The extreme male brain revisited: gender coherence in adults with autism spectrum disorder
The extreme male brain revisited: gender coherence in adults with autism spectrum disorder
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DOI：
10.1192/bjp.bp.111.097899
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发表时间：
2012-08-01
影响因子：
10.5
通讯作者：
Eriksson, Elias
中科院分区：
文献类型：
--
作者：
Bejerot, Susanne;Eriksson, Jonna M.;Eriksson, Elias
“极端男性大脑”理论认为，自闭症谱系障碍（ASD）是男性智力的极端变体。然而，有些矛盾的是，许多ASD患者无论性别如何都表现出雌雄同体的身体特征。目的评估有和无ASD成人中可能与雄激素影响相关的生理指标。方法测定50例成人高功能ASD患者血清激素水平、人体测量、2 - 4指长比（2D:4D）及精神症状。8名评估人员获得了脸部和身体的照片以及录音，并就性别一致性进行了盲目和独立的评估。结果与对照组相比，患有自闭症谱系障碍的女性有更高的总睾酮和生物活性睾酮水平，更少的女性化面部特征和更大的头围。据评估，ASD组男性的身体特征和声音质量较不男性化，2D:4D比率较高（即较不男性化），但睾丸激素水平与对照组相似。在整个样本中，用自闭症谱商测量的雌雄同体的面部特征与自闭症特征呈显著正相关。与对照组相比，男性和女性ASD患者的硫酸脱氢表雄酮没有随着年龄的增长而下降。结论：与对照组相比，患有ASD的女性睾酮水平升高，并且具有一些男性化特征，而患有ASD的男性则表现出一些女性化特征。我们的研究结果表明，自闭症谱系障碍可能是一种性别违抗性障碍，而不是男女都表现为男性化。
BackgroundThe 'extreme male brain' theory suggests that autism spectrum disorder (ASD) is an extreme variant of male intelligence. However, somewhat paradoxically, many individuals with ASD display androgynous physical features regardless of gender.AimsTo assess physical measures, supposedly related to androgen influence, in adults with and without ASD.MethodSerum hormone levels, anthropometry, the ratio of 2nd to 4th digit length (2D:4D) and psychiatric symptomatology were measured in 50 adults with high-functioning ASD and age- and gender-matched neurotypical controls. Photographs of face and body, as well as voice recordings, were obtained and assessed with respect to gender coherence, blindly and independently, by eight assessors.ResultsWomen with ASD had higher total and bioactive testosterone levels, less feminine facial features and a larger head circumference than female controls. Men in the ASD group were assessed as having less masculine body characteristics and voice quality, and displayed higher (i.e. less masculine) 2D:4D ratios, but similar testosterone levels to controls. Androgynous facial features correlated strongly and positively with autistic traits measured with the Autism-Spectrum Quotient in the total sample. In males and females with ASD dehydroepiandrosterone sulfate did not decrease with age, in contrast to the control group.ConclusionsWomen with ASD had elevated testosterone levels and several masculinised characteristics compared with controls, whereas men with ASD displayed several feminised characteristics. Our findings suggest that ASD, rather than being characterised by masculinisation in both genders, may constitute a gender defiant disorder.