Shenk Chad E, Dorn Lorah D, Kolko David J, Susman Elizabeth J, Noll Jennie G, Bukstein Oscar G
Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 3015, Cincinnati, OH 45229.
Western Psychiatric Institute & Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA.
J Child Fam Stud. 2012 Dec;21(6):973-981. doi: 10.1007/s10826-011-9557-x. Epub 2011 Dec 20.
Variations in adrenal and gonadal hormone profiles have been linked to increased rates of oppositional defiant disorder (ODD) and conduct disorder (CD). These relationships suggest that certain hormone profiles may be related to how well children respond to psychological treatments for ODD and CD. The current study assessed whether pre-treatment profiles of adrenal and gonadal hormones predicted response to psychological treatment of ODD and CD. One hundred five children, 6 - 11 years old, participating in a randomized, clinical trial provided samples for cortisol, testosterone, dehydroepiandrosterone, and androstenedione. Diagnostic interviews of ODD and CD were administered up to three years post-treatment to track treatment response. Group-based trajectory modeling identified two trajectories of treatment response: 1) a High-response trajectory where children demonstrated lower rates of an ODD or CD diagnosis throughout follow-up, and 2) a Low-response trajectory where children demonstrated higher rates of an ODD or CD diagnosis throughout follow-up. Hierarchical logistic regression predicting treatment response demonstrated that children with higher pre-treatment concentrations of testosterone were four times more likely to be in the Low-response trajectory. No other significant relationship existed between pre-treatment hormone profiles and treatment response. These results suggest that higher concentrations of testosterone are related to how well children diagnosed with ODD or CD respond to psychological treatment over the course of three years.
肾上腺和性腺激素水平的变化与对立违抗障碍(ODD)和品行障碍(CD)的发病率增加有关。这些关系表明,某些激素水平可能与儿童对ODD和CD心理治疗的反应程度有关。当前的研究评估了肾上腺和性腺激素的治疗前水平是否能预测ODD和CD心理治疗的反应。105名6至11岁的儿童参与了一项随机临床试验,提供了皮质醇、睾酮、脱氢表雄酮和雄烯二酮的样本。在治疗后长达三年的时间里进行ODD和CD的诊断访谈,以跟踪治疗反应。基于组的轨迹模型确定了两条治疗反应轨迹:1)高反应轨迹,即儿童在整个随访期间ODD或CD诊断率较低;2)低反应轨迹,即儿童在整个随访期间ODD或CD诊断率较高。预测治疗反应的分层逻辑回归表明,治疗前睾酮浓度较高的儿童处于低反应轨迹的可能性是其他儿童的四倍。治疗前激素水平与治疗反应之间不存在其他显著关系。这些结果表明,较高的睾酮浓度与被诊断为ODD或CD的儿童在三年期间对心理治疗的反应程度有关。