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Predicting Treatment Response for Oppositional Defiant and Conduct Disorder Using Pre-Treatment Adrenal and Gonadal Hormones

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Abstract

Variations in adrenal and gonadal hormone profiles have been linked to increased rates of oppositional defiant disorder (ODD) and conduct disorder (CD). These relationships suggest that certain hormone profiles may be related to how well children respond to psychological treatments for ODD and CD. The current study assessed whether pre-treatment profiles of adrenal and gonadal hormones predicted response to psychological treatment of ODD and CD. One hundred five children, 6–11 years old, participating in a randomized, clinical trial provided samples for cortisol, testosterone, dehydroepiandrosterone, and androstenedione. Diagnostic interviews of ODD and CD were administered up to 3 years post-treatment to track treatment response. Group-based trajectory modeling identified two trajectories of treatment response: (1) a High-response trajectory where children demonstrated lower rates of an ODD or CD diagnosis throughout follow-up, and (2) a Low-response trajectory where children demonstrated higher rates of an ODD or CD diagnosis throughout follow-up. Hierarchical logistic regression predicting treatment response demonstrated that children with higher pre-treatment concentrations of testosterone were four times more likely to be in the Low-response trajectory. No other significant relationship existed between pre-treatment hormone profiles and treatment response. These results suggest that higher concentrations of testosterone are related to how well children diagnosed with ODD or CD respond to psychological treatment over the course of 3 years.

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Acknowledgments

This manuscript was supported by grants from the National Institutes of Nursing Research (R01NR07615), Mental Health (R01MH57727), and Diabetes and Digestive and Kidney Diseases (T32DK063929). We thank Dr. James Peugh for providing his statistical expertise to the data analysis in this study.

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Authors and Affiliations

  1. University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 3015, Cincinnati, OH, 45229, USA

    Chad E. Shenk, Lorah D. Dorn & Jennie G. Noll

  2. Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    David J. Kolko

  3. The Pennsylvania State University, University Park, PA, USA

    Elizabeth J. Susman

  4. University of Texas Health Science Center, Houston, TX, USA

    Oscar G. Bukstein

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  1. Chad E. Shenk
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  2. Lorah D. Dorn
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  5. Jennie G. Noll
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  6. Oscar G. Bukstein
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Correspondence to Chad E. Shenk.

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Shenk, C.E., Dorn, L.D., Kolko, D.J. et al. Predicting Treatment Response for Oppositional Defiant and Conduct Disorder Using Pre-Treatment Adrenal and Gonadal Hormones. J Child Fam Stud 21, 973–981 (2012). https://doi.org/10.1007/s10826-011-9557-x

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