Adolescents' internalizing and externalizing problems predict their affect-specific HPA and HPG axes reactivity

"Puberty age gap": new method of assessing pubertal timing and its association with mental health problems

Puberty is linked to mental health problems during adolescence, and in particular, the timing of puberty is thought to be an important risk factor. This study developed a new measure of pubertal timing that was built upon multiple pubertal features and their nonlinear changes over time (i.e., with age), and investigated its association with mental health problems. Using the Adolescent Brain Cognitive Development (ABCD) cohort (N ~ 9900, aged 9-13 years), we employed three different models to assess pubertal timing. These models aimed to predict chronological age based on: (i) observed physical development, (ii) hormone levels (testosterone and dehydroepiandrosterone [DHEA]), and (iii) a combination of both physical development and hormones. To achieve this, we utilized a supervised machine learning approach, which allowed us to train the models using the available data and make age predictions based on the input pubertal features. The accuracy of these three models was evaluated, and their associations with mental health problems were examined. The new pubertal timing model performed better at capturing age variance compared to the more commonly used linear regression method. Further, the model based on physical features accounted for the most variance in mental health, such that earlier pubertal timing was associated with higher symptoms. This study demonstrates the utility of our new model of pubertal timing and suggests that, relative to hormonal measures, physical measures of pubertal maturation have a stronger association with mental health problems in early adolescence.

Transgenerational effect of Mothers' experiences of discrimination on Black youths' hormone coupling in response to laboratory stress

Exposure to pervasive racial discrimination of Black Americans is transgenerational in that mothers' experiences of discriminatory violence impacts their children. This study explored whether stress-related biomarkers reflect transgenerational racial stress by implementing a "dual activation" framework to probe how adrenal and gonadal hormones underlying adolescent development are co-regulated during a laboratory stressor. Data were collected from 120 Black families in the United States. Children completed the Trier Social Stress Task (TSST-C) and provided 4 saliva samples across 2 days that were assayed for cortisol (C), dehydroepiandrosterone (DHEA), and testosterone (T). Mothers reported their experiences of total discrimination and racial discrimination related to skin color/race. Thirty four percent reported experiences of discrimination and on average 46.7% reported experiences of discrimination due to their race or skin tone. Mothers' experiences of racial discrimination were associated with their child's hormonal reactivity to and recovery from the TSST-C. Youth showed stronger positive hormone coupling between C-T if their mother experienced greater discrimination. Mothers' experiences of racial discrimination influenced both C-T coupling and youths' cortisol recovery from the TSST-C. For youths with high testosterone, cortisol recovery was blunted. Results suggest that associations between racism and hormonal stress response may be transgenerational. Mothers' experiences of discrimination had a profound impact on their children's hormonal co-regulation.

A multidimensional approach to understanding the emergence of sex differences in internalizing symptoms in adolescence

Women are more vulnerable to internalizing disorders (e.g., depression and anxiety). This study took an integrative developmental approach to investigate multidimensional factors associated with the emergence of sex differences in internalizing symptoms, using data from the Adolescent Brain Cognitive Development (ABCD) study. Indices of sex hormone levels (dehydroepiandrosterone, testosterone, and estradiol), physical pubertal development, task-based functional brain activity, family conflict, and internalizing symptoms were drawn from the ABCD study's baseline sample (9- to 10-year-old; N = 11,844). Principal component analysis served as a data-driven dimensionality reduction technique on the internalizing subscales to yield a single robust measure of internalizing symptoms. Moderated mediation analyses assessed whether associations between known risk factors and internalizing symptoms vary by sex. Results revealed direct and indirect effects of physical pubertal development on internalizing symptoms through family conflict across sexes. No effects were found of sex hormone levels or amygdala response to fearful faces on internalizing symptoms. Females did not report overall greater internalizing symptoms relative to males, suggesting that internalizing symptoms have not yet begun to increase in females at this age. Findings provide an essential baseline for future longitudinal research on the endocrine, neurocognitive, and psychosocial factors associated with sex differences in internalizing symptoms.

A dual-system, machine-learning approach reveals how daily pubertal hormones relate to psychological well-being in everyday life

The two studies presented in this paper seek to resolve mixed findings in research linking activity of pubertal hormones to daily adolescent outcomes. In study 1 we used a series of Confirmatory Factor Analyses to compare the fit of one and two-factor models of seven steroid hormones (n = 994 participants, 8084 samples) of the HPA and HPG axes, using data from a field study (https://www.icpsr.umich.edu/web/ICPSR/studies/38180) collected over ten consecutive weekdays in a representative sample of teens starting high school. In study 2, we fit a Bayesian model to our large dataset to explore how hormone activity was related to outcomes that have been demonstrated to be linked to mental health and wellbeing (self-reports of daily affect and stress coping). Results reveal, first that a two-factor solution of adolescent hormones showed good fit to our data, and second, that HPG activity, rather than the more often examined HPA activity, was associated with improved daily affect ratios and stress coping. These findings suggest that field research, when it is combined with powerful statistical techniques, may help to improve our understanding of the relationship between adolescent hormones and daily measures of well-being.

The association between cortisol-AA coordination in response to stress, negative urgency, and antisocial behavior in an urban adult sample

Prior study has found that the interplay of the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS) influences behavior problems in youth. Yet, little is known regarding this relationship in adults and traits related to the coordination of the stress systems. This study aims to extend the findings of a youth sample that the coordination between HPA and ANS, measured as cortisol and alpha-amylase (AA) respectively, was associated with antisocial behavior in adults. Additionally, this study tests whether cortisol-AA coordination was associated with a conceptually relevant trait, negative urgency. A heterogeneous sample of 124 adults (college students, active offenders, and demographically matched controls) was recruited from a southern city. Participants filled out instruments for negative urgency and antisocial behavior, completed a modified Trier Social Stress Test (mTSST), and provided four saliva samples before and after mTSST to assay for cortisol and AA. Results showed that cortisol-AA stress coordination was stronger among offenders than other groups. Cortisol-AA stress coordination was also positively associated with antisocial behavior and with negative urgency. This study found support for the interpretation that cortisol-AA stress coordination may indicate an overshooting ANS response at high emotional distress, and highlight the importance of the multisystem approach in gaining new insights into behavior research.

The codevelopment of adolescents' and parents' anxiety and depression: Moderating influences of youth gender and psychophysiology

METHODS

In a 2-year longitudinal study of 220 families, we examined how youth gender and adrenocortical and parasympathetic activity moderated reciprocal, bidirectional relations between parent and youth anxiety and depression problems.

RESULTS

Maternal anxiety predicted subsequent youth anxiety and depression. Maternal depression predicted youth anxiety and, for daughters and youth with low adrenocortical reactivity, youth depression. Youth depression predicted maternal depression only for youth with high adrenocortical reactivity. There were no associations between paternal and youth psychopathology.

DISCUSSION

Examining youth gender and psychophysiological characteristics that shape the nature of bidirectional influences may inform efforts to identify families at heightened risk for intergenerational transmission of psychopathology.

Relation between basal cortisol and reactivity cortisol with externalizing problems: A systematic review✰

Delinquent behavior describes one of the most severe forms of antisocial and aggressive behavior, causing the highest mental health and public expenditures of problematic behavior in adolescence. Literature suggests that different concentrations of cortisol may serve as a biological marker for a severe antisocial subgroup of adolescents, although from the environmental risk factors that play a role in the development of severe delinquent and aggressive behavior, other neurobiological factors may be important. This review aims to analyze the association of cortisol levels with the development of delinquent behavior. Studies related to the topic were obtained from multiple databases, through rigorous exclusion and inclusion criteria. Only papers with empirical and quantitative methodologies from scientific and academic publications were included. Aims, methodological aspects (sample and instruments), and main conclusions were extracted from each study. Overall, the data suggest that regardless of the literature relating low cortisol levels to conduct problems and antisocial behavior, the lack of consensus in the examined studies demonstrates that more studies are needed to reveal the role of biosocial mechanisms in this hormonal-behavior link, and how these mechanisms are involved in establishing and maintaining delinquent behavior.

Increased dehydroepiandrosterone (DHEA) is associated with anxiety in adolescent girls

The pubertal period is a time of rapid increase in the incidence of anxiety disorders, and thus, pubertal hormones may play a role in the precipitation of anxious psychopathology. DHEA, a steroid hormone that surges in adolescence, has been previously linked to anxiety, although the direction of this effect has been mixed. Using a cross-sectional design in a sample of 286 adolescent girls, the present study examined associations between salivary DHEA concentrations and self-report and interview-based measures of anxiety while controlling for pubertal status, menarche status, assessment time of day, and other hormones including testosterone, estradiol, and progesterone. Increased salivary DHEA concentrations were associated with more self-reported anxiety symptoms, increased anxiety symptom counts based on clinical interview, and increased probability of an anxiety disorder. Out of all anxiety symptom domains examined, generalized anxiety disorder symptoms were the best predictor of salivary DHEA concentrations after controlling for pubertal development. Collectively, our findings suggest relevance for DHEA in the development of anxiety in the pubertal period, as well as a robust relationship between DHEA and emerging symptoms of pathological worry during adolescence. The present study underscores the importance of examining associations between DHEA concentrations and anxiety in longitudinal designs.

Testosterone-cortisol dissociation in children exposed to prenatal maternal stress, and relationship with aggression: Project Ice Storm

Prenatal maternal stress (PNMS) has been associated with postnatal behavioral alterations that may be partly explained by interactions between the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes. Yet it remains unclear whether PNMS leads to enduring HPA-HPG alterations in the offspring, and whether HPA-HPG interactions can impact behavior during development, in particular levels of aggression in childhood. Here we investigated the relationship between a marker for HPG axis function (baseline testosterone) and a marker for HPA axis response (cortisol area under the curve) in 11½-year-olds whose mothers were exposed to the 1998 Quebec ice storm during pregnancy (n = 59 children; 31 boys, 28 girls). We examined (a) whether the degree of objective or subjective PNMS regulates the testosterone-cortisol relationship at age 11½, and (b) whether this testosterone-cortisol relationship is associated with differences in aggressive behavior. We found that, at lower levels of subjective PNMS, baseline testosterone and cortisol reactivity were positively correlated; in contrast, there was no relationship between these hormones at higher levels of subjective PNMS. Cortisol response moderated the relationship between testosterone and aggression. These results support the notion PNMS may explain variance in fetal HPA-HPG interactions, and that these interactions may be associated with aggressive behavior in late childhood.

The role of trauma in the hormonal interplay of cortisol, testosterone, and oxytocin in adolescent aggression

Although numerous studies have examined the neuroendocrinology of aggression, the findings are mixed and focused on cortisol and testosterone. We argue that past findings remain inconclusive partly because the key roles of oxytocin and trauma have not been systematically integrated yet. Oxytocin is associated with social behavior and interacts with cortisol and testosterone, whereas trauma is a crucial risk factor of aggression that strongly affects hormonal activity. In this review, we investigate the role of trauma in the hormonal interplay of cortisol, testosterone, and oxytocin in aggression during adolescence. We first discuss how these hormones interact with each other and how trauma influences these interactions and then we propose a model that highlights the role of trauma in the hormonal interplay in aggression. We suggest that the timing of trauma has a distinct effect on hormonal activity and it should be integrated into any comprehensive model. Current trauma is linked to different levels of oxytocin, cortisol, testosterone, and testosterone/cortisol ratio than childhood trauma, but this distinction is also influenced by gender and type of aggression. We conclude that in order to better understand the neuroendocrinology of aggression, it is crucial to incorporate the investigation of oxytocin and trauma in future research.

Social evaluative threat with verbal performance feedback alters neuroendocrine response to stress

Laboratory stress tasks such as the Trier Social Stress Test (TSST) have provided a key piece to the puzzle for how psychosocial stress impacts the hypothalamic-pituitary-adrenal axis, other stress-responsive biomarkers, and ultimately wellbeing. These tasks are thought to work through biopsychosocial processes, specifically social evaluative threat and the uncontrollability heighten situational demands. The present study integrated an experimental modification to the design of the TSST to probe whether additional social evaluative threat, via negative verbal feedback about speech performance, can further alter stress reactivity in 63 men and women. This TSST study confirmed previous findings related to stress reactivity and stress recovery but extended this literature in several ways. First, we showed that additional social evaluative threat components, mid-task following the speech portion of the TSST, were still capable of enhancing the psychosocial stressor. Second, we considered stress-reactive hormones beyond cortisol to include dehydroepiandrosterone (DHEA) and testosterone, and found these hormones were also stress-responsive, and their release was coupled with one another. Third, we explored whether gain- and loss-framing incentive instructions, meant to influence performance motivation by enhancing the personal relevance of task performance, impacted hormonal reactivity. Results showed that each hormone was stress reactive and further had different responses to the modified TSST compared to the original TSST. Beyond the utility of showing how the TSST can be modified with heightened social evaluative threat and incentive-framing instructions, this study informs about how these three stress-responsive hormones have differential responses to the demands of a challenge and a stressor.

Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review

In this meta-analytic and narrative review, we examine several overarching issues related to the study of coping, emotion regulation, and internalizing and externalizing symptoms of psychopathology in childhood and adolescence, including the conceptualization and measurement of these constructs. We report a quantitative meta-analysis of 212 studies (N = 80,850 participants) that measured the associations between coping and emotion regulation with symptoms of internalizing and externalizing psychopathology. Within the meta-analysis we address the association of broad domains of coping and emotion regulation (e.g., total coping, emotion regulation), intermediate factors of coping and emotion regulation (e.g., primary control coping, secondary control coping), and specific coping and emotion regulation strategies (e.g., emotional expression, cognitive reappraisal) with internalizing and externalizing symptoms. For cross-sectional studies, which made up the majority of studies included, we examine 3 potential moderators: age, measure quality, and single versus multiple informants. Finally, we separately consider findings from longitudinal studies as these provide stronger tests of the effects. After accounting for publication bias, findings indicate that the broad domain of emotion regulation and adaptive coping and the factors of primary control coping and secondary control coping are related to lower levels of symptoms of psychopathology. Further, the domain of maladaptive coping, the factor of disengagement coping, and the strategies of emotional suppression, avoidance, and denial are related to higher levels of symptoms of psychopathology. Finally, we offer a critique of the current state of the field and outline an agenda for future research. (PsycINFO Database Record

Cortisol and DHEA in development and psychopathology

Dehydroepiandrosterone (DHEA) and cortisol are the most abundant hormones of the human fetal and adult adrenals released as end products of a tightly coordinated endocrine response to stress. Together, they mediate short- and long-term stress responses and enable physiological and behavioral adjustments necessary for maintaining homeostasis. Detrimental effects of chronic or repeated elevations in cortisol on behavioral and emotional health are well documented. Evidence for actions of DHEA that offset or oppose those of cortisol has stimulated interest in examining their levels as a ratio, as an alternate index of adrenocortical activity and the net effects of cortisol. Such research necessitates a thorough understanding of the co-actions of these hormones on physiological functioning and in association with developmental outcomes. This review addresses the state of the science in understanding the role of DHEA, cortisol, and their ratio in typical development and developmental psychopathology. A rationale for studying DHEA and cortisol in concert is supported by physiological data on the coordinated synthesis and release of these hormones in the adrenal and by their opposing physiological actions. We then present evidence that researching cortisol and DHEA necessitates a developmental perspective. Age-related changes in DHEA and cortisol are described from the perinatal period through adolescence, along with observed associations of these hormones with developmental psychopathology. Along the way, we identify several major knowledge gaps in the role of DHEA in modulating cortisol in typical development and developmental psychopathology with implications for future research.

Longitudinal synergies between cortisol reactivity and diurnal testosterone and antisocial behavior in young adolescents

The aims were to identify the correspondence between simultaneous, longitudinal changes in cortisol reactivity and diurnal testosterone and to test the hypothesis that cortisol reactivity and diurnal testosterone interact so as to influence antisocial behavior. Participants were 135 children and young adolescents assessed at 6-month intervals over 1 year. Upon enrollment girls were age 8, 10, or 12 years (N = 69, M = 10.06 years) and boys were age 9, 11, or 13 years (N = 66, M = 10.94 years). Assessments included Tanner staging by a nurse, cortisol reactivity (Trier Social Stress Test for Children), diurnal testosterone, and interviews and questionnaires. Growth models showed that cortisol reactivity and diurnal testosterone basal levels (intercept) and rate of change (slopes) were not related, suggesting different mechanisms of growth. Longitudinal regression analyses assessed cortisol reactivity and diurnal testosterone longitudinally. The interactions of cortisol reactivity and diurnal testosterone showed that when diurnal testosterone was low, boys with low cortisol reactivity were reported to have more behavior problems (i.e., oppositional defiant disorder symptoms and attention problems) than when testosterone was high. In addition, when diurnal testosterone was high, boys with high or moderate cortisol reactivity were significantly higher on total antisocial behavior, attention behavior problems, and oppositional defiant disorder symptoms than when testosterone was low or moderate. The results were similar but less frequent for girls. These findings advance the science of young adolescence by showing the interaction between preexisting sensitivity to stressors and the normative testosterone changes of puberty and antisocial behavior.

A dual-axis approach to understanding neuroendocrine development

This introduction sets out to present a series of paper about a novel perspective regarding stress and sex hormones, or what the authors within this special issue term "coupling" of hypothalamic-pituitary-adrenal and--gonadal axes. This view postulates that these axes do not necessarily operate in opposition, but can operate together as evidenced empirically as a positive within-person association between stress hormones like cortisol or sex hormones like testosterone. A wealth of papers within the special issue demonstrate positive coupling across acute, diurnal, basal, and longitudinal timeframes and across several different types of contexts. Reviews were meant to challenge whether this was physiologically plausible. Consistently, sophisticated statistical models were utilized in order to show a template for how to model positive coupling and to ensure that coupling was a within-person phenomenon. We cautiously considered positive coupling until the consistency of observing coupling was robust enough for us to consider challenging the prevailing oppositional view of these axes. We do so to acknowledge that there are contexts, moments and stages in which the function of these axes should work together: for example when contexts are both stressful and challenging or at developmental stages (like adolescence) in which the youth must grow up despite the storm and stress of youth. We hope that by putting forward a functional dual-axis approach, the field will be able to consider when and how these axes work together.

Are Executive Functioning Deficits Concurrently and Predictively Associated with Depressive and Anxiety Symptoms in Adolescents?

The central objective of the current study was to evaluate how executive functions (EF), and specifically cognitive flexibility, were concurrently and predictively associated with anxiety and depressive symptoms in adolescence. Adolescents (N = 220) and their parents participated in this longitudinal investigation. Adolescents' EF was assessed by the Wisconsin Card Sorting Test (WCST) during the initial assessment, and symptoms of depressive and anxiety disorders were reported by mothers and youths concurrently and 2 years later. Correlational analyses suggested that youths who made more total errors (TE), including both perseverative errors (PE) and nonperseverative errors (NPE), concurrently exhibited significantly more depressive symptoms. Adolescents who made more TE and those who made more NPE tended to have more anxiety symptoms 2 years later. Structural equation modeling analyses accounting for key explanatory variables (e.g., IQ, disruptive behavior disorders, and attention deficit hyperactive disorder) showed that TE was concurrently associated with parent reports of adolescent depressive symptoms. The results suggest internalizing psychopathology is associated with global (TE) and nonspecific (NPE) EF difficulties but not robustly associated with cognitive inflexibility (PE). Future research with the WCST should consider different sources of errors that are posited to reflect divergent underlying neural mechanisms, conferring differential vulnerability for emerging mental health problems.