Temporal patterns, heterogeneity, and stability of diurnal cortisol rhythms in children with autism spectrum disorder

Abstract

The current study used a multifaceted approach to assess whether children with ASD have a distinctive diurnal rhythm of cortisol that differentiates them from typically developing (TD) peers and whether sub-groups of ASD children can be identified with unique diurnal profiles. Salivary cortisol was sampled at four time points during the day (waking, 30-min post-waking, afternoon, and evening) across three days in a sample of 36 children with autism spectrum disorder (ASD) and 27 typically developing (TD) peers. Between-group comparisons on both mean levels and featural components of diurnal cortisol indicated elevated evening cortisol and a dampened linear decline across the day in the ASD group. No differences were evident on the cortisol awakening response (CAR). Group-based trajectory modeling indicated that a subgroup (25%) of ASD children demonstrated an attenuated linear decline while the cortisol trajectory of the second subgroup was indistinguishable from that of the TD group. Intraclass correlations indicated that, when aggregated across days, cortisol measures were generally stable over the interval assessed. There were few significant relations between cortisol measures or sub-groups and measures of stress, temperament, and symptoms. Results encourage follow-up studies to investigate the functional significance, heterogeneity and longer-term stability of diurnal cortisol profiles in children with ASD.

Characterizing Sleep in Adolescents and Adults with Autism Spectrum Disorders

“…The diurnal decline in cortisol throughout the day, with lowest levels in the evening, has been well established (Anders 1982; Weitzman 1971). In ASD, an attenuated linear decline in cortisol has been observed in many children with ASD (Tomarken et al 2015), with this subset postulated to have associated sleep disturbance or dysregulation in arousal. Two adolescents with ASD had higher cortisol at night than in the morning.…”

“…While these bedtime schedules may have biologically contributed to our findings of a higher cortisol at bedtime than in the morning, it is also possible that technical factors were at play; their erratic bedtime schedules may have been associated with their not being meticulous collectors of cortisol. It is also important to note that previous studies reporting differences in cortisol regulation, including elevated evening cortisol, have been conducted in children (not adolescents or young adults) with ASD emphasizing the need to carefully examine age and pubertal effect over the course of development (Corbett et al, 2006; 2008; Tomarken et al, 2015). Additionally, psychotropic medications taken by participants with ASD may have affected cortisol results (Granger et al 2009).…”

“…Cortisol, a marker of the hypothalamic-pituitary-adrenal (HPA) axis, demonstrates a circadian rhythm, with levels highest in the morning and falling in the evening as bedtime approaches. Dysregulation of the cortisol rhythm, with diminished reduction of the expected fall in evening cortisol, has been observed in insomnia (Buckley & Schatzberg 2005) and also in ASD (Corbett et al 2008; Tomarken et al, 2015) in association with daytime stressors such as fears or a change in routine (Corbett et al 2009). Tomarken et al (2015) identified a subset of children with ASD showing an attenuated linear decline in evening cortisol, and encouraged follow-up studies to investigate the functional significance of their findings, including effects on sleep disturbance.…”

Children with orofacial clefts : dental caries and health-related quality of life

“…If the rabbit antibodies in the batches of the commercial RIA method used in this study were more sensitive than antibodies used in earlier studies the evening cortisol concentration would also have been high and not normally low. Cortisol concentrations in the present study were also higher than in studies conducted in other countries, on the same age groups, with sampling of saliva at home and using immunoassay analysis (Davis, Bruce et al 2002, Tomarken, Han et al 2015. However, comparison of the results from different studies is complicated because of the use of differences in analytical methods, time points for saliva sampling, situations, and units of measurement.…”

Background cortisol versus social anxiety as correlates of HPA‐axis recovery from stress in boys with Autism Spectrum Disorder

“…There is some initial evidence that this dysregulation of the HPA axis may also be associated with gastrointestinal disorders in these children (Ferguson et al, 2016). In contrast, there are studies demonstrating no significant differences in the HPA axis diurnal variation and CAR across ASD and non‐ASD samples (Corbett and Schupp, 2014; Gabriels et al, 2013; Marnovic‐Curin et al, 2008; Tomarken et al, 2015). As might be expected, not all participants in this kind of study react identically.…”