Cortisol levels in childhood associated with emergence of attenuated psychotic symptoms in early adulthood
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BACKGROUND: In individuals at clinical high-risk for psychosis, elevated cortisol levels predict subsequent onset of psychotic disorder. However, it is unclear whether cortisol alterations are evident at an earlier clinical stage and promote progression of psychosis expression. This study aimed to address this issue by investigating whether cortisol levels in childhood were associated with the emergence of attenuated psychotic symptoms in early adulthood. In exploratory analyses, we examined whether cortisol and psychosocial stress measures interacted in predicting attenuated psychotic symptoms. METHODS: A sample of children (N = 109) enriched for psychosis risk factors were recruited at age 9-12 years and assessed at age 11-14 years (T1) and 17-21 years (T2). Measures of psychopathology, psychosocial stressors, and salivary cortisol were obtained at T1. Attenuated psychotic symptoms were assessed at T2 using the Prodromal Questionnaire. RESULTS: Diurnal cortisol (β = 0.915, 95% CI: 0.062-1.769) and daily stressors (β = 0.379, 95% CI: 0.034-0.723) at T1 were independently associated with total Prodromal Questionnaire scores at T2 after accounting for demographic factors and T1 psychopathology. Exploratory analyses indicated a significant interaction between T1 diurnal cortisol and daily stressors (β = 0.743, 95% CI: 0.081-1.405), with the highest predicted T2 total Prodromal Questionnaire scores occurring when both diurnal cortisol and daily stressors were increased. CONCLUSIONS: Our findings suggest that daily stressors and elevations in diurnal cortisol in late childhood/early adolescence increases risk for developing attenuated psychotic symptoms. These findings emphasize the importance of assessing environmental and biological risk factors for psychosis during neurodevelopmentally vulnerable time periods.
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Individuals with prodromal or attenuated psychosis are more likely to show HPA hyperresponsiveness to daily stressors.
“individuals with prodromal or attenuated psychosis are more likely to show HPA hyperresponsiveness to daily stressors.”
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Causes and Outcome of Psychosis
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- Authors
- Cullen, A. E., Fisher, H. L., Gullet, N., Fraser, E. R., Roberts, R. E., Zahid, U., To, M., Yap, N. H., Zunszain, P. A., Pariante, C. M., Wood, S. J., McGuire, P., Murray, R. M., Mondelli, V., & Laurens, K. R.
- Affiliations
- King's College London (GB)
- The University of Melbourne (AU)
- Queensland University of Technology (AU)
- Corresponding author
- Cullen, Alexis E.
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2022-01
- Volume
- 91
- Issue
- 2
- Pages
- 226-235
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC7612877
- OpenAlex
- W3196085452
- Cited by
- 27
- References
- 69
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 5 · 2022: 4
- FWCI
- 3.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Biological Psychiatry (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by)
- QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute for Health Research
- National Institute for Health Research Imperial Biomedical Research Centre (CDF/08/01/015)
- Department of Health and Social Care
- British Medical Association
- King's College London
- Brain and Behavior Research Foundation (28336)
- Australian Research Council (FT170100294)
- Wellcome Trust (107395/Z/15/Z)
- Fundação Bial (192/12, 35/06)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- salivary cortisol, diurnal cortisol rhythm, attenuated psychotic symptoms, prodromal psychosis, daily hassles, clinical high risk for psychosis, Prodromal Questionnaire, early adolescence, brain development, psychosis risk factors
- MeSH terms
- Adolescent, Adult, Child, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Psychotic Disorders, Risk Factors, Saliva, Stress, Psychological
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