Transcript ICT aan de VU projecten en plannen

hpa axis activity
in delinquent male adolescents
arne popma
department of child
and adolescent
psychiatry
vu amsterdam
outline
background
literature
overall project
study 1
study 2
study 3
conclusion
discussion
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
theoretical framework
underarousal
fearlessness
sensation seeking
(zuckermann,1977)
(raine, 1993)
biological parameters
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)
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)
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
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
overall project: instruments
diagnostic interwiew schedule for children
child behavior checklist
wechsler intelligence scale
subjects
normal controls:
diversion project without DBD:
diversion project with DBD:
DBD = ODD ór CD
NC
DPDP+
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
study 1: diurnal cycle of cortisol, incl CAR
results
14
cortisol (nmol/l)
12
NC (n = 32)
10
DP- (n = 61)
8
DP+ (n = 20)
6
4
2
0
7:00
8:00
9:00
10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00
time
study 2: psychosocial stress test
aim
measuring salivary cortisol, HR
hypotheses:
DP+ lower basal cortisol and HR,
smaller increase cortisol and HR
as compared with NC
study 2: psychosocial stress test
timeschedule
initial resting period
psychosocial stress test
post-test resting period
t = -50 min
t = -25
t=0
t = 10
t = 15
t = 35
t = 55
t =75
saliva
nms 1
saliva
nms
saliva
nms
saliva
nms
saliva
nms
saliva
nms
saliva
nms
HR and SCL
1
Von Zerssen negative mood scale
study 2: psychosocial stress test
salivary cortisol
4
3,5
cortisol (nmol/l)
3
2,5
2
1,5
NC (n = 30)
DP- (n = 45)
DP+ (n = 21)
1
0,5
prepare speaking
0
-40
-30
-20
-10
0
10
20
time
30
40
50
60
70
80
study 2: psychosocial stress test
heartrate
90
NC (n = 30)
88
DP- (n = 49)
86
heartrate (bpm)
DP+ (n = 21)
84
82
80
78
76
74
prepare speaking
72
-40
-30
-20
-10
0
10
20
time
30
40
50
60
70
80
study 2: psychosocial stress test
negative affect
5
negative mood
4
NC (n = 30)
DP- (n = 50)
DP+ (n = 22)
3
2
1
prepare speaking
0
-40
-30
-20
-10
0
10
20
time
30
40
50
60
70
80
study 2: psychosocial stress test
results
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
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
conclusion
when studying HPA activity
in relation to disruptive behavior
it is important to take into account
diurnal variation
and basal versus stress conditions
testosterone and cortisol
evidence from studies in animals that
testosterone influences HPA-functioning
(Luine 2002)
ánd cortisol influences testosterone
levels (Viau 2002)
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)
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”
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”
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%)
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
testosteron x cortisol > overt aggression
Overt Aggression
14
12
10
Cortisol 1SD below mean
Cortisol mean
8
Cortisol 1 SD above mean
6
0
50
100
150
Testosterone (pmol/l)
200
250
discussion
how to understand this interaction?
1: cortisol related to psychosocial factors
(social withdrawal, inhibition) that influence
the testosterone-aggression relationship
discussion
2: high cortisol protective against aggression
(Shirtcliff 2005)
3: cortisol directly influences effects of
testosterone, for example on receptor level
(Viau 2002)
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
thank you!
Theo Doreleijers
Herman van Engeland
Robert Vermeiren
Lucres Jansen
Stephanie van Goozen
Wim van den Brink
Thomas Rinne
Hans Steiner
Adrian Raine