Cited by 258Stress Responses and CortisolAutism Spectrum Disorder ResearchNeuroendocrine regulation and behavior

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Cortisol circadian rhythms and response to stress in children with autism

Corbett, Blythe A., Mendoza, Sally, Abdullah, Maryam, Wegelin, Jacob A., Levine, Seymour·2006·Psychoneuroendocrinology

DOI 10.1016/j.psyneuen.2005.05.011

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Abstract

Background Autism is a severe neurodevelopmental disorder characterized by impairment in communication, social interaction, repetitive behaviors and difficulty adapting to novel experiences. The Hypothalamic-Pituitary-Adrenocortical (HPA) system responds consistently to perceived novel or unfamiliar situations and can serve as an important biomarker of the response to a variety of different stimuli. Previous research has suggested that children with autism may exhibit dysfunction of the HPA system, but it is not clear whether altered neuroendrocrine regulation or altered responsiveness underlies the differences between children with and without autism. In order to provide preliminary data concerning HPA regulation and responsiveness, we compared circadian rhythms and response to a non-social, environmental stressor in children with and without autism.Methods Circadian rhythms of cortisol were estimated in children with (N=12) and without (N=10) autism via analysis of salivary samples collected in the morning, afternoon and evening on 2 consecutive days. HPA responsiveness was assessed by examining the time course of changes in salivary cortisol in response to a mock MRI.Results Both groups showed expected circadian variation with higher cortisol concentration in morning than in the evening samples. The children with autism, but not typical children, showed a more variable circadian rhythm as well as statistically significant elevations in cortisol following exposure to a novel, nonsocial stimulus.Conclusions The results suggest that children with autism process and respond idiosyncratically to novel and threatening events resulting in an exaggerated cortisol response.

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Blue, M. E., Johnston, M. V., Moloney, C. B., & Höhmann, C. F. (2008) · Humana Press eBooks · doi:10.1007/978-1-60327-489-0_5 · Cited by 6
“stress [61, 62].”
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Cachia, R. L. (2017) · InTech eBooks · doi:10.5772/65394 · Cited by 6
Environmental Factors and Limbic Vulnerability in Childhood Autism
Lathe, R. (2008) · American journal of biochemistry & biotechnology/American journal of biochemistry and biotechnology · doi:10.3844/ajbbsp.2008.183.197 · Cited by 6
Introversion And Autism: A Conceptual Exploration Of The Placement Of Introversion On The Autism Spectrum
Grimes, J. O. (2010) · Journal of International Crisis and Risk Communication Research · Cited by 6
Cortisol in individuals with autism spectrum disorders – review
Lewandowska, Z., Mazur‐Melewska, K., & Figlerowicz, M. (2020) · Child Neurology · doi:10.20966/chn.2020.59.467 · Cited by 5
Social context in stress and autism: comparing physiological profiles across two social paradigms in youth with and without autism spectrum disorder
Muscatello, R. A., McGonigle, T., Vandekar, S., & Corbett, B. A. (2024) · Research in Autism · doi:10.1016/j.rasd.2024.102354 · Cited by 7
Self-citation
Effects of varied‑intensity endurance exercise training on oxidative and antioxidant factors in the liver of rats with valproic acid‑induced autism
Mirzavandi, F., Sabet, N., Aminzadeh, A., Heidari, M., Pouya, F. S., Moslemizadeh, A., parizi, A. S., & Bashiri, H. (2023) · Acta Neurobiologiae Experimentalis · doi:10.55782/ane-2023-003 · Cited by 5
Occupational Therapy Using Zones of Regulation™ Concepts: A Feasibility Study
Peters, B., Gabriels, R., Schmid, A. A., Lassell, R. K. F., Pan, Z., Hoffman, A., & Hepburn, S. (2024) · OTJR: Occupation, Participation and Health · doi:10.1177/15394492241246549 · Cited by 4
“physiological reactivity to daily activities (Corbett et al., 2006; Spratt et al., 2012), and may demonstrate behavioral difficulties such as excessive irritability, hyperactivity, aggression, elopement, and self-injury (Doehring et al., 2014; Mazefsky et al., 2014).”
The relationship between hair cortisol concentration and autism diagnosis
Lin, P., John, J. R., Masi, A., Ong, L. K., Mathew, N. E., Moni, M. A., Eapen, V., & Walker, A. K. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.05.052 · Cited by 5
Diurnal cortisol profiles in autistic adolescents and young adults: Associations with social difficulties and internalizing mental health symptoms
Ilen, L., Delavari, F., Feller, C. M., Zanoletti, O., Sandi, C., & Schneider, M. (2024) · Autism Research · doi:10.1002/aur.3184 · Cited by 6
“Although many studies observed typical cortisol profiles in autistic compared with nonautistic individuals (e.g., Corbett et al., 2006; Goldman et al., 2017), flattened CAR (Bros-nan et al., 2009), higher overall cortisol (Tomarken et al., 2015), and flatter DCS (e.g., Muscatello & Cor-bett, 2018;…”
Cortisol as a Biomarker for Stress During the Assessment and Treatment of Destructive Behavior
Smith, S. W., Johnson, P. R., Sullivan, W. E., Mauzy, C. R., Antúnez, B. E. A., Craig, A. R., Howard, A. R., Nguyen, T., Hoffman, C., Adavikolanu, S., et al. (2025) · Behavioral Sciences · doi:10.3390/bs15040475 · Cited by 5
“Corbett et al. (2006) conducted an experiment that serves as good example of how to use salivary cortisol concentration as a biomarker for stress.”
The intersection and developmental trajectory of morning cortisol and testosterone in autistic and neurotypical youth
Corbett, B. A., McGonigle, T., Muscatello, R. A., Vandekar, S., & Calvosa, R. (2025) · Molecular Autism · doi:10.1186/s13229-025-00658-0 · Cited by 5
“Research in salivary cortisol in children and adolescents with autism has frequently reported dysregulation of the HPA axis showing variable diurnal rhythms [53–57], which includes elevated evening cortisol [55, 58] and blunted diurnal slope [59, 60].”
Self-citation
Explicit and implicit attachment representations in cognitively able school-age children with autism spectrum disorder: A window to their inner world
Giannotti, M., Bentenuto, A., Venuti, P., & de Falco, S. (2022) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045221113390 · Cited by 4
“Specifically, it has been suggested that children with ASD showed greater sensitivity to stressful stimuli (Corbett et al., 2006) and higher difficulties in emotion regulation, defined as the ability to modulate one’s physiological arousal (related to internal affective changes) to promote an optimal engagement in one…”
Background
The Association between Movement Behaviors and Mental Health Issues in Adolescents with Neurodevelopmental Disorders
Dastamooz, S., Ho, R., Arbour‐Nicitopoulos, K. P., Wong, S. H., & Sit, C. H. P. (2024) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003628 · Cited by 4
“However, the literature on individuals with NDD is rare and may differ due to the distinct patterns of HPA axis dysregulation in ADHD and ASD (23,37).”
Autism and arousal
Hyde, J., & García‐Rill, E. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-817992-5.00006-4 · Cited by 4
The feasibility of occupational therapy using Zones of Regulation™ Concepts in an equine environment
Peters, B., Gabriels, R. L., Schmid, A. A., Pan, Z., Merritt, T., Hoffman, A., & Hepburn, S. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1401222 · Cited by 4
“Impaired self-regulation is believed to be inherent in autism, as evidenced by dif ﬁ culty managing emotions (7), heightened physiological reactivity to daily activities (8, 9), and increased irritability, hyperactivity, aggression, elopement, and self-injury (10, 11).”
Background
The Neurobiology of Autism
Gillberg, C., Allely, C. S., Bourgeron, T., Coleman, M., Fernell, E., Hadjikhani, N. K., & Sarovic, D. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108297769.007 · Cited by 5
Incidence, profiles and correlates of the Cortisol Awakening Response in high-functioning young males with ASD
Sharpley, C. F., Bitsika, V., McMillan, M., & Agnew, L. L. (2018) · Research in Autism · doi:10.1016/j.rasd.2018.11.001 · Cited by 4
Cortisol Responsivity to Social Play in Children with Autism: A Systematic Review
Alagendran, K., Hitch, D., Wadley, C., & Stagnitti, K. E. (2019) · Journal of Occupational Therapy Schools & Early Intervention · doi:10.1080/19411243.2019.1604285 · Cited by 4
“This is consistent with previous research, which found significant variation in diurnal cortisol and/or responsivity to non-naturalistic, social and non-social stressors amongst children with ASD (Corbett et al., 2006; Corbett, Mendoza, & Wegelin et al., 2008; Hollocks, Howlin, Papadopoulos, Khondoker, & Simonoff, 201…”
BackgroundResult
Salivary IL-1 Beta Level Associated with Poor Sleep Quality in Children/Adolescents with Autism Spectrum Disorder
Fuentes-Albero, M., Mafla-España, M. A., Martı́nez-Raga, J., & Cauli, O. (2024) · Pediatric Reports · doi:10.3390/pediatric16040081 · Cited by 14
Environmental Factors in the Aetiology of Autism – Lessons from Animals Prenatally Exposed to Valproic Acid
Schneider, T., & Przewo̵cki, R. (2011) · InTech eBooks · doi:10.5772/20391 · Cited by 2
“Moreover, autistic children exhibit increased autonomic responses, indicative of enhanced amygdala activity (Corbett et al., 2006; Hirstein et al., 2001; Tordjman et al., 1997), and increased corticosterone blood level was observed in VPA rats (Schneider et al., 2008).”
Background
Clinical profiles in autism spectrum disorder: Enhancing diagnosis, treatment, and overall health outcomes
Cruz, T. M. (2024) · Medicine Advances · doi:10.1002/med4.89 · Cited by 3
Stress and Mental Flexibility in Autism Spectrum Disorders
Stone, W. S., & Iguchi, L. (2013) · North American Journal of Medicine and Science · Cited by 3
Hypothalamus-pituitary-adrenal-axis associations with self- vs. parental ratings of depression in boys with an autism spectrum disorder
Bitsika, V., Sharpley, C. F., Andronicos, N. M., & Agnew, L. L. (2015) · International Journal on Disability and Human Development · doi:10.1515/ijdhd-2014-0030 · Cited by 3
Hormonal Influences in Typical Development
Bonnie Auyeung, B., & Baron‐Cohen, S. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-391924-3.00015-6 · Cited by 3
Faculty Opinions recommendation of Variable cortisol circadian rhythms in children with autism and anticipatory stress.
Jessop, D. S. (2009) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.1147891.604983 · Cited by 3
The Acceptability of Occupational Therapy Using Zones of Regulation™ Concepts in an Equine Environment to Autistic Children
Browne, J. M., Reega, S. J., Rankins, E. M., Schmid, A. A., & Peters, B. (2025) · Behavioral Sciences · doi:10.3390/bs15040495 · Cited by 2
“…to as “autistic” moving forward (Bottema-Beutel et al., 2021), impaired self-regulation is often exhibited in increased physiological responsiveness to everyday activities (Corbett et al., 2006; Spratt et al., 2012) and challenges with emotional management (Beck et al., 2020; Cai et al., 2018).”
Autonomic and hormonal biomarkers in individuals with autism spectrum disorders and developmental or intellectual delay: A systematic PRISMA review
Vidal, O., Merino, D., Fernandez, A., Mercery, M., Herbreteau, L., Askenazy-Gittard, F., Zuluaga, M. A., Ismailova, E., Douet, V., & Thümmler, S. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106496 · Cited by 2
Genetic and Environmental Predisposing Factors of Autism Spectrum Disorders
Yontan, E. (2020) · Journal of Experimental and Basic Medical Sciences · doi:10.5606/jebms.2020.75604 · Cited by 2
Relationship Between Parental Attachment and Stress Elevation and Synchrony in Pediatric Occupational Therapy Patient–Parent Dyads
Scott, S., Nealey-Moore, J. B., & Zylstra, S. E. (2020) · American Journal of Occupational Therapy · doi:10.5014/ajot.2021.041483 · Cited by 2
“Among neurologically atypical children, those with ASD are at increased risk of cellular oxidative stress (James et al., 2004) and respond to novel and social – evaluative stimuli with altered physiological stress (Corbett et al., 2006; Spratt et al., 2012; Taylor & Corbett, 2014).”
Children’s stress activation in integrated early childhood special education and its connections to special educational needs and temperament
Kesäläinen, J., Suhonen, E., Saha, M., & Sajaniemi, N. K. (2022) · European Early Childhood Education Research Journal · doi:10.1080/1350293x.2022.2055104 · Cited by 2
“…stress in parents who have children with disabilities (Lovell, Moss, and Wetherell 2012, 682–687; Chen et al. 2015, 9; Dunn et al. 2001, 39– 52) and stress activation in children with autism spectrum disorders (Spratt et al. 2012, 75–81; Corbett et al. 2009, 39–49; Corbett et al. 2006, 59–68).”
Background
SOCIAL FUNCTIONING IN ADULTS WITH AUTISM SPECTRUM DISORDER: THE ROLE OF BIOLOGICAL STRESS RESPONSE AND PSYCHOSOCIAL STRESS
Bishop, L. (2015) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 2
Treatment Response in Behaviour Disorders in Rett Syndrome
Martínez, A. R., Turón, M., Póo, L. C., Sole, E., Armstrong, J., & Pineda, M. (2013) · Journal of Behavioral and Brain Science · doi:10.4236/jbbs.2013.32023 · Cited by 2
“Measurement of cortisol in oral saliva reveals a wellknown correlation with levels in blood: saliva cortisol levels may be useful as a laboratory parameter of stress, and as a reflection of changes occurring in Neurometabolic Rett syndrome [28-30].”
Background
Action and social spaces in typical development and in autism spectrum disorder
Candini, M., di Pellegrino, G., & Frassinetti, F. (2021) · Oxford University Press eBooks · doi:10.1093/oso/9780198851738.003.0016 · Cited by 2

Authors: Corbett, B. A., Mendoza, S., Abdullah, M., Wegelin, J. A., & Levine, S.
Affiliations: University of California, Davis (US)
ORCID: Corbett, Blythe A.
Abdullah, Maryam
Venue: Psychoneuroendocrinology
Publisher: Elsevier BV
Published: 2006-01
Volume: 31
Issue: 1
Pages: 59-68
ISSN: 0306-4530 (ISSN-L)
DOI: 10.1016/j.psyneuen.2005.05.011
OpenAlex: W2124859267
Cited by: 258
References: 35
Citations by year: 2026: 5 · 2025: 8 · 2024: 11 · 2023: 5 · 2022: 11 · 2021: 15 · 2020: 18 · 2019: 11 · 2018: 21 · 2017: 10 · 2016: 8 · 2015: 16 · 2014: 20 · 2013: 17 · 2012: 14
FWCI: 4.19
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Psychoneuroendocrinology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (1r21mh065672-01)
University of California, Davis
National Institute of Mental Health (MH065672)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroendocrine regulation and behavior
Keywords: autism spectrum disorder, cortisol, circadian rhythm, hypothalamic-pituitary-adrenal axis, stress response, salivary cortisol, children, novel stimuli, neuroendocrine regulation, biomarkers
MeSH terms: Autistic Disorder, Child, Circadian Rhythm, Environment, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Surveys and Questionnaires, Saliva, Sensation, Specimen Handling, Stress, Psychological, Feedback, Psychological

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Cortisol circadian rhythms and response to stress in children with autism

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