Psychiatric Quarterly

, Volume 84, Issue 4, pp 475–484

The Association Between Salivary Hormone Levels and Children’s Inpatient Aggression: A Pilot Study

  • Drew H. Barzman
  • Douglas Mossman
  • Kacey Appel
  • Thomas J. Blom
  • Jeffrey R. Strawn
  • Nosa N. Ekhator
  • Bianca Patel
  • Melissa P. DelBello
  • Michael Sorter
  • David Klein
  • Thomas D. GeraciotiJr.
Original Paper

DOI: 10.1007/s11126-013-9260-8

Cite this article as:
Barzman, D.H., Mossman, D., Appel, K. et al. Psychiatr Q (2013) 84: 475. doi:10.1007/s11126-013-9260-8

Abstract

Aggression is a common management problem for child psychiatry hospital units. We describe an exploratory study with the primary objective of establishing the feasibility of linking salivary concentrations of three hormones (testosterone, dehydroepiandrosterone [DHEA], and cortisol) with aggression. Between May 2011 and November 2011, we recruited 17 psychiatrically hospitalized boys (age 7–9 years). We administered the Brief Rating of Aggression by Children and Adolescents (BRACHA) and Predatory-Affective Aggression Scale (PAAS) upon admission. Saliva samples were collected from the participants during a 24-h period shortly after admission: immediately upon awakening, 30 min later, and again between 3:45 and 7:45 P.M. Nursing staff recorded Overt Aggression Scale ratings twice a day during hospitalization to quantify aggressive behavior. The salivary cortisol concentrations obtained from aggressive boys 30 min after awakening trended higher than levels from the non-aggressive boys (p = 0.06), were correlated with the number of aggressive incidents (p = 0.04), and trended toward correlation with BRACHA scores (p = 0.06). The aggressive boys also showed greater morning-to-evening declines in cortisol levels (p = 0.05). Awakening levels of DHEA and testosterone were correlated with the severity of the nearest aggressive incident (p < 0.05 for both). The BRACHA scores of the aggressive boys were significantly higher than scores of the non-aggressive boys (p < 0.001). Our data demonstrate the feasibility of collecting saliva from children on an inpatient psychiatric unit, affirm the utility of the BRACHA in predicting aggressive behavior, and suggest links between salivary hormones and aggression by children who undergo psychiatric hospitalization.

Keywords

AggressionBRACHAHormonesChildPsychiatric hospitalization

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Drew H. Barzman
    • 1
  • Douglas Mossman
    • 3
  • Kacey Appel
    • 5
  • Thomas J. Blom
    • 3
  • Jeffrey R. Strawn
    • 3
  • Nosa N. Ekhator
    • 3
  • Bianca Patel
    • 4
  • Melissa P. DelBello
    • 3
  • Michael Sorter
    • 1
  • David Klein
    • 2
  • Thomas D. GeraciotiJr.
    • 3
  1. 1.Division of Child and Adolescent PsychiatryCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Division of EndocrinologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Department of Psychiatry and Behavioral NeuroscienceUniversity of Cincinnati College of MedicineCincinnatiUSA
  4. 4.Case-Western Reserve UniversityClevelandUSA
  5. 5.Cincinnati Children’s Hospital Medical CenterCincinnatiUSA