ICT aan de VU projecten en plannen

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

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

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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

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theoretical framework

• underarousal
• fearlessness
  sensation seeking
• (zuckermann,1977)
  
  (raine, 1993)
• biological
  parameters

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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)

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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)

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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

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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

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overall project instruments
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subjects

• normal controls NC
• diversion project without DBD DP-
• diversion project with DBD DP
• DBD ODD ór CD

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study 1 diurnal cycle of cortisol, incl. CAR aim

• 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

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study 1 diurnal cycle of cortisol, incl CAR
results
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study 2 psychosocial stress testaim
measuring salivary cortisol, HR hypotheses
DP lower basal cortisol and HR, smaller
increase cortisol and HR as compared with NC
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study 2 psychosocial stress testtimeschedule
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study 2 psychosocial stress testsalivary
cortisol
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study 2 psychosocial stress testheartrate
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study 2 psychosocial stress testnegative affect
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study 2 psychosocial stress testresults
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
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conclusion
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
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conclusion
when studying HPA activity in relation to
disruptive behavior it is important to take into
account diurnal variation and basal versus
stress conditions
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testosterone and cortisol

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

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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)

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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

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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 dont show it, I am
• sometimes eaten up with jealousy
• - If I let people see the way I feel, Id be
• considered a hard person to get along
• with

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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)

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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

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testosteron x cortisol gt overt aggression
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discussion
how to understand this interaction? 1 cortisol
related to psychosocial factors (social
withdrawal, inhibition) that influence the
testosterone-aggression relationship
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discussion
2 high cortisol protective against aggression
(Shirtcliff 2005) 3 cortisol directly influences
effects of testosterone, for example on
receptor level (Viau 2002)
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future plans
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
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thank you!
Theo Doreleijers Herman van Engeland Robert
Vermeiren Lucres Jansen Stephanie van Goozen Wim
van den Brink Thomas Rinne Hans Steiner Adrian
Raine