A meta-analytic review of the association between cortisol reactivity in response to a stressor and attention-deficit hyperactivity disorder

Kamradt, Jaclyn M.; Momany, Allison M.; Nikolas, Molly A.

doi:10.1007/s12402-017-0238-5

Cited by 20 publications

(18 citation statements)

References 59 publications

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“…A blunted cortisol response, such as we identified in the ADHDt children, had been identified by previously in children with ADHD as a whole, and within a population of children with ADHD and behavioral co-morbidities (King et al, 1998; Maldonado et al, 2009; Van West et al, 2009). However, these findings are quite inconsistent across studies (Kamradt et al, 2018). Kamradt et al (2018) indicate that a link between the HPA axis and ADHD had been found for children with severe externalizing behaviors, and that these behaviors might be the driver of this relationship.…”

Section: Adhd Cortisol Electrodermal Response and Anxiety: Findingmentioning

confidence: 97%

Sensory Over-Responsivity as an Added Dimension in ADHD

Lane

Reynolds

2019

Front. Integr. Neurosci.

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Years of research have added to our understanding of Attention Deficit Hyperactivity Disorder (ADHD). None-the-less there is still much that is poorly understood. There is a need for, and ongoing interest in, developing a deeper understanding of this disorder to optimally identify risk and better inform treatment. Here, we present a compilation of findings examining ADHD both behaviorally and using neurophysiologic markers. Drawing on early work of McIntosh and co-investigators, we examined response to sensory challenge in children with ADHD, measuring HPA activity and electrodermal response (EDR) secondary to sensory stressors. In addition, we have examined the relationship between these physiologic measures, and reports of behavioral sensory over-responsivity and anxiety. Findings suggest that sensory responsivity differentiates among children with ADHD and warrants consideration. We link these findings with research conducted both prior to and after our own work and emphasize that there a growing knowledge supporting a relationship between ADHD and sensory over-responsivity, but more research is needed. Given the call from the National Institute of Health to move toward a more dimensional diagnostic process for mental health concerns, and away from the more routine categorical diagnostic process, we suggest sensory over-responsivity as a dimension in the diagnostic process for children with ADHD.

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Section: Adhd Cortisol Electrodermal Response and Anxiety: Findingmentioning

confidence: 97%

Sensory Over-Responsivity as an Added Dimension in ADHD

Lane

Reynolds

2019

Front. Integr. Neurosci.

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“…The hypothalamus-pituitary-adrenal axis (HPA axis) is an important responder to stressful environments. Several studies have shown that stress reactions are different in ADHD patients compared to healthy controls [148][149][150][151] . ADHD patients show reduced diurnal cortisol levels compared to healthy controls 152,153 .…”

Section: Stress and Adhdmentioning

confidence: 99%

The stress–Wnt-signaling axis: a hypothesis for attention-deficit hyperactivity disorder and therapy approaches

et al. 2020

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Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric neurodevelopmental disorders in children and adolescents. Although ADHD has been studied for nearly a century, the cause and pathophysiology of ADHD is yet largely unknown. However, findings from previous studies have resulted in the formation of a new hypothesis: Apart from the well-known multifactorial etiology of ADHD, recent evidence suggests that the interaction between genetic and environmental factors and especially Wnt- and mTOR-signaling pathways might have an important role in the pathophysiology of ADHD. The Wnt-signaling pathway is known to orchestrate cellular proliferation, polarity, and differentiation, and the mTOR pathway is involved in several significant processes of neurodevelopment and synaptic plasticity. As a result, dysregulations of these pathways in a time-dependent manner could lead to neurodevelopmental delays, resulting in ADHD phenotype. This review presents further evidence supporting our hypothesis by combining results from studies on ADHD and Wnt- or mTOR-signaling and the influence of genetics, methylphenidate treatment, Omega-3 supplementation, and stress.

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“…A genetic family-based study found an association between functional polymorphisms of the gene encoding the glucocorticoid receptor and childhood ADHD-related behaviors, which, given the pivotal role of glucocorticoid receptor on the HPA axis, suggests a possible involvement of the HPA axis in ADHD [ 51 ]. Many studies have focused on differences in cortisol level, particularly in stress responsivity [ 52 , 53 ], although there has been significant heterogeneity in approach and findings have been inconclusive, particularly with respect to differences in ADHD subtype, presence of co-occurring mental health conditions, and sex. Studies on the relationship between androgen levels and attention and conduct problems in children and adolescents have been similarly divergent [ 14 , 54 , 55 ], likely because of the diversity of specific hormones being investigated, consideration of prenatal versus postnatal exposures, and the complicating role of sex.…”

Section: Discussionmentioning

confidence: 99%

Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents With Congenital Adrenal Hyperplasia

Harasymiw

Grosse

Sarafoglou

2020

Journal of the Endocrine Society

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Background Little is known regarding risk for co-occurring mental health conditions among pediatric patients with congenital adrenal hyperplasia (CAH). The objective of the current study was to investigate the prevalence of medically managed attention-deficit/hyperactivity disorder (ADHD) in two large administrative samples of insured children and adolescents with and without CAH in the United States. Methods We assessed the prevalence of CAH and of medically managed ADHD using algorithms defined from diagnosis codes and filled prescriptions data using the IBM® MarketScan® Commercial and Multi-State Medicaid claims databases. We evaluated subjects who were continuously enrolled for ≥12 months with a first claim during October 2015-December 2017 when they were 5-18 years old. Results The administrative prevalence of CAH in the Commercial (N=3,685,127) and Medicaid (N=3,434,472) samples was 10.1 per 100,000 (n=372) and 7.2 per 100,000 (n=247), respectively. The prevalence of medically managed ADHD in the non-CAH population was 8.4% in the Commercial sample and 15.1% in the Medicaid sample. Among children with CAH, there was no increased prevalence of ADHD in the Commercial (9.2%, prevalence ratio (PR) = 1.1, 95% CI: 0.82-1.54, p = 0.48) or Medicaid (13.8%, PR = 0.91, 95% CI: 0.67-1.24, p = 0.55) samples compared to the general population. Conclusions Using two large samples of insured children and adolescents in the United States, we found similar prevalence of medically managed ADHD among those with CAH and the general population. Future research to assess the validity of our claims algorithm for identifying pediatric CAH cases is warranted.

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A meta-analytic review of the association between cortisol reactivity in response to a stressor and attention-deficit hyperactivity disorder

Cited by 20 publications

References 59 publications

Sensory Over-Responsivity as an Added Dimension in ADHD

Sensory Over-Responsivity as an Added Dimension in ADHD

The stress–Wnt-signaling axis: a hypothesis for attention-deficit hyperactivity disorder and therapy approaches

Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents With Congenital Adrenal Hyperplasia

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