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Increased hair testosterone but unaltered hair cortisol in female patients with borderline personality disorder
Abstract
A number of studies have reported on dysfunctions in steroid secretion, including altered cortisol and testosterone levels in borderline personality disorder (BDP) patients compared to healthy controls. The present study extends findings from blood and saliva studies to the cumulative measure of hair steroids. We investigated women with BPD (n = 18) and age- and education-matched healthy women (n = 17). We did not find differences between BPD patients and healthy women (p = 0.40) concerning hair cortisol levels but increased hair testosterone levels among BPD patients compared to controls (p = 0.03). These results remained when restricting the analyses to unmedicated patients. Our data indicate altered long-term testosterone but not cortisol levels in females with BPD. Future studies should address the possible impact of altered testosterone on medical illness processes including metabolic syndrome in this population.
... Previous studies have reported higher basal cortisol levels within BPD samples (Lieb et al., 2004;Rausch et al., 2015). Other studies have found no such effect, or only in BPD participants with co-morbid trauma histories (Jogems-Kosterman et al., 2007;Dettenborn et al., 2016). A recent review and meta-analysis by Thomas et al. (2019) reported inconsistencies within the cortisol and BPD literature, with some studies reporting higher and some lower cortisol levels in individuals with BPD, however only 12 studies were available. ...
... Higher levels of testosterone have been shown to influence aggression and risk taking behavior (Montoya et al., 2012;Mehta et al., 2015). Interestingly, a high rate of comorbidity of polycystic ovary syndrome (PCOS), a condition characterized by increased testosterone, has been noted in females with BPD (Roepke et al., 2010;Rausch et al., 2015;Dettenborn et al., 2016;Trisno et al., 2016;Tan et al., 2018). As well as being associated with reproductive, endocrine and metabolic features, PCOS is linked to psychological distress and negative mood states including anger and hostility (Borghi et al., 2018). ...
... These findings lead to the suggestion that testosterone disturbances may be associated with symptoms of BPD. There is currently a lack of research reporting correlations between BPD symptoms and testosterone levels however higher testosterone levels in BPD have been proposed as a potential mechanism contributing to aggressive symptoms in BPD (Rausch et al., 2015;Dettenborn et al., 2016). ...
Background
Borderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following psychological treatment.
Methods
Participants with BPD ( n = 33) completed a 12-week Dialectical Behavior Therapy group program. Pre and post salivary testosterone and cortisol were analyzed. Baseline hormones in the BPD group were compared to age-and-sex matched controls ( n = 33). Non-parametric tests were utilized to investigate group differences, pre-post treatment hormone and symptom changes, and associations between symptoms and hormone levels.
Results
Participants with BPD had significantly higher testosterone levels than controls. Mean testosterone levels in females with BPD were double that of female controls. Testosterone and cortisol levels were related, and some BPD symptoms were associated with with hormone levels. BPD symptoms reduced significantly with treatment, however pre to post hormone levels did not change.
Conclusions
This study supports an association between BPD symptoms and neuroendocrine dysfunction at baseline, however we found no reduction in hormone dysfunction post treatment. Further research into relationships between stress signaling and neuroendocrine disturbances in BPD may inform aetiological and treatment models.
Trial registration
Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018.
... Borderline Personality Disorder (BPD) is, among other symptoms, characterized by externalizing behavior, risk taking, antagonism, aggression and impulsivity [29,34]; behavioral dispositions which have been associated with elevated testosterone levels [17,28,52]. In fact, previous studies could demonstrate higher basal testosterone levels in female BPD patients [18,54,56], potentially as a consequence of a disturbed androgen metabolism in this patient group [56]. Another mental disorder which is frequently comorbid with BPD is PTSD [51,64]. ...
... In BPD, stress can trigger and increase severity of symptoms [9,11,42,63] and basal testosterone levels are chronically elevated [18,54,56]. Taken together, we predicted that in BPD the testosterone level should increase after acute stress. ...
... Although the vast majority of PTSD patients are women [14], the associations between PTSD and testosterone described in the existing literature have, to the best of our knowledge, only been investigated in men and in a military context. For BPD, there is also evidence of altered testosterone metabolism in female patients [18,54]. However, gender differences exist for BPD in different domains such as impulsivity or aggressiveness, which could be at least partly related to underlying neurobiological and endocrinal differences [6,45,54]. ...
Background
The gonadal hormone testosterone not only regulates sexual behavior but is also involved in social behavior and cognition in both sexes. Changes in testosterone secretion in response to stress have been reported. In addition, stress associated mental disorders such as borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are characterized by alterations in basal testosterone metabolism. However, testosterone changes to stress have not been investigated in mental disorders such as BPD and PTSD so far.
Methods
In the study described, we investigated testosterone reactivity to an acute psychosocial stressor, the Trier Social Stress Test (TSST). Our sample consisted of young adult women with BPD (n = 28), PTSD (n = 22) or both disorders (n = 22), and healthy control (n = 51). Based on previous studies on basal testosterone secretion in these disorders, we expected the stress-associated testosterone reactivity to be higher in the BPD group and lower in the PTSD group, when compared to the healthy control group.
Results
The study could demonstrate an increase in testosterone after acute stress exposure across all groups and independent of BPD or PTSD status. Different possible explanations for the absence of a group effect are discussed.
Conclusions
From the results of this study, we conclude that stress-related changes in testosterone release are not affected by BPD or PTSD status in a female patient population. This study expands the knowledge about changes in gonadal hormones and stress reactivity in these disorders.
... Another study found increased salivary testosterone levels in BPD patients compared to healthy controls [26]. In addition, increased hair testosterone levels were reported in BPD patients compared to controls [27]. Progesterone, estradiol and estrogen are regulated by the hypothalamic HPG axis. ...
... Accordingly, abnormalities in noradrenergic activity have been later noted for BPD [44]. Given the abnormalities in stress reactivity in BPD, the endocrinological dysregulation of HPA function and cortisol synthesis remains an unresolved question in the literature [27,42]. Dettenborn et al. [27] reported no difference in cortisol levels between BPD patients and healthy controls, but they concede that higher baseline levels of cortisol were reported in BPD patients in most studies, compared to healthy controls. ...
... Given the abnormalities in stress reactivity in BPD, the endocrinological dysregulation of HPA function and cortisol synthesis remains an unresolved question in the literature [27,42]. Dettenborn et al. [27] reported no difference in cortisol levels between BPD patients and healthy controls, but they concede that higher baseline levels of cortisol were reported in BPD patients in most studies, compared to healthy controls. In addi-tion, only BPD patients compared with cluster C personality disorders demonstrated reduced cortisol levels with a blunted cortisol and heart rate reactivity in stress tests [27,45]. ...
Borderline Personality Disorder (BPD) is a chronic debilitating psychiatric disorder characterized mainly by emotional instability, chaotic interpersonal relationships, cognitive disturbance (e.g. dissociation and suicidal thoughts) and maladaptive behaviors. BPD has a high rate of comorbidity with other mental disorders and high burden on society. In this review, we focus on two compromised brain regions in BPD – the hypothalamus and the corticolimbic system, emphasizing the involvement and potential contribution of the endocannabinoid system (ECS) to improvement in symptoms and coping. The hypothalamus-regulated endocrine axes (hypothalamic pituitary – gonadal, thyroid & adrenal) have been found to be dysregulated in BPD. There is also substantial evidence for limbic system structural and functional changes in BPD, especially in amygdala and hippocampus, including cortical regions within the corticolimbic system. Extensive expression of CB1 and CB2 receptors of the ECS has been found in limbic regions and the hypothalamus. This opens new windows of opportunity for treatment with cannabinoids such as cannabidiol (CBD) as no other pharmacological treatment has shown long-lasting improvement in the BPD population to date. This review aims to show the potential role of the ECS in BPD patients through their most affected brain regions, the hypothalamus and the corticolimbic system. The literature reviewed does not allow for general indications of treatment with CBD in BPD. However, there is enough knowledge to indicate a treatment ratio of high level of CBD to low level of THC. A randomized controlled trial investigating the efficacy of cannabinoid based treatments in BPD is warranted.
... Nine records were identified to contain information specific to BPD (or at least Cluster B personality disorders specifically) and PCOS (or at least symptoms and markers specific to PCOS), per our inclusion criteria. Three of these records were cross-sectional studies investigating the prevalence of PCOS or symptoms of PCOS in women with BPD (Dettenborn et al., 2016;Rausch et al., 2015;Roepke et al., 2010), while three records were cross-sectional and cohort studies examining the prevalence of psychiatric diagnoses in women with PCOS (Cesta et al., 2016;Sahingoz et al., 2013;Scaruffi et al., 2014). Finally, another three records were case reports of comorbid BPD and PCOS (Jain et al., 2015;Sharma, 2015;Trisno et al., 2016). ...
... In 2016, Dettenborn et al. (2016) provided further evidence for an association between BPD and PCOS symptomology using hair analysis to demonstrate significantly increased hair testosterone levels in 18 female BPD patients compared to 17 matched healthy volunteers (p = 0.03). This finding remained even when factors such as medication, smoking, MDD and PTSD were controlled for. ...
... Indeed, an adrenal component has been observed in a substantial number of women with PCOS, with adrenocortical dysfunction being associated in about 30-50% of PCOS patients (Azziz, 2000;Kumar et al., 2005). This also corresponds to the observations of increased testosterone levels in women with BPD (Dettenborn et al., 2016;Rausch et al., 2015;Roepke et al., 2010) described earlier (Table 1). ...
Objective:
This review examines the existing evidence for the relationship between borderline personality disorder and polycystic ovary syndrome, and to identify commonalities in etiological mechanisms of borderline personality disorder and polycystic ovary syndrome that might explain the relationship between these seemingly disparate disorders.
Methods:
A search of Medline, EMBASE and Cochrane Central was undertaken on 5 December 2016 to identify studies investigating women with borderline personality disorder and polycystic ovary syndrome (or symptoms and markers specific to polycystic ovary syndrome).
Results:
Nine studies were identified, including three cross-sectional studies investigating symptoms of polycystic ovary syndrome in women with borderline personality disorder, two cross-sectional and one cohort study examining the prevalence of psychiatric diagnoses in women with polycystic ovary syndrome and three case reports of comorbid borderline personality disorder and polycystic ovary syndrome.
Conclusion:
Overall, the literature shows women with borderline personality disorder to have higher than expected serum androgen levels and incidence of polycystic ovaries, which can be key features of polycystic ovary syndrome. However, this research is still in its infancy, which limits our understanding of this potential comorbid phenomenon. Given the emerging anecdotal and empirical evidence to date, a theoretical discussion of the potential psychoneuroendocrinological mechanism underlying the borderline personality disorder and polycystic ovary syndrome comorbidity is provided. Further rigorous studies using standardized diagnostic criteria for polycystic ovary syndrome are warranted. Specifically, the use of prospective controlled cohort studies may be able to determine the causality and temporality of observed comorbid borderline personality disorder and polycystic ovary syndrome.
... Based on findings in PTSD patients, we expected to find reduced long-term concentrations of endocannabinoids in BPD as well. Given the close relationship between the endocannabinoid system and the hypothalamic pituitary adrenal axis (Riebe & Wotjak, 2011), we additionally analyzedbased on results one of our former studies (Dettenborn et al., 2016)whether hair endocannabinoids and hair cortisol are correlated. ...
... As reported previously, there were no group differences in hair cortisol in this sample (Dettenborn, et al., 2016). Hair 1-AG/2-AG levels did not correlate with CTQ nor BDI scores (both p > 0.72). ...
Endocannabinoids are involved in depressive and anxious symptoms and might play a role in stress-associated psychiatric disorders. While alterations in the endogenous cannabinoid system have been repeatedly found in patients with posttraumatic stress disorder (PTSD), this system has been mostly neglected in borderline personality disorder (BPD). However, there is first evidence for elevated serum levels of the endocannabinoids arachidonylethanolamide (AEA) and 2-arachidonyl-sn-glycerol (2-AG) in BPD patients compared to healthy controls and PTSD patients. In this study, hair endocannabinoids were analyzed, reflecting long-term endocannabinoid concentrations. We assessed AEA concentrations as well as 2-AG and the 2-AG main isomer 1-AG (1-AG/2-AG) in hair in women with BPD (n = 15) and age- and education-matched healthy women (n = 16). We found significantly reduced log AEA in BPD patients compared to healthy women (p = .03) but no differences in log 1-AG/2-AG concentrations. In addition, there was no association between 1-AG/2-AG and hair cortisol, but we found a non-significant correlation between hair concentrations of AEA and cortisol (p = .06). Our data indicate altered long-term release of endogenous cannabinoids in women with BPD depending on type of endocannabinoid. AEA has been suggested to modulate the basal activity of the endocannabinoid system and seems to attenuate depressive and anxious symptoms. Thus, chronically reduced AEA might contribute to psychiatric symptoms in BPD.
... Similarly, the cortisol metabolite cortisone has been suggested as an additional endogenous stress marker that can be measured in hair (Pittner et al., 2020a;Staufenbiel et al., 2015;Voegel et al., 2020). In addition to the glucocorticoids, testosterone can also be determined in hair (Dettenborn et al., 2016;Hildebrandt et al., 2016;Shields et al., 2019), for example to investigate the relation of its cumulative load with social behavior and cognition (Dettenborn et al., 2013;Duell et al., 2021;Grotzinger et al., 2018;Shields et al., 2019). ...
Objective: Epidemiological studies increasingly use hair samples to assess people’s cumulative exposure to steroid
hormones, but how the use of different psychoactive substances may affect steroid hormone levels in hair is, so
far, largely unknown. The current study addresses this gap by establishing the substance exposure correlates of
cortisol, cortisone, and testosterone in hair, while also accounting for a number of relevant covariates.
Method: Data came from a large urban community-sample of young adults with a high prevalence of substance
use (N = 1002, mean age=20.6 years, 50.2% female), who provided 3 cm of hair samples. Liquid
chromatography-tandem mass spectrometry (LC-MS/MS) quantified cortisol, cortisone, and testosterone, as well
as delta-9-tetrahydrocannabinol (THC), 3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”), cocaine,
several opioids, and their respective metabolites. Multiple linear regression models with covariates were used to
predict steroid hormone levels from substance exposure in a four-step approach: In the full sample, low and high
substance hair concentrations (median split) were first tested against no use for each substance individually (step
1) and for all substances together (step 2). Then, within the participants with any substance in hair only, the
continuous hair concentration of each substance in pg/mg (step 3) and finally of all substances together, were
regressed (step 4).
Results: Low, high, and continuous levels of THC in hair were robustly associated with higher levels of cortisol
(sig. in step 1 low THC: β = 0.29, p = .021; high THC: β = 0.42, p = .001; step 2: low THC: β = 0.27, p = 0.036,
and high THC: β = 0.40, p = .004, and step 4: β = 0.12, p = .041). Participants with high MDMA levels had
higher levels of cortisone without adjusting for other substances (step 1: β = 0.34, p = .026), but this effect was
not significant in the other models. While high THC levels were associated with lower levels of testosterone in
step 2 (β = 0.35, p = .018), MDMA concentration was positively related to testosterone concentration with and
without adjusting for other substances (step 3: β = 0.24, p = .041; step 4: β = 0.17, 95%, p = .015) in male
participants.
Conclusion: The use of psychoactive substances, especially of cannabis and ecstasy, should be considered in
studies investigating steroid hormones in hair.
... This axis in turn is connected to the stress response system (HPA-axis; [46]), with the HPA and ANS axes being known to show several dysregulations in patients with BPD, such as a blunted stress response towards socio-evaluative threat [26,30,47]. Aligning with this notion, previous research on testosterone and BPD revealed elevated baseline testosterone levels in women with BPD [48,49], a possible result of a dysregulated androgen metabolism within this sample [46]. Furthermore, HPG-axis dysregulation has been associated with traumatic childhood experiences as well as chronic exposure to stress during developmentally relevant stages [50], with both factors commonly experienced by individuals with BPD [20,[51][52][53]. ...
Relationship dysfunction—marked by frequent conflicts—is one of the hallmark features of borderline personality disorder (BPD). However, the BPD couple as a dyad and partner-related features have rarely been taken into account. The aim of the present study was to investigate hormonal, personality, and relationship relevant factors, such as relationship satisfaction, attachment, and trauma in both partners within a dyad where one partner is diagnosed with BPD. The total sample consisted of 26 heterosexual couples. All studies were conducted at 2 p.m. Primary outcomes: Neo-Five-Factor-Inventory, Childhood Trauma Questionnaire, Experiences in Close Relationships Scale. Secondary outcomes: Problem List, Partnership Questionnaire, Questionnaire for Assessing Dyadic Coping. Upon questionnaire completion, one saliva sample was taken via passive drool to assess baseline cortisol and testosterone levels. Results showed that females with BPD have higher scores on childhood maltreatment, dysfunctional attachment styles, and neuroticism than mentally healthy females. Furthermore, they have more relationship-related problems and are less satisfied in their romantic relationship. Male partners of women with BPD showed lower testosterone levels, higher levels of childhood maltreatment, dysfunctional attachment styles, neuroticism, and openness compared with the healthy control partners. Furthermore, childhood trauma, neuroticism as well as dysfunctional attachment styles displayed a significant positive correlation with relationship-related problems. Traumatic childhood experiences, insecure attachment styles as well as neurotic personality characteristics contribute to increased relationship disruptions in couples. Relevant hormonal and psychosocial parameters in BPD partners should be taken into account when treating females with BPD.
... While relatively little is known about the causal effects of AAS use on psychopathology and personality in females, it is possible that increased testosterone may contribute to certain traits. Elevated testosterone levels have been observed in female borderline personality disorder patients relative to controls (Dettenborn et al., 2016). Exogenous testosterone has also been associated with a decrease in empathetic behaviour, which may explain some of the current findings, particularly related to sadistic and antisocial traits among women who have used AAS (Hermans et al., 2006;van Honk et al., 2011). ...
Anabolic-androgenic steroids (AAS) are primarily used to improve physical appearance and increase lean muscle mass. Due to their masculinizing properties, the majority of people using AAS are men; however, AAS use among females may increase with changing body ideals trending towards a more muscular appearance. AAS use among males have been associated with risky behavior, and increased prevalence of personality disorders and psychopathology. As a result of low perceived prevalence and stigma among females who use AAS, the relationship between AAS use and psychopathology in this population is not well-known. AAS using women (n = 16) and weight-lifting controls (WLC) (n = 16) completed questionnaires regarding AAS use, health and training information. Psychopathology was evaluated using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Group differences on demographic variables and scores on MCMI-III scales were evaluated with Mann-Whitney U tests. The clinical cut-off was then applied to all MCMI-III scales and groups were compared using Fisher's exact test. AAS consumers demonstrated significantly greater psychopathology than WLC on several scales. Externalizing personality disorder scales were elevated among those who use AAS relative to controls, such as borderline (p < 0.001), antisocial (p = 0.007) and sadistic (p = 0.002), and in addition depressive (p = 0.012), negativistic (p = 0.001) and masochistic (p = 0.029) personality disorders scales. Furthermore, all clinical syndromes were elevated among AAS consumers. AAS consumers thus demonstrated multi-pathology, and 56% (n = 9) of the group met the clinical criteria for six or more disorders. Females who use AAS experience in general increased levels of psychopathology compared to WLC. Clinicians should be aware of these traits and the challenges they present in providing care to this population.
... Therefore, neuroendocrine mechanisms associated with suicide do not seem to show sex specificity. The presented findings of hypercortisolism in the groups hypothesized to be associated with chronic stress are contrary to results from other stress-related conditions with reported alterations in HPA-axis regulation, including hypocortisolism in PTSD [44] and also depression [32], or even no changes in (female) patients with borderline personality disorder [65]. The precise character of this possible physiological difference between these clinical cohorts needs to be further elaborated. ...
Depression and suicidal behavior are interrelated, stress-associated mental health conditions, each lacking biological verifiability. Concepts of predictive, preventive, and personalized medicine (3PM) are almost completely missing for both conditions but are of utmost importance. Prior research reported altered levels of the stress hormone cortisol in the scalp hair of depressed individuals, however, data on hair cortisol levels (HCL) for suicide completers (SC) are missing. Here, we aimed to identify differences in HCL between subject with depression ( n = 20), SC ( n = 45) and mentally stable control subjects ( n = 12) to establish the usage of HCL as a new target for 3PM. HCL was measured in extracts of pulverized hair (1-cm and 3-cm hair segments) using ELISA. In 3-cm hair segments, an average increase in HCL for depressed patients (1.66 times higher; p = .011) and SC (5.46 times higher; p = 1.65 × 10 ⁻⁵ ) compared to that for controls was observed. Furthermore, the average HCL in SC was significantly increased compared to that in the depressed group (3.28 times higher; p = 1.4 × 10 ⁻⁵ ). A significant correlation between HCL in the 1-cm and the 3-cm hair segments, as well as a significant association between the severity of depressive symptoms and HCL (3-cm segment) was found. To conclude, findings of increased HCL in subjects with depression compared to that in controls were replicated and an additional increase in HCL was seen in SC in comparison to patients with depression. The usage of HCL for creating effective patient stratification and predictive approach followed by the targeted prevention and personalization of medical services needs to be validated in follow-up studies.
... In contrast, the meta-analysis by Drews et al. [35] including 37 studies revealed that adults with BPD, when compared with healthy and clinical controls, demonstrate an elevated continuous cortisol secretion along with an attenuated cortisol response to psychosocial stress. Additionally, adults with BPD have been found to show elevated testosterone levels when compared with healthy controls [36][37][38][39]. Further, there is evidence for greater resting-state HR and reduced restingstate vagally mediated HR variability (HRV) in adults and adolescents with BPD pathology [40][41][42][43]. ...
Introduction:
Aggressive behavior in reaction to threats, frustration, or provocation is prevalent in borderline personality disorder (BPD). This study investigated aggressive behavior and its biological correlates in adolescents with BPD.
Methods:
Twenty-one female adolescents with a DSM-IV BPD diagnosis and 25 sex- and age-matched healthy controls participated in the Taylor Aggression Paradigm (TAP), a laboratory-based experiment measuring aggressive behavior in the interpersonal context. Heart rate was measured and saliva samples were taken throughout the experiment.
Results:
Multilevel mixed-effects linear regression analyses revealed no significant group difference in aggressive behavior induced by the TAP. Additionally, the two groups did not differ in cortisol, testosterone, and heart rate responses to the aggression induction. The BPD group showed a significant cortisol increase in the time preceding the start of the TAP in contrast to the healthy control group, in whom a significant heart rate increase from baseline to the first block of the TAP was observed.
Discussion:
There was no evidence, either at the phenomenological or the biological level, of increased task-induced aggression in adolescents with BPD. The results may indicate that adolescents with BPD experienced fearful stress in anticipation of the experimental task in contrast to healthy controls who showed an adaptive response of the autonomic nervous system necessary to deal with the upcoming demand.
... In male patients suffering from the systemic disease Sarcoidosis, which is associated with higher levels of fatigue and psychological distress, hair testosterone levels were not different between male cases (n ¼ 13) and male controls (n ¼ 62) and the correlation between hair testosterone and depressive symptoms was non-significant (Van Manen et al. 2019). However, in women with a borderline personality disorder (n ¼ 18) showing significantly increased levels of depressive symptomatology, hair testosterone levels were increased in comparison to matched healthy women (n ¼ 17) (Dettenborn et al. 2016). In addition, a recent study of our group examining a large sample of 2105 Indian women reported hair testosterone to be positively associated with depressive symptoms (Walther, Tsao, et al. 2019), although this association was sensitive to the imputation of NDs. ...
Objectives: The association between depressive symptomatology and endogenous testosterone levels is inconclusive. Large inter- and intra-individual testosterone differences suggest point measurements from saliva or serum to be inadequate to map basal testosterone concentrations highlighting the potential for long-term integrated testosterone levels from hair.
Methods: Using data from a prospective cohort study, a total of 578 participants (74% female) provided complete data on depressive symptomatology, clinical features, and hair samples for quantification of testosterone concentrations at baseline. Available data of three annual follow-up examinations was used for longitudinal analyses.
Results: Correlation analysis showed in both, men and women, hair testosterone across all four time points not to be significantly related to depressive symptoms. Examined clinical features were not associated with testosterone levels, except for having a current diagnosis of a psychological disorder, which was associated with reduced testosterone levels in men, but not in women. Acceptable model fit for an autoregressive cross-lagged panel analysis emerged only for the female subsample suggesting inverse cross-relations for the prediction of testosterone by depressive symptomatology and vice versa.
Conclusions: Findings from this study add to the literature by showing no association between long-term integrated testosterone in hair and depressive symptomatology in men and women.
... Blood and saliva measurements reflect steroid excretion rates for short periods of time and are influenced by a number of factors such as time of the day, food intake prior to sampling or sleep-related factors (Dettenborn et al., 2012). Alternative sampling methods, such as from hair or fingernails were found to be fairly robust to these factors and to provide a cumulative measure representing steroid excretion levels over a longer period of time (Dettenborn et al., 2016;Matas and Koren, 2016). Thus, an interesting avenue for future research would be to assess whether hair or nail samples provide a stronger test of the relationship between baseline levels of T or C and RA in explicit recognition tasks. ...
Successful emotion recognition is a key component of human socio-emotional communication skills. However, little is known about the factors impacting males’ accuracy in emotion recognition tasks. This pre-registered study examined potential candidates, focusing on the modality of stimulus presentation, emotion category and individual baseline hormone levels. In an additional exploratory analysis, we examined the association of testosterone x cortisol interaction with recognition accuracy and reaction times. We obtained accuracy and reaction time scores from 282 males who categorized voice, face and voice-face stimuli for nonverbal emotional content. Results showed that recognition accuracy was significantly higher in the audio-visual than in the auditory or visual modality. While Spearman’s rank correlations showed no significant association of testosterone (T) with recognition accuracy or with response times for specific emotions, the logistic and linear regression models uncovered some evidence for a positive association between T and recognition accuracy as well as between cortisol (C) and reaction time. In addition, the overall effect size of T by C interaction with recognition accuracy and reaction time was significant, but small. Our results establish that audio-visual congruent stimuli enhance recognition accuracy and provide novel empirical support by showing that the interaction of testosterone and cortisol relates to males’ accuracy and response times in emotion recognition tasks.
... Accordingly, many smokers believe that smoking will reduce their stress and NA (Copeland et al., 1995). NA has also been associated with cessation failure and relapse (Cinciripini et al., 2003;Kenford et al., 2002;Messer et al., 2018), with nicotine dependence being prevalent in individuals with NA-based disorders such as social anxiety (Piper et al., 2011), major depression (Breslau et al., 1991;Breslau et al., 1998;Brown et al., 1996;Leventhal et al., 2012;Stubbs et al., 2018), dysthymic disorder , panic disorder (Piper et al., 2011), posttraumatic stress disorder (PTSD; Alexander et al., 2019), schizophrenia (Dalack et al., 1998;Castle et al., 2019;Hunter et al., 2020), schizotypal and borderline personality traits (Kolliakou, and Joseph, 2000;Dettenborn et al., 2016) coronary artery disease, (Brummett et al., 2002) and generalized anxiety disorder (GAD; Piper et al., 2011). In addition, nicotine dependence is one of the comorbidity modes (Breslau, 1995;Upadhyaya et al., 2002;John et al., 2004; M. Akbari, et al. ...
Background:
Negative Affect (NA), as a personality trait is a tendency towards experiencing a more negative emotion. The body of research suggests that NA encourages smoking relapse and smoking as a reason for NA reduction, though. The likelihood of this connection does not seem to be bright yet. The present study critically reviews researches to synthesize the existing literature to determine the strength of this linkage.
Methods:
Key-word related research was systematically searched in PubMed, PsychINFO, Science Direct and Google Scholar for studies conducted from 1980 to 2019, followed by, the assessment and selection of retrieved studies based on defined inclusion criteria. A random-effects meta-analysis model was used to examine the prospective relationship between NA and smoking. Meta-regression was also used to dig for possible explanations of heterogeneity. Furthermore a multi-moderators model and sub-group analyses examined the moderating factors.
Results:
Forty effect-sizes comprising 12 cross-sectional studies, 28 longitudinal studies and 24,913 participants were included in the meta-analysis. The forest plot of the pooled correlation effect size in the random model indicates a significant effect size of the relationship between NA and smoking (r=0.11; 95%CI 0.071-0.15, P= 0.001) in the meta-analysis with high heterogeneity (Q=473.916; df=39; P=0.001; I2=91.77%). Also, the pooled effect size was obtained as 0.143 (95%CI 0.071-0.214) for light-to-moderate and 0.112 (95%CI 0.057-0.166) for moderate-to-heavy smokers, with the effect size ranging from 0.061 to 0.195 which significant among all subtypes, though this trend seem higher among adolescents, males, and longitudinal studies than in adults, females, and cross-sectional studies.
Limitations:
The review was limited to English articles, and the heterogeneity of the studies were high.
Conclusion:
These results support the notion that NA was positively and weakly linked to smoking and this linkage is stronger in light-to-moderate smokers, males, and adolescents. Theoretical and clinical implications are discussed with the aim of extending future directions on NA and smoking.
... Furthermore, chronic or continuous cortisol levels, largely defined by 24-hr urinary cortisol output 55 and multi-sampling morning assessment 60 have shown increased basal cortisol levels, whereas chronic output assessed by hair analysis has shown no significant differences between BPD patients and controls. 61 The influence of HPA activity on cognition including memory retrieval has also been explored in BPD, as cognitive dysfunction has been described as a core feature of BPD symptomatology. 62 Largely consistent results in healthy individuals report the administration of cortisol (hydrocortisone) or psychosocial challenges impairs memory retrieval and executive function. ...
Borderline personality disorder (BPD) is a complex psychiatric illness for which treatment poses a significant challenge due to limited effective pharmacologic treatments, and under-resourced psychological interventions. BPD is one of the most stigmatized conditions in psychiatry today, but can be understood as a modifiable, neurodevelopmental disorder that arises from maladaptive responses to trauma and stress. Stress susceptibility and reactivity in BPD is thought to mediate both the development and maintenance of BPD symptomatology, with trauma exposure considered an early life risk factor of development, and acute stress moderating symptom trajectory. An altered stress response has been characterized in BPD at the structural, neural, and neurobiological level, and is believed to underlie the maladaptive behavioral and cognitive symptomatology presented in BPD. The endocrine hypothalamus-pituitary-adrenal (HPA) axis represents a key stress response system, and growing evidence suggests it is dysfunctional in the BPD patient population. This theoretical review examines BPD in the context of a neurodevelopmental stress-related disorder, providing an overview of measurements of stress with a focus on HPA-axis measurement. Potential confounding factors associated with measurement of the HPA system are discussed, including sex and sex hormones, genetic factors, and the influence of sample collection methods. HPA-axis dysfunction in BPD largely mirrors findings demonstrated in post-traumatic stress disorder and may represent a valuable neuroendocrine target for diagnostic or treatment response biomarkers, or for which novel treatments can be investigated.
... However, recently, it was shown that alterations of the HPA axis occur as a response to early maltreatment rather than as a consequence of comorbid BPD pathology (101,102). A few studies demonstrated increased testosterone levels in saliva after awakening (103) and in hair (104), as well as reduced plasma oxytocin in BPD women (105). The latter particularly occurs in BPD patients with unresolved (disorganized) attachment representations (106). ...
Objective:
Borderline personality disorder (BPD) occurs in 0.7-3.5% of the general population. Patients with BPD suffer from excessive comorbidity of psychiatric and somatic diseases and are known to be high utilizers of health care services. Because of a range of challenges related to adverse health behaviors and their interpersonal style, patients with borderline personality disorder are often regarded as "difficult" to interact with and treat optimally.
Methods:
This narrative review focuses on epidemiological studies on BPD and its comorbidity with a specific focus on somatic illness. Empirically-validated treatments are summarized and implementation of specific treatment models is discussed.
Results:
The prevalence of BPD among psychiatric inpatients (9-14%) and outpatients (12-18%) is high; medical service use is very frequent, annual societal costs vary between &OV0556; 11,000 and 28,000. BPD is associated with cardiovascular diseases and stroke, metabolic disease including diabetes and obesity, gastrointestinal disease, arthritis and chronic pain, veneral diseases and HIV infection as well as sleep disorders. Psychotherapy is the treatment of choice for BPD. Several manualized treatments for BPD have been empirically validated, including Dialectical Behavior Therapy (DBT), Transference-Focused Psychotherapy (TFP), Mentalization-based Therapy (MBT), and Schema-focused Therapy (SFT).
Conclusions:
Health care could be substantially improved if all medical specialties would be familiar with BPD, its pathology, medical and psychiatric co-morbidities, complications, and treatment. In mental health care, several empirically validated treatments are available that are applicable in a wide range of clinical settings.
... Lastly, the publication by Dettenborn et al. (2016) principally matches all inclusion criteria, however, no other publication reported on hair cortisol in adult BPD patients. Therefore, the study could not be compared to other studies based on meta-analytic techniques. ...
Borderline Personality Disorder (BPD) has been associated with altered hypothalamic-pituitary-adrenal (HPA) axis functioning. However, evidence is inconsistent. Therefore, the present series of meta-analyses aimed to quantify HPA axis functioning in BPD patients based on singular and continuous cortisol assessments and measures of reactivity to pharmacological and psychosocial stress. Case-control studies comparing adult BPD patients and healthy and clinical controls were considered for inclusion. The search resulted in 804 publications, of which 37 studies (k = 81; BPD n = 803, controls n = 1092) were included. Analyses were based on random effect models using standardized mean differences. BPD patients displayed elevated continuous cortisol output and blunted cortisol following psychosocial challenges. Singular cortisol assessments and cortisol after pharmacological challenges were not significantly different. Meta-analyses were limited by inconsistent reporting in individual studies and small samples for some comparisons. Due to the debilitating nature of stress-related symptoms in BPD, more research on elevated continuous cortisol output and blunted cortisol responses to psychosocial stress is warranted.
... Our non-replication of earlier findings of inter-individual associations between dominant, competitive or nurturing personality traits and baseline T (Turan et al., 2014;Sellers et al., 2007) supports Simmons and Roney's (2011) null-finding of a link between baseline T and three measures of intrasexual competitiveness (self-reported dominance and prestige as well as physical strength) in men (N = 149). To further clarify potential relationships on an interindividual difference level, alternative sampling methods, such as from hair (Dettenborn et al., 2016) or fingernails (Matas & Koren, 2016) could be employed. These can potentially provide more stable and long-term aggregated hormonal measures, and hence potentially more valid accounts of baseline T. So far, our results corroborate the idea that there may be no strong and consistent links between T and personality on a stable trait level, and that personality and behavioural effects of T reactivity are stronger, compared to baseline T . ...
Increases in men's testosterone (T) levels after intrasexual competitions and exposure to females facilitate competitive and courtship behaviours, suggesting T reactivity should affect relevant personality state changes. How exactly T reactivity, also under potential buffering effects of cortisol (C), relates to personality state changes is unclear. In a preregistered study, we aimed at inducing T increases in young men (N = 165) through dyadic intrasexual competitions while exposed to a female experimenter. We investigated self-reported and video-based observer-rated personality state changes, captured by the interpersonal circumplex and social impressions, in relation to hormonal levels. Results revealed increases in self-reported competitiveness and observer-rated self-assurance, relative to a control group, moderated by T reactivity and partly by T × C interactions, providing insights into hormone-personality response-links.
... ps > .18, N = 164; see Table S5) To further clarify potential relationships on an interindividual difference level, alternative sampling methods, such as from hair (Dettenborn et al., 2016) or fingernails (Matas & Koren, 2016) could be employed. These can potentially provide more stable and long-term aggregated hormonal measures, and hence potentially more valid accounts of baseline T. So far, our results corroborate the idea that there may be no strong and consistent links between T and personality on a stable trait level, and that personality and behavioural effects of T reactivity are stronger, compared to baseline T . ...
Increases in human male testosterone (T) levels have been found after intrasexual competitions and exposure to females, facilitating competitive and courtship behaviours. This suggests that T reactivity should affect relevant personality state changes that are also observable to others. How exactly T reactivity, also under potential buffering effects of Cortisol (C), relates to personality state changes is unclear. In a preregistered study, we aimed at inducing T increases in young men (N=165) through dyadic intrasexual competitions while exposed to a female experimenter. We investigated self-reported and video-based observer-rated personality state changes, as captured by the Interpersonal Circumplex and social impressions, in relation to hormonal levels. Results revealed increases in self-reported competitiveness, as well as observer-rated dominance and self-assurance, relative to a control group and moderated by T reactivity and partly by TxC interactions. Thus, male T reactivity in a competitive mating context increased competitiveness/dominance, but did not decrease nurturance. This provides further insights into how hormonal and personality responses to challenges are intertwined in men, and partly supports a role of T in mediating a life history trade-off between mating/competing and parenting, as well as signalling dominance to rivals and potential mates.
... [13][14][15] Interestingly, testosterone levels have recently been reported to be enhanced in female patients with BPD. [16][17][18] Taken together, these findings raise questions about whether lateral PFC activity and PFC-amygdala connectivity are altered when patients with BPD have to control emotionally relevant actions and whether such an alteration may be associated with the patients' aggression and endogenous testosterone levels. 3 To address these questions, anger-prone women with BPD and healthy female volunteers took part in an approachavoidance task during which they were instructed to respond to briefly presented happy and angry facial expressions with approach and avoidance movements. ...
Background:
Difficulty in controlling emotional impulses is a crucial component of borderline personality disorder (BPD) that often leads to destructive, impulsive behaviours against others. In line with recent findings in aggressive individuals, deficits in prefrontal amygdala coupling during emotional action control may account for these symptoms.
Methods:
To study the neurobiological correlates of altered emotional action control in individuals with BPD, we asked medication-free, anger-prone, female patients with BPD and age- and intelligence-matched healthy women to take part in an approach-avoidance task while lying in an MRI scanner. The task required controlling fast behavioural tendencies to approach happy and avoid angry faces. Additionally, before the task we collected saliva testosterone and self-reported information on tendencies to act out anger and correlated this with behavioural and functional MRI (fMRI) data.
Results:
We included 30 patients and 28 controls in our analysis. Patients with BPD reported increased tendencies to act out anger and were faster in approaching than avoiding angry faces than with healthy women, suggesting deficits in emotional action control in women with BPD. On a neural level, controlling fast emotional action tendencies was associated with enhanced activation in the antero- and dorsolateral prefrontal cortex across groups. Healthy women showed a negative coupling between the left dorsolateral prefrontal cortex and right amygdala, whereas this was absent in patients with BPD.
Limitations:
Specificity of results to BPD and sex differences remain unknown owing to the lack of clinical control groups and male participants.
Conclusion:
The results indicate reduced lateral prefrontal-amygdala communication during emotional action control in anger-prone women with BPD. The findings provide a possible neural mechanism underlying difficulties with controlling emotional impulses in patients with BPD.
... We acknowledge several limitations that serve as avenues for future research. First, although the total sample size is relatively large compared to other hair sample studies (e.g., Iglesias et al., 2015;Dettenborn et al., 2016), the number of men in our sample was relatively small. As the behavioral effects of testosterone are known to differ between men and women (e.g., Turanovic et al., 2017), future studies should replicate our findings in a more balanced gender sample. ...
Using a recently developed alternative assay procedure to measure hormone levels from hair samples, we examined the relationships between testosterone, cortisol, 2D:4D ratio, overconfidence and risk taking. A total of 162 (53 male) participants provided a 3 cm sample of hair, a scanned image of their right and left hands from which we determined 2D:4D ratios, and completed measures of overconfidence and behavioral risk taking. While our sample size for males was less than ideal, our results revealed no evidence for a relationship between hair testosterone concentrations, 2D:4D ratios and risk taking. No relationships with overconfidence emerged. Partially consistent with the Dual Hormone Hypothesis, we did find evidence for the interacting effect of testosterone and cortisol on risk taking but only in men. Hair testosterone concentrations were positively related to risk taking when levels of hair cortisol concentrations were low, in men. Our results lend support to the suggestion that endogenous testosterone and 2D:4D ratio are unrelated and might then exert diverging activating vs. organizing effects on behavior. Comparing our results to those reported in the existing literature we speculate that behavioral correlates of testosterone such as direct effects on risk taking may be more sensitive to state-based fluctuations than baseline levels of testosterone.
... Hair sampling, a simpler alternative that can be carried out in a single visit, provides a putative measure of systemic, free hormone secretion over a period of several months . Although no studies to date have used hair testosterone as a predictor of externalizing behaviors, positive associations between hair testosterone and other psychiatric outcomes (e.g., borderline personality disorder; Dettenborn et al., 2016) have been reported. ...
Although testosterone is associated with aggression in the popular imagination, previous research on the links between testosterone and human aggression has been inconsistent. This inconsistency might be because testosterone’s effects on aggression depend on other moderators. In a large adolescent sample (N = 984, of whom 460 provided hair samples), we examined associations between aggression and salivary testosterone, hair testosterone, and hair cortisol. Callous-unemotional traits, parental monitoring, and peer environment were examined as potential moderators of hormone-behavior associations. Salivary testosterone was not associated with aggression. Hair testosterone significantly predicted increased aggression, particularly at low levels of hair cortisol (i.e., Testosterone × Cortisol interaction). This study is the first to examine the relationship between hair hormones and externalizing behaviors and adds to the growing literature that indicates that androgenic effects on human behavior are contingent on aspects of the broader endocrine environment—in particular, levels of cortisol.
... [13][14][15] Interestingly, testosterone levels have recently been reported to be enhanced in female patients with BPD. [16][17][18] Taken together, these findings raise questions about whether lateral PFC activity and PFC-amygdala connectivity are altered when patients with BPD have to control emotionally relevant actions and whether such an alteration may be associated with the patients' aggression and endogenous testosterone levels. 3 To address these questions, anger-prone women with BPD and healthy female volunteers took part in an approachavoidance task during which they were instructed to respond to briefly presented happy and angry facial expressions with approach and avoidance movements. ...
Background:
Difficulty in controlling emotional impulses is a crucial component of borderline personality disorder (BPD) that often leads to destructive, impulsive behaviours against others. In line with recent findings in aggressive individuals, deficits in prefrontal amygdala coupling during emotional action control may account for these symptoms.
Methods:
To study the neurobiological correlates of altered emotional action control in individuals with BPD, we asked medication-free, anger-prone, female patients with BPD and age- and intelligence-matched healthy women to take part in an approach-avoidance task while lying in an MRI scanner. The task required controlling fast behavioural tendencies to approach happy and avoid angry faces. Additionally, before the task we collected saliva testosterone and self-reported information on tendencies to act out anger and correlated this with behavioural and functional MRI (fMRI) data.
Results:
We included 30 patients and 28 controls in our analysis. Patients with BPD reported increased tendencies to act out anger and were faster in approaching than avoiding angry faces than with healthy women, suggesting deficits in emotional action control in women with BPD. On a neural level, controlling fast emotional action tendencies was associated with enhanced activation in the antero- and dorsolateral prefrontal cortex across groups. Healthy women showed a negative coupling between the left dorsolateral prefrontal cortex and right amygdala, whereas this was absent in patients with BPD.
Limitations:
Specificity of results to BPD and sex differences remain unknown owing to the lack of clinical control groups and male participants.
Conclusion:
The results indicate reduced lateral prefrontal-amygdala communication during emotional action control in anger-prone women with BPD. The findings provide a possible neural mechanism underlying difficulties with controlling emotional impulses in patients with BPD.
... The evaluation of HTC showed only a numerically and not significant reduction after the first sampling, remaining then constant. Since 1998 (Wheeler et al. 1998) different studies reported testosterone (Dettenborn et al. 2013(Dettenborn et al. , 2016Kapoor et al. 2016) and testosterone esters (Kintz et al. 1999;Pozo et al. 2009) measurement in human hair. On the other hand, only few studies regarding the cattle species can be recorded. ...
The experiment was aimed to evaluate the usefulness of hair cortisol concentrations (HCC) in
revealing the activation of the hypothalamic-pituitary-adrenal (HPA) axis due to the passage of
young bulls from genetic rearing stations to artificial insemination (AI) centre and the influence
of this passage on hair testosterone concentrations (HTC). Hair samples on 33 yearling bulls
were collected at the time of arrival (ST1) to the AI centre and 3 more hair samples (ST2, ST3,
ST4) were collected at monthly intervals. After the end of quarantine each animal was submitted
to the standard procedures for collection and production of semen. Overall HCC were significantly
affected by period of collection (p<.01). In particular, HCC was higher in samples
obtained after finishing the quarantine period (ST2) compared with those obtained on ST1. After
ST2, the HCC decreased reaching at ST4 a value similar to that recorded at ST1. An effect of sampling
time on HTC was not found (p>.05). The effect of breed was observed only for HTC that
was higher in PRI than BS (p<.01). The HCC group have not influenced the semen variables
(p>.05). On the contrary, the effect of breed was evident. The results of this study replicated
the effects of a major environmental stressor on mean cortisol concentrations assessed in hair,
and add to the growing body of evidence that HCC is an effective and simply collected marker
for long-term activity of the HPA system in response to persistent environmental challenge.
Depression and suicidal behaviour are interrelated, stress-associated mental health conditions, each lacking biological verifiability. Concepts of predictive, preventive and personalised medicine (3PM) are almost completely missing for both conditions but are of utmost importance. Research reported altered levels of the stress hormone cortisol in the scalp hair of depressed individuals, while data on hair cortisol concentrations (HCC) for suicide completers (SC) are completely missing. Compared to mentally-stable control subjects (n = 12), we expected chronic stress-associated HCC elevation in depressed patients (n = 20), with an additional HCC increase in SC (n = 45) that might lead to the identification of between-group differences towards a 3PM conceptualization. HCC was measured cross-sectionally in extracts of pulverized hair (1cm and 3cm hair segments) using ELISA. In 3cm hair segments, we found an average increase in HCC for depressed patients (x1.66) and SC (x5.46) compared to controls. Furthermore, the average HCC in SC was significantly increased compared to the depressed group (x3.28). A significant correlation between HCC in the 1cm and the 3cm hair segments, as well as a significant association between HCC (3cm segment) and the severity of depressive symptoms, were also found. We replicate findings of increased HCC in depressed subjects compared to controls. Additionally, we provide data on HCC in SC, showing an additional increase in HCC compared to both controls and depressed patients. The usage of HCC as a predictive/preventive tool in the context of 3PM to possibly indicate and monitor suicidal risk in depression is an urgent question that needs to be answered timely.
Background
Oxytocin, cortisol, and testosterone are involved in the processing of reward and stress and greatly influence mother-child interactions. Altered hormonal systems have been associated with borderline personality disorder (BPD), a disorder characterized by interpersonal deficits. Mothers with BPD tend to perceive interactions with the child as less rewarding and more stressful and interactions are often less reciprocal and have more negative states (i.e. constricted, tense, uncoordinated behaviors). Their children are at elevated risk for psychopathologies. Here, we studied underlying hormonal mechanisms of disrupted mother-child interaction in BPD.
Methods
Twenty-five mothers with BPD and 29 healthy mothers with their 18- to 36-month-old toddlers participated in a free-play mother-child interaction, which was evaluated with the Coding Interactive Behavior (CIB) Manual. Maternal blood samples were analyzed at baseline for oxytocin, cortisol, and testosterone, and after interaction for oxytocin and cortisol.
Results
Oxytocin decreased and cortisol remained unchanged in mothers with BPD while healthy mothers showed stable oxytocin and decreased cortisol after interaction. Testosterone basal levels were significantly higher in mothers with BPD. Cortisol reactivity and testosterone levels mediated the association between maternal BPD and dyadic negative states during interaction.
Conclusions
These findings suggest that alterations in oxytocin, cortisol, and testosterone contribute to disruptions in mother-child interaction in BPD. Interacting with their child might not result in reward and relief of stress in mothers with BPD, in contrast to healthy mothers. Further research is needed to understand more about dyadic bio-behavioral processes in order to provide targeted parenting support. This could break the cycle of transgenerational transmission and improve maternal and child well-being.
The simultaneous determination of a large number of steroids (a.k.a. steroid profile) is a powerful tool that provides useful information about the status of steroid hormones. Steroid profile evaluated in matrices such as urine, saliva and plasma provide one-off moment information about the hormonal status and is highly affected by different factors such as circadian rhythm or apprehension to needles. In contrast, the determination of the steroid profile in hair would provide information about the chronic status of the steroid hormones. The objective of the current research was to develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) methodology for the determination of 11 steroids in hair, including 6 hormones and 5 metabolites. We have optimized different parts of the analytical procedure such as (i) hair shredding, (ii) hair amount, (iii) extraction from hair, (iv) extraction time, (v) required extractions and (vi) analytes preconcentration. MS parameters such as the inclusion of ESI- transitions were also evaluated. The optimization of these parameters was found to be critical to achieve the required sensitivity for the determination of steroids in hair. The method was validated with appropriate linearity in the endogenous range, intra- and inter-assay accuracies and matrix effect between 80% and 120% and intra- and inter-assay precisions below 20% for all analytes. Most of the analytes showed to be stable up to 10 months at room temperature. The suitability of the method was evaluated by obtaining the endogenous concentration range of steroids in 30 healthy volunteers. Results agreed with the scarce data previously reported for some steroids. For others, endogenous concentration ranges in hair were reported for the first time. Additionally, the method was used to compare intraindividual levels of steroids in beard and hair. Results revealed that with the exception of testosterone, beard is a suitable alternative to the hair determination of the steroid profile. In summary, the present strategy to evaluate the steroid profile in hair may be a useful tool with a high potential for a wide range of clinical purposes.
Hair has become an invaluable resource in forensic, clinical, and bioarchaeological research. The unique interaction between the growing hair fiber, the hair follicle, and the endocrine system inundates the growing hair fiber with an incremental record of many of the discreet physiological processes of the body. A novel study by Webb et al. (2010) demonstrated that endogenous records of cortisol, the “stress hormone”, are capable of being extracted from archaeological human hair through a modified enzyme-linked immunosorbent assay (ELISA) technique, thus providing insight into the “invisible” stress experiences of an individual that would otherwise not be detectable through skeletal analysis. This study seeks to apply this technique to archaeological hair from 10 individuals from the Kellis 2 cemetery, Dakhleh Oasis, Egypt to evaluate patterns of cortisol production and to determine whether endogenous patterns of secretion are detectable for the steroid reproductive hormones estradiol and testosterone. All three hormones were identified in each individual within the sample, and analyses revealed that preservation was favorable. Incremental patterning of each hormone appears to reflect endogenous hormone secretion in life. Values for cortisol, estradiol in pre-menopausal females, and testosterone extracted from samples fall within reference values taken from archaeological and clinical research, though estradiol values for males and postmenopausal females exceeded projected reference values. The results of this study demonstrate that steroid reproductive hormones can be preserved in archaeological human hair, and that these hormones can be analyzed to create additional lines of inquiry into bioarcheological studies of ancient health and fertility.
Objective:
Borderline personality disorder (BPD) is a prevalent, complex, and serious mental disorder involving multiple symptoms and maladaptive behaviour. The underlying psychobiological mechanisms involved are not yet fully understood, but increasing evidence indicates that changes in hypothalamic-pituitary-adrenal stress axis (HPA) activity may contribute to BPD. Whilst various studies have demonstrated elevated levels of cortisol (the end-product of the HPA axis) in BPD sufferers, others have presented opposite findings. Inconsistent findings may be attributable to comorbidities, collection and measurement methods, gender, and sample size. Considering these discrepancies, the aim of this systematic review and meta-analysis was to assess available studies in the scientific literature examining basal/ baseline cortisol levels in patients diagnosed with borderline personality disorder compared to non-psychiatric controls.
Methods:
A systematic literature review was conducted with descriptions of primary studies in addition to a meta-analysis of studies with a control group. Meta-analysis was performed using Comprehensive Meta-analysis software (CMA version 2). The effect size (Hedges' g) was calculated with random-effect model.
Results:
A systematic literature search identified 16 studies that met the eligibility criteria from a total of 1076 unique records initially examined. Twelve studies (N = 546; 278 borderline personality disorder and 268 non-psychiatric controls) fulfilled the inclusion criteria for meta-analysis. The standardised mean difference (Hedges' g) of basal cortisol level between BPD and control groups was -0.32 (pooled data from 12 studies; 95% confidence interval -0.56 to -0.06, p = 0.01), indicating significantly lower mean cortisol level for the BPD group.
Conclusion:
Cortisol as a biomarker of the HPA axis is an important and helpful measure in the study of stress disorders such as BPD. However, considerations of potential confounding factors must be considered.
Hormone analysis is a valuable tool for understanding how physiology and behavior interact. Cortisol in hair has recently been examined as a measure of longer‐term hormone output. The aim of this study was to investigate the relationships between other androgens in hair and anthropometric measures. In a child sample (n = 114, mean age: 8.5 years, 66 females) levels of cortisol, dehydroepiandrosterone (DHEA) and testosterone were assayed in the 0–3 cm section proximal to scalp. The 3–6 cm segment within a subsample of female participants (n = 35) was examined and compared. Results showed that testosterone strongly correlated with DHEA, and moderately correlated with cortisol (0–3 cm only). Higher hormone concentrations were present in the 3–6 cm segment. Finally, there was a weak positive association between DHEA and height. The replication of previously identified associations between androgens, particularly testosterone‐DHEA, and with developmental measures suggests hair may offer a valid method of hormone measurement for DHEA and testosterone.
Caretakers are often intimidated or alienated by patients with borderline personality disorder (BPD), compounding the clinical challenges posed by the severe morbidity, high social costs and substantial prevalence of this disorder in many health-care settings. BPD is found in â1.7% of the general population but in 15-28% of patients in psychiatric clinics or hospitals and in a large proportion of individuals seeking help for psychological problems in general health facilities. BPD is characterized by extreme sensitivity to perceived interpersonal slights, an unstable sense of self, intense and volatile emotionality and impulsive behaviours that are often self-destructive. Most patients gradually enter symptomatic remission, and their rate of remission can be accelerated by evidence-based psychosocial treatments. Although self-harming behaviours and proneness to crisis can decrease over time, the natural course and otherwise effective treatments of BPD usually leave many patients with persistent and severe social disabilities related to depression or self-harming behaviours. Thus, clinicians need to actively enquire about the central issues of interpersonal relations and unstable identity. Failure to correctly diagnose patients with BPD leads to misleading pharmacological interventions that rarely succeed. Whether the definition of BPD should change is under debate that is linked to not fully knowing the nature of this disorder. © 2018 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.
Introduction. This article focuses on the system analysis and comparative analysis of different classifications of personality disorders on the basis of the phenomenological approach, as well as search for new methodological foundations for the study and description of the problem of personality disorders. ?lassifications of K. Schneider, P. B. Gannushkin, A. E. Lichko, K. Leongard, N. Mac-Wil-liams, F. Riman are considered; correlation of types which description allows to consider them similar is proved. Relying on large-scale data analysis of different systems of personality disorders typologies, the article points to the systemic deficiencies of the classical phenomenological-descriptive approach, to some extent used in the creation of the most of the existing classifications. It doesǹt take into account the fact that human behavior is adapted relative to the strata of society and professional deformation, as well as the growth of systems of classifications connected with their empirical character. The criti-cism of classical clinical approaches for lack of deep levels of the phenomenological reduction obliga-Tory in the corresponding methodology is given. Materials and Methods. The phenomenological reduction allows not to address real behavior, but mention only subjective -Truly human in the person that opens new opportunities both to study, and therapy of personal features is normal and in pathology. Results. The author also proposes her own, entirely new criteria for the consideration of person-Ality disorders in the psychological and medical discourses, based not on the external manifestations of the disorder in the behavior of the individuals, but rather on the leading paradigms in their relation to the world and the self. Such approach proceeds from the concept of identity - it is much more concrete category, besides much more flexible and less burdened by various low-compatible interpretations. In confirmation of this thesis the analysis of different interpretations of identity is carried out, their corre-lation is shown. Conclusions. The phenomenological model constructed on truly ontologic base is described. In functional system of coordinates of the vital world, in which the personality both normal, and abnormal can be described, two axes of interaction with the vital world are allocated, each of which has two directions of development - relationship with category World (hysteroid - compulsive), relationship with category We (melancholic - schizoid).
Background:
Individuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes "mental pain." Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness. The present study investigated whether mental pain is elevated in BPD compared to Depressive Disorders (DD) without BPD.
Methods:
The Orbach and Mikulincer Mental Pain Scale (OMMP) was administered to BPD (N = 57), DD (N = 22), and healthy controls (N = 31). The OMMP assesses total mental pain, comprised of nine subtypes: irreversibility, loss of control, narcissistic wounds, emotional flooding, freezing, self-estrangement, confusion, social distancing, and emptiness. Co-occurring psychiatric diagnoses, depression severity, and other potentially confounding clinical and demographic variables were also assessed.
Results:
The total Mental Pain score did not differentiate BPD from DD. Moreover, most of the subscales of the OMMP were not significantly different in BPD compared to DD. However, the elevation of mental pain subscale "narcissistic wounds," characterized by feeling rejected and having low self-worth, was a specific predictor of BPD status and the severity of BPD symptoms.
Conclusion:
On OMMP total score, mental pain was similarly elevated in BPD and DD. However, the narcissistic wounds sub-type of mental pain was a sensitive and specific diagnostic indicator of BPD and, therefore, may be an important aspect of BPD in need of increased focus in assessment and theoretical models.
To inform the future use of hair cortisol measurement, we have investigated influences of potential confounding variables (natural hair colour, frequency of hair washes, age, sex, oral contraceptive (OC) use and smoking status) on hair cortisol levels. The main study sample comprised 360 participants (172 women) covering a wide range of ages (1-91 years; mean = 25.95). In addition, to more closely examine influences of natural hair colour and young age on hair cortisol levels, two additional samples comprising 69 participants with natural blond or dark brown hair (hair colour sample) as well as 28 young children and 34 adults (young age sample) were recruited. Results revealed a lack of an effect for natural hair colour, OC use, and smoking status on hair cortisol levels (all p's >0.10). No influence of frequency of hair washes was seen for proximal hair segments (p = 0.335) but for the third hair segment indicating lower cortisol content (p = 0.008). We found elevated hair cortisol levels in young children and older adults (p < 0.001). Finally, men showed higher hair cortisol levels than women (p = 0.002). The present data indicate that hair cortisol measurement provides a useful tool in stress-related psychobiological research when applied with the consideration of possible confounders including age and sex.
Although animal researchers established the role of testosterone as a 'social hormone' decades ago, the investigation of its causal influence on human social behaviors has only recently begun. Here, we review and discuss recent studies showing the causal effects of testosterone on social interactions in animals and humans, and outline the basic neurobiological mechanisms that might underlie these effects. Based on these recent findings, we argue that the role of testosterone in human social behavior might be best understood in terms of the search for, and maintenance of, social status.
Background: Unemployment and financial strain are chronic stressors that have been shown to be associated with an increase in mean salivary and serum cortisol levels. The impact of chronic stress on cortisol excretion is best measured using a summary index of cortisol excretion over longer periods of time rather than momentary assessments. Hair analysis for cortisol content is a new promising tool by which hair segmental analysis may provide a retrospective calendar of cumulative cortisol exposure. Methods: Participants of this study were 31 unemployed and 28 employed individuals (n=46 women). Hair segmental analysis was conducted using 3cm -long segments starting with the scalp-near segment. Due to differing hair length, n=52 individuals had values for the second segment and n=33 individuals had values for the third segment. Results: Univariate analysis of variance indicated that unemployed individuals had higher cortisol content in the first (p<0.05, eta2=0.071) and second (p<0.05, eta2=0.085) hair segment (a total of 6cm long hair representing the preceding 6 months of collection). Duration of unemployment was related to hair cortisol content (r=0.415 and r=0.430 for segment 1 and 2, respectively). Interestingly, BMI was related to hair cortisol content (r=0.430) but was not different between groups. Consistent with other data from our laboratory, there was a wash-out effect for the third segment (p<0.05 for segment 3 vs. segment 1 and 2). Conclusions: We conclude that hair analysis for cortisol content may be a valid method to detect differences in cumulative cortisol exposure between chronically stressed individuals and healthy controls. Due to a wash-out effect, retrospective ascertainment of cortisol exposure may be limited to the preceding 6 months of specimen collection.
A large body of evidence indicates that individual differences in baseline concentrations of testosterone (T) are only weakly correlated with human aggression. Importantly, T concentrations are not static, but rather fluctuate rapidly in the context of competitive interactions, suggesting that acute fluctuations in T may be more relevant for our understanding of the neuroendocrine mechanisms underlying variability in human aggression. In this paper, we provide an overview of the literature on T and human competition, with a primary focus on the role of competition-induced T dynamics in the modulation of human aggression. In addition, we discuss potential neural mechanisms underlying the effect of T dynamics on human aggression. Finally, we highlight several challenges for the field of social neuroendocrinology and discuss areas of research that may enhance our understanding of the complex bi-directional relationship between T and human social behavior.
Copyright © 2014. Published by Elsevier Ltd.
Stress hormones influence a wide range of cognitive functions, including memory performance and executive function. It is well established that glucocorticoids enhance memory consolidation but impair memory retrieval. While most of the effects have been attributed to glucocorticoid receptors (GR), the importance of mineralocorticoid receptors (MR) has been also emphasized.
Dysfunctions in hypothalamic–pituitary–adrenal (HPA) axis have been reported for several mental disorders. While major depressive disorder (MDD) as well as borderline personality disorder (BPD) seem to be characterized by enhanced cortisol release in concert with a reduced feedback sensitivity of the HPA axis, in posttraumatic stress disorder (PTSD) a contrary picture has been reported. Despite the fact that altered GR function has been discussed for these disorders only very few studies have investigated the effects of glucocorticoids on cognitive performance in these patients so far.
In a series of studies, we investigated the effects of glucocorticoids on cognition (i.e. declarative memory, working memory and response inhibition) in different mental disorders such as MDD, PTSD and BPD. While in patients with MDD cortisol administration failed to effect memory retrieval, patients with PTSD and BPD showed enhanced rather than impaired memory retrieval after cortisol administration. These results indicate an altered sensitivity to cortisol in these disorders. Results from one of our recent studies in the field of social cognition underline the importance of the MR. We found that emotional empathy was enhanced through stimulation of the MR via fludrocortisone in healthy participants and women with BPD. This review aims to integrate these findings and discuss potential mechanisms and implications.
The analysis of steroid hormones in hair is increasingly used in the field of stress-related research to obtain a retrospective index of integrated long-term hormone secretion. Here, most laboratories have so far relied on immunochemical assays originally developed for salivary analyses. Although these assays are fast and easy to perform, they have a reduced reliability and specificity due to cross-reactivity with other substances and are limited to the detection of one hormone at a time. Here, we report the development of a LC-MS/MS-based method for simultaneous identification of endogenous concentrations of seven steroid hormones (cortisol, cortisone, testosterone, progesterone, corticosterone, dehydroepiandrosterone (DHEA) and androstenedione) in human hair. Hair samples were washed with isopropanol and steroid hormones were extracted from 10mg whole, nonpulverized hair by methanol incubation. A column switching strategy for on-line solid phase extraction (SPE) was applied, followed by analyte detection on an AB Sciex API 5000 QTrap mass spectrometer. Results indicated linearity of the method for all steroids over ranges of 0.09-90pg/mg (0.9-900pg/mg for DHEA) with correlation coefficients ranging between 0.9995 and 0.9999. Intra- and inter-assay coefficients of variation were between 3.7 and 9.1%. The limits of quantification (LOQ) were below (or equal to) 0.1pg/mg for all steroids, except of DHEA for which the LOQ was 0.9pg/mg. An analysis of 30 natural hair samples (15 men/15 women) using this method confirmed that all steroid hormones could be quantified at endogenous levels in each individual. In addition, the use of whole hair samples and on-line SPE resulted in a significant reduction in sample throughput times, increasing the applicability of this method for research questions where a larger number of samples needs to be processed.
Borderline personality disorder (BPD) is a complex and serious mental disorder that is commonly seen psychiatric practice. Although stress, especially early life stress, seems to be associated with the development of the disorder, there has been far less research on the function of the hypothalamic-pituitary-adrenal (HPA) axis in BPD, compared to other psychiatric disorders, such as major depressive disorder and post-traumatic stress disorder. Stress has been suggested to exert damaging effects on the brain, particularly the hippocampus; therefore, neuroimaging studies yield important insight into the neurobiology of BPD. This article reviews research on the HPA axis and neuroimaging studies in BPD and aims to integrate these findings.
Depression has been linked to increased cortisol concentrations using point measures taken from urine, blood, or saliva samples. However, with regard to hypercortisolism-induced consequences, long-term cumulative cortisol burden is of relevance. Our objective was to use hair analysis as a new method to assess cortisol exposure over 6 months in depressed patients and healthy controls. We examined 23 depressed patients (8 men and 15 women, mean age: 41.6 years ( ± standard deviation (SD), 13.1 years); mean duration of current depressive episode 9 months ( ± SD, 13 months)) and 64 healthy controls, matched for age and gender. Cortisol concentrations in two 3-cm hair segments from near to the scalp were analyzed, representing cortisol secretion during the 6 months prior to sampling. Compared with healthy individuals, depressed patients had higher hair cortisol concentrations in the first (mean ± SD: 26.7 ± 20.8 vs. 18.7 ± 11.5 pg/mg, p < 0.05) and second hair segment (mean ± SD: 21.9 ± 23.7 vs. 13.4 ± 9.6 pg/mg, p < 0.05). In conclusion, hair cortisol analysis confirmed enhanced cortisol secretion in depressed patients over a prolonged time period. Because of the retrospective and cumulative nature of cortisol in hair, the assessment of hair cortisol concentration may help in addressing unanswered questions regarding hypothalamic-pituitary-adrenal axis overactivity and associated health consequences in psychiatric disorders.
The analysis of cortisol in human hair constitutes a promising method for the retrospective assessment of cumulative cortisol secretion over extended periods of time. An implicit assumption underlying the use of this method is that in the absence of major life changes hair cortisol concentrations show a high level of intraindividual stability, i.e. single hair cortisol assessments exhibit considerable trait-specificity and are only to a smaller extent influenced by state-dependent factors. Here, we present data from two independent studies examining patterns of intraindividual stability in hair cortisol levels. In study I, 45 participants were examined at two sampling points carried out one year apart from each other. In study II, 64 individuals provided data at three sampling points which occurred at two-month intervals. In both studies, at each time point hair was sampled and relevant psychosocial and hair-related variables were assessed. Results of both studies consistently revealed strong test-retest associations for repeated hair cortisol measurements ('r's between 0.68 and 0.79, 'p's <0.0001). Findings of structural equation modelling applied to data of study II showed that single hair cortisol assessments comprise a strong trait component, explaining between 59 and 82% of variance, and are only to a lesser extent influenced by state-related factors. Only inconsistent evidence for covariation of changes in hair cortisol concentrations and simultaneous changes in perceived stress or other relevant variables was seen across the two studies. The current findings suggest a considerable degree of intraindividual stability in hair cortisol levels which highlights the utility of this method for obtaining trait estimates of long-term cortisol secretion in psychoneuroendocrinological research.
A novel "field" study recently published in Aggressive Behavior found that individual differences in baseline testosterone concentrations were positively correlated with endorsement of political aggression and that baseline cortisol concentrations were negatively correlated with self-reported aggression among Palestinian boys living in Gaza. Here, we discuss recent evidence indicating that testosterone and cortisol interact to predict competitive, aggressive, and dominant behaviors and urge researchers collecting both hormones to perform and report analyses that formally test for such interaction effects.
Unemployment and financial strain are chronic stressors that have been shown to be associated with an increase in mean salivary and serum cortisol levels. Hair analysis for cortisol content is a new promising tool by which hair segmental analysis may provide a retrospective calendar of cumulative cortisol exposure over time rather than momentary assessments. Participants of this study were 31 unemployed and 28 employed individuals (46 women). Hair segmental analysis was conducted using 3-cm long segments starting with the scalp-near segment. Due to differing hair length, 52 individuals had values for the second segment and n=33 individuals had values for the third segment. Univariate analysis of variance indicated that unemployed individuals had higher cortisol content in the first (p<0.05, eta(2)=0.071) and second (p<0.05, eta(2)=0.085) hair segment (a total of 6 cm long hair representing the preceding 6 months of collection). Consistent with other data from our laboratory, there was a wash-out effect for the third segment (p<0.05 for segment 3 vs. segment 1 and 2). Unemployed individuals indicated increased levels of perceived stress and impairments in subjective well-being compared to employed individuals. These subjective measures of perceived stress and well-being were unrelated to cortisol content in hair. We conclude that hair analysis for cortisol content may be a valid method to detect differences in cumulative cortisol exposure between chronically stressed individuals and healthy controls. Due to a wash-out effect, retrospective ascertainment of cortisol exposure may be limited to the preceding 6 months of specimen collection.
Obesity, increased visceral fat and disturbed glucose metabolism have been found in borderline personality disorder (BPD) patients. These conditions are often associated with disturbed androgen metabolism. Elevated androgens in women are related to polycystic ovaries (PCO) and might have an impact on psychopathology. Thus, higher prevalence of PCO and elevated androgen levels are suspected in BPD. In the study, we examined 31 BPD patients and 30 healthy controls ultrasonographically for PCO and measured their serum levels of androgens and interacting hormones. Furthermore, influence on psychopathology of free testosterone (FT) serum level was assessed. PCO was significantly more prevalent in BPD patients (30.4%) compared to healthy controls (6.9%). Testosterone, FT, androstenedione (A), and 17alpha-hydroxyprogesterone (17-OHP) were significantly elevated in the BPD group independently of BMI. FT serum level significantly correlated with depressive symptoms. In summary, our data suggest a disturbed androgen metabolism in BPD patients.
Both biosociological and psychological models, as well as animal research, suggest that testosterone has a key role in social interactions. Evidence from animal studies in rodents shows that testosterone causes aggressive behaviour towards conspecifics. Folk wisdom generalizes and adapts these findings to humans, suggesting that testosterone induces antisocial, egoistic, or even aggressive human behaviours. However, many researchers have questioned this folk hypothesis, arguing that testosterone is primarily involved in status-related behaviours in challenging social interactions, but causal evidence that discriminates between these views is sparse. Here we show that the sublingual administration of a single dose of testosterone in women causes a substantial increase in fair bargaining behaviour, thereby reducing bargaining conflicts and increasing the efficiency of social interactions. However, subjects who believed that they received testosterone-regardless of whether they actually received it or not-behaved much more unfairly than those who believed that they were treated with placebo. Thus, the folk hypothesis seems to generate a strong negative association between subjects' beliefs and the fairness of their offers, even though testosterone administration actually causes a substantial increase in the frequency of fair bargaining offers in our experiment.
Increased aggressiveness frequently occurs in patients with bulimia nervosa (BN), but its neurobiological correlates have been poorly investigated. In this study, we investigated possible relationships between such clinical measure and blood levels of endogenous hormones in patients with BN. Morning plasma levels of testosterone, 17beta-estradiol, prolactin (PRL) and cortisol were measured in 33 bulimic women and 22 healthy female controls. The eating-related psychopathology, depression and aggressiveness were rated by specific psychometric scales. Bulimic patients showed decreased plasma levels of PRL and 17beta-estradiol, and increased concentrations of cortisol and testosterone. Moreover, patients scored higher than healthy controls on rating scales assessing eating-related psychopathology, depressive symptoms and aggressiveness. A significant positive correlation was found between testosterone plasma levels and aggressiveness in patients but not in controls. These findings suggest that in BN, increased plasma levels of testosterone may play a role in the modulation of aggressiveness.
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Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability in affect regulation, impulse control, interpersonal relationships, and self-image. In previous studies, we have used portable mini-computers to assess the severity of recurrent states of aversive emotional distress and dissociation during ambulatory conditions. Here, we used this approach for the assessment of the hypothalamic-pituitary-adrenal (HPA) axis in patients with BPD. We studied 23 unmedicated female patients with BPD and 24 matched healthy controls. Salivary cortisol was collected from all participants during ambulatory conditions in response to reminders provided by portable mini-computers on 3 consecutive days every 2 h for 14 h after awakening. In addition, cortisol in response to awakening was determined in four 15 min intervals on days 1 and 2. After the last collection of cortisol on the second day, 0.5 mg dexamethasone was administered in order to achieve cortisol suppression on day 3 (low-dose dexamethasone suppression test, DST). Patients with BPD displayed significantly higher salivary cortisol levels than healthy controls as demonstrated by higher total cortisol in response to awakening and higher total daily cortisol levels. There were significantly more non-suppressors of cortisol in the low-dose DST in the patient group when compared to the control group. The ambulatory assessment of saliva cortisol is a suitable approach to study basic parameters of the HPA-axis in patients with BPD. Increased adrenal activity and lowered feedback sensitivity of the HPA-axis may characterise BPD. Further studies have to reveal reasons of heightened adrenal activity in these patients.
In animals, strong evidence exists for an association between testosterone and aggression. In humans, and particularly in children and adolescents, findings have been less consistent. Previous research has suggested that this may partly be due to moderating effects of other factors, e.g., hormones. This study aims to investigate the moderating effect of cortisol on the relationship between testosterone and subtypes of aggression in delinquent male adolescents.
Participants were 103 boys (mean age 13.7) referred to a delinquency diversion program. Testosterone and cortisol levels were determined from saliva samples collected during resting conditions and related to self-report scores on overt and covert aggression.
Linear regression analyses revealed a significant interaction between cortisol and testosterone in relation to overt aggression, with a significant positive relationship between testosterone and overt aggression in subjects with low cortisol levels but not in subjects with high cortisol levels. Using the same model for covert aggression, no significant effects of testosterone, cortisol, or testosterone x cortisol interaction were found.
These results indicate a moderating effect of cortisol on the relationship between testosterone and overt aggression in delinquent male adolescents. Implications and directions for future research are discussed.
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