CONGENITAL ADRENAL-HYPERPLASIA .2. GENDER-RELATED BEHAVIOR AND ATTITUDES IN FEMALE SALT-WASTING AND SIMPLE-VIRILIZING PATIENTS
CONGENITAL ADRENAL-HYPERPLASIA .2. GENDER-RELATED BEHAVIOR AND ATTITUDES IN FEMALE SALT-WASTING AND SIMPLE-VIRILIZING PATIENTS
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DOI：
10.1016/0306-4530(90)90066-i
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发表时间：
1990-01-01
影响因子：
3.7
通讯作者：
WALLIS, H
中科院分区：
文献类型：
--
作者：
DITTMANN, RW;KAPPES, MH;WALLIS, H
先天性肾上腺增生症 (CAH) 的盐消耗 (SW) 和单纯男性化 (SV) 形式的特征是不同的产前激素环境。为了测试这些激素环境是否对女性 CAH 患者“更男性化”的行为模式的发展产生不同的影响（Dittmann 等，1990），将 SW 患者 (N = 13) 与 SV 患者 (N = 20) 和两组健康姐妹 (N = 16) 进行比较。这些数据基于半结构化访谈，其中受试者（11-41岁）和母亲被问及“与性别相关的兴趣和行为”、“活动水平”、“社交行为”（反映例如自信、主导地位和同伴群体的接受度）和“外表”等方面；这些感兴趣的领域由复合量表表示。在大多数量表上，通过母亲评估和自我评估，SW 患者在“更男性化”的取向上与 SV 患者和姐妹有显着差异。 SW 患者还表现出更高的“活动水平”。这些 SW 组结果可能解释了配套文章中报道的大部分 CAH/姐妹差异（Dittmann 等，1990）。相比之下，SV 患者与姐妹样本仅在几个方面有所不同。 SV 和 SW 受试者的外生殖器男性化程度没有显着差异（表明产前雄激素化没有组间差异）。 SW患者在出生后接受“更早”和“更好”的治疗（表明产后雄激素化程度较低）。然而，这些医疗条件以及一些心理社会/人口统计学变量无法解释群体行为差异。这些结果不支持对 CAH 患者行为发展的主要心理社会解释，尤其是患有 SW 病症的患者；他们更倾向于认为，在产前中枢神经系统发育的关键时期，两种不同的激素环境（SV 与 SW）对组织的影响不同。
The salt-wasting (SW) and simple-virilizing (SV) forms of congenital adrenal hyperplasia (CAH) are characterized by distinct prenatal hormonal milieus. To test whether these hormonal milieus differentially influence the development of a "more masculine" behavioral pattern in female CAH patients (Dittmann et al., 1990), SW patients (N = 13) were compared both to SV patients (N = 20) and healthy sisters of both groups (N = 16). The data are based on semi-structured interviews in which subjects (11-41 yr) and mothers were asked about aspects of "Gender-related interests and behavior," "Level of activity," "Social behavior," (reflecting e.g., assertiveness, dominance, and acceptance by peer groups) and "Appearance"; these areas of interest were represented by composite scales.On most scales, and by both mother-assessment and self-assessment, SW patients differed significantly from both SV patients and sisters in having a "more masculine" orientation. SW patients also showed a higher "Level of activity." These SW group results probably account for much of the CAH/sister differences reported in the companion article (Dittmann et al., 1990). In contrast, SV patients differed from the sister sample on only a few scales. There were no significant differences between SV and SW subjects in the degree of virilization of the external genitalia (indicating no group difference in prenatal androgenization). SW patients were treated "earlier" and "better" after birth (indicating less postnatal androgenization). However, these medical conditions, as well as several psychosocial/demographic variables, could not explain the group behavioral differences.These results do not support a primarily psychosocial explanation of behavioral development in CAH patients, especially those with the SW condition; they rather suggest differential organizational effects of two different hormonal environments (SV vs. SW) during critical periods of prenatal CNS development.