University of Kentucky.
Psychol Bull. 2013 Nov;139(6):1221-59. doi: 10.1037/a0032247. Epub 2013 Apr 29.
Despite the well-established sex difference in prevalence of many childhood and adolescent psychopathological conditions, no integrative metatheory of sex differences in psychopathology exists. This review attempts to provide a metatheoretical framework to guide empirical examination of sex differences in prevalence of childhood-onset "externalizing" and adolescent-onset "internalizing" disorders, based on sexual selection evolutionary theory. Sexual selection theory suggests important between-sex differences in markers, mechanisms, etiology, and developmental timing of risk and resilience relevant to psychopathology. Namely, sexual selection theory hypothesizes that disinhibition and sensation-seeking may be important proximate risk markers for childhood-onset externalizing disorders in males. The theory suggests that these male-biased markers may be a product of their higher exposure to prenatal testosterone, which makes them more susceptible to prenatal stressors with downstream effects on dopaminergic neurotransmission, especially for those with genetic alleles associated with lower dopaminergic function. In contrast, sexual selection theory hypothesizes that negative emotionality, empathy, and cognitive rumination may be important proximate risk markers for adolescent-onset internalizing disorders in females. The theory suggests that these markers are propagated by rapidly rising levels of estradiol at puberty that interact with cortisol and oxytocin. These hormones exert downstream effects on the serotonergic system in such a way as to increase females' sensitivity to interpersonal stressors particularly at puberty and especially for those with lower functional serotonergic activity. Such a metatheory can help integrate prior ideas about sex differences and can also generate new predictions of sex differences in markers, etiology, mechanisms, and developmental timing of common forms of psychopathology.
尽管许多儿童和青少年精神病理学状况的流行存在着明确的性别差异，但目前还没有一个关于精神病理学性别差异的综合元理论。本综述试图基于性选择进化理论，为指导儿童期起病的“外化”和青少年期起病的“内化”障碍流行率的性别差异的实证研究提供一个元理论框架。性选择理论表明，与精神病理学相关的风险和弹性的标志物、机制、病因和发展时间在两性之间存在重要差异。也就是说，性选择理论假设，对于男性而言，抑制解除和寻求刺激可能是儿童期起病的外化障碍的重要近因风险标志物。该理论表明，这些男性偏爱的标志物可能是其暴露于产前睾酮更高的产物，这使他们更容易受到产前应激的影响，从而对多巴胺能神经传递产生下游影响，尤其是对于那些与多巴胺能功能较低的遗传等位基因相关的个体。相比之下，性选择理论假设，对于女性而言，负性情绪、共情和认知反刍可能是青少年期起病的内化障碍的重要近因风险标志物。该理论表明，这些标志物是由青春期快速上升的雌二醇水平传播的，雌二醇与皮质醇和催产素相互作用。这些激素对 5-羟色胺能系统产生下游影响，使女性对人际应激源的敏感性增加，尤其是在青春期，尤其是对于那些 5-羟色胺能活性较低的女性。这种元理论可以帮助整合关于性别差异的先前观点，也可以对常见精神病理学形式的标志物、病因、机制和发展时间的性别差异产生新的预测。
