Cortisol levels at baseline and under stress in adolescent males with attention-deficit hyperactivity disorder, with or without comorbid conduct disorder.
Reported findings on cortisol reactivity to stress in young people with ADHD are very variable. This inconsistency may be explained by high rates of comorbidity with Conduct Disorder (CD). The present study examined cortisol responses to a psychosocial stressor in a large sample of adolescent males with ADHD (n=202), with or without a comorbid diagnosis of Conduct Disorder (CD). Associations between stress reactivity and callous-unemotional traits and internalizing symptoms were also assessed. The ADHD only (n=95) and ADHD+CD (n=107) groups did not differ in baseline cortisol, but the ADHD+CD group showed significantly reduced cortisol stress reactivity relative to the ADHD only group. Regression analyses indicated that ADHD symptom severity predicted reduced baseline cortisol, whereas CD symptom severity predicted increased baseline cortisol (ADHD β=-0.24, CD β=0.16, R=0.26) and reduced cortisol stress reactivity (β=-0.17, R=0.17). Callous-unemotional traits and internalizing symptoms were not significantly related to baseline or stress-induced cortisol. Impaired cortisol reactivity is hypothesised to reflect fearlessness and is associated with deficient emotion regulation and inhibition of aggressive and antisocial behaviour. Consequently, it may partly explain the greater severity of problems seen in those with comorbid ADHD and CD.
School of Psychology, Cardiff University, UK. Electronic address: NorthoverC@cardiff.ac.uk.
Clare
C
Northover
MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK. Electronic address: Thapar@cardiff.ac.uk.
Anita
A
Thapar
School of Psychology, Cardiff University, UK; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK. Electronic address: LangleyK@cardiff.ac.uk.
Kate
K
Langley
Academic Unit of Psychology, Southampton University, UK. Electronic address: G.F.Fairchild@soton.ac.uk.
Graeme
G
Fairchild
School of Psychology, Cardiff University, UK. Electronic address: VangoozenS@cardiff.ac.uk.
Stephanie H M
SHM
van Goozen
D000293:Adolescent; D000374:Aggression; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000503:physiopathology* / Q000523:psychology; D004644:Emotions; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D012463:Saliva / Q000737:chemistry*; D013312:Stress, Physiological / Q000502:physiology*
D006854:Hydrocortisone
ADHD; Callous-unemotional traits; Conduct disorder; Cortisol; Stress