Callous-unemotional traits and early life stress predict treatment effects on stress and sex hormone functioning in incarcerated male adolescents

Gender operationalisation and stress measurement in research with adolescent males: a scoping review

Aim

Stress measurement in adolescent males is in its relative infancy, which is likely to influence the effectiveness of mental health services for this heterogeneous population. Although evidence suggests the prevalence of mental health difficulties increases during adolescence, the relationship between gender and stress measurement is less explored or understood. This review summarizes findings on gender operationalisation and stress measurement in research with adolescent males.

Methods

For this scoping review, six electronic databases across social and life sciences were searched using terms linked to adolescence, male, stress and research design. Articles were screened, data were extracted, and a narrative synthesis used to characterise studies by research design, adaptation of method for participants’ cultural context, operationalisation of gender, and measurement of stress.

Results

Searches identified 3259 citations, 95 met inclusion criteria and were reviewed. Findings suggest that research on psychological stress in adolescence is a developing field, but one that is currently dominated by Western studies. Furthermore, the results indicate that stress measurement research with adolescent males tends not to make adaptations relative to participants' gender, age, or context.

Conclusions

Stress research with adolescent males is lacking in scope. This review highlights the need for researchers to consider stress responses as more than a biological response, as it has been conceptualised historically. Recommendations for researchers to report research design and protocol more clearly are made to support readers to understand how stress and gender have been operationalised and measured and how this may influence research methodology. Future research should avoid conflating biological differences with gendered experience and demonstrate greater sensitivity to how gender identity may intersect with age and location to perpetuate gendered inequalities.

Editorial: The Importance of Considering Multiple Factors Simultaneously to Advance Psychopathology Research

Recent advances in scientific techniques, particularly in psychoneuroendocrinology and functional neuroimaging, have made it clear that clinically significant antisocial behavior, such as that seen in conduct disorder, cannot be understood without reference to multiple biological systems.¹ However, the additional complexity arising from the interaction between the multiple biological systems implicated in conduct disorder has not typically been reflected in the complexity of experimental designs. Most often, studies examine only one system or subsystem at a time. Furthermore, the majority of studies of conduct disorder have not included female participants, have included few female participants, and/or have not explicitly considered biological sex in analytic strategies.² Particularly in the context of endocrinological functioning, biological sex is an important but understudied biological variable.³ Greater complexity in experimental design, incorporating data from different biological systems, and factoring in important variables such as sex will be needed moving forward to adequately model data from all of the relevant levels of analysis. This is true with respect not just to conduct disorder but to all psychopathology. The paper by Bernhard et al⁴ published in this issue is an excellent example of the types of studies that are required to grapple with the complexity of any psychiatric illness. Their study is notable for its examination of multiple endocrine systems simultaneously and for adequately incorporating biological sex as a variable into the study.

Dehydroepiandrosterone (DHEA) and its ratio to cortisol moderate associations between maltreatment and psychopathology in male juvenile offenders

This study examined whether DHEA and its ratio to cortisol moderated risk for psychopathology among incarcerated youth exposed to childhood maltreatment. Resistance to stress-related psychopathology under adversity was also examined in relation to callous-unemotional (CU) traits, a personality construct characterized by resistance to pathological anxiety and blunted reactivity to threatening stimuli. Participants were 201 ethnically heterogeneous (41.8% White, 35.3% Black, 17.2% Hispanic) adolescent boys (M age = 16.75, SD = 1.15 years) incarcerated in a juvenile detention facility in the South Eastern United States who provided four afternoon saliva samples (later assayed for DHEA and cortisol) and completed self-report questionnaires. Results indicated that childhood maltreatment was associated with greater internalizing problems at lower DHEA concentrations and at higher cortisol-to-DHEA ratios. Conversely, higher DHEA levels and lower cortisol-to-DHEA ratios were associated with greater CU traits, irrespective of maltreatment exposure. CU traits did not attenuate levels of psychopathology in maltreated youth. Findings inform biosocial models of how exposure to parental maltreatment in early life contributes to risk and resilience through mechanisms associated with adaptive environmentally sensitive biological systems and processes.