory.

RESULTS

Adolescents' aggressiveness was found to be related to their risk of IGD. The father-child communication style mediated the relationship between aggression and risk of IGD. However, the mother-child communication style had no mediating effect.

CONCLUSIONS

Our findings suggest that fathers should make an effort to improve open and positive communication skills with their children, because the father-child communication style plays an important role in the relationship between adolescent aggressiveness and risk of IGD.

Comparing Postnatal Development of Gonadal Hormones and Associated Social Behaviors in Rats, Mice, and Humans

Postnatal development includes dramatic changes in gonadal hormones and the many social behaviors they help regulate, both in rodents and humans. Parental care-seeking is the most salient social interaction in neonates and infants, play and prosocial behaviors are commonly studied in juveniles, and the development of aggression and sexual behavior begins in peripubertal stages but continues through late adolescence into adulthood. Although parental behaviors are shown after reproductive success in adulthood, alloparenting behaviors are actually high in juveniles as well. These behaviors are sensitive to both early-life organizational effects of gonadal hormones and later-life activational regulation. However, changes in circulating gonadal hormones and the display of the previous behaviors over development differ between rats, mice, and humans. These endpoints are of interest to endocrinologist, toxicologists, and neuroscientists because of their relevance to mental health disorders and their vulnerability to effects of endocrine-disrupting chemical exposure. As such, the goal of this mini-review is to succinctly describe and relate the postnatal development of gonadal hormones and social behaviors to each other, over time, and across animal models. Ideally, this will help identify appropriate animal models and age ranges for continued study of both normative development and in contexts of environmental disruption.

The Increased Sex Differences in Susceptibility to Emotional Stimuli during Adolescence: An Event-Related Potential Study

The present study investigated how pubertal development and sex interact to influence humans’ emotion susceptibility during adolescence. Event-related potentials were recorded for highly emotional, mildly emotional and neutral stimuli in positive and negative blocks, when 73 adolescents (36 pre-/early pubertal students, 19 boys, 10–12 years old; 37 mid-/late pubertal students, 18 boys, 11–13 years old) performed an implicit emotion task. Behavioral analysis showed higher positive mood ratings for pre-/early compared to mid-/late pubertal subjects, irrespective of sex and block. ERP analysis demonstrated increasing Late Positive Potential (LPP) amplitudes from neutral, Mildly Positive (MP) to Highly Positive (HP) stimuli in pre-/early pubertal, but not in mid-/late pubertal adolescents. However, girls exhibited higher P3a amplitudes during mid-/late relative to pre-/early puberty for negative stimuli irrespective of intensity; while this puberty effect was absent in boys. In addition, girls compared to boys exhibited a more pronounced LPP enhancement effect for Highly Negative (HN) stimuli and a lower threshold of responding to negative stimuli in P3b amplitudes, regardless of puberty. These results suggest that, though there is a puberty-independent sensitivity to negative stimuli in girls relative to boys, puberty selectively intensifies girls’ attention bias for negative stimuli and reduces experiential sensitivity to positive stimuli in both sexes. The implication of these results for the sex-related psychopathology during adolescence were discussed.

Sex differences in depression during pregnancy and the postpartum period

Women have a lifetime risk of major depression double that of men but only during their reproductive years. This sex difference has been attributed partially to activational effects of female sex steroids and also to the burdens of pregnancy, childbirth, and parenting. Men, in contrast, have a reproductive period difficult to delineate, and research on the mental health of men has rarely considered the effects of fatherhood. However, the couple goes through a number of potentially stressing events during the reproductive period, and both mothers and fathers are at risk of developing peripartum depression. This Review discusses the literature on maternal and paternal depression and the endocrine changes that may predispose a person to depression at this stage of life, with specific focus on the hypothalamus–pituitary axis, oxytocin, and testosterone levels in men. Important findings on sex differences in the neural correlates of maternal and paternal behavior have emerged, highlighting the relevance of the emotional brain in mothers and the sociocognitive brain in fathers and pointing toward the presence of a common parents' brain. Additionally, sex differences in neurogenesis and brain plasticity are described in relation to peripartum depression. © 2016 The Authors. Journal of Neuroscience Research Published by Wiley Periodicals, Inc.

Within-person changes in salivary testosterone and physical characteristics of puberty predict boys' daily affect

Recent investigations highlighted the role of within-person pubertal changes for adolescents' behavior. Yet, little is known about effects on adolescents' daily affect, particularly regarding the hormonal changes underlying physical changes during puberty. In a study with 148 boys aged 10 to 20years, we tested whether within-person physical and hormonal changes over eight months predicted everyday affect fluctuations, measured with experience sampling. As expected, greater within-person changes in testosterone (but not in dehydroepiandrosterone) were associated with higher affect fluctuations in daily life. Additionally, greater physical changes predicted higher affect fluctuations for individuals in the beginning of puberty. The findings demonstrate the relevance of physical and hormonal changes in boys' affective (in)stability.

Exploring the role of testosterone in the cerebellum link to neuroticism: From adolescence to early adulthood

Previous research has found an association between a smaller cerebellar volume and higher levels of neuroticism. The steroid hormone testosterone reduces stress responses and the susceptibility to negative mood. Together with in vitro studies showing a positive effect of testosterone on cerebellar gray matter volumes, we set out to explore the role of testosterone in the relation between cerebellar gray matter and neuroticism. Structural magnetic resonance imaging scans were acquired, and indices of neurotic personality traits were assessed by administering the depression and anxiety scale of the revised NEO personality inventory and Gray's behavioural avoidance in one hundred and forty-nine healthy volunteers between 12 and 27 years of age. Results demonstrated an inverse relation between total brain corrected cerebellar volumes and neurotic personality traits in adolescents and young adults. In males, higher endogenous testosterone levels were associated with lower scores on neurotic personality traits and larger cerebellar gray matter volumes. No such relations were observed in the female participants. Analyses showed that testosterone significantly mediated the relation between male cerebellar gray matter and measures of neuroticism. Our findings on the interrelations between endogenous testosterone, neuroticism and cerebellar morphology provide a cerebellum-oriented framework for the susceptibility to experience negative emotions and mood in adolescence and early adulthood.

Longitudinal synergies between cortisol reactivity and diurnal testosterone and antisocial behavior in young adolescents

The aims were to identify the correspondence between simultaneous, longitudinal changes in cortisol reactivity and diurnal testosterone and to test the hypothesis that cortisol reactivity and diurnal testosterone interact so as to influence antisocial behavior. Participants were 135 children and young adolescents assessed at 6-month intervals over 1 year. Upon enrollment girls were age 8, 10, or 12 years (N = 69, M = 10.06 years) and boys were age 9, 11, or 13 years (N = 66, M = 10.94 years). Assessments included Tanner staging by a nurse, cortisol reactivity (Trier Social Stress Test for Children), diurnal testosterone, and interviews and questionnaires. Growth models showed that cortisol reactivity and diurnal testosterone basal levels (intercept) and rate of change (slopes) were not related, suggesting different mechanisms of growth. Longitudinal regression analyses assessed cortisol reactivity and diurnal testosterone longitudinally. The interactions of cortisol reactivity and diurnal testosterone showed that when diurnal testosterone was low, boys with low cortisol reactivity were reported to have more behavior problems (i.e., oppositional defiant disorder symptoms and attention problems) than when testosterone was high. In addition, when diurnal testosterone was high, boys with high or moderate cortisol reactivity were significantly higher on total antisocial behavior, attention behavior problems, and oppositional defiant disorder symptoms than when testosterone was low or moderate. The results were similar but less frequent for girls. These findings advance the science of young adolescence by showing the interaction between preexisting sensitivity to stressors and the normative testosterone changes of puberty and antisocial behavior.

The Relationship between Aggression and Serum Thyroid Hormone Level in Individuals Diagnosed with Antisocial Personality Disorder

INTRODUCTION

Aggression is one of the leading clinical characteristics of antisocial personality disorder (APD). Studies aiming to clarify and control the biological basis of aggression are ongoing. Thyroid hormones have been indicated to play a role in the development of aggression. The aim of this study was to examine the level of aggression and serum thyroid hormone in a sample of APD and to make contributions to this field with the current findings.

METHODS

The sample consisted of 96 subjects with a diagnosis of APD and 97 subjects as a control group. Structured Clinical Interview for DSM-IV Axis (SCID) 1 and 2 were used for the diagnosis, and the Buss-Perry Aggression Questionnaire was administered. Based on criminal patterns, the APD group was then divided into two subgroups: "criminal" and "noncriminal" APD groups. The day after the interview, after one night of fasting, blood was collected from the subjects between 7:00 a.m. and 9:00 a.m.. Thyroid function tests and other biochemical analyses related to the confounding variables were also administered. The study group and the control group were compared in terms of their aggression scores and thyroid hormone levels.

RESULTS

The mean score of free T3 level in the criminal APD group was found to be significantly higher than that in the noncriminal APD group. APD subjects with higher free T3 levels also had higher aggression scores. In the noncriminal APD group, as serum free T3 and T4 levels increased, there was also an increment in the aggression scores. However, in the criminal APD group, there was no significant correlation between thyroid hormone levels and aggression.

CONCLUSION

The findings of this study indicated that criminal and noncriminal APD groups actually show different properties.

Gender and Racial Disparities in Cases of Autoenucleation

OBJECTIVE

This review demonstrates the gender and racial disparities among patients who have committed ocular autoenucleation.

DESIGN

Peer-reviewed articles were identified and reviewed on the basis of a literature search in PubMed/MEDLINE and Ovid/EMBASE databases from all available literature to date.

RESULTS

We identified 60 cases of autoenucleation published in contemporary literature with nine attempted cases. The ratio of men to women who have committed autoenucleation is 8:1. Only 28 cases of autoenucleation included confirmed reports of racial makeup. 17 out of 28 cases were White, eight out of 28 cases were Hispanic or Asian, and only three cases were Black. White patients account for 61% of the cases, while Black patients make up 11% and other races constitute 28%. The common underlying psychiatric motivations among autoenucleation patients include biblical interpretations, religious delusions, and paranoia of the eye. The most common associated psychiatric disorders among patients with autoenucleation include schizophrenia, major depressive disorder, and bipolar disorder.

CONCLUSION

Autoenucleation largely occurs amongst male patients with active psychiatric disorders. Our findings challenge previously published reviews where the incidence of autoenucleation is reported as equal for the two sexes. A higher incidence among the White population is also suggested. This is the first time gender and racial disparity have been demonstrated with respect to autoenucleation.

Latent trait testosterone among 18-24 year olds: Methodological considerations and risk associations

The study investigated the relationship between latent trait testosterone (LTT) and risk-taking among 126 youth (M age=21.34years; 56% female; 52% African American). Latent state-trait (LST) modeling isolates observed variance of samples via their correlations into (1) a latent trait testosterone (LTT) factor capturing individual differences, and (2) a component of state testosterone factor (LST) capturing state-specific situational or environmental influences and random error variances. Participants provided four laboratory (20min apart) and four home (waking, 20-min post-waking, noon, evening) salivary samples (later assayed for testosterone). Participants reported risk-taking tendencies and behaviors via an Audio Computer Assisted Self-Interview. Behavioral risk was measured using the Balloon Analog Risk Task. Results revealed: (1) LTT model invariance (operated similarly) for females and males; (2) LTT accounted for 18-89% (home samples) and 61-95% (lab samples) of the variance in testosterone levels, and (3) LTT was associated with risk-seeking behaviors and the strength of this association was similar across males and females. LST Modeling has potential to advance our understanding of testosterone-behavior associations to new limits by estimating stable trait-like components of the variance in testosterone levels.

Urinary Sex Steroids and Anthropometric Markers of Puberty - A Novel Approach to Characterising Within-Person Changes of Puberty Hormones

Background/Aims

The longitudinal relationships of within-individual hormone and anthropometric changes during puberty have not ever been fully described. The objectives of this study were to demonstrate that 3 monthly urine collection was feasible in young adolescents and to utilise liquid chromatography-tandem mass spectrometry assay methods for serum and urine testosterone (T), estradiol (E₂) and luteinizing hormone (LH) in adolescents by relating temporal changes in urine and serum hormones over 12 months to standard measures of pubertal development.

Methods

A community sample of 104 adolescents (57 female) was studied over 12 months with annual anthropometric assessment, blood sampling and self-rated Tanner staging and urine collected every 3 months. Serum and urine sex steroids (T, E₂) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and LH by immunoassay.

Results

A high proportion (92%) of scheduled samples were obtained with low attrition rate of 6.7% over the 12 months. Urine hormone measurements correlated cross-sectionally and longitudinally with age, anthropometry and Tanner stage.

Conclusion

We have developed a feasible and valid sampling methodology and measurements for puberty hormones in urine, which allows a sampling frequency by which individual pubertal progression in adolescents can be described in depth.

Men's violence against women and men are inter-related: Recommendations for simultaneous intervention

Men are more likely than women to perpetrate nearly all types of interpersonal violence (e.g. intimate partner violence, murder, assault, rape). While public health programs target prevention efforts for each type of violence, there are rarely efforts that approach the prevention of violence holistically and attempt to tackle its common root causes. Drawing upon theories that explain the drivers of violence, we examine how gender norms, including norms and social constructions of masculinity, are at the root of most physical violence perpetration by men against women and against other men. We then argue that simply isolating each type of violence and constructing separate interventions for each type is inefficient and less effective. We call for recognition of the commonalities found across the drivers of different types of violence and make intervention recommendations with the goal of seeking more long-standing solutions to violence prevention.

The effects of estradiol on mood and behavior in human female adolescents: a systematic review

Mood disorders and health risk behaviors increase in adolescence. Puberty is considered to contribute to these events. However, the precise impact of pubertal hormone changes to the emergence of mood disorders and risk behaviors is relatively unclear. It is important that inappropriate attribution is not made. Our aim was to determine what is known about the effect of endogenous estradiol on human adolescent girls' mood and behavior. The databases searched were MEDLINE, Embase, PsycINFO, Education Resources Information Center (ERIC), Pre-MEDLINE, Web of Science, and Scopus for all dates to October 2014. For inclusion, contemporaneous hormone and mood or behavioral assessment was required. Data were extracted following a template created by the authors. Fourteen studies met our inclusion criteria. There was some consistency in findings for mood and estradiol levels, with associations between estradiol and depression and emotional tone and risk taking. Results were less consistent for studies assessing other mood and behavioral outcomes. Most studies were cross-sectional in design; assay methodologies used in older studies may lack the precision to detect early pubertal hormone levels.

CONCLUSION

Three longitudinal and several cross-sectional studies indicate potential associations between estradiol and certain mood or affective states, especially depression and mood variability though there are insufficient data to confirm that the rise in estradiol during puberty is causative. We believe that it is important for health professionals to take care when attributing adolescent psychopathology to puberty hormones, as the current data supporting these assertions are limited.