HORMONAL INFLUENCES ON HUMAN SEXUALLY-DIMORPHIC BEHAVIOR

这是对先天性肾上腺增生症(CAH)患者早期暴露于过量雄激素对行为影响的系统研究的继续。先前的研究结果表明，早期的雄激素确实会影响性型行为的各个方面，对这些影响的性质和程度进行详细研究是合适的。拟议项目的目的是审查：(A)在早期荷尔蒙的影响方面研究不足的行为，包括女性比男性更常见或更高的那些行为；(B)受荷尔蒙影响的童年游戏行为与青少年/青年认知能力和性取向之间的关系；(C)与早期荷尔蒙和疾病特征，特别是生殖器异常和手术有关的性心理发展和心理调整；(D)产前和产后雄激素在行为男性化和去女性化方面的相对重要性。患有CAH的青少年和年轻人--84名女性和70名男性--及其未受影响的兄弟姐妹--65名女性和88名男性--将接受性别类型活动和兴趣、性别认同、认知能力(空间和机械能力、言语记忆和情绪解码)、情绪调节的评估，对于16岁及以上的女性，将评估其性兴趣和经历。大约60%的人从小就参与了这项研究，所以童年的行为可能与现在的行为有关。一小群3-8岁的CAH女孩接受了产前糖皮质激素治疗，她们已经接受了测试。这项研究的结果将提供关于同一性的基本方面的发展的信息，以及荷尔蒙对与心理健康和社会成功相关的重要人类行为的影响的性质和程度。有关心理结果的数据将有助于目前关于需要对患有CAH的女孩进行早期手术干预和产前治疗的辩论。这些问题变得越来越重要，因为许多CAH病例现在是通过新生儿筛查来确定的。

This is a continuation of a systematic study of the behavioral effects of early exposure to excess androgens in individuals with congenital adrenal hyperplasia (CAH). Previous results suggest that early androgens do affect aspects of sex-typed behavior, and it is appropriate to study in detail the nature and extent of these effects. The purpose of the proposed project is to examine: (a) behaviors that have been under- studied with respect to effects of early hormones, including those that are more common or higher in females than in males; (b) the relation between hormonally-influenced childhood play behavior and adolescent/young adult cognitive abilities and sexual orientation; (c) psychosexual development and psychological adjustment in relation to early hormones and disease characteristics, especially genital anomalies and surgery in CAH females; (d) the relative importance of prenatal versus postnatal androgens in behavioral masculinization and defeminization. Adolescent and young adults ages 9-25) with CAH--84 females and 70 males-- and their unaffected siblings--65 females and 88 males--will be assessed on sex-typed activities and interests, gender identity, cognitive abilities (spatial and mechanical abilities, verbal memory, and decoding of emotions), emotional adjustment, and, in females aged 16 and older, sexual interests and experiences. About 60% have participated in the study since childhood, so childhood behavior can be related to current behavior. A small group of CAH girls aged 3-8 who received prenatal glucocorticoid treatment who have already been tested. Results of this study will provide information about the development of basic aspects of identity, and the nature and extent of hormonal influences on important human behaviors associated with mental health and social success. Data about psychological outcome will contribute to current debates about the need for early surgical intervention and prenatal treatment of girls with CAH. These issues are increasingly important because many cases of CAH are now identified through newborn screening.