A systematic review of the relationship between cortisol, testosterone, and aggression in children and adolescents

Aggression, influenced by biological, psychological, and environmental factors, poses a significant public health concern. This paper reviews the hormonal influences on youth aggression, focusing on cortisol and testosterone. Employing PRISMA guidelines, we systematically searched major databases to identify relevant studies involving children and adolescents. Among the 79 articles that met the inclusion criteria, the findings were predominantly non-significant or mixed. Significant results suggest a modest correlation between testosterone and aggression specifically in adolescents. Cortisol demonstrated a more complex pattern, with low cortisol levels associated with increased aggression in adolescents, particularly in males, while findings in younger children were less conclusive. The interaction between testosterone and cortisol in relation to aggression also varied; high testosterone and low cortisol were linked to increased aggression in adolescent samples. These results highlight the intricate interplay of hormonal influences on aggression, modulated by age and sex. The observed association between elevated testosterone and aggression in adolescence aligns with testosterone's role in status-driven behaviors. Consistent with the dual-hormone hypothesis, the influence of testosterone on aggression appears to be moderated by cortisol levels, suggesting adolescence as a critical period for targeted interventions. Future research should prioritize longitudinal studies to clarify these relationships and further test the dual-hormone hypothesis across developmental stages.