Androgens and child behavior: Color and toy preferences in children with congenital adrenal hyperplasia (CAH)

Human males and females show average gender/sex differences for certain psychological phenomena. Multiple factors may contribute to these differences, including sex chromosomes, exposure to gonadal hormones, and socialization or learning. This study investigated potential hormonal and socialization/learning influences on gender/sex differences in childhood preferences for color, specifically pink and red vs. blues, and for toys. Children (aged 4 to 11 years) with congenital adrenal hyperplasia (CAH, n = 43 girls and 37 boys), marked by elevated prenatal adrenal androgen exposure, and without CAH (n = 41 girls and 31 boys) were studied. Prior research indicates girls with CAH are masculinized for certain behaviors, such as toy choices, while boys with CAH generally do not differ from boys without CAH. In the current study, children indicated preferences for stereotyped hues of pink vs. blue as well as two control color pairs. They also indicated their preference between gender/sex-typed toys (doll vs. car) presented in black and white, in gender/sex-congruent colors (pink doll vs. blue car) and in gender/sex-incongruent colors (pink car vs. blue doll). Color findings: Control girls preferred stereotyped pink over blue more than boys or girls with CAH did; the latter two groups did not differ in their color preferences. No preference differences occurred for other color pairs. Toy findings: In black/white or gender/sex-congruent colors, boys preferred the car more than control girls or girls with CAH did, while girls with CAH preferred the car more than control girls did. In gender/sex-incongruent colors (pink car vs. blue doll), boys still preferred the car, while girls with CAH showed reduced and control girls showed increased preferences for the pink car compared to the car preferences in black/white. Results support learning theories of color preferences, perhaps also influenced by pre-existing toy preferences which may occur for other reasons, including early androgen exposure. Specifically, girls with CAH may have learned they do not enjoy stereotypical toys for girls, often colored pink, and pink coloring may subsequently diminish their preference for a car. Our results highlight the importance of gonadal hormones and learning in the development of childhood toy and color preferences.

No Evidence for Enhancement of Spatial Ability with Elevated Prenatal Androgen Exposure in Congenital Adrenal Hyperplasia: A Meta-Analysis

Spatial abilities contribute to life and occupational competencies, and certain spatial skills differ, on average, between males and females, typically favoring males when differences occur. Factors contributing to spatial skills could include prenatal as well as experiential/cultural influences, with biological and social influences likely interacting and difficult to disentangle. This meta-analysis examined the potential influence of prenatal androgen exposure on spatial skill by examining studies of patients with congenital adrenal hyperplasia (CAH). CAH involves elevated adrenal androgens prenatally, with overall androgen concentrations higher for females with CAH versus same-sex controls but with little overall difference between males with CAH versus controls. We hypothesized that, if androgens contribute prenatally to neurobehavioral development in humans as in many other species, females with CAH would show spatial enhancement versus control females, but with no definitive hypothesis for males. Meta-analysis of 12 studies examining overall spatial skill and three spatial subcategories failed to support enhanced spatial performance for females with CAH; males with CAH showed lower spatial ability compared to control males, at least for the category of overall spatial skill. Although statistical logic precludes accepting the null hypothesis for females, the meta-analysis failed to support the idea that prenatal exposure to androgens explains spatial gender/sex differences in humans. Alternative explanations for average gender/sex differences in some spatial tasks could include androgen exposure at other times, such as mini-puberty, or different social factors experienced by males and females. We also discuss possible explanations for the different outcomes seen in females versus males with CAH.

Sex Differences in Line Judgment: Relation to Mathematics Preparation and Strategy Use

This study explored visuospatial ability using a new group-administered task, the Judgment of Line Angle and Position-15 test (JLAP–15). We investigated how this task relates to the Vandenberg Mental Rotation Test and whether the sex difference in performance could be explained by the number of prior mathematics courses or strategy used. Undergraduates ( n = 86 men and 112 women) completed the two tests and reported their strategies. Men had higher scores than women on both tests ( d = 1.04 for JLAP–15 and 1.10 for the Vandenberg Mental Rotation Test), with a significant intertask correlation of .41. Regression analyses indicated that strategy type, number of mathematics courses completed, and sex were significant predictors of performance on the JLAP–15 but only accounted for 21% of the variance.

Clinical Neurophysiology in the Schools

Criticisms of many commonly used psycho-educational tests have stimulated interest in development of more objective and culturally less biased assessment procedures. The disciplines of neuropsychology, electrophysiology and psychophysiology use procedures which could be of value in this regard. Potential contributions of each of these disciplines are discussed. Brief descriptions are given of representative assessment tools used by clinical neuropsychologists and psychophysiologists. Several approaches to computer scored measurement of electrical activity of the brain in assessment of school learning problems are described.

Large Sex Difference in Adolescents on a Timed Line Judgment Task: Attentional Contributors and Task Relationship to Mathematics

Visuospatial performance, assessed with the new, group-administered Judgment of Line Angle and Position test (JLAP-13), varied with sex and mathematical competence in a group of adolescents. The JLAP-13, a low-level perceptual task, was modeled after a neuropsychological task dependent upon functioning of the posterior region of the right hemisphere [Benton et al, 1994 Contributions to Neuropsychological Assessment: A Clinical Manual (New York: Oxford University Press)]. High-school boys ( N = 52) performed better than girls ( N = 62), with a large effect for sex ( d= 1.11). Performance increased with mathematical competence, but the sex difference did not vary significantly across different levels of mathematics coursework. On the basis of earlier work, it was predicted that male, but not female, performance in line judgment would decline with disruptions to task geometry (page frame), and that the sex difference would disappear with disruptions to geometry. These predictions were supported by a number of univariate and sex-specific analyses, although an omnibus repeated-measures analysis did not detect the predicted interaction, most likely owing to limitations in power. Thus, there is partial support for the notion that attentional predispositions or strategies may contribute to visuospatial sex differences, with males more likely than females to attend to, and rely upon, internal or external representations of task geometry. Additional support for this hypothesis may require development of new measures or experimental manipulations with more powerful geometrical disruptions.

Reduced short term memory in congenital adrenal hyperplasia (CAH) and its relationship to spatial and quantitative performance

Girls and women with classical congenital adrenal hyperplasia (CAH) experience elevated androgens prenatally and show increased male-typical development for certain behaviors. Further, individuals with CAH receive glucocorticoid (GC) treatment postnatally, and this GC treatment could have negative cognitive consequences. We investigated two alternative hypotheses, that: (a) early androgen exposure in females with CAH masculinizes (improves) spatial perception and quantitative abilities at which males typically outperform females, or (b) CAH is associated with performance decrements in these domains, perhaps due to reduced short-term-memory (STM). Adolescent and adult individuals with CAH (40 female and 29 male) were compared with relative controls (29 female and 30 male) on spatial perception and quantitative abilities as well as on Digit Span (DS) to assess STM and on Vocabulary to assess general intelligence. Females with CAH did not perform better (more male-typical) on spatial perception or quantitative abilities than control females, failing to support the hypothesis of cognitive masculinization. Rather, in the sample as a whole individuals with CAH scored lower on spatial perception (p ≤ .009), a quantitative composite (p ≤ .036), and DS (p ≤ .001), despite no differences in general intelligence. Separate analyses of adolescent and adult participants suggested the spatial and quantitative effects might be present only in adult patients with CAH; however, reduced DS performance was found in patients with CAH regardless of age group. Separate regression analyses showed that DS predicted both spatial perception and quantitative performance (both p ≤ .001), when age, sex, and diagnosis status were controlled. Thus, reduced STM in CAH patients versus controls may have more general cognitive consequences, potentially reducing spatial perception and quantitative skills. Although hyponatremia or other aspects of salt-wasting crises or additional hormone abnormalities cannot be ruled out as potential contributors, elevated GCs appear to be the most likely contributor to reductions in STM. Additional efforts to monitor GC administration protocols may help achieve optimal cognitive outcomes. Educational intervention for individuals with CAH might also be useful.

Virtual navigation performance: the relationship to field of view and prior video gaming experience

Two experiments examined whether learning a virtual environment was influenced by field of view and how it related to prior video gaming experience. In the first experiment, participants (42 men, 39 women; M age = 19.5 yr., SD = 1.8) performed worse on a spatial orientation task displayed with a narrow field of view in comparison to medium and wide field-of-view displays. Counter to initial hypotheses, wide field-of-view displays did not improve performance over medium displays, and this was replicated in a second experiment (30 men, 30 women; M age = 20.4 yr., SD = 1.9) presenting a more complex learning environment. Self-reported video gaming experience correlated with several spatial tasks: virtual environment pointing and tests of Judgment of Line Angle and Position, mental rotation, and Useful Field of View (with correlations between .31 and .45). When prior video gaming experience was included as a covariate, sex differences in spatial tasks disappeared.

Sex differences in mental rotation and line angle judgments are positively associated with gender equality and economic development across 53 nations

Mental rotation and line angle judgment performance were assessed in more than 90,000 women and 111,000 men from 53 nations. In all nations, men's mean performance exceeded women's on these two visuospatial tasks. Gender equality (as assessed by United Nations indices) and economic development (as assessed by per capita income and life expectancy) were significantly associated, across nations, with larger sex differences, contrary to the predictions of social role theory. For both men and women, across nations, gender equality and economic development were significantly associated with better performance on the two visuospatial tasks. However, these associations were stronger for the mental rotation task than for the line angle judgment task, and they were stronger for men than for women. Results were discussed in terms of evolutionary, social role, and stereotype threat theories of sex differences.

Stereotype Threat and Gender Differences in Performance on a Novel Visuospatial Task

Stereotype threat research has shown that being a member of a negatively stereotyped group may result in impaired performance on tests of skills thought to be relevant to the stereotype. This study investigated whether stereotype threat influences gender differences in performance on a novel test of visuospatial ability. Undergraduates ( N = 194) were told that men outperform women on the test (explicit threat), were given no gender-relevant information (implicit threat), or were told that men and women do not differ (nullified stereotype). Although men outperformed women in the explicit and implicit stereotype threat groups, women's performance did not differ significantly from men's when told there is no gender difference. The effect was most pronounced for difficult line judgments. Although stereotypes regarding visuospatial ability may be less culturally salient than those of other cognitive abilities, these findings suggest that they influence performance nonetheless. Implications for optimizing cognitive test performance are discussed.

Motor development in individuals with congenital adrenal hyperplasia: strength, targeting, and fine motor skill

This study investigated early androgen influence on the development of human motor and visuomotor characteristics. Participants, ages 12-45 years, were individuals with congenital adrenal hyperplasia (CAH), a disorder causing increased adrenal androgen production before birth (40 females, 29 males) and their unaffected relatives (29 females, 30 males). We investigated grip strength and visuomotor targeting tasks on which males generally outperform females, and fine motor pegboard tasks on which females generally outperform males. Physical characteristics (height and weight) were measured to explore whether body parameters could explain differences in motor skills. Females with CAH were stronger and showed better targeting than unaffected females and showed reduced fine visuomotor skill on one pegboard measure, with no difference on the other. Males with CAH were weaker than unaffected males in grip strength but did not differ on the targeting or pegboard measures. Correction for body size could not explain the findings for females, but suggests that the reduced strength of males with CAH may relate to their smaller stature. Further, the targeting advantage in females with CAH persisted following adjustment for their greater strength. Results in females support the hypothesis that androgen may masculinize, or promote, certain motor characteristics at which males excel, and contribute to defeminization of certain fine motor characteristics at which females excel. Thus, these data suggest that organizational effects of androgens on behavior during prenatal life may extend to motor characteristics and may contribute to general sex differences in motor-related behaviors; however, alternative explanations based on activational influences of androgen or altered experiential factors cannot be excluded without further study.

Visuospatial performance on an internet line judgment task and potential hormonal markers: sex, sexual orientation, and 2D:4D

We investigated whether performance on a visuospatial line judgment task, the Judgment of Line Angle and Position-15 test (JLAP-15), showed evidence of sensitivity to early sex steroid exposure by examining how it related to sex, as well as to sexual orientation and 2D:4D digit ratios. Participants were drawn from a large Internet study with over 250,000 participants. In the main sample (ages 12-58 years), males outperformed females on the JLAP-15, showing a moderate effect size for sex. In agreement with a prenatal sex hormone hypothesis, line judgment accuracy in adults related to 2D:4D and sexual orientation, both of which are postulated to be influenced by early steroids. In both sexes, better visuospatial performance was associated with lower (more male-typical) digit ratios. For men, heterosexual participants outperformed homosexual/bisexual participants on the JLAP-15 and, for women, homosexual/bisexual participants outperformed heterosexual participants. In children aged 8-10 years, presumed to be a largely prepubertal group, boys also outperformed girls. These findings are consistent with the hypothesis that visuospatial ability is influenced by early sex steroids, although they do not rule out alternative explanations or additional influences. More broadly, such results support a prenatal sex hormone hypothesis that degree of androgen exposure may influence the neural circuitry underlying cognition (visuospatial ability) and sexual orientation as well as aspects of somatic (digit ratio) development.

Gender and sexual orientation differences in cognition across adulthood: age is kinder to women than to men regardless of sexual orientation

Despite some evidence of greater age-related deterioration of the brain in males than in females, gender differences in rates of cognitive aging have proved inconsistent. The present study employed web-based methodology to collect data from people aged 20-65 years (109,612 men; 88,509 women). As expected, men outperformed women on tests of mental rotation and line angle judgment, whereas women outperformed men on tests of category fluency and object location memory. Performance on all tests declined with age but significantly more so for men than for women. Heterosexuals of each gender generally outperformed bisexuals and homosexuals on tests where that gender was superior; however, there were no clear interactions between age and sexual orientation for either gender. At least for these particular tests from young adulthood to retirement, age is kinder to women than to men, but treats heterosexuals, bisexuals, and homosexuals just the same.

Large visuospatial sex difference in line judgment: possible role of attentional factors

This article describes a large sex difference on a new, group-administered visuospatial task, the Judgment of Line Angle and Position (JLAP) test, and investigates the role of attentional factors in the difference. On the JLAP, adapted from a neuropsychological task (Benton et al., 1983), participants evaluate spatial attributes of lines. Study 1: College males (N = 48) outperformed females (N = 80), resulting in a large effect for sex (d = 0.85). Errors were more common on oblique (vs horizontal or vertical) lines, especially for females. Study 2: Task attributes were manipulated (N = 33 males and 36 females) to study the role of attentional factors. Findings suggest that males are more likely than females to normally attend to and be aided by geometrical reference cues.

Cognitive and behavioral characteristics of turner syndrome: exploring a role for ovarian hormones in female sexual differentiation

To better understand factors contributing to behavioral development, we studied patients with Turner syndrome (TS), a disorder typically marked by prenatal onset of ovarian dysfunction. We compared girls and women (ages 12 and up) with TS (n = 21) to matched controls (n = 21) in cognitive and motor skills, as well as sex-typed personality characteristics and activity preferences. Measures were categorized (based on prior studies) as showing an average male advantage (male-superior measures), female advantage (female-superior measures), or no sex difference (sex-neutral measures). It was hypothesized that, if gonadal function contributes to behavioral development, effects of this deficiency would be more prominent on sexually differentiated than sex-neutral measures and thus that patient-control differences would be most marked for measures that show sex differences. Our findings indicated that TS patients and controls differed more on cognitive and motor domains that show sex differences than on sex-neutral domains. Patients also had more "undifferentiated" personalities and showed reduced sex-typed interests and activities. Differing experiences, as indexed by interests and activities, did not explain the observed cognitive and motor differences. These results are consistent with a role for ovarian hormones acting on the brain to influence cognitive and behavioral development, although they do not rule out other possible interpretations.

Human behavioral sex differences: a role for gonadal hormones during early development?

Evidence that gonadal hormones during prenatal and neonatal development influence behavior is reviewed. Several theoretical models of hormonal influences, derived from research in other species, are described. These models are evaluated on the basis of data from humans with either normal or abnormal hormonal exposure. It is concluded that the evidence is insufficient to determine which model best explains the data. Sexual differentiation may involve several dimensions, and different models may apply to different behaviors. Gonadal hormones appear to influence development of some human behaviors that show sex differences. The evidence is strongest for childhood play behavior and is relatively strong for sexual orientation and tendencies toward aggression. Also, high levels of hormones do not enhance intelligence, although a minimum level may be needed for optimal development of some cognitive processes. Directions for future research are proposed.

Magnetoencephalographic localization of a language processing cortical area adjacent to a cerebral arteriovenous malformation. Case report

In order to accurately estimate the risk of surgery for dominant perisylvian arteriovenous malformations, the topographical relationship of the lesion to language cortex must be determined. A case is presented in which a magnetoencephalographic (MEG) study was used to map preoperatively and noninvasively an intracortical source of speech-receptive cortex in a 25-year-old right-handed man with a dominant left temporal lobe arteriovenous malformation. The speech-evoked magnetic field was analyzed at 36 positions over the left hemisphere in response to presentations of the consonant-vowel syllables "da" and "ga." A topographical map of the magnetic component evoked at 110 msec after stimulus onset, which was negative going to the vertex in concurrent electrical recordings, was congruent with a superficial cortical neuronal current source. This source was displaced from that usually observed in normal individuals to tonal or click stimuli, being superior to the probable location of auditory cortex, and superior and anterior to the probable location of Wernicke's area as conventionally described. The MEG results were in accord with the determination of position of a language-processing cortical area as assessed by direct electrical stimulation of the cortex during surgery under local anesthesia, and by superselective Amytal (amobarbital) injection during angiography. The MEG recordings and exposed brain stimulation sites were coordinated by cranial measurements, skull x-ray landmarks, and angiographic anatomy. Investigations such as this, which compare MEG findings with those from established clinical procedures, are an essential step in determining the physiological and anatomical utility of magnetoencephalography for noninvasive clinical functional localization.

A measure of short-term visual memory based on the WISC-R coding subtest

Adapted the Coding subtest of the WISC-R to provide a measure of visual memory. Three hundred and five children, aged 8 through 12, were administered the Coding test using standard directions. A few seconds after completion the key was taken away, and each was given a paper with only the digits and asked to write the appropriate matching symbol below each. This was termed "Coding Recall." To provide validity data, a subgroup of 50 Ss also was administered the Attention Span for Letters subtest from the Detroit Tests of Learning Aptitude (as a test of visual memory for sequences of letters) and a Bender Gestalt recall test (as a measure of visual memory for geometric forms). Coding Recall means and standard deviations are reported separately by sex and age level. Implications for clinicans are discussed. Reservations about clinical use of the data are given in view of the possible lack of representativeness of the sample used and the limited reliability and validity of Coding Recall.