hpa axis activity in delinquent male adolescents

1. hpa axis activity in delinquent male adolescents department of child and adolescent psychiatry vu amsterdam arne popma

2. outline • background • literature • overall project • study 1 • study 2 • study 3 • conclusion • discussion

3. background • disruptive behaviour disorders (dbd): • oppositional defiant disorder (odd) • conduct disorder (cd) • - high prevalence • - high risk for problems in adulthood • - major public health problem • - resistant to treatment

4. theoretical framework underarousal fearlessness sensation seeking (zuckermann,1977) (raine, 1993) biological parameters

5. biological parameters: the ans • autonomic nervous system activity • in antisocial children: • low basal heart rate (hr): • (ortiz & raine, 2004) • smaller increase during stress: (van goozen al., 1998 & 2000)

8. biological paramaters: cortisol • cortisol • in antisocial children: • low basal cortisol (???) • (Mc Burnett et al., 2000; Shoal et al., 2003) blunted cortisol reaction during stress • (Van Goozen et al., 1998 & 2000; Moss al.,1995)

9. overall project: aim • non clinically referred group • early in adolescence (follow-up) • study 1: diurnal cortisol cycle • study 2: hpa/ans: psychosocial stress test • hpa/ans: frustrating stress test • interactions between hormones in relation to subtypes of aggression

10. overall project: study population 12-14 year old boys from (n = 110) delinquency diversion project (DP) in amsterdam (petty crime: shoplifting, vandalism, aggression) normal control boys (n = 35) matched group wise on age, ses, ethnicity, IQ

11. overall project: instruments • diagnostic interwiew schedule for children • child behavior checklist • wechsler intelligence scale

12. subjects normal controls: NC diversion project without DBD: DP- diversion project with DBD: DP+ DBD = ODD ór CD

13. measuring cortisol levels in saliva • in the first hour after waking up: • the cortisol awakening response (CAR) • during the day • hypotheses: • smaller CAR and lower cortisol levels over the day in DP+ compared to NC study 1: diurnal cycle of cortisol, incl. CARaim

14. study 1: diurnal cycle of cortisol, incl CARresults

15. measuring salivary cortisol, HR hypotheses: DP+ lower basal cortisol and HR, smaller increase cortisol and HR as compared with NC study 2: psychosocial stress testaim

16. study 2: psychosocial stress testtimeschedule

17. study 2: psychosocial stress testsalivary cortisol

18. study 2: psychosocial stress testheartrate

19. study 2: psychosocial stress testnegative affect

20. in resting situation: no differences cortisol, HR negative mood during stress: DP+ smaller increase in cortisol and HR, but similar increase in negative mood during psychosocial stressor as compared with NC study 2: psychosocial stress testresults

21. delinquent boys with a disruptive behavior disorder show differences in cortisol levels, 1 in the first hours after waking up 2 during a psychosocial stressor as compared with normal controls conclusion

22. when studying HPA activity in relation to disruptive behavior it is important to take into account diurnal variation and basal versus stress conditions conclusion

23. testosterone and cortisol evidence from studies in animals that testosterone influences HPA-functioning (Luine 2002) ánd cortisol influences testosterone levels (Viau 2002)

24. aggression • The Buss-Durkee Hostility Inventory (BDHI; Buss-Durkee and Baer 1956) • - self-report questionnaire • - translated and validated for the • Netherlands by Lange et al (1995)

25. bdhi: items • overt aggression: • feeling angry and displaying aggression, often impulsive and poorly controlled • - ”When I am angry, I slam doors” • - “I have known people who pushed me • so far that we came to blows” • - “When I really lose my temper, I am • capable of slapping someone”

26. behavioral measure: items • covert aggression: • feeling angry without expressing openly, is more hidden and controlled • - “I am irritated a great deal more than • people are aware of” • - “Although I don’t show it, I am • sometimes eaten up with jealousy” • - “If I let people see the way I feel, I’d be • considered a hard person to get along • with”

27. study population 12-14 year old boys (n = 103; m.a.13.68 ± 0.74) from delinquency diversion project in amsterdam (petty crime: shoplifting, vandalism, aggression) 27 participants had a DBD diagnosis (26%)

28. instruments linear regression analyses were performed with aggression (overt and covert aggression respectively) as dependent variable and with testosterone, cortisol and testosterone x cortisol as independent variables

29. testosteron x cortisol > overt aggression

30. how to understand this interaction? 1: cortisol related to psychosocial factors (social withdrawal, inhibition) that influence the testosterone-aggression relationship discussion

31. 2: high cortisol protective against aggression (Shirtcliff 2005) 3: cortisol directly influences effects of testosterone, for example on receptor level (Viau 2002) discussion

32. follow up: do HPA and ANS (re)activity predict (persistency of) disruptive behavior? how do environmental factors (ie traumatic events) interact with these biological factors in relation to disruptive behavior? which subtypes op disruptive behavior correlate best with HPA activity future plans

33. Theo Doreleijers Herman van Engeland Robert Vermeiren Lucres Jansen Stephanie van Goozen Wim van den Brink Thomas Rinne Hans Steiner Adrian Raine thank you!