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Cited by 26Attention Deficit Hyperactivity DisorderSexual Differentiation and DisordersAutism Spectrum Disorder Research

Potential role of pre- and postnatal testosterone levels in attention-deficit/hyperactivity disorder: is there a sex difference?

Open access
Wang, Liang-Jen, Chou, Miao-Chun, Chou, Wen-Jiun, Lee, Min-Jing, Lee, Sheng-Yu, Lin, Pao-Yen, Lee, Yi-Hsuan, Yang, Yi-Hsin +1 more·2017·Neuropsychiatric Disease and Treatment
DOI 10.2147/ndt.s136717PMC PMC5439987
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Abstract

Objective: Both prenatal testosterone (T) exposure and postnatal T levels have been associated with developing neural circuitry and behavioral systems. This study examined the potential correlation between pre- and postnatal T levels and behavioral and neurocognitive profiles of children with attention-deficit/hyperactivity disorder (ADHD). Methods: Two hundred ADHD patients with a mean age of 8.7±2.0 years (158 boys and 42 girls) were recruited. The ratio of the length of the right index finger (2D) to that of the right ring finger (4D) (2D/4D ratio) served as a surrogate of prenatal T exposure, and postnatal T was determined using salivary T concentration. Behavioral symptoms were evaluated using the Swanson, Nolan, and Pelham – Version IV Scale for ADHD (SNAP-IV). Neurocognitive function was assessed using the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) and Conners’ Continuous Performance Test (CPT). Results: Lower 2D/4D ratios were associated with comorbid disruptive behavior disorders ( t =2.15, P =0.033) in all participants. Among the boys with ADHD, neither 2D/4D ratios nor salivary T levels were associated with behavioral symptoms or neurocognitive function. Among the girls with ADHD, the salivary T level was positively correlated with the Perceptual Reasoning Index of the WISC-IV ( r =0.48, P =0.001) and the Confidence Index ( r =0.37, P =0.017) and Omission Errors of the CPT ( r =0.62, P <0.001). Conclusion: Findings suggest that a higher prenatal T exposure is associated with a greater risk of developing disruptive behavior disorders, and T may exert differential neurocognitive effects between boys and girls with ADHD. However, the neurobiological mechanisms of T involved in the pathogenesis of ADHD warrant further investigation. Keywords: ADHD, endocrinology, cognition, psychopathology, comorbidity

AI snapshot

Written from the paper’s full text.

TL;DR

In 200 children with ADHD, lower prenatal testosterone exposure proxy (2D/4D ratio) was associated with comorbid disruptive behavior disorders, but not with ADHD symptoms or neurocognition. Salivary testosterone showed sex-specific correlations with neurocognitive measures in girls only, with no such associations in boys.

Key findings

  • Lower 2D/4D ratios were associated with comorbid disruptive behavior disorders (ODD or conduct disorder) in all participants (t=2.15, P=0.033); 2D/4D ratios were not correlated with any clinical measure or neuropsychological performance in either sex.
  • Among boys with ADHD, salivary testosterone was not correlated with behavioral symptoms or neurocognitive performance, but was positively correlated with age (r=0.22, P=0.005), height (r=0.22, P=0.005), body weight (r=0.24, P=0.003), and BMI (r=0.17, P=0.036).
  • Among girls with ADHD, salivary testosterone was positively correlated with WISC-IV Perceptual Reasoning Index (r=0.48, P=0.001), CPT Confidence Index (r=0.37, P=0.017), and CPT Omission Errors (r=0.62, P<0.001).
  • Salivary testosterone levels were significantly higher in boys than girls (t=2.04, P=0.043), and salivary testosterone was not significantly correlated with 2D/4D ratios (r=0.09, P=0.229).

Methods

  • Cross-sectional study of 203 recruited ADHD patients; 200 analyzed after excluding 3 with undetermined salivary testosterone. Mean age was 8.7±2.0 years; 158 boys and 42 girls. Patients were Han Chinese, aged 6–16 years, recruited from child psychiatry outpatient clinics in Taiwan, diagnosed with ADHD by DSM-IV-TR criteria using the Chinese K-SADS-E.
  • Prenatal testosterone exposure was indexed by right-hand 2D/4D ratio; postnatal testosterone was measured from morning salivary samples using chemiluminescence immunoassay. Behavioral symptoms used SNAP-IV parent and teacher forms; neurocognitive function used WISC-IV and Conners’ CPT.
  • Analyses used SPSS 16.0 with chi-square or Fisher’s exact tests, independent t-tests, and Pearson correlations; two-tailed P<0.05 was considered significant.

Limitations

  • Stated: no control group; cross-sectional design prevents causal inference; salivary testosterone may not represent central nervous system testosterone exposure; girls’ sample was relatively small; only one saliva sample per subject was collected; exploratory analyses did not correct for multiple testing, and the authors note that none of the significant findings would survive Bonferroni correction; important mediators such as personality traits or prenatal alcohol exposure were not evaluated.
  • Evident from the text: the sample was predominantly boys (79%), so sex-specific findings in girls are based on a small subgroup and may be underpowered.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2147/ndt.s136717

Cites

54 of 54 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 27 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Among boys with ADHD, salivary T levels were positively correlated with height (r=0.22, P=0.005).

    “Among the boys with ADHD, salivary T levels were positively correlated with age (r=0.22, P=0.005), height (r=0.22, P=0.005), body weight (r=0.24, P=0.003), and BMI (r=0.17, P=0.036)”
    Quote in the paperNot a substantial claim
  • Findingown data

    Among ADHD patients, salivary T levels were not significantly correlated with behavioral symptoms and comorbidities.

    “Furthermore, our results show that, among ADHD patients, current salivary T levels are not significantly correlated with their behavioral symptoms and comorbidities.”
    Quote in the paperSubstantial claim
  • Findingown data

    Among ADHD patients, 2D/4D ratios were not correlated with any clinical measure or neuropsychological performance in both sexes.

    “In both sexes, the 2D/4D ratios were not correlated with any clinical measure or neuropsychological performance.”
    • Also stated in: § 2D/4D ratios and ADHD · plain
      “In both sexes, the 2D/4D ratios were not correlated with any clinical measure or neuropsychological performance.”
    Quote in the paperSubstantial claim
  • Findingown data

    Among boys with ADHD, salivary T levels were positively correlated with body weight (r=0.24, P=0.003).

    “Among the boys with ADHD, salivary T levels were positively correlated with age (r=0.22, P=0.005), height (r=0.22, P=0.005), body weight (r=0.24, P=0.003), and BMI (r=0.17, P=0.036)”
    Quote in the paperNot a substantial claim
  • Findingown data

    Among boys with ADHD, salivary T levels were positively correlated with BMI (r=0.17, P=0.036).

    “Among the boys with ADHD, salivary T levels were positively correlated with age (r=0.22, P=0.005), height (r=0.22, P=0.005), body weight (r=0.24, P=0.003), and BMI (r=0.17, P=0.036)”
    Quote in the paperNot a substantial claim
  • May combine two claims. 12
  • Classified as probably not a substantial claim. 16

  • May combine two claims.

    Findingown data

    Among girls with ADHD, salivary T levels were not correlated with age, height, body weight, or BMI.

    “We found that salivary T levels were positively correlated with age, height, body weight, and BMI in boys, but this phenomenon was not observed in girls.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Several studies suggested that individuals with a lower, more male-typical, 2D/4D ratio tend to exhibit more prominent ADHD features.

    “Several studies suggested that individuals with a lower, more male-typical, 2D/4D ratio tend to exhibit more prominent ADHD features.16–19”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [16] Stevenson JC Everson PM Williams DC Hipskind G Grimes M Mahoney ER Attention deficit/hyperactivity disorder (ADHD) symptoms and digit ratios in a college sample Am J Hum Biol 2007 19 1 41 50 17160985

      Not checked in the free run.

    • cites [17] James WH Further evidence that some male-based neurodevelopmental disorders are associated with high intrauterine testosterone concentrations Dev Med Child Neurol 2008 50 1 15 18 18173623

      Not checked in the free run.

    • cites [18] Martel MM Conscientiousness as a mediator of the association between masculinized finger-length ratios and attention-deficit/hyperactivity disorder (ADHD) J Child Psychol Psychiatry 2009 50 7 790 798 19298468 PMC4311552

      Not checked in the free run.

    • cites [19] Roberts BA Martel MM Prenatal testosterone and preschool disruptive behavior disorders Pers Individ Dif 2013 55 8 962 966 25598567 PMC4295489

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Peripheral T levels are similar among boys and girls during early childhood, but T levels notably increase in prepubertal boys.

    “Peripheral T levels are similar among boys and girls during early childhood,31 but T levels notably increase in prepubertal boys.9”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [31] Biro FM Pinney SM Huang B Hormone changes in peripubertal girls J Clin Endocrinol Metab 2014 99 10 3829 3835 25029416 PMC4184081

      Not checked in the free run.

    • cites [9] Albin AK Norjavaara E Pubertal growth and serum testosterone and estradiol levels in boys Horm Res Paediatr 2013 80 2 100 110 23988590

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Herguner et al reported that women with polycystic ovary syndrome had more ADHD symptoms than did control subjects.

    “Herguner et al26 reported that women with polycystic ovary syndrome (an endocrine disorder that manifests hyperandrogenism) had more ADHD symptoms than did control subjects.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Herguner S Harmanci H Toy H Attention deficit-hyperactivity disorder symptoms in women with polycystic ovary syndrome Int J Psychiatry Med 2015 50 3 317 325 26449924

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Dorn et al suggested that no significant association is found between salivary T levels and children's disruptive behavior disorders (DBD).

    “In contrast, Dorn et al30 suggested that no significant association is found between salivary T levels and children’s disruptive behavior disorders (DBD).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Dorn LD Kolko DJ Susman EJ Salivary gonadal and adrenal hormone differences in boys and girls with and without disruptive behavior disorders: contextual variants Biol Psychol 2009 81 1 31 39 19428966 PMC2680777

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The inconsistency between studies might be caused by sample diversity (e.g., clinical or community sample, age distribution, and specific sex).

    “The inconsistency between studies might be caused by sample diversity (eg, clinical or community sample, age distribution, and specific sex).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some researchers have not found associations between 2D/4D ratios and ADHD features or externalizing behavior problems in children.

    “However, some researchers have not found associations between 2D/4D ratios and ADHD features or externalizing behavior problems in children.20–22”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [20] Mahone EM Why fewer females than males are diagnosed with attention-deficit-hyperactivity disorder: it might not be hormones Dev Med Child Neurol 2010 52 9 790 791 20497456

      Not checked in the free run.

    • cites [21] Lemiere J Boets B Danckaerts M No association between the 2D:4D fetal testosterone marker and multidimensional attentional abilities in children with ADHD Dev Med Child Neurol 2010 52 9 e202 e208 20491856

      Not checked in the free run.

    • cites [22] Liu J Portnoy J Raine A Association between a marker for prenatal testosterone exposure and externalizing behavior problems in children Dev Psychopathol 2012 24 3 771 782 22781854 PMC4247331

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both prenatal T exposure and postnatal T levels have been associated with developing neural circuitry and behavioral systems.

    “Both prenatal T exposure and postnatal T levels have been associated with developing neural circuitry and behavioral systems.10,11”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [10] Auyeung B Lombardo MV Baron-Cohen S Prenatal and postnatal hormone effects on the human brain and cognition Pflugers Arch 2013 465 5 557 571 23588379

      Not checked in the free run.

    • cites [11] Juraska JM Sisk CL DonCarlos LL Sexual differentiation of the adolescent rodent brain: hormonal influences and developmental mechanisms Horm Behav 2013 64 2 203 210 23998664

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Few studies have simultaneously investigated the potential roles of prenatal and postnatal T exposure on the clinical features of ADHD.

    “However, few studies have simultaneously investigated the potential roles of prenatal and postnatal T exposure on the clinical features of ADHD.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Current T level may exert neurodevelopmental effects and modify cognitive patterns, particularly among girls with ADHD.

    “we suggest that the current T level may exert its neurodevelopmental effects and modify cognitive patterns, particularly among girls with ADHD.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Higher T levels in saliva or in plasma have been observed in children with aggressive tendencies compared with those without aggressive tendencies.

    “Furthermore, higher T levels in saliva or in plasma have been observed in children with aggressive tendencies compared with those without aggressive tendencies.27–29”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [27] Scerbo AS Kolko DJ Salivary testosterone and cortisol in disruptive children: relationship to aggressive, hyperactive, and internalizing behav-iors J Am Acad Child Adolesc Psychiatry 1994 33 8 1174 1184 7982868

      Not checked in the free run.

    • cites [28] Pajer K Tabbah R Gardner W Rubin RT Czambel RK Wang Y Adrenal androgen and gonadal hormone levels in adolescent girls with conduct disorder Psychoneuroendocrinology 2006 31 10 1245 1256 17126492

      Not checked in the free run.

    • cites [29] Yu YZ Shi JX Relationship between levels of testosterone and cortisol in saliva and aggressive behaviors of adolescents Biomed Environ Sci 2009 22 1 44 49 19462687

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    T has been implicated in dominant behavior and muscular physiology change but does not necessarily cause aggression or externalized problem behaviors.

    “The possible explanation is that T has been implicated in dominant behavior and muscular physiology change but does not necessarily cause aggression or externalized problem behaviors.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [23] Nguyen TV McCracken JT Albaugh MD Botteron KN Hudziak JJ Ducharme S A testosterone-related structural brain phenotype predicts aggressive behavior from childhood to adulthood Psychoneuroendo-crinology 2016 63 109 118 PMC4695305 26431805

      Not checked in the free run.

    • cites [24] Rice TR Postnatal testosterone may be an important mediator of the association between prematurity and male neurodevelopmental disorders: a hypothesis Int J Adolesc Med Health 2017 29 2 pii 26356360

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    During this period, the activation of preformed brain structures leads to sexually dimorphic, physical, behavioral, and cognitive alterations.

    “During this period, the activation of preformed brain structures leads to sexually dimorphic, physical, behavioral, and cognitive alterations.10”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] Auyeung B Lombardo MV Baron-Cohen S Prenatal and postnatal hormone effects on the human brain and cognition Pflugers Arch 2013 465 5 557 571 23588379

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Girls with ADHD possibly were more susceptible to endogenous T exposure, which further influenced their neuropsychological performance.

    “Girls with ADHD possibly were more susceptible to endogenous T exposure, which further influenced their neuropsychological performance.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    ADHD diagnoses were established by a senior child psychiatrist based on DSM-IV-TR criteria after structured interviews using the Chinese K-SADS-E.

    “The inclusion criteria were 1) clinical diagnosis of ADHD by a senior child psychiatrist based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) after structured interviews based on the Chinese version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children, epidemiologic version (K-SADS-E);32”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Kaufman J Birmaher B Brent D Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data J Am Acad Child Adolesc Psychiatry 1997 36 7 980 988 9204677

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    High levels of prenatal T may affect the dopaminergic neural circuitry and decelerate neural development globally.

    “High levels of prenatal T may affect the dopaminergic neural circuitry and decelerate neural development globally.12”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Morris JA Jordan CL Breedlove SM Sexual differentiation of the vertebrate nervous system Nat Neurosci 2004 7 10 1034 1039 15452574

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The study lacked a control group.

    “This study has several limitations: first, this study lacked a control group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The study was cross-sectional, so causal relationships between T exposure, DBD, and neurocognitive deficits remain unclear.

    “Second, this study was performed with a cross-sectional design. The causal relationships between T exposure, DBD, and neurocognitive deficits remain unclear.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Analyses were exploratory, and correction for multiple testing was not performed; if Bonferroni correction were applied, none of the significant findings would survive.

    “Fourth, because the analyses in this study were exploratory, correction of multiple testing was not performed. However, if Bonferroni correction was performed to adjust for multiple testing in the correlation matrix (Table 3), none of the significant findings would survive.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Chinese version of the SNAP-IV parent form and the SNAP-IV teacher form have satisfactory levels of reliability and concurrent validity.

    “The Chinese version of the SNAP-IV parent form37 and the SNAP-IV teacher form38 were reported to have satisfactory levels of reliability and concurrent validity.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [37] Gau SS Shang CY Liu SK Psychometric properties of the Chinese version of the Swanson, Nolan, and Pelham, version IV scale – parent form Int J Methods Psychiatr Res 2008 17 1 35 44 18286459 PMC6878250

      Not checked in the free run.

    • cites [38] Gau SS Lin CH Hu FC Psychometric properties of the Chinese version of the Swanson, Nolan, and Pelham, Version IV Scale-Teacher Form J Pediatr Psychol 2009 34 8 850 861 19074488

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Only one saliva sample was collected per subject, lacking duplicates.

    “Moreover, we collected only one saliva sample for each subject, lacking duplicates to perform further analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Salivary T was used as a surrogate marker of postnatal T exposure, and peripheral salivary T levels may not represent T exposure in the central nervous system.

    “In addition, this study used salivary T as a surrogate marker of postnatal T exposure. The mechanisms by which postnatal T exposure during patients’ early childhood influences their current ADHD characteristics is unknown, and peripheral salivary T levels may not necessarily represent the T exposure in the central nervous system.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The Chinese version of K-SADS-E has established validity and reliability in Taiwan.

    “The validity and reliability of the Chinese version of K-SADS-E have been established in Taiwan.33”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Gau SF Soong WT Psychiatric comorbidity of adolescents with sleep terrors or sleepwalking: a case-control study Aust N Z J Psychiatry 1999 33 5 734 739 10544999

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Salivary T levels were quantified using a chemiluminescence immunoassay with intra- and interassay coefficients of variation of 2.9-7.0% and 1.5-3.2%.

    “Salivary T levels were quantified using a chemiluminescence immunoassay (IB57403; IBL-America, Minneapolis, MN, USA). The sensitivity of detection of this method was 1.0 pg/mL. The intra- and interassay coefficients of variation were 2.9%–7.0% at 21–557 pg/mL and 1.5%–3.2% at 38–541 pg/mL, respectively.”
    Quote in the paperNot a substantial claim
24 of 24

  • The authors state this as an assumption.

    CPT may be more sensitive for detecting impaired attention than SNAP-IV scores.

    “We assume that CPT may be more sensitive for detecting impaired attention than the scores of the SNAP-IV.”

  • The paper relies on this without support.

    Few studies have simultaneously investigated the potential roles of prenatal and postnatal T exposure on the clinical features of ADHD.

    “However, few studies have simultaneously investigated the potential roles of prenatal and postnatal T exposure on the clinical features of ADHD.”

  • The paper relies on this without support.

    How T influences neurocognitive function in patients with ADHD and whether there is a sex difference in the relationship between T and ADHD presentations remains poorly understood.

    “In addition, how T influences the neurocognitive function in patients with ADHD and whether there is a sex difference in the relationship between T and ADHD presentations remains poorly understood.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Prior research indicates that organizational testosterone contributes to ADHD symptoms in both sexes, especially in males.

    “Prior work suggests a role for organizational testosterone (T) in ADHD symptoms in both sexes (Wang et al., 2017), but particularly males (Martel, 2009; McFadden et al., 2005).”

    From Reproductive steroids and ADHD symptoms across the menstrual cycle (2018) · cites this paper as Wang et al., 2017

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Bonferroni claim conflicts with the reported correlation

    Major

    The reported correlation between salivary testosterone and CPT omission errors in girls (r=0.62) would have a two-sided P-value of roughly 0.00003 or less with at least 39 girls (42 enrolled, at most three with undetermined testosterone). It would survive Bonferroni correction for hundreds of comparisons, contrary to the statement that none of the significant findings would survive correction of the Table 3 correlation matrix.

1 of 1

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Related

Authors
Wang, L.-J., Chou, M.-C., Chou, W.-J., Lee, M.-J., Lee, S.-Y., Lin, P.-Y., Lee, Y.-H., Yang, Y.-H., & Yen, C.-F.
Affiliations
  • Kaohsiung Medical University (TW)
  • Chang Gung University (TW)
  • Kaohsiung Chang Gung Memorial Hospital (TW)
Corresponding author
Yen, Cheng-Fang
ORCID
Venue
Neuropsychiatric Disease and Treatment
Publisher
Informa UK Limited
Published
2017-05
Volume
Volume 13
Pages
1331-1339
ISSN
  • 1176-6328 (ISSN-L)
  • 1178-2021
DOI
10.2147/ndt.s136717
PMC
PMC5439987
OpenAlex
W2616520918
Semantic Scholar
92a9217e013600e112caaace7d63cc9745612d5c
Cited by
26
References
55
Citations by year
2025: 3 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 8 · 2017: 1
FWCI
2.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Funders
  • National Science Council (MOST 103-2314-B-182A)
  • Chang Gung Medical Foundation
  • Ministry of Science and Technology, Taiwan (MOST103-2314-B182A-017)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
attention deficit hyperactivity disorder, prenatal testosterone exposure, 2D:4D digit ratio, salivary testosterone, sex differences, disruptive behavior disorders, neurocognitive function, perceptual reasoning, continuous performance test, children

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