Cortisol reactivity in boys with attention-deficit/hyperactivity disorder and disruptive behavior problems: The impact of callous unemotional traits (original) (raw)

Aggression in ADHD: relation to salivary cortisol

Middle East Current Psychiatry, 2021

Background Study of cortisol levels in patients with ADHD in correlation with aggressive behaviors associated with ADHD has received limited research attention. This factor is essential for comprehending the psychopathophysiology of ADHD and its comorbidities. The present study aimed to investigate the cortisol level in ADHD children and its relation to severity of symptoms and associated aggressive behavior in those children. The sample consisted of 129 patients and 80 healthy controls evaluated by administering the Mini International Neuropsychiatric Interview for Children, The Wechsler Intelligence Scale for Children, Conners’ parent rating scale, problem scale of C.B.C.L., and Socioeconomic Status Scale. Salivary cortisol was measured using radio-immune assay. Results Salivary cortisol level in our ADHD subjects was significantly lower (11.826 ng/ml) than in the control group (19.619 ng/ml with P-value 0.001). Our results failed to find any correlation between ADHD symptoms seve...

Cortisol, callous-unemotional traits, and pathways to antisocial behavior

Current Opinion in Psychiatry, 2009

Two decades of research has implicated the hypothalamic-pituitary-adrenal (HPA) axis in the development of antisocial behavior in children. However, findings regarding the association between cortisol and antisocial behavior have been largely inconsistent, and the role of the HPA axis in relation to broader etiological processes remains unclear. We examine evidence that the role of the HPA axis in the development of antisocial behavior may differ across subgroups of children.

Adrenocortical Functioning in Boys with Attention-Deficit/Hyperactivity Disorder: Examining Subtypes of ADHD and Associated Comorbid Conditions

Journal of Abnormal Child Psychology, 2009

Disruptions to hypothalamic-pituitary-adrenal (HPA) axis function have been associated with varying forms of psychopathology in children. Studies suggesting children with ADHD have blunted HPA function have been complicated by the prevalence of comorbid diagnoses and heterogeneity of ADHD. The goals of this research were to assess the relations between waking and stress-response salivary cortisol levels and comorbid disruptive behavior (DBD) and anxiety (AnxD) disorders and problems in boys with ADHD, and to examine whether cortisol levels varied across ADHD subtypes. One hundred seventy elementary school-age boys with ADHD provided salivary cortisol at waking and in reaction to venipuncture. Parent reports were used to assess boys' psychiatric diagnoses and severity of behavioral problems. Boys' comorbid AnxD and anxiety problems were associated with greater cortisol reactivity, whereas boys' comorbid DBD and oppositional problems predicted diminished adrenocortical activity. Reactive cortisol increases were greatest in boys with ADHD and comorbid AnxD, but without DBD. ADHD subtypes were not differentially associated with waking, pre-stress baseline, or reactive cortisol levels. However, comorbid DBD predicted decreased cortisol reactivity in boys with inattentive and hyperactive subtypes of ADHD, but not in boys with combined subtype of ADHD. The results clarify previous patterns of distinct and divergent dysregulations of HPA function associated with boys' varying kinds of psychopathology.

Callous-unemotional traits, low cortisol reactivity and physical aggression in children: findings from the Wirral Child Health and Development Study

Translational Psychiatry, 2019

Callous-unemotional (CU) traits are thought to confer risk for aggression via reduced amygdala responsivity to distress cues in others. Low cortisol reactivity is thought to confer risk for aggression via reduced arousal and this effect may be confined to boys. We tested the hypothesis that the association between childhood CU traits and aggression would be greatest in the absence of the inhibitory effects of cortisol reactivity, and that this effect would be sex dependent. Participants were 283 members of a stratified subsample within an epidemiological longitudinal cohort (WCHADS). Cortisol reactivity to a social stressor was assessed at 5 years. CU traits were reported by mothers at 5 years, and physical aggression by mothers and teachers at age 7. Results showed that CU traits were associated with elevated aggression at 7 years controlling for earlier aggression. There was no main effect of cortisol reactivity on regression. The association between CU traits and aggression was moderated by cortisol reactivity (p = .011) with a strong association between CU traits and aggression in the presence of low reactivity, and a small and non-significant association in the presence of high reactivity. This association was further moderated by child sex (p = .041) with the joint effect of high CU traits and low cortisol reactivity seen only in boys (p = .016). We report first evidence that a combined deficit in inhibitory processes associated with CU traits and low cortisol reactivity increases risk for childhood aggression, in a sex-dependent manner.

Hypothalamic Pituitary Adrenal Axis Functioning in Reactive and Proactive Aggression in Children

Journal of Abnormal Child Psychology, 2009

Methods-Forty-six subjects with DD without lifetime PTSD, 35 subjects with PTSD, and 58 HC subjects, free of current major depression, were studied as inpatients. After a 24-hour urine collection and hourly blood sampling for ambient cortisol determination, a low-dose dexamethasone suppression test was administered, followed by the Trier Social Stress Test.

Does the cortisol response to stress mediate the link between expressed emotion and oppositional behavior in Attention-Deficit/Hyperactivity-Disorder (ADHD)?

Behavioral and Brain Functions, 2010

Background: Expressed Emotions (EE) are associated with oppositional behavior (OPB) in children with Attention Deficit/Hyperactivity Disorder (ADHD). EE has been linked to altered stress responses in some disorders, but ADHD has not been studied. We test the hypothesis that OPB in ADHD is mediated by altered stress-related cortisol reactivity to EE. Methods: Two groups of children (with/without ADHD) and their respective parents were randomly assigned to two different conditions with/without negative emotion and participated in an emotion provocation task. Parents' EE, their ratings of their children's OPB and their children's salivary cortisol levels were measured. Results: Low parental warmth was associated with OPB in ADHD. High levels of parental EE elicited a larger cortisol response. Stress-related cortisol reactivity mediated the EE-OPB link for all children. This highlights the general importance of parent-child interactions on externalizing behavior problems. Conclusion: High EE is a salient stressor for ADHD children that leads to increased levels of cortisol and OPB. The development of OPB might be mediated by the stress-response to high EE.

Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

European Child & Adolescent Psychiatry, 2009

Some evidence suggests that the HPA axis may be dysfunctional in children with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to investigate whether a different pattern of HPA axis activity is found between the inattentive (I) and combined (C) subtypes of ADHD, in comparison with healthy control children. A total of 100 prepubertal subjects [52 children with ADHD combined type (ADHD-C), 23 children with ADHD predominantly inattentive type (ADHD-I), and 25 healthy control subjects] were studied. The effects of stress were studied by comparing cortisol responses to a psychosocial stressor, consisting of a public speaking task. Children with ADHD-I showed an elevated cortisol response to the psychosocial stressor, in contrast to children with ADHD-C who showed a blunted cortisol response to the psychosocial stressor. When a distinction was made between responders and non-responders (a subject was classified as a responder when there was an increase in cortisol reactivity), hyperactivity symptoms were clearly related to a lower cortisol reactivity to stress.

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.

Callous–unemotional traits in conduct disorder in relation to salivary cortisol level

Egyptian Journal of Psychiatry, 2017

Objectives To show the correlation between items of Callous Unemotional Inventory (CUI) and Conduct Disorder and to assess correlation between salivary cortisol and Conduct Disorder. Background Emerging evidence suggests that low levels of cortisol may act as a biological marker for the Callous Unemotional traits (CU Traits) subgroup of Conduct Disorder. Materials and methods The current study tested the presence of items of Callous Unemotional Inventory (CUI) and the salivary cortisol level among group of patients with Conduct Disorder (Forty patients from 12 to 16 years old, diagnosed according to criteria of DSM IV and recruited from Kasr El Aini Psychiatric hospital) and group of control (Forty healthy volunteers). Both groups were subjected to Callous Unemotional traits Inventory and salivary cortisol level was assessed using ELISA. Results Patient group showed high levels of CU traits compared to control group. Patient group showed significant difference in salivary cortisol level (mean is 3.188 ±1.1108) compared to control group (mean is 5.01±1.846).This study found correlation between Callous traits and severity of Conduct Disorder. Conclusion The current findings build upon recent research in suggesting that low cortisol level may be a biological marker for patients with Conduct Disorder and high levels of CU traits.