Testosterone and explosive aggression in autism spectrum disorders

Autism spectrum disorders (ASD) are a set of heterogeneous neurodevelopmental conditions, characterized by early-onset difficulties in social communication and unusually restricted, repetitive behavior and interests. Children with ASD have a high rate of irritability and aggressive symptoms which have significant impact on their lives, families and society. The etiology of aggression in humans is likely complex and includes both biological and behavioral causes. Biological approaches have focused on hormones and neurotransmitters that are hypothesized to contribute to the etiology and clinical manifestation of aggressive behavior in humans. Testosterone is a male sex hormone and some studies suggest that it can play a role in the complex etiology of aggressive behavior. Two specific subtypes of aggression have been identified: explosive and non-explosive. Explosive aggression is accompanied by a raged affect and is usually more dangerous and not immediately responsive to behavioral treatment. In our review we would like to provide current findings and discuss potential limitation of research in this area. We propose to determine bio-behavioral model of explosive aggression in children with ASD which will predict which children will be most responsive to potential antiandrogen therapy and behavioral therapy.