Ventral frontal cortex in children: morphology, social cognition and femininity/masculinity

The ventral frontal cortex (VFC) has been shown to differ morphologically between sexes. Social cognition, which many studies demonstrate involves the VFC, also differs between sexes, with females being more adept than males. In a previous study of subregions of the VFC in our lab, in an adult population, size of the straight gyrus (SG) but not the orbitofrontal cortex (OFC), differed between sexes and correlated with better performance on a test of social cognition and with greater identification with feminine characteristics. To investigate the relationship between VFC structure and social cognition in children, VFC gray matter volumes were measured on MRIs from 37 boys and 37 girls aged 7 to 17. The VFC was subdivided into the OFC and SG. Subjects were also administered a test of social perceptiveness and a rating scale of femininity/masculinity. In contrast to our findings in adults, the SG was slightly smaller in girls than boys. In girls, but not boys, smaller SG volumes significantly correlated with better social perception and higher identification with feminine traits. No volume differences by sex or significant correlations were found with the OFC. These data suggest a complex relationship between femininity, social cognition and SG morphology.     

Psychosexual outcome of gender-dysphoric children

ObjectiveTo establish the psychosexual outcome of gender-dysphoric children at 16 years or older and to examine childhood characteristics related to psychosexual outcome.MethodWe studied 77 children who had been referred in childhood to our clinic because of gender dysphoria (59 boys, 18 girls; mean age 8.4 years, age range 5–12 years). In childhood, we measured the children's cross-gender identification and discomfort with their own sex and gender roles. At follow-up 10.4 ± 3.4 years later, 54 children (mean age 18.9 years, age range 16–28 years) agreed to participate. In this group, we assessed gender dysphoria and sexual orientation.ResultsAt follow-up, 30% of the 77 participants (19 boys and 4 girls) did not respond to our recruiting letter or were not traceable; 27% (12 boys and 9 girls) were still gender dysphoric (persistence group), and 43% (desistance group: 28 boys and 5 girls) were no longer gender dysphoric. Both boys and girls in the persistence group were more extremely cross-gendered in behavior and feelings and were more likely to fulfill gender identity disorder (GID) criteria in childhood than the children in the other two groups. At follow-up, nearly all male and female participants in the persistence group reported having a homosexual or bisexual sexual orientation. In the desistance group, all of the girls and half of the boys reported having a heterosexual orientation. The other half of the boys in the desistance group had a homosexual or bisexual sexual orientation.ConclusionsMost children with gender dysphoria will not remain gender dysphoric after puberty. Children with persistent GID are characterized by more extreme gender dysphoria in childhood than children with desisting gender dysphoria. With regard to sexual orientation, the most likely outcome of childhood GID is homosexuality or bisexuality. J. Am. Acad. Child and Adolesc. Psychiatry, 2008;47(12):1413–1423.     

Assessing fears and related anxieties in children and adolescents with learning disabilities or mild mental retardation

The purpose of the present study was to examine self-reported fears and related anxieties in children and adolescents (7-18 years of age) having learning disabilities (LD) or mild mental retardation (MIMR), and whether these fears and related anxieties differ based on gender and age. Students responded to two well validated instruments, The Fear Survey Schedule for Children-Revised and Revised Children's Manifest Anxiety Scale. The results revealed age, gender, and disability interaction effects. Adolescent boys having mild mental retardation reported highest levels of fear related to failure and criticism, a finding that was different from those reported in previous studies. In addition, girls reported higher levels than boys of total fear, fears related to minor injury and small animals, and worry/oversensitivity. Age main effects were also observed where younger students from both the LD and the MIMR groups reported higher levels of non-specific general anxiety. Implications and directions for future research were presented.     

Sex, gender role orientation, gender role attitudes and suicidal thoughts in three generations

Background Suicide and other suicidal behaviours are markedly (though differently) patterned by gender. The increase in young male suicide rates in many countries has heightened interest in whether suicidal behaviours and ideation (thoughts) are related to masculinity. Relatively little research has explored the relationship between gender role attitudes and orientation and suicidal behaviours and ideation. Most research in this area has been conducted with young people. Objective We investigated whether gender role orientation (masculinity and femininity scores) and gender role attitudes were related to the reporting of serious suicidal thoughts in three generations (early adulthood, and early and late middle age) in a community sample. Methods Subjects (653 men and women aged around 23 years, 754 aged around 43 years, 722 aged around 63 years) completed home interviews with nurses as part of an ongoing longitudinal community-based study of social factors and health. These included measures of suicidal ideation (thoughts), attitudes to traditional gender roles, and a validated measure of gender role orientation (masculinity and femininity scores). Results The prevalence of serious suicidal thoughts was higher in early adulthood (10% men, 15% women) than in early (4% men, 8% women) and late (6% men, 5% women) middle age. In early adulthood only sex was significantly related to suicidal thoughts, with women at higher risk (adjusted OR 1.74, 95% CI 1.01–3.00). In early middle age masculinity scores were negatively related to suicidal thoughts (adjusted OR for each unit increase in score 0.65: 95% CI 0.46–0.93), and more traditional views on gender roles were positively associated with suicidal thoughts (adjusted OR 1.48: 95% CI 1.07–2.04). In late middle age trends were in the same direction as in early middle age, but were not statistically significant. Femininity scores were unrelated to serious suicidal thoughts at any age. Conclusion The high rates of suicidal thoughts amongst men and women in early adulthood point to the importance of understanding mental health problems at this age. The results raise a number of questions and suggest that suicide researchers should pay more attention to gender roles and attitudes in older adults. Ethical approval was obtained from the Glasgow University ethics committee for non clinical research involving human subjects. Funding: the Twenty–07 study is funded by the Medical Research Council of Great Britain. KH, HS and MK are employed by the MRC.     

Self-reported fears: a comparison study of youths with and without an intellectual disability

Normal fear plays an essential role in human development and experience, and much research attention has been devoted to its study in the general population. In contrast, the normal fears of youths with intellectual disabilities have largely been ignored. The present paper reports the normative fears of 187 youths with mild to moderate intellectual disabilities. Data were also gathered from 372 youths of average intelligence for comparison purposes. All respondents were aged between 7 and 18 years. Fear was assessed using the Fear Survey Schedule for Children-ll (FSSC-II), an instrument which has been psychometrically validated in samples with and without disabilities. The youths with disabilities reported significantly higher levels of fearfulness and a greater range of fears than youths without disabilities. The content of their fears was also more likely to resemble those of younger children without disabilities. The fears that best discriminated between the two samples were those related to supernatural phenomena or animals. Included were fears of bees, lizards, ghosts or similar eerie things, and cemeteries. Nevertheless, there was considerable similarity between the two samples. For both samples, females reported a higher level of fearfulness and a greater range of fear than males, and fears of death and danger were endorsed as arousing the strongest fear for all respondents. The theoretical and applied implications of these results are discussed.     

Fearfulness moderates the link between childhood social withdrawal and adolescent reward response

Withdrawal from peers during childhood may reflect disruptions in reward functioning that heighten vulnerability to affective disorders during adolescence. The association between socially withdrawn behavior and reward functioning may depend on traits that influence this withdrawal, such as fearfulness or unsociability. In a study of 129 boys, we evaluated how boys’ fearfulness and sociability at age 5 and social withdrawal at school at ages 6 to 10 and during a summer camp at age 9/10 were associated with their neural response to reward at age 20. Greater social withdrawal during childhood was associated with heightened striatal and mPFC activation when anticipating rewards at age 20. Fearfulness moderated this effect to indicate that social withdrawal was associated with heightened reward-related response in the striatum for boys high on fearfulness. Altered striatal response associated with social withdrawal and fearfulness predicted greater likelihood to have a lifetime history of depression and social phobia at age 20. These findings add greater specificity to previous findings that children high in traits related to fear of novelty show altered reward responses, by identifying fearfulness (but not low levels of sociability) as a potential underlying mechanism that contributes to reward alterations in withdrawn children.     

Moderation of the relationship between the error-related negativity and anxiety by age and gender in young children: A preliminary investigation

The error-related negativity (ERN) is a neurophysiologic response to errors that associates with anxiety. Despite the potential relevance of the ERN for understanding mechanisms of early anxiety problems in the developing brain, the relation between ERN and anxious symptoms in young children remains poorly understood. Emerging evidence suggests that ERN-anxiety associations could vary by developmental stage, but this work requires replication and consideration of gender effects, given earlier maturation of the ERN and higher rates of anxiety problems in girls relative to boys. To address this gap, the ERN was collected in 49 preschool- to school-aged children (ages 4–9; 26 girls) sampled across a wide range of anxiety severity. Regression analyses revealed that ERN - anxiety associations depended on age and gender. Specifically, larger (more negative) ERN associated with more anxiety in older girls, whereas smaller ERN associated with more anxiety symptoms in younger girls. No ERN-anxiety association was found in boys. These findings suggest that age and gender moderate the direction of the relation between ERN and anxiety in early childhood and could have important implications for the development of ERN-based risk identification and targeted treatment strategies tailored to individual children.     

The relationship of gender,gender identity,and coping strategies in late adolescents

The relationships among gender, gender identity, and coping in late adolescents were examined. One hundred sixty-nine late adolescents completed measures assessing their masculinity and femininity, as well as their use of coping strategies. Females endorsed greater use of emotion-focused coping strategies than males. Late adolescents who were high in masculinity endorsed higher levels of problem-focused coping strategies than those who were low in masculinity. In contrast, late adolescents who were high in femininity endorsed higher levels of emotion-focused coping strategies than those who were low in femininity. Neither the gender nor the masculinity and femininity of late adolescents were predictive of the use of avoidant coping strategies. Overall, gender identity made an important and independent contribution to the endorsement of coping strategy use. These results emphasize the importance of assessing both gender and gender identity with regard to coping in late adolescents.     

Occupational interests of epileptic children and possibilities of their realization]

The purpose of this study was an analysis of occupational interests and their relationship to the intellectual capacities of epileptic children. Thirty-three children (20 girls and 13 boys) from the 8th class of elementary school were studied. They had been under treatment for 3 years, at least. The study was performed using the General Classification Test and the Technical Thinking Test. The investigations demonstrated that the girls were interested in humanistic fields while the boys in agriculture and technique. In relation to healthy children the level of occupational aspiration was lower in these children, particularly the boys. The children explained lowering of their occupational aspirations with low intellectual abilities. This motivation has, however, not been confirmed by the results of tests. The authors put forward the hypothesis that lowering aspirations may be also caused by erroneous attitude of the community towards these children.     

Pre-school children with suspected autism spectrum disorders: Do girls and boys have the same profiles?

The male to female ratio is raised in autism spectrum disorders (ASD). Previous studies have suggested that girls with ASD have more problems with communication than boys, but boys show more repetitive behaviours than girls. In this study, 20 girls, 1.8–3.9 years of age were matched for chronological and developmental age with 20 boys with suspected ASD. All the children were recruited after population screening and referral by Child Health Care Services to a specialised neuropsychiatry clinic, where they underwent comprehensive neuropsychiatric assessments. Comparisons were made with regard to diagnosis, developmental profiles and global disability. No significant gender differences were found. There were strong correlations between results obtained in different developmental areas. The results suggest that either (1) previous studies finding clear gender differences may have overrated discrepancies between girls and boys in ASD, or that (2) there may be girls, who will not be identified in the early years with our current screening instruments. More research with a much larger population representative study samples is required.     

Normative development of fears in Greece: self-reports on the Hellenic Fear Survey Schedule for Children

This study assessed the psychometric properties of self-reports on the Hellenic Fear Survey Schedule for Children (FSSC-GR), a Greek-language version of Ollendick's FSSC-R [Behav. Res. Ther. 21 (1983) 685-692], and explored the factor structure, intensity, prevalence, and content of fears of Hellenic children aged 7-12 years. Internal consistency and temporal stability assessments of responding on the FSSC-GR were comparable to those obtained on the FSSC-R. A seven-factor solution provided the best conceptual fit for the structure of children's fears in Greece, including five components similar to factors previously obtained for the FSSC-R, plus two unique components, "Travel and Agoraphobic Fears" and "School Performance Fears." Fear intensity and prevalence scores of Hellenic children were higher than scores observed in most countries. Self-reported fear scores were higher for Hellenic girls than for boys. The relation between age and self-reported fears in Greece was complex and interpreted in relation to age-related changes in environmental demands.     

Children's family drawings and internalizing problems

The aim of this study was to examine the associations between specific indicators in children's family drawings and their internalizing problems among Two hundred twenty-two Israeli children (M = 9.70). Drawings were coded using Kaplan and Main's (1986) coding system. Indicators reflecting attachment insecurity, such as omitting and adding parts of the figures, adding bizarre marks and lack of femininity, were correlated with internalizing problems. In addition, different associations were found among boys and girls. Among girls, better grounding and centering of the figures, movement, feminine marks and distance from both parents were negatively associated with internalizing problems, while bizarre marks were positively associated. For boys, centering of the figures, sweetness, distance from mother and the addition of strange objects were positively correlated with maladjustment, while completeness of figures and gender differences were correlated negatively. Moreover, our study depicted a moderation of children's gender on the associations between specific indicators and children's internalizing problems. Discerning specific and relatively easily-coded features in children's family drawings may be a useful research and clinical tool to identify internalizing problems.     

Comparative effects of methylphenidate on ADD girls and ADD boys

The effects of 0.3 mg/kg methylphenidate were compared for 12 ADD boys and 12 ADD girls participating in a summer treatment program for children with behavior and/or learning problems. Previous investigations have suggested that ADD girls may differ from ADD boys in some important respects. No information exists regarding whether the effects of the most common treatment for these children, methylphenidate, has comparable effects on boys and girls. The boys and girls were matched for age and IQ. The results revealed equivalent and beneficial effects of methylphenidate for both boys and girls. Methylphenidate therefore would appear to be as useful a treatment for ADD girls as for ADD boys.     

Childhood behavioral profiles leading to adolescent conduct disorder: risk trajectories for boys and girls

OBJECTIVE: To examine the link between childhood behavioral dimensions and adolescent conduct disorder (CD) among a large sample of boys and girls monitored longitudinally. METHOD: Teachers rated the behaviors of 1,569 children every year between kindergarten and grade 6. On the basis of these seven yearly ratings, groups of children who followed distinct trajectories on three behavioral dimensions--hyperactivity, fearfulness, and helpfulness--were identified with a semiparametric statistical analysis. Children were then categorized into one of eight behavioral profiles, representing different combinations of the trajectories. Logistic regressions were used to estimate the relation between the profiles and CD in adolescence (mean = 15.7 years). RESULTS: Boys had a significant risk for CD if they were hyperactive (odds ratio [OR] = 4.27; 95% confidence interval [CI], 1.8-10.16); hyperactive and unhelpful (OR = 2.83; CI, 1.07-7.46); or hyperactive, fearless, and unhelpful (OR = 3.93; CI, 1.27-12.17). Girls had a significant risk for CD only if they were both hyperactive and unhelpful (OR = 4.61; CI, 1.31-16.24). More boys than girls exhibited profiles of risk and met criteria for CD in adolescence. CONCLUSIONS: Sex-specific childhood behavioral profiles that represented risk for CD in adolescence were identified.There were sex differences in the prevalence of the childhood profiles representing risk for CD.     

Influence of gender on attention deficit hyperactivity disorder in children referred to a psychiatric clinic.

OBJECTIVE: The substantial discrepancy in the male-to-female ratio between clinic-referred (10 to 1) and community (3 to 1) samples of children with attention deficit hyperactivity disorder (ADHD) suggests that gender differences may be operant in the phenotypic expression of ADHD. In this study the authors systematically examined the impact of gender on the clinical features of ADHD in a group of children referred to a clinic. METHOD: The study included 140 boys and 140 girls with ADHD and 120 boys and 122 girls without ADHD as comparison subjects. All subjects were systematically assessed with structured diagnostic interviews and neuropsychological batteries for subtypes of ADHD as well as emotional, school, intellectual, interpersonal, and family functioning. RESULTS: Girls with ADHD were more likely than boys to have the predominantly inattentive type of ADHD, less likely to have a learning disability, and less likely to manifest problems in school or in their spare time. In addition, girls with ADHD were at less risk for comorbid major depression, conduct disorder, and oppositional defiant disorder than boys with ADHD. A statistically significant gender-by-ADHD interaction was identified for comorbid substance use disorders as well. CONCLUSIONS: The lower likelihood for girls to manifest psychiatric, cognitive, and functional impairment than boys could result in gender-based referral bias unfavorable to girls with ADHD.     

Oxytocin administration leads to a preference for masculinized male faces

Preferences for sexually dimorphic traits in men's faces are consistent with a trade-off between cues to indirect (genetic) and direct (prosociality) benefits, associated perceptually with relative masculinity and femininity respectively. As the neuropeptide oxytocin (OT) has been shown to promote social perception, we hypothesized that temporary OT elevation would result in a preference for masculinity in men's faces, by reducing the apparent social costs of masculine traits. In a double-blind, placebo-controlled study, 96 participants received either 24 IU OT or placebo. They then completed a computer task in which they used the mouse to alter the shape of displayed men's and women's faces, making them look more or less masculine. Participants were instructed to make each face as attractive as possible. OT administration led to a trend for a relative preference for masculinity in men's faces but did not affect preferences for femininity in women's faces, and this effect occurred irrespective of the participant's sex. We tentatively speculate that OT may 'mask' negative personality attributions normally associated with masculine male faces. These results may be pointing to the role of personality attribution in attractiveness judgements, and the role of OT in social perception.     

The Massachusetts General Hospital studies of gender influences on attention-deficit/hyperactivity disorder in youth and relatives.

With the single exception of SUDs, no statistically significant gender-by ADHD interactions were identified in the multiple, outcomes evaluated. These results suggest that with the exception of SUDs, ADHD expresses itself similarly in boys and girls relative to comparison subjects of the same gender, indicating that ADHD-associated impairments are correlates of ADHD in both genders. Gender differences, such as the higher prevalence of symptoms of inattention and lower rates of comorbidity with disruptive behavior disorders, major depression, and learning disability, were identified among the ADHD subjects. Because these differences were caused by the main effects of gender rather than effect modification of ADHD by gender, these findings indicate that girls were at the same relative risk for these adverse outcomes as boys, but that female gender resulted in a different clinical presentation than that affecting boys.The single statistically significant gender-by-ADHD interaction identified was the association between ADHD and SUDs (alcohol or drug abuse or dependence). ADHD in females was a more serious risk factor for SUDsthan it was in males was an unanticipated and surprising finding. In light of ongoing concerns regarding ADHD as a putative risk factor of SUDs [12],this finding may indicate that girls are particularly at risk in early adolescence. Considering that the age of onset of ADHD and SUDs are separated by at least a decade [13.14], this finding would support targeting of substance abuse prevention programs to girls with ADHD.Furthermore, results show that although the combined type of ADHDwas the predominant type in both genders, girls with ADHD were twice as likely as boys with ADHD to manifest the predominantly inattentive type of the disorder. Because symptoms of inattention are more covert than those of hyperactivity and impulsivity, their higher prevalence in girls with ADHDrelative to boys also may explain partially the markedly higher male-to-female ratios in referred versus nonreferred samples of children withADHD.This work also showed that the pattern of transmission of ADHD and comorbid disorders is not influenced by the proband's gender. This is true for the type of disorder transmitted and the degree of risk to relatives. The finding of no interactions between proband ADHD diagnosis and pro-band gender clearly rejects the idea that gender differences in comorbid disorders can be attributed to genes or other familial causes. Prior work had shown this to be true for the diagnosis of ADHD in relatives [15-20].Thus, gender and ADHD appear to be independent risk factors for comorbid psychopathology and for the familial transmission of comorbid psychopathology.In summary, these results suggest that gender was a limited effect modifier of ADHD as a risk factor for ADHD-associated dysfunction in referred children and adolescents. Gender, however, did impact the clinical presentation of the disorder. This was largely because girls with ADHDwere less likely than boys to have comorbid disruptive behavior problems and higher prevalence of symptoms of inattention. Because these features could result in gender-based referral bias unfavorable to girls, more work is needed in referred and nonreferred samples of youth with ADHD to more fully assess this issue. These results also showed similar patterns in the familial transmission of comorbid disorders in families of boys and girls with ADHD. Thus, although ADHD is associated with the familial trans-mission of comorbid disorders, the pattern of transmission is not influenced by the proband's gender. These similar patterns provide further evidence for the idea that, when ADHD is diagnosed in girls it corresponds to the same disorder diagnosed in boys.     

Alcohol dependence and gender-role orientation.

OBJECTIVE: The overall increase of female alcoholism is supposed to be associated with the change of the traditional female role, and it is especially seen as a consequence of role convergence or gender-role conflicts. The aim of the present pilot study is to explore whether the approach of gender-role orientation would be empirically useful in contributing to these hypotheses. METHOD: One hundred twelve patients with alcohol dependence meeting DSM-III-R criteria were explored after detoxification; gender-role orientation was measured by a German version of the "Extended Personal Attributes Questionnaire", categorising gender-role orientation into four subgroups: masculine, feminine, androgynous, and undifferentiated. RESULTS: In comparison with a population-based sample, there are significant differences in the distribution of the four subgroups of gender-role orientation, showing a predominance of the undifferentiated self-concept in the alcoholic sample (49%). Alcoholic females describe themselves as rather undifferentiated, and rather feminine than masculine. Low masculinity and low femininity, as well as high femininity, correlate positively with distress, depressiveness, social anxiety, insecurity and concomitant personality disorders. CONCLUSION: Our data do not support the convergence hypothesis related to gender-role orientation, but support the traditional feminine self-concept as an unspecific risk factor for vulnerability. The question whether an undifferentiated self-concept could be a specific risk factor for alcoholism is discussed.     

Effects of autistic traits on social and school adjustment in children and adolescents: The moderating roles of age and gender

This study examined the associations between children's and adolescents’ autistic-like social deficits and school and social adjustment as well as the moderating roles of age and gender in these associations. The sample consisted of 1321 students (48.7% boys) in Grade 1 to Grade 8 from northern Taiwan. Children's and adolescents’ autistic-like social deficits were assessed using the Social Responsiveness Scale (SRS), and their school and social adjustment (i.e., academic performance, negative attitudes toward schoolwork/teachers/classmates, behavioral problems at schools, negative peer relationships, and problems with peers) were assessed using the Social Adjustment Inventory for Children and Adolescents (SAICA). Both measures were completed by the mothers of the participants. Results from the linear mixed models demonstrated that autistic-like social deficits were associated with poor academic performance, negative attitudes toward schoolwork, teachers, and classmates, behavioral problems at schools, negative peer relationships, and problematic peer interactions. Moreover, gender and/or age moderated the associations between autistic-like social deficits and school and social adjustment problems. For example, autistic-like social deficits were more strongly related to negative school attitude, school social problems, and negative peer relationships in boys than in girls. Further, autistic-like social deficits were more strongly related to problems with peers in older girls than in older boys or younger children (regardless of gender). In conclusion, the present study suggests that autistic-like social deficits may place children and adolescents at increased risk for social and school maladjustment and that the extent of maladjustment may vary with the child's age and gender and the domains of adjustment under discussion.     

Salivary cortisol and dehydroepiandrosterone in relation to puberty and gender

This study investigates basal levels of cortisol and dehydroepiandrosterone (DHEA), and their relation to gender and pubertal development, in healthy children and adolescents. Salivary cortisol and DHEA levels were examined in 129 normally developing subjects aged eight to 16 years. Subjects provided morning (08:00 h) and evening (20:00 h) saliva samples over four consecutive days. Pubertal stage was assessed using Tanner stage sketches, and subjects were grouped according to their general status of pubertal development (pre-early puberty: Tanner stageII). Results showed that morning salivary cortisol in mid-postpubertal girls was greater than in mid-postpubertal boys, but not pre-early pubertal girls and boys. Mean levels of salivary DHEA were greater in mid-postpubertal boys and girls than in pre-early pubertal boys and girls. Changes in hypothalamic-pituitary-adrenal (HPA) axis function that occur during puberty may have implications for immediate and long-term adolescent health.