HORMONAL INFLUENCES ON HUMAN SEXUALLY-DIMORPHIC BEHAVIOR

这是对先天性肾上腺增生（CAH）患者早期暴露于过量雄激素的行为影响的系统研究的继续。以前的研究结果表明，早期雄激素确实影响性别类型行为的各个方面，详细研究这些影响的性质和程度是合适的。拟议项目的目的是审查：（a）关于早期激素影响的研究不足的行为，包括女性比男性更常见或更高的行为;（B）受母亲影响的儿童游戏行为与青少年/年轻成人认知能力和性取向之间的关系;（c）性心理发育和心理调整与早期激素和疾病特征的关系，特别是CAH女性的生殖器异常和手术;（d）产前与产后雄激素在行为男性化和女性化中的相对重要性。患有CAH的青少年和年轻人（9-25岁）-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-将评估性别类型的活动和兴趣，性别认同，认知能力（空间和机械能力，言语记忆和情感解码），情绪调节，以及16岁及以上女性的性兴趣和经历。大约60%的人从小就参与了这项研究，因此儿童时期的行为可能与当前的行为有关。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有关身份的基本方面的发展，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的信息。有关心理结果的数据将有助于目前的辩论需要早期手术干预和产前治疗的女孩与CAH。这些问题越来越重要，因为许多CAH病例现在都是通过新生儿筛查确定的。

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.