Does the cortisol response to stress mediate the link between expressed emotion and oppositional behavior in Attention-Deficit/Hyperactivity-Disorder (ADHD)?

Behavioral and Brain Functions : BBF
Hanna ChristiansenEdmund J Sonuga-Barke

Abstract

Expressed Emotions (EE) are associated with oppositional behavior (OPB) in children with Attention Deficit/Hyperactivity Disorder (ADHD). EE has been linked to altered stress responses in some disorders, but ADHD has not been studied. We test the hypothesis that OPB in ADHD is mediated by altered stress-related cortisol reactivity to EE. Two groups of children (with/without ADHD) and their respective parents were randomly assigned to two different conditions with/without negative emotion and participated in an emotion provocation task. Parents' EE, their ratings of their children's OPB and their children's salivary cortisol levels were measured. Low parental warmth was associated with OPB in ADHD. High levels of parental EE elicited a larger cortisol response. Stress-related cortisol reactivity mediated the EE-OPB link for all children. This highlights the general importance of parent-child interactions on externalizing behavior problems. High EE is a salient stressor for ADHD children that leads to increased levels of cortisol and OPB. The development of OPB might be mediated by the stress-response to high EE.

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Citations

Jul 20, 2012·American Journal on Intellectual and Developmental Disabilities·Jan GreenbergJinkuk Hong
Sep 15, 2012·Journal of Psychiatric Research·Johan IsakssonFrank Lindblad
Oct 2, 2012·Journal of the American Academy of Child and Adolescent Psychiatry·Catia ScassellatiMassimo Gennarelli
Jun 25, 2015·Psychoneuroendocrinology·Sivan Raz, Dmitry Leykin
Jan 2, 2015·Child Psychiatry and Human Development·Tara S Peris, David J Miklowitz
Nov 6, 2018·Autism : the International Journal of Research and Practice·Jason K BakerDavid Huynh
Oct 11, 2019·Journal of Clinical Medicine·Sarah Kittel-SchneiderAndreas Reif

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