Personality and congenital adrenal hyperplasia: Possible effects of prenatal androgen exposure

Influences of early androgen exposure on personality were investigated. Participants were either exposed to abnormal levels of androgens prenatally due to congenital adrenal hyperplasia (CAH, 40 females, 29 males), or were unaffected relative controls (29 females, 30 males). Compared to female controls, females with CAH were less tender-minded (p<.001; 16 Personality Factor Inventory (16PF)), and reported greater physical aggression (p=.03; Reinisch Aggression Inventory) and less interest in infants (p<.001; Melson's Questionnaire), but did not differ in dominance (16PF). Males with CAH did not differ from male controls in interest in infants but were less dominant (p=.008), and more tender-minded (p=.033) and reported reduced physical aggression (p=.025). Thus, both males and females with CAH showed alteration in three of the four constructs assessed. Prenatal androgen exposure may shift some, but not all, personality characteristics in the male-typical direction in females. It may also be associated with a decrease in some aspects of male-typical personality development in males, although personality differences in males with CAH could relate to illness.

[1]  A. Eagly Sex differences in social behavior : a social-role interpretation , 1987 .

[2]  J. Reinisch,et al.  A test of sex differences in aggressive response to hypothetical conflict situations. , 1986, Journal of personality and social psychology.

[3]  M. Hines,et al.  Spatial abilities following prenatal androgen abnormality: targeting and mental rotations performance in individuals with congenital adrenal hyperplasia , 2003, Psychoneuroendocrinology.

[4]  S. Yen,et al.  Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management , 1999 .

[5]  M. Hines,et al.  Androgen and the development of human sex-typical behavior: rough-and-tumble play and sex of preferred playmates in children with congenital adrenal hyperplasia (CAH). , 1994, Child development.

[6]  I. Merkatz,et al.  Amniotic Fluid Concentrations of Δ5 and Δ4 Steroids in Fetuses with Congenital Adrenal Hyperplasia due to 21 Hydroxylase Deficiency and in Anencephalic Fetuses , 1980 .

[7]  R. Gorski,et al.  Participation of estrogens in female sexual differentiation of the brain; neuroanatomical, neuroendocrine and behavioral evidence. , 1984, Progress in brain research.

[8]  Sheri A. Berenbaum,et al.  Early Androgens Are Related to Childhood Sex-Typed Toy Preferences , 1992 .

[9]  C. Migeon Diagnosis and management of congenital adrenal hyperplasia. , 1977, Hospital practice.

[10]  S. Lambert The “Sissy Boy Syndrome” and the Development of Homosexuality , 1988 .

[11]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[12]  P. Hindmarsh,et al.  Increased aggression and activity level in 3- to 11-year-old girls with congenital adrenal hyperplasia (CAH) , 2007, Hormones and Behavior.

[13]  M. Hines,et al.  Androgen and psychosexual development: Core gender identity, sexual orientation, and recalled childhood gender role behavior in women and men with congenital adrenal hyperplasia (CAH) , 2004, Journal of sex research.

[14]  I. Merkatz,et al.  Amniotic fluid concentrations of delta 5 and delta 4 steroids in fetuses with congenital adrenal hyperplasia due to 21 hydroxylase deficiency and in anencephalic fetuses. , 1980, The Journal of clinical endocrinology and metabolism.

[15]  Rebecca C. Knickmeyer,et al.  Androgens and autistic traits: A study of individuals with congenital adrenal hyperplasia , 2006, Hormones and Behavior.

[16]  M. Diamond,et al.  Sex behavior after neonatal progesterone, testosterone, estrogen, or antiandrogens , 1973 .

[17]  G. J. Vries,et al.  Anatomy, Development, and Function of Sexually Dimorphic Neural Circuits in the Mammalian Brain , 2002 .

[18]  R. Briscoe,et al.  Effect of perinatal gonadal hormones on selected nonsexual behavior patterns: a critical assessment of the nonhuman and human literature. , 1977, Psychological bulletin.

[19]  K. Fujieda,et al.  Worldwide experience in newborn screening for classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency. , 1988, Pediatrics.

[20]  F. Wu,et al.  Male Puberty and Its Disorders , 1999 .

[21]  M. Hines,et al.  Human behavioral sex differences: a role for gonadal hormones during early development? , 1995, Psychological bulletin.

[22]  R. Gorski,et al.  Independent masculinization of neuroendocrine systems by intracerebral implants of testosterone or estradiol in the neonatal female rat , 1978, Brain Research.

[23]  J. Money,et al.  Progestin‐induced hermaphroditism: IQ and psychosexual identity in a study of ten girls∗∗ , 1967 .

[24]  G. Fink,et al.  Altered sexual development in male rats after oestrogen administration during the neonatal period. , 1975, Journal of reproduction and fertility.

[25]  P. Hindmarsh,et al.  Prenatal hormones and postnatal socialization by parents as determinants of male-typical toy play in girls with congenital adrenal hyperplasia. , 2005, Child development.

[26]  G. Edman,et al.  Personality characteristics and platelet MAO activity in women with congenital adrenal hyperplasia (CAH) , 1993, Psychoneuroendocrinology.

[27]  J. Money,et al.  Fetal androgens in the early treated adrenogenital syndrome of 46 XX hermaphroditism: Influence on assertive and aggressive types of behavior , 1976 .

[28]  S. Resnick,et al.  Early androgen effects on aggression in children and adults with congenital adrenal hyperplasia , 1997, Psychoneuroendocrinology.

[29]  J. Reinisch Prenatal exposure to synthetic progestins increases potential for aggression in humans. , 1981, Science.

[30]  Rebecca C. Knickmeyer,et al.  Fetal Testosterone Predicts Sexually Differentiated Childhood Behavior in Girls and in Boys , 2009, Psychological science.

[31]  P. L. Munson Adrenal Cortex , 1951, British medical journal.

[32]  D. Buss,et al.  Psychological Sex Differences: Origins through Sexual Selection. , 1995 .

[33]  K. Zucker,et al.  Psychosexual Development of Women with Congenital Adrenal Hyperplasia , 1996, Hormones and Behavior.

[34]  J. Rust,et al.  Testosterone during pregnancy and gender role behavior of preschool children: a longitudinal, population study. , 2002, Child development.

[35]  M. New,et al.  SERUM ANDROGEN CONCENTRATIONS IN NEONATES AND YOUNG INFANTS WITH CONGENITAL ADRENAL HYPERPLASIA DUE TO 21‐HYDROXYLASE DEFICIENCY * , 1979, Clinical endocrinology.

[36]  S. M. Breedlove,et al.  Masculinized Finger Length Patterns in Human Males and Females with Congenital Adrenal Hyperplasia , 2002, Hormones and Behavior.

[37]  F. Bercovitch,et al.  Behavioral masculinization is independent of genital masculinization in prenatally androgenized female rhesus macaques , 1988, Hormones and Behavior.

[38]  P. White,et al.  Steroid 21-hydroxylase deficiency , 1989 .

[39]  D. Orth.,et al.  THE ADRENAL CORTEX , 1948 .

[40]  C. Leveroni,et al.  Early androgen effects on interest in infants: Evidence from children with congenital adrenal hyperplasia , 1998 .

[41]  J. Rainer Sex Differences in Behavior , 1975 .

[42]  A. Feingold,et al.  Gender differences in personality: a meta-analysis. , 1994, Psychological bulletin.

[43]  E. Hampson,et al.  Spatial reasoning in children with congenital adrenal hyperplasia due to 21‐hydroxylase deficiency , 1998 .

[44]  R. Dittmann,et al.  Congenital adrenal hyperplasia I: Gender-related behavior and attitudes in female patients and sisters , 1990, Psychoneuroendocrinology.

[45]  E. Maccoby,et al.  The Psychology of Sex Differences , 1974 .

[46]  P. Costa,et al.  Gender differences in personality traits across cultures: robust and surprising findings. , 2001, Journal of personality and social psychology.

[47]  H. Dörr,et al.  Profiling steroid hormones in amniotic fluid of midpregnancy by routine stable isotope dilution/gas chromatography-mass spectrometry: reference values and concentrations in fetuses at risk for 21-hydroxylase deficiency. , 1999, The Journal of clinical endocrinology and metabolism.

[48]  A. Fausto-Sterling Sexing the Body , 2000 .

[49]  F. Slijper,et al.  Androgens and gender role behaviour in girls with congenital adrenal hyperplasia (CAH). , 1984, Progress in brain research.

[50]  J. Money,et al.  Fetal androgens and female gender identity in the early-treated adrenogenital syndrome. , 1968, The Johns Hopkins medical journal.

[51]  Donald W. Pfaff,et al.  Hormones, brain, and behavior , 2009 .

[52]  Anke A. Ehrhardt,et al.  Fetal androgens, human central nervous system differentiation, and behavior sex differences. , 1974 .

[53]  P. Costa,et al.  Revised NEO Personality Inventory (NEO-PI-R) and NEO-Five-Factor Inventory (NEO-FFI) , 1992 .

[54]  M. J. Baum,et al.  Neuroendocrine effects of perinatal androgenization in the male ferret. , 1975, Progress in brain research.

[55]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[56]  G. Bohlin,et al.  Sex-typed toy play behavior correlates with the degree of prenatal androgen exposure assessed by CYP21 genotype in girls with congenital adrenal hyperplasia. , 2002, The Journal of clinical endocrinology and metabolism.

[57]  M. Hines,et al.  Androgenic influences on neural asymmetry: Handedness and language lateralization in individuals with congenital adrenal hyperplasia , 2004, Psychoneuroendocrinology.

[58]  B. McEwen Sexual differentiation of the brain , 1981, Nature.