Salivary Cortisol Response to a Psychosocial Stressor on Children Diagnosed with Attention-Deficit/Hyperactivity Disorder: Differences Between Diagnostic Subtypes

The purpose of the present study was to compare the reactivity of the HPA-axis in children diagnosed with different subtypes of ADHD against a healthy control group. This study included a total of 66 children: 33 children with ADHD diagnoses (10 with prevalent inattentive symptoms, 9 with prevalent hyperactive-impulsive symptoms and 14 with the combined subtype) and 33 healthy controls. The Trier Stress Social Test for Children (TSST-C) was employed as stressor. This test included two main stressors: first, completing a story initiated by an interviewer, and second, executing a timed cognitive task. Saliva samples were then obtained at -1, and +1, +10, +20 and +30 minutes with respect to the stress-inducing task. While the repeated-measures ANOVA showed a statistically significant time effect, the expected cortisol stress-response was not observed in any group. A difference was observed in the response from the hyperactive-impulsive group that was also observed in the AUC(G) comparisons with the subgroups. The ADHD group with prevalent hyperactivity-impulsive symptoms showed more significantly reduced cortisol levels than the control group and other experimental subgroup with prevalent inattentive symptoms.