Adrenocortical Functioning in Boys with Attention-Deficit/Hyperactivity Disorder: Examining Subtypes of ADHD and Associated Comorbid Conditions |
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Authors: | Paul D Hastings Isabel Fortier William T Utendale Louise R Simard Philippe Robaey |
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Institution: | 1. Department of Psychology, Centre for Research in Human Development, Concordia University, Montreal, H4B 1R6, QC, Canada 2. l’H?pital Sainte-Justine, l’Université de Montréal, Montréal, QC, Canada 3. Biochemistry & Medical Genetics, University of Manitoba, Winnipeg, MA, Canada
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Abstract: | 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.
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Keywords: | ADHD Comorbidity Cortisol Disruptive behaviour disorders Anxiety disorders Stress response |
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