Elizabeth A. Shirtcliff

Disorders of Childhood and Adolescence: Gender and Psychopathology

Early-onset disorders (e.g., conduct problems, autism) show a marked male preponderance, whereas adolescent-onset disorders (e.g., depression, anxiety) show a marked female preponderance. A developmental psychopathology framework provides a means to investigate complex gender-related etiologies of these different disorders. This review focuses on biological and environmental factors implicated in the development of conduct problems and depression in boys and girls. Boys and girls showed certain differences in types, rates, comorbidities, antecedents, correlates, and trajectories of these problems. Origins of male and female preponderant problems are likely to be rooted, in part, in biological, physical, cognitive, and social-emotional differences in boys and girls that can precede the expression of clinical problems. These male-like and female-like characteristics are considered regarding conduct problems and depression to explore how they inform biological and environmental theories about gender and psychopathology. At the same time, because boys and girls also show many similarities, it is important to avoid sex-stereotyping mental health problems.

The Adaptive Calibration Model of stress responsivity

This paper presents the Adaptive Calibration Model (ACM), an evolutionary-developmental theory of individual differences in the functioning of the stress response system. The stress response system has three main biological functions: (1) to coordinate the organisms allostatic response to physical and psychosocial challenges; (2) to encode and filter information about the organisms social and physical environment, mediating the organisms openness to environmental inputs; and (3) to regulate the organisms physiology and behavior in a broad range of fitness-relevant areas including defensive behaviors, competitive risk-taking, learning, attachment, affiliation and reproductive functioning. The information encoded by the system during development feeds back on the long-term calibration of the system itself, resulting in adaptive patterns of responsivity and individual differences in behavior. Drawing on evolutionary life history theory, we build a model of the development of stress responsivity across life stages, describe four prototypical responsivity patterns, and discuss the emergence and meaning of sex differences. The ACM extends the theory of biological sensitivity to context (BSC) and provides an integrative framework for future research in the field.

Use of salivary biomarkers in biobehavioral research: cotton-based sample collection methods can interfere with salivary immunoassay results

In a series of studies, we evaluated the susceptibility of immunoassays for saliva biomarkers to interference effects caused by cotton materials used to absorb saliva during sample collection. Salivary assay results for testosterone, DHEA, progesterone, and estradiol are artificially high, and for sIgA artificially low, when samples are collected using cotton absorbent materials. In contrast, results for salivary cortisol, DHEA-S, and cotinine are not affected by the use of cotton collection methods. The order of individual results from samples collected using cotton versus no-cotton methods for certain markers is not conserved, suggesting that for some biomarkers this collection method can be a significant source of unsystematic error. It was shown, using DHEA as an example, that the cotton interference effect is of sufficient magnitude to attenuate the association between serum and saliva levels. Awareness of this issue is critical to ensure measurement validity in future studies and analyses of archived samples collected using cotton materials.

Testosterone, cortisol, and women's competition

Abstract Hormone (testosterone, cortisol)–behavior relationships have been extensively studied among male competitors, and far less so among female competitors. To address this gap, we studied members of a nationally recognized college womens rugby team. Seventeen players (ages 18–22 years) provided saliva samples 24 h before, 20 min prior to, and immediately after five league matches. Subjects self-reported aggressiveness, team bonding, pregame mental state, postgame performance evaluation, and whether the opponent was more or less challenging than expected. Results revealed that both testosterone and cortisol levels increased in anticipation of the matches. Postgame levels of both hormones were higher than pregame levels. The pregame rise in testosterone was associated with team bonding, aggressiveness, and being focused, but was unrelated to perceptions of the opponents skill. Testosterone change during the game was unrelated to winning or losing, evaluations of personal performance, or perceptions of the opponents threat. Game changes in cortisol were positively related to player evaluations of whether the opponent was more of a challenge than expected, and negatively related to losing. These results are compared with hormone–behavior patterns found among male competitors and are interpreted within a recent theory of sex differences in response to challenges.

Concurrent and longitudinal associations of basal and diurnal cortisol with mental health symptoms in early adolescence

Recent biosocial theories postulate that both biological risk and the social context influence the development of mental health problems [Boyce and Ellis (2005) Development and Psychopathology, 17(2), 271-301]. Guided by this framework, we examined whether basal cortisol and its diurnal rhythm were associated with mental health symptoms in early adolescence. Because cross-sectional and longitudinal investigations sometimes reveal different cortisol-mental health associations, we examined the association both concurrently and longitudinally when children transition to middle school, a time which entails a major change in social context from single to multiple teachers, classrooms, and sets of classmates. Salivary cortisol was measured three times a day (waking, afternoon, and bedtime) across 3 days when adolescents were 5th graders. Mental health was measured when adolescents were in 5th and 7th grades, just before and after the transition to middle school. To deal with the substantial comorbidity of internalizing and externalizing symptoms at this developmental stage, mental health measures distinguished overall symptom severity from the preponderance of internalizing versus externalizing symptoms (i.e., directionality). A three-level Hierarchical Linear Model was used to extract basal cortisol and its diurnal rhythm separate from the day-to-day and within-the-day fluctuations in cortisol in response to daily experiences. Results were specific to symptom severity, suggesting that cortisol is a nonspecific risk factor for mental health symptoms in young adolescents. At 5th grade, low basal cortisol was associated with concurrent symptom severity. However, longitudinally, it was adolescents with high cortisol at 5th grade who were at risk for increasing mental health symptoms by 7th grade. Flat diurnal rhythms in 5th grade were related to levels of symptom severity at both 5th and 7th grades. Considering the change in social context, as defined by the transition to middle school, helped resolve seemingly inconsistent evidence that both hypo- and hyper-arousal were associated with mental health symptoms in early adolescence.

Quantifying blood leakage into the oral mucosa and its effects on the measurement of cortisol, dehydroepiandrosterone, and testosterone in saliva

The impact of blood leakage due to microinjury to the oral cavity on the measurement of salivary hormones was examined. Saliva samples were collected before, immediately after, and then every 15 min for 1 h following vigorous tooth brushing. Blood in saliva was quantified by visual inspection of discoloration, Hemastix reagent strips to detect hemoglobin, and an immunoassay for transferrin. The presence of blood in saliva immediately after microinjury was confirmed by all methods. Hemoglobin and transferrin levels remained elevated over baseline for at least 30 min. Levels of salivary testosterone increased over baseline and remained elevated for 30 min in response to microinjury. Microinjury induced change in salivary testosterone was more closely associated with the change in transferrin than hemoglobin levels or discoloration ratings. On average, levels of salivary dehydroepiandrosterone (DHEA) did not increase in response to microinjury. However, individual differences in microinjury induced change in DHEA were associated with discoloration ratings. Salivary cortisol levels, on average, were neither responsive to microinjury, nor were individual differences in cortisol change associated with blood contamination measures. Neither diurnal nor gender-related differences in baseline hormone levels predicted the impact of blood leakage on quantitative salivary measurements. The findings suggest ecologically valid minor-to-moderate level microinjuries to the oral cavity have negligible effects on the measurement of salivary cortisol, but may be important to quantify and control when assessing other hormones especially testosterone.

Neuroendocrine dysregulation following early social deprivation in children

Human and nonhuman animal studies reveal that early experiences with caregivers shape childrens ability to regulate their responses to stress. To understand the effects of early deprivation on the regulation of the hypothalamic-pituitary-adrenal axis following social interactions, we examined urinary cortisol levels in a group of internationally adopted children who had experienced institutional care, and thus, species-atypical attachment relationships, early in life prior to adoption. Cortisol regulation was assessed both basally and following standardized interpersonal interactions between the child and his/her mother and the child and an unfamiliar adult. Postinstitutionalized children showed prolonged elevations in cortisol levels following the mother, but not the stranger, interaction. More severe neglect was associated with the highest basal cortisol levels and the most impaired cortisol regulation following the mother interaction. These results suggest that early social deprivation may contribute to long-term regulatory problems of the stress-responsive system, and that these differences are most evident within the context of ongoing, close interpersonal relationships.

Longitudinal stability and developmental properties of salivary cortisol levels and circadian rhythms from childhood to adolescence.

This study aimed to (1) identify a stable, trait-like component to cortisol and its circadian rhythm, and (2) investigate individual differences in developmental trajectories of HPA-axis maturation. Multiple salivary cortisol samples were collected longitudinally across four assessments from age 9 (3rd grade) through age 15 (9th grade) in a community sample of children (N = 357). Sophisticated statistical models examined cortisol levels and its rhythm over time; effects of age, puberty and gender were primarily considered. In addition to situation-specific and stable short-term or epoch-specific cortisol components, there is a stable, trait-like component of cortisol levels and circadian rhythm across multiple years covering the transition from childhood into adolescence. Youth had higher cortisol and flatter circadian rhythms as they got older and more physically developed. Girls had higher cortisol, stronger circadian rhythms, and greater developmental influences across adolescence. Distinguishing a stable, trait-like component of cortisol level and its circadian rhythm provides the empirical foundation for investigating putative mechanisms underlying individual differences in HPA functioning. The findings also provide important descriptive information about maturational processes influencing HPA-axis development.

Salivary testosterone diurnal variation and psychopathology in adolescent males and females: Individual differences and developmental effects

Individual differences in salivary testosterone were examined in 213 adolescents (106 boys, 107 girls; mean age = 13.66 years) in relation to externalizing and internalizing psychopathology. Self- and parent-report measures of behavior problems and psychiatric symptoms were obtained. Latent anxiety-depression, disruptive behavior, and attention problem constructs were developed using multitrait, multimethod procedures. Saliva samples were collected in the morning, midday, and late afternoon on multiple days and were later assayed for testosterone. Latent constructs were derived for testosterone level and diurnal variation across the six sampling occasions. Structural equations modeled relationships between problem behavior and intra- and interindividual differences in testosterone separately by gender. For boys, lower levels of testosterone and testosterone levels that decreased more slowly across the day were related to higher levels of anxiety-depression and attention problems. These associations were not moderated by pubertal development. For girls, steep declines in testosterone production across the day related to higher levels of disruptive behavior problems, but this association was only evident after including pubertal development as a moderator in the model. These findings raise novel questions regarding the nature and magnitude of links between testosterone and problem behavior in youth.

Influence of early life stress on later hypothalamic–pituitary–adrenal axis functioning and its covariation with mental health symptoms: A study of the allostatic process from childhood into adolescence

The hypothalamic-pituitary-adrenal (HPA) axis is a primary mechanism in the allostatic process through which early life stress (ELS) contributes to disease. Studies of the influence of ELS on childrens HPA axis functioning have yielded inconsistent findings. To address this issue, the present study considers multiple types of ELS (maternal depression, paternal depression, and family expressed anger), mental health symptoms, and two components of HPA functioning (traitlike and epoch-specific activity) in a long-term prospective community study of 357 children. ELS was assessed during the infancy and preschool periods; mental health symptoms and cortisol were assessed at child ages 9, 11, 13, and 15 years. A three-level hierarchical linear model addressed questions regarding the influences of ELS on HPA functioning and its covariation with mental health symptoms. ELS influenced traitlike cortisol level and slope, with both hyper- and hypoarousal evident depending on type of ELS. Further, type(s) of ELS influenced covariation of epoch-specific HPA functioning and mental health symptoms, with a tighter coupling of HPA alterations with symptom severity among children exposed previously to ELS. Results highlight the importance of examining multiple types of ELS and dynamic HPA functioning in order to capture the allostatic process unfolding across the transition into adolescence.