The Association Between Salivary Hormone Levels and Children’s Inpatient Aggression: A Pilot Study
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
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.
- Barzman DH, Brackenbury L, Sonnier L, et al.: Brief rating of aggression by children and adolescents (BRACHA): Development of a tool for assessing risk of inpatients’ aggressive behavior. Journal of the American Academy of Psychiatry and the Law 39(2):170–179, 2011.
- Vitiello B, Behar D, Hunt J, Stoff D, Ricciuti A: Subtyping aggression in children and adolescents. Journal of Neuropsychiatry and Clinical Neurosciences 2(2):189–192, 1990.
- Barzman D, Patel A, Sonnier L, Strawn J: Neuroendocrine aspects of pediatric aggression: Can hormone measures be clinically useful? Neuropsychiatric Disease and Treatment 6:691–697, 2010. CrossRef
- Granger DA, Schwartz EB, Booth A, Arentaz M: Salivary testosterone determination in studies of child health and development. Hormones and Behavior 35(1):18–27, 1999. CrossRef
- Barzman D, Mossman D, Sonnier L, Sorter M: Brief rating of aggression by children and adolescents (BRACHA): A reliability study. Journal of the American Academy of Psychiatry and the Law 40:374–382, 2012.
- Yudofsky SC, Silver JM, Jackson W, Endicott J, Williams D: The overt aggression scale for the objective rating of verbal and physical aggression. American Journal of Psychiatry 143:35–39. 1986.
- Kafantaris V, Lee DO, Magee H, et al.: Assessment of children with the overt aggression scale. Journal of Neuropsychiatry and Clinical Neurosciences 8:186–193, 1996.
- Cueva JE, Overall JE, Small AM, et al.: Carbamazepine in aggressive children with conduct disorder: A double-blind and placebo-controlled study. Journal of the American Academy of Child and Adolescent Psychiatry 35:480–490, 1996. CrossRef
- Malone RP, Delaney MA, Luebbert JF, et al.: A double-blind placebo-controlled study of lithium in hospitalized aggressive children and adolescents with conduct disorder. Archives of General Psychiatry 57:649–654, 2000. CrossRef
- Dura Trave T, Juste Ruiz M, Gonzalez Montero R, Gutierrez Teren M, Mauri Dot M, Moya Benavent M: Sensitivity of the clonidine and guanfacine tests (alpha-2-adrenergic agonists) as pharmacologic stimulants of growth hormone. Effects on plasma cortisol. Anales Españoles de Pediatría 45:575–578, 1996.
- McBurnett K, Lahey BB, Rathouz PJ, Loeber R: Low salivary cortisol and persistent aggression in boys referred for disruptive behavior. Archives of General Psychiatry 57:38–43, 2000. CrossRef
- Van Bokhoven I, Van Goozen SHM, van Engeland H, Schaal B, Arseneault L, Séguin JR, Nagin DS, Vitaro F, Tremblay RE: Salivary cortisol and aggression in a population-based longitudinal study of adolescent males. Journal of Neural Transmission 112:1083–1096, 2005. CrossRef
- Shoal GD, Giancola PR, Kirillova GP: Salivary cortisol, personality, and aggressive behavior in adolescent boys: A 5-year longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry 42:1101–1107, 2003. CrossRef
- The Association Between Salivary Hormone Levels and Children’s Inpatient Aggression: A Pilot Study
Volume 84, Issue 4 , pp 475-484
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Psychiatric hospitalization
- Author Affiliations
- 1. Division of Child and Adolescent Psychiatry, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- 3. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- 5. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- 4. Case-Western Reserve University, Cleveland, OH, USA
- 2. Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA