Killer Cortisol: How hormones drive violent behaviors and a suggestion for change.

In the wake of yet another tragic school shooting (the 18th school shooting in 2018) at Marjory Stoneman Douglas High School in Parkland, Florida, where young lives have been lost, and friends and families have been violently ripped apart, perhaps it's time we took a closer look at prevention beyond the highly politicized gun issue. 

For me, prevention begins at the hormonal level. I should note (with full disclosure of my own bias) that as a physiologist, I am strongly inclined to believe that our hormones regulate our behaviors nearly exclusively.  Further, as a stress physiologist, my main focus has been on the stress hormone cortisol (CORT). And so this is where  I began to re-explore how cortisol is involved in social aggression and what factors we might be able to control to better regulate cortisol production in teenagers.

In an age when profiling is commonly used to help investigators identify “would-be” perpetrators, I decided to piece together my own profile–of the hormonal variety–for school shooters.

One of the most striking commonalities of all school shootings (and most mass shootings in general) is that the shooters tend to be male. My interest in this is piqued by the driving male sex hormone, testosterone, that is intimately linked with cortisol in eliciting aggressive social behaviors.

Consider that school shootings often occur around the time of puberty–a time when these young men are experiencing a major surge of testosterone. Recent research (see also: Glenn et al., 2011; Mehta et al., 2008; Mehta and Josephs, 2010; Pajer et al., 2006; Popma et al., 2007) suggests that premeditated violent behaviors might be predicted by the testosterone/cortisol ratio (T/CORT).

High T elevates gene expression at the amygdala (a section of the brain whose functions include aiding in decision-making and emotional responses), increasing the probability of an aggressive interaction.

Interestingly, an excess of CORT promotes a different type of gene expression in the amygdala resulting in fear/anxiety and behavioral withdrawal (Schulkin, 2007; Schulkin et al., 1998).

High T, fight. High CORT, flight.

But it’s the ratio of the two that drives the most interesting behaviors. A neurobiological profile of low CORT and high T levels would predispose an individual toward aggressive social behaviors–dulling their fearful withdrawal response and avoidance motivation while increasing the tendency for an aggressive approach.

In chronically stressful conditions, CORT levels are high, often leading to social withdrawal and anxiety. What might some of those chronically stressful conditions look like? Probably pretty similar to those environments that we hear about in the stories of shooters (social rejection/alienation/bullying). With chronic exposure to high CORT, the cortisol response feeds back and ultimately will dampen, setting up the conditions for the low CORT, high T hormonal profile that drives social aggression.

So what do we do?

We may not be able to control the leap in testosterone at puberty, but what if we could mediate the behavioral effects it has on aggression by changing the cortisol profiles of teenagers?

In a study of 113 late-adolescent male offenders, high testosterone was positively correlated to more violent crimes but only when offenders also demonstrated low CORT levels. Those with high T and CORT levels did not demonstrate a relationship between T and aggression.

We need to find a way to balance out cortisol.

My best suggestion?

Let’s get meditation into every school in the country.

Study after study continue to demonstrate the positive effects meditation has on lowering cortisol (and improving overall health, happiness, social anxiety, etc.). 

If you’re confused about why we need to lower cortisol, you aren’t alone. Everything I’ve suggested above shows that low CORT in combination with high T is the problem, not the solution!

The trick here is understanding that those low CORT profiles are likely the result of adrenal exhaustion–a cycle of chronic stress, with an overproduction of high cortisol leading up to a lack of responsiveness and low CORT.

The difference between this unhealthy dampened response of CORT and a healthy low CORT profile is the key.

We have to break the chronic stress cycle early so these teenagers never experience the dampened response. A healthy low CORT profile would allow a rapid rise in cortisol levels at appropriate times, modulating the effects of high T.

As Dabbs et al. (1991) suggest, CORT is a “biological predictor of psychological variables (e.g., social withdrawal) that moderates the testosterone-behavior relationship.”

In other words, control CORT and you might be able to control the chaos.

Instead of arming teachers with firearms, let’s see if first we can get hormones firing differently with simple, scientifically valid, and free techniques. I'm not saying it's a catch all solution, and certainly meditation is only one component of a broader plan that needs to be implemented to improve the health and lives of our children - but why not start here?

It costs nothing

Meditate on it… and then tell me why something this simple isn’t being implemented posthaste?

Children’s lives are at stake.  

What are we waiting for?