Behavior in Congenital Adrenal Hyperplasia

Sheri A. Berenbaum, Department of Psychology, Pennsylvania State University

We study behavior in girls and boys with CAH and in their siblings and cousins without CAH in order to understand (1) the relation between early exposure to androgens and various aspects of social behavior and abilities, and (2) any behavioral consequences of the disease itself.

To summarize major findings – Girls with CAH are different from their sisters without CAH in some ways, but not in other ways.

• Girls with CAH have “typical” female gender identity. Most girls with CAH clearly identify themselves as girls and have no wish to be boys.
• It is characteristic of girls with CAH (especially those with salt-wasting CAH) to play with boys’ toys in childhood and to continue to be interested in “boy-typical” activities in adolescence (such as sports and electronics). But, girls with CAH are not the same as boys in their activities, there is variation among girls, and there is nothing wrong with girls with CAH who are interested in boys’ activities. The results suggest that boy-typical interests result, in part, from effects of androgen exposure that occur during brain development before birth.
• Boys with CAH are generally similar to boys without CAH in their behavior and preferences. For example, there is no difference between boys with and without CAH in their activities, suggesting that differences between girls with and without CAH are not due to general factors associated with having the disease.

We are currently studying several questions following naturally from our previous results.

• Hobbies and occupational interests. Are young women with CAH likely to pursue science and engineering in college, or to continue sports participation?
• Dating and romantic interests. For example, do young women with CAH start dating later than women without CAH? Many girls and parents wonder about this. By continuing this research, we will be in a better position to answer these questions.
• Behavioral effects (if any) of prenatal dexamethasone treatment for girls with CAH and other treated children.
• Behavior in relation to aspects of medical treatment, such as age at surgery.

Our studies involve participants across a range of ages (2 years to young adulthood). We would be happy to have you join our research program. If you are interested in participating, please contact us at Psychology, Penn State, University Park PA 16802, 814-863-6018, or by
email. We travel to visit participants in their homes, so don’t hesitate to volunteer even if you don’t live in Pennsylvania.