Exogenous Testosterone Enhances the Reactivity to Social Provocation in Males

Supraphysiological testosterone levels from anabolic steroid use and reduced sensitivity to negative facial expressions in men

RATIONALE

Anabolic-androgenic steroids (AAS) are used to improve physical performance and appearance, but have been associated with deficits in social cognitive functioning. Approximately 30% of people who use AAS develop a dependence, increasing the risk for undesired effects.

OBJECTIVES

To assess the relationship between AAS use (current/previous), AAS dependence, and the ability to recognize emotional facial expressions, and investigate the potential mediating role of hormone levels.

METHODS

In total 156 male weightlifters, including those with current (n = 45) or previous (n = 34) AAS use and never-using controls (n = 77), completed a facial Emotion Recognition Task (ERT). Participants were presented with faces expressing one out of six emotions (sadness, happiness, fear, anger, disgust, and surprise) and were instructed to indicate which of the six emotions each face displayed. ERT accuracy and response time were recorded and evaluated for association with AAS use status, AAS dependence, and serum reproductive hormone levels. Mediation models were used to evaluate the mediating role of androgens in the relationship between AAS use and ERT performance.

RESULTS

Compared to never-using controls, men currently using AAS exhibited lower recognition accuracy for facial emotional expressions, particularly anger (Cohen's d = -0.57, pFDR = 0.03) and disgust (d = -0.51, pFDR = 0.05). Those with AAS dependence (n = 47) demonstrated worse recognition of fear relative to men without dependence (d = 0.58, p = 0.03). Recognition of disgust was negatively correlated with serum free testosterone index (FTI); however, FTI did not significantly mediate the association between AAS use and recognition of disgust.

CONCLUSIONS

Our findings demonstrate impaired facial emotion recognition among men currently using AAS compared to controls. While further studies are needed to investigate potential mechanisms, our analysis did not support a simple mediation effect of serum FTI.

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.

A quasi-experimental study in sibling dyads: differential provocation-aggression patterns in the interactive taylor aggression paradigm

Introduction

The Taylor Aggression Paradigm (TAP) is a well-established tool for assessing provocation-induced reactive aggression. We introduce an interactive version, the iTAP, with real-time opponents across 60 trials, including five simulated provocation trials in the middle. In this quasi-experimental study, we evaluate the effectiveness of the paradigm to investigate reactive aggression in interacting participants. The design allows us to employ the TAP in settings of high familiarity dyads, addressing an existing gap.

Method

Twenty-eight healthy same-sex adult sibling pairs (N = 56) competed against each other in the iTAP, exemplifying high familiarity through their social and emotional co-development, and mutual knowledge. Additionally, we explore naturally arising aggression types in terms of sibling pairs' reciprocal aggression trajectories across trials. Lastly, we investigate situational and personal variables influencing reactive aggression on the iTAP within high familiarity dyads.

Results

In line with non-interactive TAP versions, siblings employed a global "tit-for-tat" strategy in response to heightened provocation: Aggression increased during manipulated trials of increasing provocation, persisted during real interaction and declined in the final block, suggesting sibling co-regulation which was underscored by the convergence in within-pair aggression level. We found no gender differences in these dynamics but a trend for higher initial aggression levels within brother pairs and higher responsiveness to increased provocation in sister pairs. Overall aggression levels were related to situational variables including trial outcome (lost, won, and tie), Further, siblings' state anger correlated positively with aggression scores on the iTAP. Aggression was not reliably related to personal variables predicting aggression. We identified subgroups of sibling pairs with distinct provocation-aggression patterns related to differences in reported behavioral motivations and emotional states. The results highlight situational over personal variables in determining aggressive behavior on the task in this sample of healthy adults. While no direct link between sibling relationship quality and aggression was found, the overall behavior was likely influenced by the familiarity between siblings and the specific context of their relationship.

Conclusion

The iTAP demonstrates promise as a tool for studying reciprocal aggressive behavior. The emergence of different interaction patterns underscores the ecological validity introduced by the interactive context, which complements the standard versions of the TAP.

Testosterone administration modulates inequality aversion in healthy males: evidence from computational modeling

Fairness concerns play a prominent role in promoting cooperation in human societies. Social preferences involving fairness concern have been associated with individual testosterone levels. However, the causal effects of testosterone administration on fairness-related decision making remain to be elucidated. Here, we used a randomized, double-blind, between-participant design and administered testosterone or placebo gel to 120 healthy young men. Three hours after administration, participants performed a modified Dictator Game from behavioral economics, in which they were asked to choose one of two monetary allocations between themselves and anonymous partners. Participants were either in a position of advantageous inequality (i.e., endowed with more than others) or disadvantageous inequality (i.e., endowed with less than others). Computational modeling showed that inequality-related preferences explained behavior better than competing models. Importantly, compared with the placebo group, the testosterone group showed significantly reduced aversion to advantageous inequality but enhanced aversion to disadvantageous inequality. These findings suggest that testosterone facilitates decisions that prioritize selfish economic motives over fairness concerns, which in turn may boost status-enhancing behaviors.

Dissociation of behavioral and neural responses to provocation during reactive aggression in healthy adults with high versus low externalization

The externalizing spectrum describes a range of heterogeneous personality traits and behavioral patterns, primarily characterized by antisocial behavior, disinhibition, and substance (mis)use. In psychopathology, abnormalities in neural threat, reward responses and the impulse-control system may be responsible for these externalizing symptoms. Within the non-clinical range, mechanisms remain still unclear. In this fMRI-study, 61 healthy participants (31 men) from the higher versus lower range of the non-clinical variation in externalization (31 participants with high externalization) as assessed by the subscales disinhibition and meanness of the Triarchic-Psychopathy-Measure (TriPM) performed a monetary modified Taylor-Aggression-Paradigm (mTAP). This paradigm consisted of a mock competitive-reaction-time-task played against a fictional opponent with preprogrammed win- and lose-trials. In lose-trials, participants were provoked by subtraction of an amount of money between 0 and 90 cents. As a manipulation check, provocation induced a significant rise in behavioral aggression levels linked with an increased activation in the anterior cingulate cortex (ACC). High externalization predicted reduced ACC responses to provocation. However, high externalizing participants did not behave more aggressively than the low externalization group. Additionally, the high externalizing group showed a significantly lower positive affect while no group differences emerged for negative affect. In conclusion, high externalization in the non-clinical range was related to neural alterations in regions involved in affective decision-making as well as to changes in affect but did not lead to higher behavioral aggression levels in response to the mTAP. This is in line with previous findings suggesting that aberrations at multiple levels are essential for developing externalizing disorders.

Reactive vs proactive aggression: A differential psychobiological profile? Conclusions derived from a systematic review

INTRODUCTION

Scholars have established subcategories of aggressive behavior in order to better understand this construct. Specifically, a classification based on motivational underpinnings makes it possible to differentiate between reactive and proactive aggression. Whereas reactive aggression is characterized by emotional lability, which means it is prone to impulsive reactions after provocation, proactive aggression is driven by low emotionality and high levels of instrumentality to obtain benefits. Some authors have conceived these two types as having a dichotomous nature, but others argue against this conceptualization, considering a complementary model more suitable. Hence, neuroscientific research might help to clarify discussions about their nature because biological markers do not present the same biases as psychological instruments.

AIM

The main objective of this study was to carry out a systematic review of studies that assess underlying biological markers (e.g., genes, brain, psychophysiological, and hormonal) of reactive and proactive aggression.

METHODS

To carry out this review, we followed PRISMA quality criteria for reviews, using five digital databases complemented by hand-searching.

RESULTS

The reading of 3993 abstracts led to the final inclusion of 157 papers that met all the inclusion criteria. The studies included allow us to conclude that heritability accounted for approximately 45% of the explained variance in both types of aggression, with 60% shared by both, especially, for overt and physical expression forms, and 10% specific to each type. Regarding allelic risk factors, whereas low functioning variants affecting serotonin transport and monoaminoxidase increased the risk of reactive aggression, high functioning variants were associated with proactive aggression. Furthermore, brain analysis revealed an overlap between the two types of aggression and alterations in the volume of the amygdala and temporal cortex. Moreover, high activation of the medial prefrontal cortex (PFC) facilitated proneness to both types of aggression equally. Whereas stimulation of the right ventrolateral (VLPFC) and dorsolateral (DLPFC) reduced proneness to aggression, inhibition of the left DLPFC increased it. Finally, psychophysiological and hormonal correlates in general did not clearly differentiate between the two types because they were equally related to each type (e.g., low basal cortisol and vagal variability in response to acute stress) CONCLUSIONS: This study reinforces the complementary model of both types of aggression instead of a dichotomous model. Additionally, this review also offers background about several treatments (i.e., pharmacological, non-invasive brain techniques…) to reduce aggression proneness.

Testosterone administration does not alter the brain activity supporting cognitive and affective empathy

Although there is evidence that testosterone has deteriorating effects on cognitive and affective empathy, whether testosterone administration influences both routes to understanding others has not yet been simultaneously investigated.

We conducted a functional magnetic resonance imaging (fMRI) pharmacological study using a within-subjects, randomized, placebo-controlled, double-blind crossover design to examine the effects of 100 mg transdermal testosterone administration on brain activation during a task that examines affective and cognitive empathy simultaneously in a sample of 23 healthy right-handed adult men.

Relative to placebo, testosterone did not alter affective or cognitive empathy functional brain networks. Instead, the task yielded activation in the canonical networks associated with both types of empathy. Affective empathy yielded activation in the inferior and middle frontal gyri, inferior temporal gyri, and the cingulate cortex. Cognitive empathy was associated with activation of the temporoparietal junction, medial prefrontal cortex, middle and inferior temporal gyri, and temporal pole. Behaviourally, testosterone administration decreased error rates and increased participants’ confidence in their responses regardless of response accuracy. Independent of testosterone administration, participants reported higher affective responses during emotionally negative scenarios.

Even though our results provide further evidence that testosterone administration in healthy men does not alter brain activity underlying cognitive and affective empathy, testosterone administration does influence the empathic concern and hence socio-cognitive processes. The reproducibility and variability of the current and previous findings should nevertheless be addressed in upcoming studies.

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High testosterone concentrations are associated with deficient social cognition such as higher aggression and lower empathy.

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We investigated whether 100mg testosterone administration alters the brain activity supporting empathy in 23 healthy men.

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Results showed that neither affective nor cognitive empathy brain network activity was altered by testosterone.

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Independent of testosterone, participants responded with more affective empathy and concern during negative scenarios.

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Our results show that acute testosterone administration in healthy men does not alter most socio-cognitive processes.

Hormonal abnormalities in alexithymia

Alexithymia is a personality trait characterized by difficulties in emotion recognition and regulation that is associated with deficits in social cognition. High alexithymia levels are considered a transdiagnostic risk factor for a range of psychiatric and medical conditions, including depression, anxiety, and autism. Hormones are known to affect social-emotional cognition and behavior in humans, including the neuropeptides oxytocin and vasopressin, the steroid hormones testosterone and estradiol, the stress hormone cortisol as well as thyroid hormones. However, few studies have investigated hormonal effects on alexithymia and on alexithymia-related impairments in emotion regulation and reactivity, stress response, and social cognition. Here, we provide a brief overview of the evidence linking alexithymia to abnormalities in hormone levels, particularly with regard to cortisol and oxytocin, for which most evidence exists, and to thyroid hormones. We address the current lack of research on the influence of sex hormones on alexithymia and alexithymia-related deficits, and lastly provide future directions for research on associations between hormonal abnormalities and deficits in emotion regulation and social cognition associated with alexithymia.

A Combined Administration of Testosterone and Arginine Vasopressin Affects Aggressive Behavior in Males

Aggressive behavior is modulated by many factors, including personality and cognition, as well as endocrine and neural changes. To study the potential effects on the reaction to provocation, which was realized by an ostensible opponent subtracting money from the participant, we administered testosterone (T) and arginine vasopressin (AVP) or a respective placebo (PL). Forty males underwent a functional magnetic resonance imaging session while performing a provocation paradigm. We investigated differential hormone effects and the potential influence of Machiavellian traits on punishment choices (monetary subtractions by the participant) in the paradigm. Participants in the T/AVP group subtracted more money when they were not provoked but showed increased activation in the inferior frontal gyrus and inferior parietal lobule during feedback compared to PL. Higher Machiavellian traits significantly increased punishing behavior independent of provocation only in this group. The pilot study shows that T/AVP affects neural and behavioral responses during a provocation paradigm while personality characteristics, such as Machiavellian trait patterns, specifically interact with hormonal influences (T/AVP) and their effects on behavior.

A meta-analysis on shared and distinct neural correlates of the decision-making underlying altruistic and retaliatory punishment

Individuals who violate social norms will most likely face social punishment sanctions. Those sanctions are based on different motivation aspects, depending on the context. Altruistic punishment occurs if punishment aims to re‐establish the social norms even at cost for the punisher. Retaliatory punishment is driven by anger or spite and aims to harm the other. While neuroimaging research highlighted the neural networks supporting decision‐making in both types of punishment in isolation, it remains unclear whether they rely on the same or distinct neural systems. We ran an activation likelihood estimation meta‐analysis on functional magnetic resonance imaging data on 24 altruistic and 19 retaliatory punishment studies to investigate the neural correlates of decision‐making underlying social punishment and whether altruistic and retaliatory punishments share similar brain networks. Social punishment reliably activated the bilateral insula, inferior frontal gyrus, midcingulate cortex (MCC), and superior and medial frontal gyri. This network largely overlapped with activation clusters found for altruistic punishment. However, retaliatory punishment revealed only one cluster in a posterior part of the MCC, which was not recruited in altruistic punishment. Our results support previous models on social punishment and highlight differential involvement of the MCC in altruistic and retaliatory punishments, reflecting the underlying different motivations.

Proactive vs. Reactive Aggression Within Two Modified Versions of the Taylor Aggression Paradigm

The Taylor Aggression Paradigm (TAP) has been widely used to measure reactive aggression following provocation during competitive interactions. Besides being reactive, aggression can be goal-directed (proactive aggression). Our study presents a novel paradigm to investigate proactive aggression during competitive interactions. Sixty-seven healthy participants competed in two modified versions of the TAP against an ostensible opponent while skin conductance responses (SCRs) were recorded. During the proactive TAP (pTAP), only the participant could interfere with the ostensible opponent’s performance by blurring the screen. In the reactive TAP (rTAP), the opponent repeatedly provoked the participant by blurring the screen of the participant, impeding their chance to win. In both versions, the blurriness levels chosen by the participant served as a measure of aggression (unprovoked in the pTAP and provoked in the rTAP). In the pTAP, trial-by-trial mixed model analyses revealed higher aggression with higher self-reported selfishness. SCRs decreased with increasing proactive aggression. An interaction effect between gender and proactive aggression for the SCRs revealed increased SCRs at higher aggression levels in females, but lower SCRs at higher aggression levels in males. In the rTAP, SCRs were not associated with reactive aggression but aggression increased with increasing provocation and especially after losing against the opponent when provoked. While males showed higher aggression levels than females when unprovoked, reactive aggression increased more strongly in females with higher provocation. Mean levels of aggression in both tasks showed a high positive correlation. Our results highlight that, despite being intercorrelated and both motivated by selfishness, proactive and reactive aggression are differentially influenced by gender and physiological arousal. Proactive aggression is related to lower physiological arousal, especially in males, with females showing the opposite association. Reactive aggressive behavior is a result of individual responses to provocation, to which females seem to be more sensitive.

Low Competitive Status Elicits Aggression in Healthy Young Men: Behavioral and Neural Evidence

Winners are commonly assumed to compete more aggressively than losers. Here, we find overwhelming evidence for the opposite. We first demonstrate that low-ranking teams commit more fouls than they receive in top-tier soccer, ice hockey, and basketball men's leagues. We replicate this effect in the laboratory, showing that male participants deliver louder sound blasts to a rival when placed in a low-status position. Using neuroimaging, we characterize brain activity patterns that encode competitive status as well as those that facilitate status-dependent aggression in healthy young men. These analyses reveal three key findings. First, anterior hippocampus and striatum contain multivariate representations of competitive status. Second, interindividual differences in status-dependent aggression are linked with a sharper status differentiation in the striatum and with greater reactivity to status-enhancing victories in the dorsal anterior cingulate cortex. Third, activity in ventromedial, ventrolateral, and dorsolateral prefrontal cortex is associated with trial-wise increases in status-dependent aggressive behavior. Taken together, our results run counter to narratives glorifying aggression in competitive situations. Rather, we show that those in the lower ranks of skill-based hierarchies are more likely to behave aggressively and identify the potential neural basis of this phenomenon.

Review Article: Anabolic-Androgenic Steroids, Violence, and Crime: Two Cases and Literature Review

BACKGROUND AND OBJECTIVES

Anabolic-androgenic steroid (AAS) use has become a major worldwide substance use disorder, affecting tens of millions of individuals. Importantly, it is now increasingly recognized that some individuals develop uncharacteristically violent or criminal behaviors when using AAS. We sought to summarize available information on this topic.

METHODS

We reviewed the published literature on AAS-induced behavioral effects and augmented this information with extensive observations from our clinical and forensic experience.

RESULTS

It is now generally accepted that some AAS users develop uncharacteristically violent or criminal behaviors while taking these drugs. Although these behaviors may partially reflect premorbid psychopathology, sociocultural factors, or expectational effects, accumulating evidence suggests that they are also attributable to biological effects of AAS themselves. The mechanism of these effects remains speculative, but preliminary data suggest a possible role for brain regions involved in emotional reactivity, such as the amygdala and regions involved in cognitive control, including the frontal cortex. For unknown reasons, these effects appear idiosyncratic; most AAS users display few behavioral effects, but a minority develops severe effects.

CONCLUSION AND SCIENTIFIC SIGNIFICANCE

Professionals encountering AAS users in clinical or forensic settings should be alert to the possibility of AAS-induced violence or criminality and should employ strategies to assess whether AAS is indeed a contributory factor in a given case. Further research is needed to elucidate the mechanism of AAS-induced violence and to explain why only a subset of AAS users appears vulnerable to these effects. (Am J Addict 2021;00:00-00).

Aggression and Psychological Distress in Male and Female Anabolic-Androgenic Steroid Users: A Multigroup Latent Class Analysis

The relationship between anabolic-androgenic steroid (AAS) use and aggression and psychological distress requires further elucidation. No previous study has examined whether the latent patterns of aggression and psychological distress are the same in male and female AAS users. Multigroup latent class analysis (MLCA) can be used to classify individuals into groups based on their responses on a set of variables, and to investigate measurement invariance across subgroups. We therefore conducted a MLCA to identify discrete subgroups of aggression and psychological distress in AAS users, and used measurement invariance to examine whether the identified subgroups can be applied to both sexes. We also examined the relationship between sex and subgroup belongingness. The sample comprised 206 AAS users (females = 58.30%) aged 14-56 (mean = 26.86, SD = 7.12) years. They completed questionnaires assessing demographics, AAS use, aggression, and psychological distress. Based on the MLCA, five subgroups were identified: high aggression moderate distress users (HAMoD: 07.63%), moderate aggression distress users (18.64%), moderate direct aggression-mild indirect aggression moderate distress users (22.95%), mild direct aggression-moderate indirect aggression-distress users (11.71%), and low aggression mild distress users (LAMiD: 39.06%). Although a homogenous five-class solution was the best model for both sexes, sex was significantly associated with the probability of subgroup membership. In particular, members of the HAMoD subgroup were more likely to be male whereas members of the LAMiD subgroup were more likely to be female. Our study provides novel empirical evidence of the idiosyncratic patterns of aggression and psychological distress among male and female AAS users.

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.

Testosterone reactivity to competition and competitive endurance in men and women

Transient shifts in testosterone occur during competition and are thought to positively influence dominance behavior aimed at enhancing social status. However, individual differences in testosterone reactivity to status contests have not been well-studied in relation to real-time expressions of competitive behavior among men and women. This research tests the association between changes in endogenous testosterone levels during competition and performance in terms of competitive endurance. Participant sex, social presence, and relative status outcomes (e.g., winning vs. losing) are tested as moderators of this relationship. In two studies, men and women (total N = 398) competed in the competitive will task (timed weight-holding) either individually or in the presence of an opponent (Study 1) or as a team with and without the presence of a competitor team (Study 2). Results showed a positive relationship between testosterone reactivity and performance for men, particularly those who won or ranked highest among their group - with increasing testosterone predicting better performance and decreasing testosterone predicting worse performance. For women, the effect only emerged among individuals who competed in dyads and lost. In Study 2, an exploratory mediation analysis revealed that individual differences in trait dominance predicted both testosterone reactivity to competition and task performance, with testosterone reactivity (moderated by sex and status outcome) partially explaining the direct relationship between dominance-related traits and behavior. Our goal was to examine testosterone reactivity in relation to real-time competitive effort and highlight the potential role of this relationship in explaining how individual differences in trait dominance produce competitive behavior.

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.

Single-Dose of Testosterone and the MAOA VNTR Polymorphism Influence Emotional and Behavioral Responses in Men During a Non-social Frustration Task

Previous studies suggest that testosterone and several neurotransmitters might interactively influence human aggression. The current study aimed to test potential interactions of a genetic variation linked to the catabolism of serotonin, dopamine, and norepinephrine and exogenous testosterone on the reaction towards non-social provocation. In total, 146 male participants were genotyped for a prominent polymorphism of the monoamine oxidase A (MAOA) gene resulting in a short and long variant. Participants completed a non-social frustration task after receiving either testosterone or a placebo gel in a double-blind set-up. Participants performed a non-social frustration task, where they had to direct a virtually moving ball into a barrel by pulling a joystick (neutral block). During a frustration block, the joystick repeatedly did not respond to participants' reactions thereby causing failed trials to which participants reacted with increased anger and stronger pulling of the joystick. We analyzed the effect of testosterone administration on emotion and behavior in individuals who either carried a low (L) or high (H) activity MAOA variant. Testosterone administration increased provocation-related self-reported anger and abolished the association between trait aggression and joystick deflection in the frustration block. In MAOA-H carriers endogenous testosterone levels at baseline were associated with increased joystick deflection in both blocks. There was, however, no interaction of testosterone administration and genotype. Although preliminary, the results rather indicate independent influences of exogenous testosterone administration and MAOA, but support an interaction of endogenous testosterone levels and MAOA genetics in a frustration task. The administration of testosterone seems to act on the subjective emotional experience in a provoking situation, while endogenous testosterone levels increased pulling impulses only in carriers of the MAOA-H variant.

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.

Serum Testosterone and Cortisol Concentrations After Single-Dose Administration of 100-Mg Transdermal Testosterone in Healthy Men

The growing interest in testosterone's effects on men's social behaviors, in particular aggressive, risk-taking, or status maintenance behaviors, is accompanied by a paucity of dose-dependent pharmacokinetic data. Examining the neurophysiological effects of transdermal testosterone typically includes a 4h delay before further brain-behavior measurements. Nevertheless, high heterogeneity regarding the timing of follow-up measurements and dosage remains. In a double-blind placebo-controlled design, we examined the short-term pharmacokinetic profile of 100-mg transdermal testosterone (Testotop^®) to determine the optimal time for detecting testosterone-mediated effects. Across two studies, 35 healthy men received a single dose of testosterone and placebo in two separate sessions. In study one (n = 16), serum testosterone and cortisol were assessed serially every 30 min up to 2 h posttreatment. In study two (n = 19), we assessed serum testosterone and cortisol at baseline, 2 h, and 4.15 h (255 min) posttreatment. Relative to baseline and placebo, transdermal testosterone significantly increased total serum testosterone concentrations 90 min posttreatment, reaching maximum concentration between 2 h and 3 h posttreatment. Albeit elevated, serum testosterone levels gradually decreased between 2 h and 4 h following treatment. Transdermal testosterone did not suppress cortisol release. Instead, cortisol concentrations decreased according to cortisol's known circadian rhythm. Unlike previous findings showing significant testosterone concentration increases as soon as 60 min and as late as 3 h post 150-mg testosterone treatment, our 100-mg testosterone manipulation significantly increased testosterone concentrations 90 min following treatment. These pharmacokinetic data are important in facilitating the optimization of timing parameters for future testosterone challenge studies.

Autism and Reactions to Provocation in a Social and Non-social Context

Externalizing behaviors in individuals with autism spectrum disorder (ASD) are often either reduced or elevated compared to healthy controls (HCs). This study investigated the moderating role of context in ASD by comparing 32 individuals with ASD to 40 HCs during a social and a non-social provocation task. Compared to HCs, individuals with ASD showed similar externalizing behavior in the social context. In the non-social context reactions after provocation were enhanced relative to non-provoking situations. The findings implicate that the context is an important influencing variable when comparing individuals with ASD to HCs after being provoked. Impulsivity, trait aggression and empathy did not predict behavior in the ASD group but were partly related to observed behavior in HCs.

Mothers' and fathers' joint profiles for testosterone and oxytocin in a small-scale fishing-farming community: Variation based on marital conflict and paternal contributions

INTRODUCTION

Testosterone and oxytocin are psychobiological mechanisms that interrelate with relationship quality between parents and the quantity and quality of parenting behaviors, thereby affecting child outcomes. Their joint production based on family dynamics has rarely been tested, particularly cross-culturally.

METHODS

We explored family function and salivary testosterone and oxytocin in mothers and fathers in a small-scale, fishing-farming society in Republic of the Congo. Fathers ranked one another in three domains of family life pertaining to the local cultural model of fatherhood.

RESULTS

Fathers who were viewed as better providers had relatively lower oxytocin and higher testosterone than men seen as poorer providers, who had lower testosterone and higher oxytocin. Fathers also had higher testosterone and lower oxytocin in marriages with more conflict, while those who had less marital conflict had reduced testosterone and higher oxytocin. In contrast, mothers in conflicted marriages showed the opposite profiles of relatively lower testosterone and higher oxytocin. Mothers had higher oxytocin and lower testosterone if fathers were uninvolved as direct caregivers, while mothers showed an opposing pattern for the two hormones if fathers were seen as involved with direct care.

CONCLUSIONS

These results shed new light on parents' dual oxytocin and testosterone profiles in a small-scale society setting and highlight the flexibility of human parental psychobiology when fathers' roles and functions within families differ across cultures.

Testing the properties of the triarchic model of psychopathy in a community sample: Self-reported trait aggression and drug consumption associations

The triarchic model of psychopathy encompasses different conceptions of psychopathic personality characterized by three phenotypic components: boldness, disinhibition, and meanness. Psychopathy is a complex construct at both emotional and behavioral level. The aim of this study was to determine the core elements of psychopathic personality in a community sample and analyze the relation between these elements and other personality traits such as aggression, and certain specific behavioral manifestations such as substance use. The study sample comprised 1,159 participants aged between 17 and 74 years, who were administered the Triarchic Psychopathy Questionnaire, the Impulsive-Premeditated Aggression Scale, and the Aggression Questionnaire. The results show that the constructs of meanness and disinhibition are more highly associated with different forms of both impulsive and premeditated aggression. Furthermore, men scored higher on all three components of the triarchic model compared to women. Finally, higher substance use (tobacco and drugs) was associated with higher scores in meanness, boldness, and disinhibition. These findings demonstrate the importance of assessing psychopathy in a community sample, and the detection of possible risk factors for the disorder.

No correlation between serum testosterone levels and state-level anger intensity in transgender people: Results from the European Network for the Investigation of Gender Incongruence

INTRODUCTION

Anger is a state of emotions ranging from irritation to intense rage. Aggression implies externalizing anger through destructive/punitive behaviour. The World Professional Association for Transgender Health (WPATH) Standards of Care, Edition 7 (SOC7) guidelines warn about aggression in transgender men (TM) on testosterone treatment. We aimed to assess whether anger intensity increases in TM and decreases in transgender women (TW) after initiation of gender affirming hormone therapy and to identify predictors for anger intensity in transgender people.

METHODS

This prospective cohort study was part of the European Network for the Investigation of Gender Incongruence (ENIGI). Anger intensity was prospectively assessed in 898 participants (440 TM, 468 TW) by STAXI-2 (State-Trait Anger Expression Inventory-2) State Anger (S-Anger) during a three-year follow-up period, starting at the initiation of hormone treatment. Data were analysed cross-sectionally and prospectively.

RESULTS

There was no change in STAXI-2 S-Anger scores. At three, twelve and thirty-six months of gender affirming hormone therapy, STAXI-2 S-Anger scores were not correlated to serum testosterone levels, although there was a correlation with various psychological measures after three and twelve months. TM experiencing menstrual spotting after three months had higher STAXI-2 S-Anger scores compared to those without (median 26.5 [18.0-29.8] versus 15.0 [15.0-17.0], P = 0.020). Changes in STAXI-2 S-Anger scores were not correlated to changes in serum testosterone levels after three, twelve and thirty-six months in TM or TW.

CONCLUSIONS

State-level anger intensity is associated with psychological and/or psychiatric vulnerability, but not exogenous testosterone therapy or serum testosterone levels in transgender people.

Testosterone, cortisol, and status-striving personality features: A review and empirical evaluation of the Dual Hormone hypothesis

Decades of research in behavioral endocrinology has implicated the gonadal hormone testosterone in the regulation of mating effort, often expressed in primates in the form of aggressive and/or status-striving behavior. Based on the idea that neuroendocrine axes influence each other, recent work among humans has proposed that links between testosterone and indices of status-striving are rendered conditional by the effects of glucocorticoids. The Dual Hormone hypothesis is one particular instance of this argument, predicting that cortisol blocks the effects of testosterone on dominance, aggression, and risk-taking in humans. Support for the Dual Hormone hypothesis is wide-ranging, but considerations of theoretical ambiguity, null findings, and low statistical power pose problems for interpreting the published literature. Here, we contribute to the development of the Dual Hormone hypothesis by (1) critically reviewing the extant literature-including p-curve analyses of published findings; and, (2) "opening the file drawer" and examining relationships between testosterone, cortisol, and status-striving personality features in seven previously published studies from our laboratories (total N = 718; median N per feature = 318) that examined unrelated predictions. Results from p-curve suggest that published studies have only 16% power to detect effects, while our own data show no robust interactions between testosterone and cortisol in predicting status-striving personality features. We discuss the implications of these results for the Dual Hormone hypothesis, limitations of our analyses, and the development of future research.

Exogenous testosterone and the monoamine-oxidase A polymorphism influence anger, aggression and neural responses to provocation in males

Testosterone and the monoamine oxidase-A (MAOA) polymorphism are potential neuromodulators for aggression. By acting on similar brain circuits, they might interactively influence human behavior. The current study investigates the causal role of testosterone on aggression-related brain activity and the potential interaction with the MAOA polymorphism. In a double-blind process, 93 healthy males received a testosterone or placebo gel. In an fMRI session, participants performed a Taylor aggression paradigm in which they received provoking feedback and could afterwards decide how aggressively they would react. Testosterone and cortisol levels as well as subjective anger were assessed prior and after the task. Circulating testosterone levels were higher in carriers of the long compared to the short MAOA allele. An interaction of the MAOA polymorphism and testosterone administration was identified in the cuneus, where short allele carriers in the placebo group showed diminished activity in the decision period. Task-related anger was significantly higher in this group. Overall, a mesocorticolimbic network was implicated in processing of high versus low provoking feedback, and core hubs of the default mode network were implicated in the subsequent decision after high versus low provocation. Testosterone administration increased activation in this network. The data provides evidence for an interaction of the MAOA polymorphism and exogenous testosterone on anger and suggests that interactive effects on the brain signal could underlie differential emotional reactivity. The increased default mode activation in the testosterone group suggests an enhanced engagement of social cognition related regions possibly supporting responsivity towards social provocation. This article is part of the Special Issue entitled 'Current status of the neurobiology of aggression and impulsivity'.

On the Complexity of Aggressive Behavior: Contextual and Individual Factors in the Taylor Aggression Paradigm

As many paths lead to aggression, understanding which situations and which person-specific traits facilitate or impede aggressive behavior is crucial. Provocation is among one of the most frequently reported predictors of aggressive behavior. However, it remains unclear whether the reaction to provocation is universal across different forms of aggression and whether individuals differ in their reactivity to such signals. Using the Taylor Aggression Paradigm (TAP), we investigated the influence of individual and contextual factors on physical and non-physical aggression in healthy men and women. The impact of trait aggression, sex, provocation, and the success of a competition against a fictitious opponent on aggressive behavior was examined in three different versions of the TAP. While equal provocation and punishment modalities were used in the first two versions, monetary deductions in the first and heat stimulus in the second study, the third experiment used non-physical provocation to trigger physical punishment. Trial-by-trial analyses revealed that provocation, independent of its specific nature, is a strong predictor for aggressive behavior, especially in highly aggressive participants. Although women initially showed less aggression than men, sex differences were diminished under prolonged, increasing provocation when provocation and punishment modality were identical. Only when modalities diverged, women, compared with men, were more hesitant to punish their opponent. These results, thus, extend evidence that women show lower levels of aggression under low provocation. However, high levels of provocation have similar effects on males' and females' reactive aggressive behavior across different forms of aggression. When competing for money, losing against the fictitious opponent was functioning as an additional provocative signal stimulating aggressive responses. Differences in aggressive responding have to be interpreted in the context of the specific type of provocation and aggression that is investigated since these modalities are shown to interact with individual characteristics.

The influence of the OPRM1 (A118G) polymorphism on behavioral and neural correlates of aggression in healthy males

Current models of aggression suggest that in addition to personality traits and environmental factors, biological vulnerability associated with genetics substantially impacts aggressive behavior. In a functional imaging study, we investigated the influence of the single nucleotide polymorphism of the mu 1 subtype opioid receptor gene (OPRM1), implicated in sociability, on correlates of trait and state aggression to delineate the function of these influences in aggression. A key aim was further to differentiate different aspects of aggressive reactions - namely, the reaction to provocation and the decision to punish an opponent. 59 healthy males performed a modified Taylor Aggression Paradigm during functional magnetic resonance imaging. The implementation of the paradigm allowed for individual assessments of the decision to behave aggressively, the experience of provocation and the ramification of punishment for the participant or the opponent. The influence of variation in the OPRM1 gene was measured by the functional A118G polymorphism. G allele carriers showed lower levels of general aggression and self-reported physical aggression. Additionally, these participants exhibited increased activation in dorsolateral prefrontal, orbitofrontal, anterior cingulate and insular cortices when choosing higher punishments for the opponent. The OPRM1 polymorphism did not influence aggression in reaction to social provocation. Thus, we suggest that this genetic variant affects one's trait aggressiveness rather than actual behavioral reactivity to provocation. Investigating brain regions that are specifically linked to provocation yielded activation in cortico-limbic circuits which might mediate the evaluation of provocation and the experience of anger and thus shed light on neural processes underlying the risk for aggressive behavior. This article is part of the Special Issue entitled 'Current status of the neurobiology of aggression and impulsivity'.

Sex differences in the neural correlates of aggression

Although sex differences in aggression have been investigated for decades, little is known about the underlying neurobiology of this phenomenon. To address this gap, the present study implemented a social reactive aggression paradigm in 20 women and 22 men, employing a modified Taylor Aggression Task (mTAT) to provoke aggressive behavior in an fMRI setting. Subjects were provoked by money subtraction from a fake opponent and given the opportunity to retaliate likewise. In the absence of behavioral differences, male and female subjects showed differential brain activation patterns in response to provocation. Men had higher left amygdala activation during high provocation. This amygdala activation correlated with trait anger scores in men, but not in women. Also, men showed a positive association between orbitofrontal cortex, rectal gyrus and anterior cingulate cortex (ACC) activity in the provocation contrast and their tendency to respond aggressively, whereas women displayed a negative association. As the rectal gyrus and OFC have been attributed a crucial role in automatic emotion regulation, this finding points toward the assumption that highly aggressive men use automatic emotion regulation to a greater extent in response to provocation compared to highly aggressive women.