Elucidating the Impact of Sex and Gonadal Hormones on the Longitudinal Trajectory of Psychopathology Fabiola 1Donald
1 Plaza ,
Pamela DeRosse,
and Barbara Zucker School of Medicine at Hofstra/Northwell
Background Dimensional models of psychopathology describe 3 core psychopathological dimensions which capture a wide range of psychiatric symptoms1,2,3,4: 1. Internalizing dimension: encompasses over-inhibited symptoms (e.g., anxiety, fear, sadness) and indicates a propensity to mood and anxiety disorders. 2. Externalizing dimension: encompasses disinhibited symptoms (e.g., aggression, conduct problems) and indicates a propensity to substance use disorders, conduct disorder, and antisocial personality disorder5,6,7 3. Thought Disorder dimension: encompasses disordered thinking and reflects a strong propensity to more severe general psychopathology. Adult samples have reported that males typically evidence a greater propensity towards both externalizing and thought disorder dimensions, while females evidence greater propensity towards internalizing symptoms2,4. Because sex-differences inherently capture variation in the concentration of gonadal hormones, such as testosterone (T), variation in circulating levels of this hormone might also be expected to contribute to variation in the psychopathology. To date, however, little is known about the extent of these differences prior to the onset of puberty and even less is known about the extent to which changes in gonadal hormones over the pre-pubertal period might impact these relationships.
1,2 PhD 2Zucker
Results Figure 1: Baseline externalizing (left) internalizing (right) scores for males and females
Figure 2: Plotting of delta scores for psychopathology (Y axis; internalizing on left and externalizing on right) and hormone levels (X axis) for males. Participants were stratified based on pubertal stage
Methods Data was derived from the ongoing Adolescent Brain Cognitive Development (ABCD) study8 (https://nda.nih.gov/abcd) and was analyzed utilizing SPSS Statistical Software. We isolate subject data for the following variables, which were all administered at baseline and reassessed at the 1-year follow-up: • Achenbach system of empirically based assessment (ASEBA)9 and the brief version of the Prodromal Questionnaire (PQ-B)10 to assess variation in psychopathology domains. • Parent/caregiver and youth report of descriptions of their pubertal status • Hormone levels, specifically DHEA and testosterone (ERT) We excluded subjects who had a history of traumatic brain injury, cancer diagnosis, cerebral palsy, and/or diabetes. In total, we had 4187 male subjects and 3198 female subjects.
Conclusions Concordant with the previous studies done on adult participants, our research found significant differences in the population variance for males and females at baseline: • internalizing (p = .04) and externalizing (p < .01) symptoms (Figure 1). • DHEA (p < .01) and ERT (p = .01) hormone levels Additionally, we did observe a larger increase in externalizing symptoms in males vs females from baseline to one-year follow-up (p < .01), but the difference in internalizing symptoms was not significant (p = .49). Comparing male and female DHEA and ERT delta scores versus externalizing (male: p = .26; p = .94; female: p = .31; p = .91) and internalizing (male: p = .22; p = .94; female: p = .22; p = .33) symptomology delta scores yielded no significant correlation. Because of this, we are unable to correlate the differences in the variance between internalizing and externalizing scores in males and females with the difference in variance with DHEA and ERT levels (Figure 3, 4).
Future Direction
Hypothesis 1. Relative to males, females will evidence significant increases in internalizing symptoms across a 2-year period. 2. Relative to females, males will evidence significant increase in externalizing and thought disorder symptoms across a 2-year period. 3. Sex differences in psychopathology domains will be moderated by changes in level of circulating Testosterone.
Hillside Hospital
Figure 3: Plotting of delta scores for psychopathology (Y axis; internalizing on left and externalizing on right) and hormone levels (X axis) for females. Participants were stratified based on pubertal stage
Although at the present there was no relationship observed between psychopathology and hormone levels, we believe that this area still warrants additional research. The limitations of the ABCD study we noted that may have contributed to lack of correlation are the following: • Participants are still in the earlier stages of puberty. There was a small percentage of change in pubertal stage throughout follow up period, and not many participants had data at the “extremes” of the pubertal staging system (pre-puberty vs post-puberty). • There was minimal change in the hormone levels from baseline to one year follow up. We believe that it is important to continue to follow-up with the participants for multiple years to be able to see if there is any significant effect.
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