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A basic understanding of how endocrine dysfunction affects the central nervous system is important for a majority of cases referred for assessment by clinical neuropsychologists. Beyond playing a role in assessment and management in more obvious scenarios, such as pituitary adenoma and Graves' disease, increasing attention is being paid to the role of neuropsychology in assessment and management of cognitive dysfunction due to illnesses with direct or indirect effects on the endocrine system and, secondarily, the central nervous system. This chapter discusses principal syndromes of the neuroendocrine system, disorders involving the thyroid hormones, diabetes mellitus, disorders involving the reproductive hormones, disorders involving the adrenal hormones, and melatonin.

This chapter describes fear and its neuroendocrine regulation. It specifically highlights the role of elevated cortisol and corticotropin-releasing hormone (CRH) in the regulation of fear responses, placing a particular emphasis on the central nucleus of the amygdala and the bed nucleus of the stria terminalis. It starts with a discussion of the central motive state of fear and its biological basis. It then discusses the neural circuitry that underlies the perception of fearful events and fear-related behaviors. Next, it presents a description of the neuroendocrine basis of fear and a discussion of glucocorticoids and CRH in sustaining fear-related behaviors. Moreover, it evaluates the role of norepinephrine and epinephrine in facilitating responses to and memory of aversive events. It is showed that neuropeptides such as CRH chemically code the sense of fear that is sustained by elevated cortisol and that may underlie the excessively shy, fearful child's hyperexcitable central state.

This chapter explores the influences of hormones on brain development and how these effects have implications for understanding the development of both shyness and disease. It reviews studies of hormone action that illuminate these principles and illustrate the rapidly increasing understanding of the lifelong interactions between genes and environment as they affect the progression toward disease. The data presented display some of the new information indicating that the brain is a plastic and ever-changing organ of the body and is very much influenced by life experiences. It appears very likely that the condition of extreme fear and shyness offers to a lifelong pattern of allostatic load and that structural and functional correlates will be found to exist in the brains of those individuals who are extremely shy and fearful.