title: Reduced cortisol in boys with early-onset conduct disorder and callous-unemotional traits.
abstract: BACKGROUND
  A growing body of evidence suggests an association between altered hypothalamic-pituitary-adrenal axis reactivity and the development of persistent antisocial behavior in children. However the effects of altered cortisol levels remain poorly understood in the complex context of conduct disorder, callous-unemotional (CU) personality traits, and frequent comorbidities, such as attention deficit hyperactivity disorder (ADHD). The aim of the current study was to investigate associations among CU traits, antisocial behavior, and comorbid ADHD symptomatology with cortisol levels in male children and adolescents.
  
  
  METHODS
  The study included 37 boys with early-onset conduct disorder (EO-CD, mean age 11.9 years) and 38 healthy boys (mean age 12.5 years). Participants were subjected to multiple daytime salivary cortisol measurements and a psychometric characterization.
  
  
  RESULTS
  Subjects in the EO-CD group with elevated CU traits showed a diminished cortisol awakening response compared to healthy participants. In the EO-CD group, high CU traits and impulsivity were associated with decreased diurnal cortisol levels, while associations with antisocial behavior were not detected. The cortisol awakening response was significantly inversely associated with hyperactivity (P = 0.02) and marginally significant with CU traits (P = 0.07).
  
  
  CONCLUSIONS
  These results indicate a specific association between CU traits and a diminished stress response, which is not explained by antisocial behavior in general.
authors.affiliation: Department of Child and Adolescent Psychiatry, Medical Faculty, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany.
authors.forename: Georg G
authors.initials: GG
authors.lastname: von Polier
authors.forename: Beate
authors.initials: B
authors.lastname: Herpertz-Dahlmann
authors.forename: Kerstin
authors.initials: K
authors.lastname: Konrad
authors.forename: Kristine
authors.initials: K
authors.lastname: Wiesler
authors.forename: Jana
authors.initials: J
authors.lastname: Rieke
authors.forename: Monika
authors.initials: M
authors.lastname: Heinzel-Gutenbrunner
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Bachmann
authors.forename: Timo D
authors.initials: TD
authors.lastname: Vloet
mesh_terms: D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity; D002648:Child; D019955:Conduct Disorder / Q000188:drug therapy* / Q000473:pathology; D004645:Empathy / Q000187:drug effects*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage*; D008297:Male
chemical_list: D006854:Hydrocortisone