title: Mothers' parenting stress is associated with salivary cortisol profiles in children with attention deficit hyperactivity disorder.
abstract: The aim of this study was to explore the relation between mothers' parenting stress and the functioning of the hypothalamic-pituitary-adrenal axis (HPAA), as expressed by daily salivary cortisol concentrations, in their children diagnosed with attention deficit hyperactivity disorder (ADHD). Seventy-five children aged 6-11 years diagnosed with ADHD predominant hyperactive-impulsive/combined (ADHD-HI/C, N = 49) and inattentive symptoms (ADHD-I, N = 26) and 45 healthy peers and their mothers participated in the study. Μothers completed measures assessing their children's ADHD status, perceived parenting stress (Parenting Stress Index - Short Form, PSI-SF), mothers' symptoms of psychopathology, social support and socioeconomic status. Children's salivary cortisol samples were collected at six different time points on a single day. Mothers of children with ADHD-HI/C reported higher levels of parenting stress than mothers of children with ADHD-I and controls. All PSI-SF subscales showed significant associations with children's cortisol awakening response (CAR) in both ADHD groups, with the exception of the parental distress subscale in the ADHD-I group. In both ADHD groups, the parent-child dysfunctional interaction subscale, the difficult child subscale and the PSI total score were significantly associated with children's CAR. An interrelation is revealed between mothers' high levels of parenting stress and HPAA functioning in children with ADHD. In this population, CAR has been identified as a sensitive peripheral measure of HPAA functioning in children. Lay summaryThis study showed that in families of children diagnosed with ADHD, there is a complex relation between the mothers' high levels of parenting stress and children's atypical hypothalamic-pituitary-adrenal axis functioning.
authors.affiliation: a Department of Child and Adolescent Psychiatry , Athens University Medical School, "Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: Terpsichori
authors.initials: T
authors.lastname: Korpa
authors.affiliation: b Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics , National and Kapodistrian University of Athens, School of Medicine, "Aghia Sophia' Children's Hospital", Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Pervanidou
authors.affiliation: b Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics , National and Kapodistrian University of Athens, School of Medicine, "Aghia Sophia' Children's Hospital", Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Angeli
authors.affiliation: c Department of Clinical Biochemistry , " Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: Filia
authors.initials: F
authors.lastname: Apostolakou
authors.affiliation: a Department of Child and Adolescent Psychiatry , Athens University Medical School, "Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Papanikolaou
authors.affiliation: c Department of Clinical Biochemistry , " Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papassotiriou
authors.affiliation: b Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics , National and Kapodistrian University of Athens, School of Medicine, "Aghia Sophia' Children's Hospital", Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: George P
authors.initials: GP
authors.lastname: Chrousos
authors.affiliation: a Department of Child and Adolescent Psychiatry , Athens University Medical School, "Aghia Sophia" Children's Hospital: Thivon and Papadiamantopoulou , Athens , Greece.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Kolaitis
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology*; D002648:Child; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007175:Impulsive Behavior; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D016487:Parenting / Q000523:psychology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012944:Social Support; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology
chemical_list: D006854:Hydrocortisone
keywords: Attention deficit hyperactivity disorder; cortisol; cortisol awakening response; hypothalamic–pituitary–adrenal axis; parenting stress; parenting stress index