498 Chapter 13in antisocial behavior, which was linked to de-
pression. This research is consistent with the
idea that men and women manifest depression
in different ways. In this study, low testosterone
levels were associated with the more stereotypi-
cal female form of depression, whereas high
levels were associated with the more stereotypi-
cal male form of distress—acting-out behavior.
A more recent theory of hormonal influ-
ences on depression has focused on oxytocin.
Oxytocin increases during puberty and has
been shown to promote affiliative behavior
(Campbell, 2010). In experimental research,
the administration of intranasal oxytocin in-
creased trust during a game with a stranger
(Kosfeld et al., 2005), maintained trust when
it was violated (Baumgartner et al., 2008), in-
creased generosity (Zak, Stanton, & Ahmadi,
2007), and improved the recognition of happy
faces (Marsh et al., 2010). Likewise, displays
of affiliative behavior, such as touch, have
been associated with the release of oxytocin
(Holt-Lunstad, Birmingham, & Light, 2008).
Affiliative behavior, however, should
not lead to depression. But, affiliative behav-
ior could interact with some of the events
during adolescence to place women at risk for
depression. Specifically, changes in oxytocin
regulation during puberty may cause females
to be more reactive to interpersonal stressors
(Klein, Corwin, & Ceballos, 2006). Research
has linked oxytocin to relationship difficul-
ties (Taylor et al., 2006; Taylor, Saphire-
Bernstein, & Seeman, 2010). However, the
direction of the relation is not clear. Do high
levels of oxytocin cause greater relationship
difficulties, or do relationship difficulties lead
to elevated levels of oxytocin?
Thus, it appears that interpersonal
stress increases oxytocin, which then pro-
motes affiliative behavior and prosocial be-
havior, both of which could reduce distress.
So, how does oxytocin enter into the relationin hormones during puberty are associated
with the onset of depression in adolescent
females (Nolen-Hoeksema & Girgus, 1994).
Hormones may interact with other environ-
mental factors, supporting the interactive
theory of depression. For example, some re-
search suggests that hormonal changes dur-
ing puberty alter the way the body responds
to stress in females (Stroud et al., 2004).
Aside from the hormonal changes that
occur during puberty, researchers have at-
tempted to link hormonal changes at other
times in women’s lives to depression. Fluc-
tuations in women’s hormones, in particu-
lar estrogen, prior to menstruation and after
the birth of a child are related to depression,
but these effects are not nearly large enough
to account for the sex difference in depres-
sion. One study observed that depression
increased as women transitioned through
menopause and then decreased after meno-
pause (Freeman et al., 2006). These changes
in hormones were associated with the in-
crease in depression that occurred during
menopause. However, another study was
unable to link the decline in estrogen in the
elderly to depression (Erdincler et al., 2004).
In sum, it has been difficult to link increases
in female hormones to depression. It seems
more likely that a general pattern of hor-
monal fluctuation is related to depression.
Some research has focused on the pro-
tective effects of male hormones, specifically
testosterone, in regard to depression. How-
ever, even that relation is not a simple one. In
one study, testosterone showed a curvilinear
relation to depression, such that people with
extremely low or extremely high levels of tes-
tosterone were depressed (Booth, Johnson, &
Granger, 1999). The relation of high testoster-
one to depression appeared to be accounted
for by its relation to antisocial behavior. High-
testosterone men were more likely to engageM13_HELG0185_04_SE_C13.indd 498 6/21/11 12:55 PM