Testosterone, gender identity and gender-stereotyped personality attributes

Sex/gender differences in personality associated with gender stereotyped behavior are widely studied in psychology yet remain a subject of ongoing debate. Exposure to testosterone during developmental periods is considered to be a primary mediator of many sex/gender differences in behavior. Extensions of this research has led to both lay beliefs and initial research about individual differences in basal testosterone in adulthood relating to "masculine" personality. In this study, we explored the relationships between testosterone, gender identity, and gender stereotyped personality attributes in a sample of over 400 university students (65 % female assigned at birth). Participants provided ratings of their self-perceived masculinity and femininity, resulting in a continuous measure of gender identity, and a set of agentic and communal personality attributes. A saliva sample was also provided for assay of basal testosterone. Results showed no compelling evidence that basal testosterone correlates with gender-stereotyped personality attributes or explains the relationship between sex/gender identity and these attributes, across, within, or covarying out sex assigned at birth. Contributing to a more gender diverse approach to assessing sex/gender relationships with personality and testosterone, our continuous measure of self-perceived masculinity and femininity predicted additional variance in personality beyond binary sex and showed some preliminary but weak relationships with testosterone. Results from this study cast doubt on the activational testosterone-masculinity hypothesis for explaining sex differences in gender stereotyped traits and within-sex/gender variation in attributes associated with agency and communality.

The Association Between the Nonmedical use of Anabolic-Androgenic Steroids and Interpersonal Violence: A Meta-Analysis

The nonmedical use of anabolic-androgenic steroids (AAS) by athletes and the general population is a public health concern. One particular concern relates to the link between AAS use and violence. Although there is a growing body of research on the association between AAS and violence, results as to what the relationship is seem to be mixed. The aim of this meta-analysis is to improve our understanding of what the current evidence base indicates regarding the relationship between the use of AAS and interpersonal violence. In total, 14 studies with a total of 16 samples met the inclusion criteria, comprising a total sample size of 137,055 participants. The findings show that there is a significant association between AAS use and interpersonal violence (r = .21 [95% confidence intervals (CI): 0.15, 0.27], p < .00001), although small. It is however unclear what the direction of this relationship is as almost all studies failed to demonstrate whether AAS use occurred prior or subsequent to the violent behavior. Risk of bias for most studies was moderate or high. Three potential moderators, AAS use via self-report or testing, interpersonal violence via self-report or criminal records of violent behavior, and proportion of males, were nonsignificant. Although a meta-analytic relationship between AAS use and interpersonal violence was found, it is unclear to what extent AAS causes violent acts. We need to carefully consider the role of mediating factors, and that the relationship between the two could be part of a broader context as opposed to AAS being the cause of violence.

Effects of testosterone enanthate on aggression, risk-taking, competition, mood, and other cognitive domains during 28 days of severe energy deprivation

RATIONALE

Behavioral effects of testosterone depend on dose, acute versus sustained formulation, duration of administration, personality, genetics, and endogenous levels of testosterone. There are also considerable differences between effects of endogenous and exogenous testosterone.

OBJECTIVES

This study was the secondary behavioral arm of a registered clinical trial designed to determine if testosterone protects against loss of lean body mass and lower-body muscle function induced by a severe energy deficit typical of sustained military operations.

METHODS

Behavioral effects of repeated doses of testosterone on healthy young men whose testosterone was reduced by severe energy deficit were examined. This was a double-blind, placebo-controlled, between-group study. Effects of four weekly intramuscular injections of testosterone enanthate (200 mg/week, N = 24) or matching placebo (N = 26) were evaluated. Determination of sample size was based on changes in lean body mass. Tasks assessing aggression, risk-taking, competition, social cognition, vigilance, memory, executive function, and mood were repeatedly administered.

RESULTS

During a period of artificially induced, low testosterone levels, consistent behavioral effects of administration of exogenous testosterone were not observed.

CONCLUSIONS

Exogeneous testosterone enanthate (200 mg/week) during severe energy restriction did not reliably alter the measures of cognition. Study limitations include the relatively small sample size compared to many studies of acute testosterone administration. The findings are specific to healthy males experiencing severe energy deficit and should not be generalized to effects of other doses, formulations, or acute administration of endogenous testosterone or studies conducted with larger samples using tests of cognitive function designed to detect specific effects of testosterone.

Testosterone's role in modulating human behaviors relevant to mating and parenting

Testosterone (T) is linked to human mating and parenting. Here, we comprehensively reviewed evidence on whether, in men and women, (1) basal T levels are related to mating and parenting behaviors, (2) T responds to reproduction-relevant cues, (3) acute changes in T map onto subsequent mating and parenting behaviors, and (4) single-dose exogenous T administration causally affects mating and parenting behaviors. We examined whether the available evidence supports trade-off interpretations of T's adaptive function whereby high T levels correspond to greater mating/reproductive effort and competition and low T levels to greater parenting effort and nurturance. We found mixed support for trade-off hypotheses, suggesting that T's function in modulating human mating and parenting might be more nuanced and highly dependent on context and individual trait differences. Results were largely similar for men and women, although studies with women were scarcer than those with men for most behaviors we reviewed.

Excluded and ashamed: Shame proneness interacts with social exclusion and testosterone reactivity to predict behavioral aggression

Exclusion from social relationships is a painful experience that may threaten an individual's status and dominance. The steroid hormone testosterone, which fluctuates rapidly in response to such threats, may be implicated in subsequent behavioral action (e.g., aggressive or prosocial responses) that aims to protect or enhance one's status after exclusion. Past research, however, indicates that the link between acute changes in testosterone and behavior depend on context-relevant individual dispositions. In the context of social exclusion, an individual's level of shame proneness-characterized by a tendency to experience shame and to react submissively-is theoretically relevant to the testosterone-induced aggression relationship but has yet to be examined empirically. Here, men (n = 167) were randomly assigned to be socially included or excluded in the virtual ball-tossing game, Cyberball, after which aggressive behavior was examined using the Point Subtraction Aggression Paradigm (PSAP). Testosterone reactivity was measured via salivary hormone samples collected pre- and post-game. Moderated multiple regression analyses were run to examine the extent to which testosterone reactivity and shame proneness moderated the effect of Cyberball condition on aggression. Results revealed a significant two-way interaction between Cyberball condition and testosterone reactivity, as well as a three-way interaction including shame proneness. For individuals low in shame proneness, exclusion was associated with higher post-cyberball aggression among those who experienced a rise in testosterone but was associated with lower post-cyberball aggression among those who experienced a decrease in testosterone. For individuals high in shame proneness, however, exclusion did not meaningfully affect aggressive responses, regardless of whether they experienced an increase or decrease in testosterone. These findings extend our understanding of the moderating roles of context and disposition on the neuroendocrinology of aggression in social interaction.

Testosterone eliminates strategic prosocial behavior through impacting choice consistency in healthy males

Humans are strategically more prosocial when their actions are being watched by others than when they act alone. Using a psychopharmacogenetic approach, we investigated the endocrinological and computational mechanisms of such audience-driven prosociality. One hundred and ninety-two male participants received either a single dose of testosterone (150 mg) or a placebo and performed a prosocial and self-benefitting reinforcement learning task. Crucially, the task was performed either in private or when being watched. Rival theories suggest that the hormone might either diminish or strengthen audience-dependent prosociality. We show that exogenous testosterone fully eliminated strategic, i.e., feigned, prosociality and thus decreased submission to audience expectations. We next performed reinforcement-learning drift-diffusion computational modeling to elucidate which latent aspects of decision-making testosterone acted on. The modeling revealed that testosterone compared to placebo did not deteriorate reinforcement learning per se. Rather, when being watched, the hormone altered the degree to which the learned information on choice value translated to action selection. Taken together, our study provides novel evidence of testosterone's effects on implicit reward processing, through which it counteracts conformity and deceptive reputation strategies.

What's in a Badge? A Computational Reproducibility Investigation of the Open Data Badge Policy in One Issue of Psychological Science

In April 2019, Psychological Science published its first issue in which all Research Articles received the Open Data badge. We used that issue to investigate the effectiveness of this badge, focusing on the adherence to its aim at Psychological Science: sharing both data and code to ensure reproducibility of results. Twelve researchers of varying experience levels attempted to reproduce the results of the empirical articles in the target issue (at least three researchers per article). We found that all 14 articles provided at least some data and six provided analysis code, but only one article was rated to be exactly reproducible, and three were rated as essentially reproducible with minor deviations. We suggest that researchers should be encouraged to adhere to the higher standard in force at Psychological Science. Moreover, a check of reproducibility during peer review may be preferable to the disclosure method of awarding badges.

Evolutionary and neuroendocrine foundations of human aggression

Humans present a behavioural paradox: they are peaceful in many circumstances, but they are also violent and kill conspecifics at high rates. We describe a social evolutionary theory to resolve this paradox. The theory interprets human aggression as a combination of low propensities for reactive aggression and coercive behaviour and high propensities for some forms of proactive aggression (especially coalitionary proactive aggression). These tendencies are associated with the evolution of groupishness, self-domestication, and social norms. This human aggression profile is expected to demand substantial plasticity in the evolved biological mechanisms responsible for aggression. We discuss the contributions of various social signalling molecules (testosterone, cortisol, oxytocin, vasopressin, serotonin, and dopamine) as the neuroendocrine foundation conferring such plasticity.

No Compelling Evidence that Self-Reported Personality Traits Explain Basal Testosterone and Cortisol’s Associations with Status-Relevant Behavior

Objective

A goal of behavioral neuroendocrinology is to understand how basal hormone levels relate to behavior. Studies of human participants sometimes measure self-reported personality traits, in addition to or instead of direct behavioral observation. Although personality traits often predict their respective behaviors, whether personality explains hormone-behavior relationships remains unclear.

Methods

We obtained data from eight previous studies (total N = 985) that examined baseline testosterone and cortisol as predictors of status-relevant behavior (competitiveness, dominance, risk-taking, aggression, affiliation, and social status). We tested whether the previously reported hormone-behavior relationships are mediated by self-reported personality traits (e.g., trait dominance, prestige, extraversion). As a secondary research question, we also tested whether trait dominance moderated the testosterone-behavior relationships.

Results

As expected, self-reported personality traits often predicted status-relevant behaviors, but there was little evidence that traits also correlated with basal testosterone or the testosterone × cortisol interaction. Across all eight studies, personality traits did not significantly mediate hormone-behavior relationships. Indeed, the effect sizes of the hormone-behavior relationships were robust to the inclusion of personality traits as covariates. Further, we did not find strong or consistent evidence that trait dominance moderates the testosterone-behavior association.

Conclusion

Results suggest that basal testosterone and cortisol predict status-related behavior independent of self-reported personality. We discuss how these results may have broader implications for the physiological mechanisms by which testosterone and cortisol influence behavior, a process that could be unconscious and automatic. We also discuss alternative explanations, limitations, and future directions.

Narcissism moderates the association between basal testosterone and generosity in men

Research has linked hormones to behavioral outcomes in intricate ways, often moderated by psychological dispositions. The associations between testosterone and antisocial or prosocial outcomes also depend on dispositions relevant to status and dominance. In two studies (N1 = 68, N2 = 83), we investigated whether endogenous testosterone, measured in saliva, and narcissism, a psychological variable highly relevant to status motivation, interactively predicted men's preferences regarding resource allocation. Narcissism moderated the links between testosterone and social value orientation: among low narcissists testosterone negatively predicted generosity in resource allocation and probability of endorsing a prosocial (vs. pro-self) value orientation, whereas among high narcissists testosterone tended to positively predict generosity and the probability of endorsing a prosocial (vs. pro-self) value orientation. We discuss these results as examples of calibrating effects of testosterone on human behavior, serving to increase and maintain social status. We advocate the relevance of psychological dispositions, alongside situations, when examining the role of T in social outcomes.

Relatively rapid effects of testosterone on men's ratings of female attractiveness depend on relationship status and the attractiveness of stimulus faces

Attractiveness judgements influence desires to initiate and maintain romantic relationships. Testosterone also predicts relationship initiation and maintenance; such effects may be driven by the hormone's modulation of attractiveness judgements, but no studies have investigated causal (and situation-dependent) effects of the hormone on these judgements. Using a placebo-controlled cross-over design, our preregistered analyses revealed order- and relationship- dependent effects: single heterosexual men judged the women as more appealing when testosterone was administered first (and placebo second), but marginally less appealing when placebo was administered first (and testosterone second). In a more complex model incorporating the women's attractiveness (as rated by an independent set of observers), however, we show that testosterone increases the appeal of women -but this effect depends upon the men's relationship status and the women's attractiveness. In partnered men (n = 53) who tend to derogate attractive alternatives (by rating them as less appealing), testosterone countered this effect, boosting the appeal of these attractive alternatives. In single men (n = 53), conversely, testosterone increased the appeal of low-attractive women. These differential effects highlight the possibility of a newly discovered mechanism whereby testosterone promotes male sexual reproduction through different routes depending on relationship status, promoting partner up- rather than down-grading when partnered and reducing choosiness when single. Further, such effects were relatively rapid [within 85 (±5) minutes], suggesting a potential non-genomic mechanism of action.

The Relationship between Androgen Receptor Gene Polymorphism, Aggression and Social Status in Young Men and Women

In both sexes, aggression has been described as a critical trait to acquire social status. Still, almost uniquely in men, the link between aggressiveness and the genetic background of testosterone sensitivity measured from the polymorphism in the androgen receptor (AR) gene has been previously investigated. We assessed the relevance of the AR gene to understand aggression and how aggressiveness affects social status in a cross-sectional study of 195 participants, for the first time in both young men and women. We estimated polymorphism sequences from saliva and measured aggression and self-perceived social status. Unfortunately, the results did not support our prediction because we did not find any of the expected relationships. Therefore, the results suggest that the genetic association between aggressive mechanisms and polymorphism of the AR gene is less straightforward than expected, at least in men, and seems to indicate that aggression is not usually used to gain social status in our population.

Aggression and criminality in androgen abusers

PURPOSE OF REVIEW

To systematically review and meta-synthesize current (2019-2021) literature on aggression and criminality in androgen abusers. Results from 13 empirical human studies are discussed.

RECENT FINDINGS

Some androgen abusers engage in aggressive and criminal behavior. Here, results show positive effects and associations between the administration of androgens and aggression, and descriptions of various patterns and kinds of aggression and criminality in androgen abusers. Still, this positive relationship seems to be mediated by various factors, such as cognition, neurobiology, personality, polypharmacy, and study methods.

SUMMARY

The current literature on aggression and criminality in androgen abusers shows methodical diversity and underlines the need to synthesize the current evidence in order to draw overall conclusions as well as identify relevant and important knowledge gaps. On the basis of a systematic literature search, we identified 13 studies and categorized them by methodology. Of the 13 studies, 4 were meta-analyses and systematic reviews, 1 was a randomized controlled trial, 4 were cross-sectional studies, and 4 constituted case reports. Evidence on the relationship between androgen abuse and involvement in aggressive behavior seems to be mediated by cognition, neurobiology, personality, and polypharmacy as well as methodical factors, such as study design, aggression severity, type of measurement, and temporal proximity. Implications for practice and future research are presented.

Development of a single-dose intranasal testosterone administration paradigm for use in men and women

For over two decades, researchers in the field of human social neuroendocrinology have been using single-dose pharmacological challenge protocols to determine the causal effects of testosterone on psychological, behavioural, and neural processes. Most of these single-dose administration studies have so far used (1) single-sex samples and (2) varying modes of testosterone administration (intramuscular, transdermal, sublingual, and intranasal) that produced vastly different dose-response curves. Moreover, whereas studies with male participants increased men's testosterone concentrations within the high normal physiological range, studies with women typically increased testosterone concentrations to supraphysiological levels. The purpose of this study was to develop a single-dose administration protocol using intranasal testosterone that would produce a proportionally similar rise in testosterone for both sexes. We found that an 11 mg intranasal testosterone dose in men and a 0.3 mg dose in women raised testosterone concentrations to the high normal physiological range for each sex, producing similar dose-response dynamics in both sexes. This paradigm will allow researchers to design studies with mixed-sex samples that test physiologically plausible sex differences/similarities in the causal effects of testosterone. It will also provide a replicable protocol to examine the possible adaptive functions of acute increases in testosterone in both sexes.

Preliminary data on increased reactivity towards children in distress after testosterone administration in women: A matter of protection?

Emotional reactivity to others' distress is a vital prerequisite for a caring response. Testosterone, in contrast, is mostly associated with protection of personal dominance and decreased responsiveness to others' needs. However, experimental work also indicates that rising testosterone levels in response to infant distress can potentially facilitate protection. We assessed the impact of testosterone administration on participants' emotional reactivity to infants in distress, measuring their facial responses on the corrugator supercilii forehead muscle ('frowning') and the zygomaticus major ('smiling') as an index of emotional responses towards children. Moreover, we probed whether the effect of testosterone is moderated by participants' self-reported nurturance and protective tendencies. Our preliminary results showed that testosterone not only increased emotional reactivity to empathy eliciting images of children, but that this increase was strongest in participants with strong protective tendencies. Our administration study is the first to link testosterone to infant protection.

Nuclear androgen and progestin receptors inversely affect aggression and social dominance in male zebrafish (Danio rerio)

Aggression is a fundamental behavior displayed universally among animal species, but hyper- or hypo-aggressiveness can be maladaptive with negative consequences for individuals and group members. While the social and ecological significance of aggression is well understood, the specific neurobiological and hormonal mechanisms responsible for mediating aggression have not been fully elucidated. Previous studies have shown a relationship between aggressive acts and circulating gonadal steroids, but whether classical nuclear steroid receptors regulate aggression in animals is still uncertain. We examined whether the nuclear androgen receptor (Ar) and nuclear progestin receptor (Pgr) were necessary for aggressive behaviors and maintenance of a dominance relationship in male zebrafish (Danio rerio). Dyadic social interactions of Ar knockout (ArKO), Pgr knockout (PgrKO) and wildtype (WT) controls were observed for two weeks (2-weeks). ArKO zebrafish were significantly less aggressive and had a less defined dominance relationship, whereas PgrKO dominant zebrafish were significantly and persistently more aggressive with a robust dominance relationship. Our results demonstrate the importance of nuclear steroid hormone receptors in regulating aggression of adult male zebrafish and provide new models for understanding of the mechanisms of aggression.

Exploratory Analysis of the Relationship between Social Identification and Testosterone Reactivity to Vicarious Combat

Testosterone (T) fluctuates in response to competitive social interactions, with the direction of change typically depending on factors such as contest outcome. Watching a competition may be sufficient to activate T among fans and others who are invested in the outcome. This study explores the change in T associated with vicarious experiences of competition among combat sport athletes viewing a teammate win or lose and assesses how individual differences in social identification with one's team relates to these patterns of T reactivity. Twenty-six male combat athletes completed a social identity questionnaire on a neutral day. Later, salivary samples (assayed for T) were obtained before and after athletes viewed a video of a teammate engaged in a formal contest. T reactivity to viewing a teammate compete varied among participants in both the magnitude and direction of change, independent of contest outcome. Individual differences in cognitive centrality, a core feature of social identification, showed a strong positive relationship with T reactivity, particularly if their teammate won. Initial findings suggest that dominance-linked androgen responses associated with watching a teammate win a competition might depend on the belief that team membership is central to one's own identity. These exploratory results in a small sample of combat athletes should be interpreted with caution. Uncovering the role of social group dynamics in influencing T responses to competition is particularly important in light of the evolutionary history of coalitional combat in humans.

Sexual Dimorphism in Language, and the Gender Shift Hypothesis of Homosexuality

Psychological sex differences have been studied scientifically for more than a century, yet linguists still debate about the existence, magnitude, and causes of such differences in language use. Advances in psychology and cognitive neuroscience have shown the importance of sex and sexual orientation for various psychobehavioural traits, but the extent to which such differences manifest in language use is largely unexplored. Using computerised text analysis (Linguistic Inquiry and Word Count: LIWC 2015), this study found substantial psycholinguistic sexual dimorphism in a large corpus of English-language novels (n = 304) by heterosexual authors. The psycholinguistic sex differences largely aligned with known psychological sex differences, such as empathising–systemising, people–things orientation, and men’s more pronounced spatial cognitive styles and abilities. Furthermore, consistent with predictions from cognitive neuroscience, novels (n = 158) by lesbian authors showed minor signs of psycholinguistic masculinisation, while novels (n = 167) by homosexual men had a female-typical psycholinguistic pattern, supporting the gender shift hypothesis of homosexuality. The findings on this large corpus of 66.9 million words indicate how psychological group differences based on sex and sexual orientation manifest in language use in two centuries of literary art.

Not giving up: Testosterone promotes persistence against a stronger opponent

Recent research suggests that when we lack a sense of control, we are prone to motivational failures and early quitting in competitions. Testosterone, on the other hand, is thought to boost competitiveness. Here we investigate the interaction between these factors, testing the testosterone's potential to enhance persistence in a competition against a stronger opponent, depending on experimentally manipulated perceived control. Healthy participants were administered a single dose of testosterone or placebo. They first underwent a task designed to either induce low or high perceived control and then entered a costly competition against a progressively stronger opponent that they could quit at any time. In the placebo group, men with low perceived control quitted twice as early as those with high perceived control. Testosterone countered this effect, making individuals with low control persist in the competition for as long as those with high perceived control, and did so also despite raising participants' explicit awareness of the opponents' advantage. This psychoendocrinological effect was not modulated by basal cortisol levels, CAG repeat polymorphism of the androgen receptor gene, or trait dominance. Our results provide the first causal evidence that testosterone promotes competitive persistence in humans and demonstrate that this effect depends on the psychological state elicited prior to the competition, broadening our understanding of the complex relationships between testosterone and social behaviors.

Anabolic androgenic steroids, antisocial personality traits, aggression and violence

BACKGROUND

Anabolic androgenic steroid (AAS) use is associated with a wide range of adverse physical, psychological and social effects. While some experience few side effects, others might experience severe consequences. Aggression and violence are among the often-cited side effects associated with high-dose AAS use; however, most of the knowledge is generated from subgroups, such as prison populations. A likely hypothesis is that AAS use is associated with aggression and violence, but that these associations are complex and may be mediated by several factors, such as substance use, AAS dependence and personality traits.

METHODS

In the present study, we tested this hypothesis by examining the relations between long-term AAS use and AAS dependence, aggression, interpersonal violence and potential mediating factors in a sample of male AAS exposed and non-exposed weightlifting controls (WLC), using self-report questionnaires. Based upon AAS dependence criteria, a sample of male AAS users and WLC (N = 139) were stratified into three groups: WLC (n = 66), AAS dependents (n = 41) and AAS non-dependents (n = 32).

RESULTS

The results demonstrate that AAS dependents reported significantly higher levels of aggression compared to WLC and AAS non-dependents. While interpersonal violence was reported in all three groups, the highest percentage was found in the AAS dependent group.

CONCLUSION

In summary, our study confirms a link between AAS use, aggression and violence in a weightlifting population. However, the association is foremost seen in AAS dependent users and it seems that antisocial personality traits are an important mediator.

Individual differences in hormonal responsiveness to social encounters: Commentary on Félix et al., 2020 and review of pertinent issues

The results of a recent study, Félix et al., 2020, give new information about the behavioral and endocrine correlates of individual differences in the potential for androgen response in male cichlid fish. We think the study raises issues that are pertinent to the study of hormones and competition in other species, particularly humans. Focusing mostly on androgen reactivity to social challenge, we emphasize the importance of inter-individual variability in physiology, personality, and motivation in studies of hormone responses to social encounters. Additionally, we give special attention to matters of "repeatability" and the timing of hormone sampling. We conclude with an appreciation of the value of comparative analysis in behavioral endocrinology.

Risks of Serious Injury with Testosterone Treatment

BACKGROUND

Injury causes significant morbidity and mortality that is sometimes attributed to testosterone and violence. We hypothesized that prescribed testosterone might be associated with the subsequent risk of serious injury.

METHODS

We conducted a self-matched individual-patient exposure-crossover analysis comparing injury risks before and after initiation of testosterone. We selected adults treated with testosterone in Ontario, Canada, from October 1, 2012, to October 1, 2017 (enrollment) and continued until October 1, 2018 (follow-up). The primary outcome was defined as an acute traumatic event that required emergency medical care.

RESULTS

A total of 64,386 patients were treated with testosterone of whom 89% were men with a median age of 52 years. We identified 34,439 serious injuries during the baseline interval before starting testosterone (584 per month) and 7349 serious injuries during the subsequent interval after starting testosterone (565 per month). Rates of injuries were substantially above the population norm in both intervals with no significant increased risk after starting testosterone (relative risk = 1.00; 95% confidence interval: 0.96-1.04, P = 0.850). The unchanged risk extended to diverse patients, was observed for different formulations and applied to all injury mechanisms. In contrast, testosterone treatment was associated with a 48% increased risk of a thromboembolic event (relative risk = 1.48; 95% confidence interval: 1.25-1.74, P < 0.001).

CONCLUSIONS

Testosterone treatment was associated with a substantial baseline risk of serious injury that did not increase further after starting therapy. Physicians prescribing testosterone could consider basic safety reminders to mitigate injury risks.

Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies

RATIONALE

Aggression and irritability are notable psychiatric side effects of anabolic-androgenic steroid (AAS) use. However, no previous study has systematically reviewed and quantitatively synthesized effects reported by experimental studies on this topic.

OBJECTIVE

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effect of AAS administration on self-reported and observer-reported aggression.

METHODS

Twelve RCTs comprising a total of 562 healthy males were identified through systematic searches of MEDLINE, PsycInfo, ISI Web of Science, ProQuest, Google Scholar, and the Cochrane Library.

RESULTS

After excluding one outlier, AAS administration was associated with an increase in self-reported aggression under a random-effects model, albeit small (Hedges' g = 0.171, 95% CI: 0.029-0.312, k = 11, p = .018), and when restricting the analysis to the effect of acute AAS administration on self-reported aggression under a fixed-effect model (g = 0.291, 95% CI: 0.014-0.524, p = .014). However, the above effects were neither replicated in the analysis of observer-reported aggression nor after restricting the analysis to the effects of the administration of higher (over 500 mg) and long-term (3 days to 14 weeks) doses.

CONCLUSIONS

The present meta-analysis provides evidence of an increase, although small, in self-reported aggression in healthy males following AAS administration in RCTs. Ecologically rational RCTs are warranted to better explore the effect of AAS administration on aggression in humans.

Persons as Effect Sizes

Traditional indices of effect size are designed to answer questions about average group differences, associations between variables, and relative risk. For many researchers, an additional, important question is, “How many people in my study behaved or responded in a manner consistent with theoretical expectation?” We show how the answer to this question can be computed and reported as a straightforward percentage for a wide variety of study designs. This percentage essentially treats persons as an effect size, and it can easily be understood by scientists, professionals, and laypersons alike. For instance, imagine that in addition to d or η2, a researcher reports that 80% of participants matched theoretical expectation. No statistical training is required to understand the basic meaning of this percentage. By analyzing recently published studies, we show how computing this percentage can reveal novel patterns within data that provide insights for extending and developing the theory under investigation.

Beyond the challenge hypothesis: The emergence of the dual-hormone hypothesis and recommendations for future research

The challenge hypothesis makes specific predictions about the association between testosterone and status-seeking behaviors, but the findings linking testosterone to these behaviors are often inconsistent. The dual-hormone hypothesis was developed to help explain these inconsistencies. Specifically, according to this hypothesis, testosterone's association with status-seeking behavior depends on levels of cortisol. Here, we (1) describe the dual-hormone hypothesis in relation to the challenge hypothesis; (2) review recent studies that tested the dual-hormone hypothesis as well as meta-scientific evidence of heterogeneous dual-hormone findings across studies; (3) discuss potential explanations for this heterogeneity, including methodological considerations, contextual factors, and individual differences; and (4) provide recommendations for new work aimed at testing and extending the dual-hormone hypothesis.

Human reproductive behavior, life history, and the Challenge Hypothesis: A 30-year review, retrospective and future directions

The Challenge Hypothesis (Wingfield et al., 1990) originally focused on adult male avian testosterone elevated in response to same-sex competition in reproductive contexts. The purpose of the present paper is to demonstrate how the Challenge Hypothesis has shaped ideas about human life histories. We conduct a citation analysis, drawing upon 400 Google Scholar citations in the human literature to identify patterns in this body of scholarship. We cover key factors, such as context and personality traits, that help explain variable testosterone responses such as winning/losing to adult competitive behavior. Findings from studies on courtship and sexual behavior indicate some variation in testosterone responses depending on factors such as motivation. A large body of research indicates that male testosterone levels are often lower in contexts of long-term committed partnerships and nurturant fathering and aligned with variation in male mating and parenting effort. As the Challenge Hypothesis is extended across the life course, DHEA and androstenedione (rather than testosterone) appear more responsive to juvenile male competitive behavior, and during reproductive senescence, baseline male testosterone levels decrease just as male life history allocations show decreased mating effort. We discuss how research on testosterone administration, particularly in older men, provides causal insight into effects of testosterone in humans, and how this "natural experiment" can be viewed in light of the Challenge Hypothesis. We synthesize central concepts and findings, such as an expanded array of costs of testosterone that inform life history tradeoffs between maintenance and reproductive effort, and we conclude with directions for future research.

Is testosterone linked to human aggression? A meta-analytic examination of the relationship between baseline, dynamic, and manipulated testosterone on human aggression

Testosterone is often considered a critical regulator of aggressive behaviour. There is castration/replacement evidence that testosterone indeed drives aggression in some species, but causal evidence in humans is generally lacking and/or-for the few studies that have pharmacologically manipulated testosterone concentrations-inconsistent. More often researchers have examined differences in baseline testosterone concentrations between groups known to differ in aggressiveness (e.g., violent vs non-violent criminals) or within a given sample using a correlational approach. Nevertheless, testosterone is not static but instead fluctuates in response to cues of challenge in the environment, and these challenge-induced fluctuations may more strongly regulate situation-specific aggressive behaviour. Here, we quantitatively summarize literature from all three approaches (baseline, change, and manipulation), providing the most comprehensive meta-analysis of these testosterone-aggression associations/effects in humans to date. Baseline testosterone shared a weak but significant association with aggression (r = 0.054, 95% CIs [0.028, 0.080]), an effect that was stronger and significant in men (r = 0.071, 95% CIs [0.041, 0.101]), but not women (r = 0.002, 95% CIs [-0.041, 0.044]). Changes in T were positively correlated with aggression (r = 0.108, 95% CIs [0.041, 0.174]), an effect that was also stronger and significant in men (r = 0.162, 95% CIs [0.076, 0.246]), but not women (r = 0.010, 95% CIs [-0.090, 0.109]). The causal effects of testosterone on human aggression were weaker yet, and not statistically significant (r = 0.046, 95% CIs [-0.015, 0.108]). We discuss the multiple moderators identified here (e.g., offender status of samples, sex) and elsewhere that may explain these generally weak effects. We also offer suggestions regarding methodology and sample sizes to best capture these associations in future work.

An updated field guide for snark hunting: Comparative contributions to behavioral neuroendocrinology in the era of model organisms

Studying neuroendocrine behavioral regulatory mechanisms in a variety of species across vertebrate groups is critical for determining how they work in natural contexts, how they evolved, and ultimately what can be generalized from them, potentially even to humans. All of the above are difficult, at best, if work within our field is exclusively done in traditional laboratory organisms. The importance of comparative approaches for understanding the relationships between hormones and behavior has been recognized and advocated for since our field's inception through a series of papers centered upon a poetic metaphor of Snarks and Boojums, all of which have articulated the benefits that come from studying a diverse range of species and the risks associated with a narrow focus on "model organisms." This mini-review follows in the footsteps of those powerful arguments, highlighting some of the comparative work since the latest interactions of the metaphor that has shaped how we think about three major conceptual frameworks within our field, two of them formalized - the Organization/Activation Model of sexual differentiation and the Social Brain Network - and one, context-dependency, that is generally associated with virtually all modern understandings of how hormones affect behavior. Comparative approaches are broadly defined as those in which the study of mechanism is placed within natural and/or evolutionary contexts, whether they directly compare different species or not. Studies are discussed in relation to how they have either extended or challenged generalities associated with the frameworks, how they have shaped subsequent work in model organisms to further elucidate neuroendocrine behavioral regulatory mechanisms, and how they have stimulated work to determine if and when similar mechanisms influence behavior in our own species.

Testosterone administration in human social neuroendocrinology: Past, present, and future

Over the past 20 years, social neuroendocrinology researchers have developed pharmacological challenge paradigms to assess the extent to which testosterone plays a causal role in human psychological and behavioural processes. The current paper provides a brief summary of this research and offers recommendations for future research examining the neuroendocrine mechanisms underlying human behaviour.

Understanding Brain Mechanisms of Reactive Aggression

PURPOSE OF REVIEW

To review the current literature on biobehavioral mechanisms involved in reactive aggression in a transdiagnostic approach.

RECENT FINDINGS

Aggressive reactions are closely related to activations in the brain's threat circuitry. They occur in response to social threat that is experienced as inescapable, which, in turn, facilitates angry approach rather than fearful avoidance. Provocation-induced aggression is strongly associated with anger and deficits in cognitive control including emotion regulation and inhibitory control. Furthermore, the brain's reward system plays a particular role in anger-related, tit-for-tat-like retaliatory aggression in response to frustration. More research is needed to further disentangle specific brain responses to social threat, provocation, and frustration. A better understanding of the psychological and neurobiological mechanisms involved in reactive aggression may pave the way for specific mechanism-based treatments, involving biological or psychotherapeutic approaches or a combination of the two.

Testosterone administration increases social discounting in healthy males

Although testosterone is thought to induce antisocial and aggressive behavior, research on social economic interactions has associated it with prosocial and affiliative behavior. Here, we investigated the effects of testosterone on social distance-dependent generosity in an economic discounting task where participants chose between selfish and generous alternatives. We administered testosterone gel or placebo to men in a double-blind, randomized design and measured how willing they were to share rewards with close and distant others. Across two studies (total n = 174), testosterone administration consistently increased social discounting, that is participants became more selfish, particularly with regard to distant others (vs. close others). This effect was not explained by testosterone-induced increases in social distance perception. Our findings provide causal evidence that-testosterone reduces generosity in human economic decision-making. Moreover, they suggest that the valuation and the perception of social distance are independently affected by testosterone.

Endogenous testosterone correlates with parochial altruism in relation to costly punishment in different social settings

Testosterone plays a key role in shaping human social behavior. Recent findings have linked testosterone to altruistic behavior in economic decision tasks depending on group membership and intergroup competition. The preferential treatment of ingroup members, while aggression and discrimination is directed towards outgroup members, has been referred to as parochial altruism. Here we investigated in two consecutive studies, whether testosterone is associated with parochial altruism depending on individual tendency for costly punishment. In the first study, 61 men performed a single-shot ultimatum game (UG) in a minimal group context, in which they interacted with members of an ingroup and outgroup. In the second study, 34 men performed a single-shot UG in a more realistic group context, in which they responded to the proposals of supporters of six political parties during the German election year 2017. Political parties varied in their social distance to the participants’ favorite party as indicated by an individual ranking. Participants of study 2 also performed a cued recall task, in which they had to decide whether they had already encountered a face during the previous UG (old-new decision). In order to make the UG data of study 2 most comparable to the data of study 1, the rejection rates of several parties were combined according to the social distance ranking they achieved. Parties ranked 1 to 3 formed the relatively close and favored ‘ingroup’ that shared similar political values with the participant (e.g., left wing parties), while the ‘outgroup’ consisted of parties ranked from 4 to 6 with more distant or even antagonistic political views (e.g., conservative to right wing parties). In both studies, results showed a parochial pattern with higher rejection rates made in response to outgroup compared to ingroup offers. Interestingly, across studies higher salivary testosterone was associated with higher rejection rates related to unfair outgroup offers in comparison to the unfair offers made by ingroup members. The present findings suggest that latent intergroup biases during decision-making may be positively related to endogenous testosterone. Similar to previous evidence that already indicated a role of testosterone in shaping male parochial altruism in male soccer fans, these data underscore the general, yet rather subtle role of male testosterone also in other social settings.

Sex, Energy, Well-Being and Low Testosterone: An Exploratory Survey of U.S. Men's Experiences on Prescription Testosterone

Prescription testosterone sales in the United States have skyrocketed in the last two decades due to an aging population, direct-to-consumer advertising, and prescriber views of the benefits and risks to testosterone, among other factors. However, few studies have attempted to directly examine patient experiences on prescription testosterone therapy. The present exploratory study involved an online self-report survey of U.S. testosterone patients who were at least 21 years of age. The primary focus was on patient perspectives concerning motivations leading to the initiation of testosterone therapy and the perceived effects of treatment. Responses to open-ended questions drew upon a coding scheme incorporating both inductive and deductive approaches, influenced by the clinical, male life history theory, and behavioral endocrinology literature. Results indicated that the most frequent reasons men gave for taking prescription testosterone were low testosterone (37.1%), well-being (35.2%), energy (28.7%), libido (21.9%), and social energy (19.4%); older men claimed libido as a motivation for testosterone initiation more frequently than younger men (p < 0.001). Men most frequently claimed testosterone improved their energy (52.3%), libido (41.9%), and muscle (28.5%). Results are interpreted in the context of medical, life history theoretical and behavioral endocrinology approaches, including an emphasis on sex and energy.

Does testosterone impair men's cognitive empathy? Evidence from two large-scale randomized controlled trials

The capacity to infer others' mental states (known as 'mind reading' and 'cognitive empathy') is essential for social interactions across species, and its impairment characterizes psychopathological conditions such as autism spectrum disorder and schizophrenia. Previous studies reported that testosterone administration impaired cognitive empathy in healthy humans, and that a putative biomarker of prenatal testosterone exposure (finger digit ratios) moderated the effect. However, empirical support for the relationship has relied on small sample studies with mixed evidence. We investigate the reliability and generalizability of the relationship in two large-scale double-blind placebo-controlled experiments in young men (n = 243 and n = 400), using two different testosterone administration protocols. We find no evidence that cognitive empathy is impaired by testosterone administration or associated with digit ratios. With an unprecedented combined sample size, these results counter current theories and previous high-profile reports, and demonstrate that previous investigations of this topic have been statistically underpowered.

Testosterone reduces the threat premium in competitive resource division

Like other animals, humans are sensitive to facial cues of threat. Recent evidence suggests that we use this information to dynamically calibrate competitive decision-making over resources, ceding more to high-threat individuals (who appear more willing/able to retaliate) and keeping more from low-threat individuals. Little is known, however, about the biological factors that support such threat assessment and decision-making systems. In a pre-registered, double-blind, placebo-controlled, cross-over testosterone administration study ( n = 118 men), we show for the first time that testosterone reduces the effects of threat on decision-making: participants ceded more resources to high-threat (versus low-threat) individuals (replicating the 'threat premium'), but this effect was blunted by testosterone, which selectively reduced the amount of resources ceded to those highest in threat. Thus, our findings suggest that testosterone influences competitive decision-making by recalibrating the integration of threat into the decision-making process.

Effect of exogenous testosterone on cooperation depends on personality and time pressure

The social heuristic hypothesis posits that human cooperation is an intuitive response that is expressed especially under conditions of time-constraint. Conversely, it proposes that for individuals given an opportunity for reflection, cooperation is more likely to be curtailed by an optimizing process calibrated to maximize individual benefit in a given situation. Notably, the steroid hormone testosterone has also been implicated in intuitive decision-making, including both prosocial and anti-social behaviors, with effects strongest in men with particular dispositional characteristics. This raises the possibility that increased testosterone may augment the effects predicted by the social heuristic hypothesis, particularly among men higher in specific dispositional characteristics (dominance, impulsivity, independent self-construal: high risk for testosterone-induced antisocial behavior). Here, in a testosterone administration study with a relatively large sample of men (N = 400), we test this possibility in a double-blind, placebo-controlled paradigm, with men randomly assigned to play a one-shot public goods game either under time-pressure (forced intuition) or with a time delay (forced reflection). Results revealed that within the placebo group, time-pressure (versus forced delay) increased cooperation among low risk men, but decreased cooperation among high risk men. Testosterone further moderated this pattern by abolishing the time-pressure effect in low risk men and-in high risk men-reversing the effect by selectively reducing offers (compared to placebo) under forced delay. This is the first evidence that testosterone and personality can interact with time-pressure and delay to predict human cooperation.