Rosh Psychiatry Board Practice Exam

In a patient with a history of conduct disorder, which hormone level is most likely to be abnormal?

1. Cortisol

2. Glucagon

3. Insulin

4. Thyroxine

The correct answer is: Cortisol

Cortisol is a hormone produced by the adrenal glands that plays a significant role in the body's response to stress. In individuals with a history of conduct disorder, research has indicated that dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis can occur. This can lead to altered cortisol levels, which may manifest as either elevated or diminished cortisol in response to stressors. The association between stress and behavioral issues, including aggression and defiance characteristic of conduct disorder, supports the likelihood that cortisol levels would be abnormal in these patients. In contrast, the other hormones mentioned—glucagon, insulin, and thyroxine—do not have a direct and well-established link to conduct disorder. Glucagon primarily regulates blood sugar levels, often in response to fasting, whereas insulin is involved in glucose metabolism and may be more relevant in contexts of metabolic disorders rather than psychiatric conditions. Thyroxine is a thyroid hormone crucial for metabolism and energy regulation, with disturbances generally associated with thyroid disorders rather than conduct disorder specifically. Thus, among the options provided, abnormal cortisol levels are the most closely associated with conduct disorder.