title: High self-perceived stress and many stressors, but normal diurnal cortisol rhythm, in adults with ADHD (attention-deficit/hyperactivity disorder).
abstract: Attention-deficit/hyperactivity disorder (ADHD) in adults is associated with significant impairment in many life activities and may thus increase the risk of chronic stress in everyday life. We compared adults with a DSM-IV ADHD diagnosis (n=28) with healthy controls (n=28) regarding subjective stress and amounts of stressors in everyday life, diurnal salivary cortisol in the everyday environment and salivary cortisol before and after cognitive stress in a laboratory setting. The association between cortisol concentrations and impulsivity was also investigated. Consistent with assumptions, individuals with ADHD reported significantly more self-perceived stress than controls, and subjective stress correlated with the amount of stressors in everyday life. The two groups were comparable with respect to overall diurnal cortisol levels and rhythm, as well as in pre- and post-stress cortisol concentrations. Post-stress cortisol (but not baseline cortisol) concentration was positively correlated with impulsivity. The group with high post-stress cortisol also reported more symptoms of depression and anxiety, as well as self-perceived stress and stressors in every-day life. The diagnosis of ADHD significantly increased the risk of belonging to the group with high post-stress cortisol levels. The results in this study warrant a focus not only on the primary diagnosis of ADHD, but also calls for a broader assessment of stressors and subjective stress in everyday life, as well as support comprising stress management and coping skills.
authors.affiliation: Department of Molecular Medicine and Surgery, Centre for Molecular Medicine L8:02, Karolinska Institute/Karolinska University Hospital, Stockholm, Sweden. Tatja.Hirvikoski@ki.se
authors.forename: Tatja
authors.initials: T
authors.lastname: Hirvikoski
authors.forename: Torun
authors.initials: T
authors.lastname: Lindholm
authors.forename: Anna
authors.initials: A
authors.lastname: Nordenström
authors.forename: Anna-Lena
authors.initials: AL
authors.lastname: Nordström
authors.forename: Svetlana
authors.initials: S
authors.lastname: Lajic
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000378:metabolism* / Q000523:psychology; D002940:Circadian Rhythm / Q000502:physiology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007175:Impulsive Behavior / Q000523:psychology; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000378:metabolism* / Q000523:psychology*; D055815:Young Adult
chemical_list: D006854:Hydrocortisone