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Early psychosocial adversity and cortisol levels in children with attention-deficit/hyperactivity disorder

Johan Isaksson1, Kent W Nilsson, Frank Lindblad

  • 1Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, 751 85, Uppsala, Sweden. johan.isaksson@neuro.uu.se

European Child & Adolescent Psychiatry
|February 12, 2013
PubMed

Insights

Children with ADHD showed higher rates of early adversity but not lower morning cortisol levels, challenging the hypothesis that psychosocial adversity programs the HPA-axis to cause low cortisol in ADHD.

Area of Science:

  • Neuroendocrinology
  • Developmental Psychology
  • Child Psychiatry

Background:

  • Children with ADHD often exhibit altered hypothalamus-pituitary-adrenal (HPA) axis regulation, characterized by lower diurnal cortisol levels.
  • Psychosocial adversity in fetal development and childhood is linked to both ADHD and HPA-axis dysfunction.
  • Early life adversity may program the HPA-axis, potentially explaining low cortisol levels observed in ADHD.

Purpose of the Study:

  • To retrospectively investigate fetal and early childhood psychosocial adversity exposures in children with ADHD.
  • To examine the relationship between these exposures and cortisol levels in children with ADHD.
  • To test the hypothesis that early adversity influences the HPA-axis, leading to lower cortisol in ADHD.

Main Methods:

  • Saliva samples were collected from children aged 6-17 with confirmed ADHD (n=197) and controls (n=221) for cortisol analysis.
  • Parental rating scales assessed ADHD subtypes and degree of psychosocial adversity exposure.
  • Radioimmunoassay was used for cortisol level determination.

Main Results:

  • Children with ADHD reported significantly more fetal and childhood adversity than controls.
  • Low morning cortisol levels remained associated with ADHD symptoms even after adjusting for adversity and other factors.
  • No direct relationship was found between fetal/childhood adversity and cortisol levels, except a positive association between childhood adversity and morning cortisol increase in ADHD.

Conclusions:

  • The study did not support the hypothesis that early adversity leads to lower cortisol levels in children with ADHD.
  • While ADHD is associated with increased early adversity, this adversity does not appear to be the primary driver of altered HPA-axis cortisol regulation in this cohort.
  • Further research is needed to elucidate the complex interplay between ADHD, HPA-axis function, and environmental factors.

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