Aggression in ADHD: relation to salivary cortisol (original) (raw)
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Salivary cortisol and aggression in a population-based longitudinal study of adolescent males
Journal of Neural Transmission, 2005
Chronic antisocial behaviour in youth has been associated with cortisol, a measure of stress reactivity. However, some studies have found low cortisol levels, while others have found elevated cortisol levels. The present study compared variously defined aggressive subgroups for differences in salivary cortisol. A population-based sample of boys was followed longitudinally from childhood to adolescence. Assessments of different forms of antisocial behaviour were obtained from various informants at several points in time, and cortisol was collected at age 13. Higher cortisol levels were found in boys with conduct disorder (CD) than in boys without CD. In addition, boys with an aggressive form of CD had higher cortisol levels than boys who showed a covert form of CD. Furthermore, reactive aggression was strongly correlated with elevated cortisol. Adolescent boys with chronic reactive aggression and those who scored high on aggressive CD symptoms seem to have a more active hypothalamic-pituitary-adrenal system.
Psychiatry Research, 2011
There is a body of literature demonstrating an association between altered hypothalamic pituitary adrenal (HPA) axis reactivity and aggressive behavior. Aggressive and disruptive behavior also is highly prevalent in children with attention deficit/hyperactivity disorder (ADHD). Findings on HPA-axis reactivity in ADHD, however, are rather inconsistent. Specific temperamental risk factors previously were associated with a specific subtype of severe disruptive behavior. These traits might also be characterized by a distinct neurobiological profile across ADHD and disruptive behavior disorders. In this study we focus on psychopathic traits, notably callous unemotional (CU) traits. The main objective of the present study was to investigate whether two groups of ADHD patients with high or low CU traits differed in cortisol reactivity. Subjects were 36 boys with ADHD and disruptive behavior symptoms aged 8 to 14 years. Salivary cortisol probes were taken before and repeatedly after an experimental standardized stress test. Patients scoring high on CU traits showed a blunted HPA axis reactivity to the experimentally induced stress. Results underscore the need to consider specific personality traits in investigating neurobiological correlates in ADHD with disruptive behavior problems.
The aetiological association between the dynamics of cortisol productivity and ADHD
Journal of neural transmission (Vienna, Austria : 1996), 2016
Attention-deficit/hyperactivity disorder (ADHD) has been linked to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, indexed by salivary cortisol. The phenotypic and aetiological association of cortisol productivity with ADHD was investigated. A selected twin design using 68 male twin-pairs aged 12-15, concordant or discordant for high ADHD symptom scores, or control twin-pairs with low ADHD symptoms, based on developmentally stable parental ADHD ratings. A genetic growth curve model was applied to cortisol samples obtained across three points during a cognitive-electroencephalography assessment, to examine the aetiological overlap of ADHD affection status (high versus low ADHD symptom scores) with latent intercept and slope factors. A significant phenotypic correlation emerged between ADHD and the slope factor, with cortisol levels dropping faster for the group with high ADHD symptom scores. The analyses further suggested this overlap was mostly driven by correlated g...
Cortisol levels in children with Attention-Deficit/Hyperactivity Disorder
Journal of Psychiatric Research, 2012
Regulation of the HypothalamusePituitaryeAdrenal axis (HPA-axis) and its end product cortisol differs among persons with certain psychiatric disorders when compared with controls. Some reports concern Attention-Deficit/Hyperactivity Disorder (ADHD) but findings are inconclusive. In this study we collected four saliva samples during a regular weekday in children, 6e17 years old, with ADHD (n ¼ 201) and nonaffected comparisons (n ¼ 221). Saliva cortisol was measured with radioimmunoassay technique. Clinical data were collected for diagnostic information. Subtypes and severity of symptoms were determined using parental rating scales. Children with ADHD had lower saliva cortisol levels than comparisons at waking up Median ¼ 9.1 versus 12.7 nmol/L (p < .001), 30 min later Median ¼ 15.8 versus 20.1 nmol/L (p < .001) and before going to bed Median ¼ 0.8 versus 1.0 nmol/L (p ¼ .015). No difference was found for the afternoon sample. When the study group was split into three different age groups similar results were found only for children above 10 years of age. Subtype of ADHD or co-occurring symptoms did not affect the cortisol levels. Degree of severity of ADHD symptoms was not associated with cortisol levels in the study group, other than a weak negative correlation between the afternoon sample and hyperactivity symptoms. The low cortisol levels in children with ADHD may indicate a dysregulation of the HPA-axis, for instance a down-regulation or a phase delay of the diurnal curve. The low levels may be related to the under-arousal possibly underlying several of the core symptoms of ADHD.
Low basal salivary cortisol is associated with teacher-reported symptoms of conduct disorder
Psychiatry Research, 2005
Cortisol has been implicated in psychobiological explanations of antisocial behavior. This study measured basal salivary cortisol in a sample of 25 children (age range 6 to 12 years) selected to vary in levels of antisocial behavior. Regression analyses were used to predict cortisol concentrations from parent-and teacher-reported symptoms. Parent-reported symptoms did not predict basal cortisol. Teacher-reported conduct disorder (CD) symptoms explained 38% of the variance in the cortisol concentrations, with high symptom severity associated with low cortisol. When a distinction was made between aggressive and non-aggressive CD symptoms, aggressive CD symptoms were more clearly related to low cortisol than non-aggressive CD symptoms. In contrast to previous research, no evidence was found for a mediating role of anxiety symptoms in the relationship between CD and cortisol. The results support biologically based models of antisocial behavior in children that involve reduced autonomic activity. D
Journal of Pediatric Psychology, 2011
Objective To compare salivary cortisol baseline levels and responsivity as well as behavioral distress to intravenous (IV) catheter insertions in 4-to 10-year-old children with (n ¼ 29) and without (n ¼ 339) attention-deficit/hyperactivity disorder (ADHD). Methods This is a secondary data analysis from a sample of 542 children who participated in a multisite study on distraction. Data included were demographic variables, Pediatric Behavior Scale-30, Observational Scale of Behavioral Distress-Revised, and four salivary cortisol samples. Results Home samples from the ADHD group revealed nonsignificant but higher cortisol levels than the non-ADHD group. However, on the clinic day, the ADHD group had significantly lower cortisol levels before (0.184 vs. 0.261, p ¼ .040) and 20-30 min after IV insertion (0.186 vs. 0.299, p ¼ .014) compared with the non-ADHD group. Conclusions Cortisol levels in children with and without ADHD differ in response to the stress of an IV insertion.
Psychoneuroendocrinology, 2018
There is growing evidence for dysregulation of the stress system in individuals with Attention Deficit Hyperactivity Disorder (ADHD). The stress system includes neuroanatomical and functional components that function in concert to maintain homeostasis and its main effectors are the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic/adrenomedullary nervous system (SNS). As stress system activity demonstrates a distinct circadian variation, we aimed to describe simultaneously, diurnal rhythms of both the HPA axis and the SNS in children with ADHD and a comparison group. Moreover, we attempted to investigate stress responses to a physical stressor, venipuncture, in both groups. Sixty-two prepubertal children with ADHD combined (ADHD-C) or inattentive (ADHD-I) type and 40 typically developing children provided saliva samples at six specific time points during a day, as well as before and 10 min after a scheduled morning venipuncture. Salivary cortisol and α- amylase were sele...
Translational Psychiatry, 2021
Several studies reported abnormal cortisol and inflammatory biomarker levels in youths with attention deficit hyperactivity disorder (ADHD), but the results have not been conclusive. We conducted a systematic review followed by a meta-analysis of case-control studies assessing blood or saliva cortisol levels and blood levels of inflammatory biomarkers in youth with ADHD. The effect sizes (ES) were synthesized by using a random-effects model. In the 19 studies on cortisol levels (totaling n = 916 youth with ADHD and n = 947 typically developing (TD), healthy youth), youth with ADHD have lower basal cortisol levels at any time-points during the day (effect size: .68; p = 0.004) and lower cumulative levels of cortisol (ES: .39, p = .008) throughout the day than TD youth. Moreover, morning cortisol levels were lower in ADHD youth when compared with TD youth (14 studies, n = 1679, ES: .84, p = 0.003), while there is no difference for the afternoon cortisol levels (p = 0.48). The meta-analysis on inflammation biomarker was conducted on 4 studies (totaling n = 404 youth) showed that Tumour Necrosis Factor-alpha (TNF-α) was lower in ADHD when compared with TD (3 studies, n = 257 youth, p = 0.004), while no differences for Interleukin-1β(IL-1β) (p = 0.21), IL-6 (p = 0.09) and IL-10 (p = 0.77). The lower cortisol in the context of low TNF-α levels may indicate a specific pattern of biomarkers in ADHD, and further investigation is warranted.
A study of cortisol level as a biological marker in disruptive aggressive behaviour in adolescence
Benha Medical Journal, 2023
Background: Adolescence is usually associated with the teenage years, but its physical, psychological or cultural expressions may begin earlier and end later. Aggression is a behavior whose primary or sole purpose or function is to injure physically or psychologically. Aim and objectives: To demonstrate that high cortisol level in relation with the comorbidity of substance abuse and the duration of abuse in the conduct group. Patients and methods: This study was conducted on 50 aggressive patients with disruptive aggressive behaviors, attending the adolescent outpatient clinic at Alabbassia Mental hospital, who in turn divided into two groups one of conduct disorder and the other of Oppositional Defiant disorder and 25 resembling the control group during the period from March 2019 to February 2020. Results: Patients with conduct disorder showed statistically significant difference between the cortisol level and the comorbidity of substance abuse and the duration of abuse (by years) (P<0.05). While in the ODD group, there was statistically significant difference between the cortisol level and the gender and the age of the adolescent (P<0.05). Conclusion: Cortisol level is higher in the disruptive aggressive adolescents than that of the control group participating in the current study, moreover it was higher in those with conduct than ODD groups. It was demonstrated that high cortisol level in relation with the comorbidity of substance abuse and the duration of abuse in the conduct group.
The Effect of Family Training on Salivary Cortisol in Children with Disruptive Behavior Disorder
Iranian journal of psychiatry and behavioral sciences, 2008
Basal cortisol is a valuable biological marker in children with disruptive behavior disorder (DBD). To investigate the association between biological factor (cortisol) and disruptive behaviors, we studied the effect of family training on salivary cortisol level in children with DBD. Methods: Basal salivary cortisol levels were studied in 19 children with DBD, (aged 8-13 years old) prior and 2 months after the treatment. The disruptive behavior of the child was also assessed by Child Behavior Checklist (CBCL), before and 2 months after treatment. Results: Children with lower basal cortisol level had more sever behavioral problems. Surprisingly, this group had a better response to family therapy. Conclusion: Parental training is an effective method for behavioral modification of children with DBD. Salivary cortisol can be considered as a biological marker for the severity of disruptive behavior and response to therapy.