Psychology Department, University of New Orleans, LA 70148, USA.
Horm Behav. 2009 Apr;55(4):465-79. doi: 10.1016/j.yhbeh.2009.02.004. Epub 2009 Mar 2.
Hormonal influences on the organization of behavior are apparent to neuroendocrinologists but under-examined in relation to childhood and adolescent mental disorders. A central mystery in the field of developmental psychopathology is the preferential male vulnerability to behavior disorders in childhood and female vulnerability to emotional disorders in adolescence. Relative neglect of a hormonal explanation may be due to lack of simple or unifying conceptual paradigms to guide studies. This paper seeks to stimulate research in this area by drawing upon clinical psychology and neuroscience literatures to offer a heuristic paradigm for clinical research. Two syndromes are selected here for illustration: Attention-Deficit/Hyperactivity Disorder (ADHD) and Major Depressive Disorder (MDD), because they have opposite gender risk profiles. Two guiding theories are evaluated. First, prenatal organizational effects of testosterone may modulate striatally-based dopaminergic circuits in such a way as to place boys at greater risk for early developing inattention and disruptive behavioral disorders. Second, activational effects of estradiol at puberty may modulate amygdalar and other circuitry, with particular effects on serotonergic pathways, in such a way as to place girls at greater risk for internalizing and mood disorders. Hypotheses from these theories are evaluated based on the current available literature, and limitations of, and future directions for, this literature are discussed.
激素对行为的组织的影响对神经内分泌学家来说是显而易见的，但与儿童和青少年精神障碍的关系却没有得到充分的研究。在发展心理病理学领域的一个核心谜团是，儿童时期男性更容易出现行为障碍，而青春期女性更容易出现情绪障碍。相对忽视激素解释可能是由于缺乏简单或统一的概念范式来指导研究。本文试图通过借鉴临床心理学和神经科学文献，为临床研究提供一个启发式范例，来激发这一领域的研究。本文选择了两种综合征来说明：注意力缺陷多动障碍（ADHD）和重度抑郁症（MDD），因为它们具有相反的性别风险特征。本文评估了两种指导理论。首先，睾酮的产前组织效应可能以一种使男孩更容易出现早期注意力不集中和破坏性行为障碍的方式调节基于纹状体的多巴胺能回路。其次，青春期雌二醇的激活效应可能调节杏仁核和其他回路，对 5-羟色胺途径有特殊影响，从而使女孩更容易患上内化和情绪障碍。基于现有文献，对这些理论的假设进行了评估，并讨论了该文献的局限性和未来方向。
