Development and Psychopathology


Association between a marker for prenatal testosterone exposure and externalizing behavior problems in children

Jianghong Liua1, Jill Portnoya1 and Adrian Rainea1 c1

a1 University of Pennsylvania


Prenatal androgen exposure has been associated with aggressive behavior in adults. It is less clear whether this association holds for childhood externalizing behavior. This study tests the hypothesis that increased prenatal androgen exposure is associated with aggressive behavior and attention problems in childhood. The ratio of the length of the second finger digit relative to the fourth digit, which is a marker for prenatal testosterone exposure, was assessed in 239 male and female fifth grade schoolchildren from Jintan, China, together with parent and teacher ratings of aggression and attention problems. Increased aggression and attention problems were both significantly associated with a lower ratio of the length of the second finger digit relative to the fourth digit ratios in boys but not girls. The effects remained significant after controlling for early adversity. These findings are the first to establish a relationship between an indirect indicator of fetal androgen exposure and any child psychopathology in Chinese children, and the observed effect size in boys was stronger than in male adults in Western studies. The results provide limited cross-cultural support for the importance of prenatal androgen exposure in contributing to the development of externalizing behavior problems in children, and they suggest that such effects may be specific to boys who may be relatively more vulnerable to early prenatal influences.

(Online publication July 02 2012)


c1 Address correspondence and reprint requests to: Adrian Raine, Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, 3809 Walnut Street, Philadelphia, PA 19104; E-mail:


This study was funded by the National Institute of Environment Health Sciences (K01-ES015 877, R01-ES018858, 1K02ES019878-01), the Jintan City Government, and Jintan Hospital, China. Thanks are extended to the participating children and their families from Jintan City and to the Jintan Cohort Study Group. We also thank our research assistants Yin Lo, Barbra Dickerman, and Genmei Jia for involvement in data collection and Xiaoyang Ma and Sophie R. Zhao for statistical assistance.