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Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence
Open accessAbstract
Levels of the stress-sensitive hormone cortisol increase dramatically in the first 30-40 minutes after waking, an effect known as the cortisol awakening response (CAR). There is considerable cross-sectional evidence that psychosocial stress is associated with an increased CAR, and the CAR has been found to be altered in the presence of stress-related diseases, including Major Depressive Disorder (MDD). To date, no prospective longitudinal studies have examined whether individual differences in the CAR serve as a premorbid risk factor for MDD. In a sample of 230 late adolescents, clinical diagnoses of MDD were predicted from the CAR as well as other indicators of basal cortisol functioning gathered one year earlier, including: waking cortisol levels, bedtime cortisol levels, the size of the CAR, average cortisol, and the slope of the diurnal cortisol rhythm across the waking day. Age and gender, health and health behaviors, baseline neuroticism, exposure to stressful life events and past episodes of mood and anxiety disorders were included as covariates, to help ensure effects are attributable to the CAR rather than related variables. A higher baseline CAR was associated with a significantly increased risk of developing MDD by follow-up, even when excluding individuals with baseline MDD. No other baseline cortisol measures were significant prospective predictors of MDD. In summary, the CAR is a significant prospective risk factor for the development of MDD in young adults, providing some support for the possibility that a heightened CAR may play a role in the etiology of Major Depressive Disorder.
Overview
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Written from the paper’s full text.
TL;DR
In a prospective sample of 230 late adolescents, a higher cortisol awakening response (CAR) at baseline predicted increased risk of developing major depressive disorder (MDD) by one-year follow-up. Other baseline cortisol measures did not significantly predict MDD, suggesting the CAR may be a premorbid risk marker.
Key findings
- A higher baseline CAR significantly predicted clinical MDD over follow-up (OR = 3.0, p = .04), and remained predictive after excluding the 16 participants with current MDD at baseline (OR = 4.0, p = .05; N = 214, 15 developed MDD).
- No other baseline cortisol measure was a significant prospective predictor: wakeup cortisol OR = .93, p = .85; wakeup + 40 min OR = 1.3, p = .59; bedtime cortisol OR = .49, p = .10; diurnal slope and average cortisol (AUC) were also non-significant.
- The CAR also predicted a larger outcome group including clinical and subclinical MDD (OR = 2.5, p = .02), and without covariates it predicted clinical MDD (OR = 2.17, p = .02) and clinical/subclinical MDD (OR = 2.0, p = .002); after removing lifetime MDD cases, it predicted new onsets of clinical/subclinical MDD (OR = 2.22, p = .01).
- In the clinical MDD model, the CAR–MDD association was weaker for men than women (OR = .02, p = .04), but only two men developed clinical MDD; no gender interaction appeared in the larger clinical/subclinical outcome model. Baseline life stress (OR = 4.0, p = .04) and increases in life stress (OR = 16.7, p = .001) independently predicted MDD, with no evidence that the CAR mediated life stress effects.
Methods
- Prospective longitudinal study of older adolescents (average age 17.0 years) from two public high schools; 230 participants (173 female, 57 male) were analyzed after exclusions. High-neuroticism youth were oversampled, with 60% of the sample scoring in the top third of neuroticism.
- Salivary cortisol was collected six times per day over three consecutive weekdays: at wake-up, 40 minutes after waking, approximately 3, 8, and 12 hours post-awakening, and bedtime. CAR was calculated as wake-up + 40 min minus wake-up cortisol, averaged across three days and log-transformed.
- MDD diagnoses were assessed with the SCID at baseline and follow-up (average 368 days after cortisol assessment). Logistic regression predicted MDD from baseline cortisol measures with covariates including past/current MDD, other mood and anxiety disorders, life stress, neuroticism, negative mood, age, gender, and health variables; robustness analyses excluded baseline MDD, removed covariates, and included subclinical cases.
Limitations
- The paper states a time delay of just over one month on average between baseline interview and cortisol sampling, so some individuals may have developed MDD in that interval; diary negative affect was included as a covariate to help address this.
- The paper states the CAR protocol was simplified to two samples (wake-up and 40 minutes), less precise than intensive 10–15 minute sampling or a 0/30/60-minute protocol, and did not allow measuring CAR area under the curve or separating CAR increase from recovery speed.
- The paper states reliance on noninvasive daytime cortisol rather than pharmacological challenges, and notes the gender finding is cautious because only two men developed clinical MDD; too few first onsets (9 cases) prevented formally comparing first onsets versus recurrences.
- Evident from the text: the sample was predominantly female and oversampled for high neuroticism, producing higher MDD rates than typical adolescent samples, which may limit generalizability; the observational design cannot establish causality or mechanism.
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Claims the paper makes
39 Own result · 18 Not checked yet · 15 Own method · 9 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No other baseline cortisol measures were significant prospective predictors of MDD.”
- Also stated in: § Prospective prediction of MDD · plain
“Steeper diurnal cortisol slopes, and average cortisol across the day (AUC), were not significantly related to later MDD, nor were gender differences in the effects of these measures observed.”
- Also stated in: § Prospective prediction of MDD · plain
“None of these variables (wakeup, wakeup plus 40 minute, and bedtime cortisol levels) were significant predictors of the development of MDD over the followup period (ORs = .93, p = .85; OR = 1.3, p = .59; and OR = .49, p = .10 for wakeup, wakeup plus 40 minute and bedtime cortisol levels, respectively).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Prospective prediction of MDD · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A higher baseline CAR was associated with a significantly increased risk of developing MDD by follow-up, even when excluding individuals with baseline MDD.”
- Also stated in: § Prospective prediction of MDD · plain
“Beyond these effects, the size of the CAR significantly predicted later MDD, with a higher CAR associated with increased odds of having an episode of MDD over the follow-up period (OR = 3.0, p = .04).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The CAR protocol used (wake-up and 40 minutes post-waking) is a valid measure of the cortisol awakening response for predicting MDD, despite being less intensive than the original protocol.
- Rests on an assumption: The baseline cortisol assessment on three consecutive weekdays captures stable individual differences in CAR that are relevant to MDD risk over the following year.
- Also stated in: § Prospective prediction of MDD · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An examination of the gender interaction indicated that the association between the CAR and later MDD was significantly weaker for men than for women (OR = .02, p = .04).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
hedgedcorrelationaln = 2 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Not surprisingly, individuals with either past or baseline episodes of MDD were significantly more likely to have another episode by followup (OR = 6.9, p = .04).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was also a trend for youth with a later average time of waking (6:50 AM for those who develop MDD by followup; 6:44 AM for those who do not) to be related to an increased odds (OR = 4.95, p = .06) of developing MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this analysis, the size of the CAR was still strongly predictive of developing MDD over the followup period (OR = 4.0, p = .05).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prediction of clinical MDD excluding baseline clinical MDD
boostedcorrelationaln = 214 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The CAR protocol used (wake-up and 40 minutes post-waking) is a valid measure of the cortisol awakening response for predicting MDD, despite being less intensive than the original protocol.
- Rests on an assumption: The baseline cortisol assessment on three consecutive weekdays captures stable individual differences in CAR that are relevant to MDD risk over the following year.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no significant associations between either past or current MDD diagnoses and the size of the CAR at baseline [t(228) = -.62, p = .54 for past history of MDD; t(228) = -.26, p = .79 for current MDD at baseline).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prediction of clinical MDD excluding baseline clinical MDD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the first to demonstrate that the size of the CAR (the increase in cortisol after waking) is a significant prospective predictor of MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After the introduction of the CAR variables, the odds ratio for baseline life stress was 4.0 (p = .04)”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Associations between life stress, the CAR and MDD
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“for increase in life stress it was 16.7 (p = .001).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Associations between life stress, the CAR and MDD
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 29
- Probably not a substantial claim. 22
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Adolescent age (OR = 3.8, p = .03), the presence of asthma at baseline (OR = 12.9, p = .02), and diary reports of fatigue (OR = 2.7, p = .04) at the time of cortisol testing were also significantly related to later MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the other covariates, there was a non-significant trend for male gender to predict reduced odds (OR = .02, p = .09) of developing MDD over the followup.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the 230 participants, 56 (24%) were diagnosed with either past or current MDD at the time of the baseline assessment (16 youth or 7% were current); 41 (18%) were diagnosed with a past or current anxiety disorder, and 25 (11%) with another mood disorder.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Descriptive Data
plainn = 230- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As seen in Table 2, net of the other variables in the model, both baseline levels of life stress (OR = 4.0, p = .04), and increases in life stress from baseline to followup (OR = 16.7, p = .001) were significantly related to the development of MDD over followup.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By follow-up, 18 (8%) youth met the symptom and severity criteria for a clinical MDD diagnsosis over the intervening time period (9 first onsets, 9 recurrences; 16 out of 18 were female), and an additional 20 (12 female, 8 male) met subclinical criteria, for a total of 38 individuals (28 female, 10 male) meeting criteria for either a clinical or a subclinical episode over the followup period.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Descriptive Data
plainn = 38- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On average, cortisol values followed the typical daily pattern: they were high upon waking (11.99 nmol/L), increased sharply immediately after waking (to 16.82 nmol/L at 40 min post-awakening), and then declined rapidly at first, and then more slowly thereafter, to reach a nadir at bedtime (2.85 nmol/L).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Descriptive Data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was, however, substantial variability in cortisol values at each sampling point, and in the parameters (average cortisol, diurnal cortisol slope, CAR) used to describe baseline diurnal cortisol patterns.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Descriptive Data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of these variables (wakeup, wakeup plus 40 minute, and bedtime cortisol levels) were significant predictors of the development of MDD over the followup period (ORs = .93, p = .85; OR = 1.3, p = .59; and OR = .49, p = .10 for wakeup, wakeup plus 40 minute and bedtime cortisol levels, respectively).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Steeper diurnal cortisol slopes, and average cortisol across the day (AUC), were not significantly related to later MDD, nor were gender differences in the effects of these measures observed.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prospective prediction of MDD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“a visual inspection of Figure 2 suggests that both the new onset cases (dark hatched line) and the recurrent cases (light hatched line) are characterized the high baseline CAR pattern.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prediction of clinical MDD excluding baseline clinical MDD
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the overall diurnal cortisol curves appear lower for males than for females, for both genders, the cortisol awakening responses is more pronounced for youth who go on to develop MDD by followup.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prediction to a larger outcome group including both clinical and subclinical MDD
hedgedcorrelationaln = 230 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our measure of baseline life stress (which assessed life stress over the prior year), and our measure of increase in life stress over the year between baseline and followup were both significantly related to MDD at followup”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When predicting to clinical cases of MDD, we found that the CAR was a significant prospective predictor for females, but not males”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There is considerable cross-sectional evidence that psychosocial stress is associated with an increased CAR”
- Also stated in: § Introduction · plain
“In particular, a larger CAR has been associated with higher levels of both acute and chronic life stress (Adam et al., 2006; Schlotz et al., 2004).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Abstract
What the sources say
- Not checked yetcites Adam et al., 2006
- Not checked yetcites Schlotz et al., 2004 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Introduction · plain
In the paper
“It is not yet clearly established in human populations whether such alterations are correlates or consequences of the experience of depressive disorder and/or its treatments, or whether they reflect risk or vulnerability factors that are present prior to the onset of disorder, thus potentially playing a role in the pathophysiology of MDD (Bhagwagar and Cowen, 2007).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Introduction
What the sources say
- Not checked yetcites Bhagwagar and Cowen, 2007 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“In particular, a larger CAR has been associated with higher levels of both acute and chronic life stress (Adam et al., 2006; Schlotz et al., 2004).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Introduction
What the sources say
- Not checked yetcites Adam et al., 2006
- Not checked yetcites Schlotz et al., 2004 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Cortisol diurnal rhythms vary according to individual sleep-wake schedules, being high upon waking, increasing to peak levels approximately 30-40 minutes after waking, and declining to a nadir around bedtime (Kirschbaum and Helhammer, 2000; Pruessner et al., 1997; Wilhelm et al., 2007).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Introduction
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“CAR increases are large (on average 50-60% above waking levels) and highly variable across individuals; as a result, individual differences in the size of this indicator can be easily detected and modeled statistically, and are of a magnitude that is likely to be physiologically meaningful (Adam et al., 2006; Clow et al., 2004).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Introduction
What the sources say
- Not checked yetcites Adam et al., 2006
- Not checked yetcites Clow et al., 2004 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Because all of the past prospective studies examined morning cortisol levels at fixed clock times (8 AM), rather than in relation to person-specific waketimes (Halligan et al., 2007), they were not in a position to identify whether the size of the cortisol awakening response serves as a risk factor for MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Introduction
What the sources say
- Not checked yetcites Halligan et al., 2007 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies examining cross-sectional associations between the CAR and depression have found mixed results: some have found significantly lower CARs in individuals with current MDD diagnoses (Huber et al., 2006; Stetler and Miller, 2005), whereas others have found current MDD or high depressive symptoms to be associated with higher CARs (Bhagwagar et al., 2005; Pruessner et al., 2003).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Introduction
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Assays were conducted in duplicate using a time-resolved immunoassay with fluorometric detection (DELFIA) (Dressendorfer et al., 1992). Intra-assay coefficients of variation (CVs) were between 4.0% and 6.7%, and inter-assay CVs ranged from 7.1% to 9.0%.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Cortisol Assessment
What the sources say
- Not checked yetcites Dressendorfer et al., 1992 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“For 69 cases, a second interviewer observed the SCID and provided independent diagnoses, with Cohen's kappas of .72 and .94 for mood and anxiety disorders, and correlations between .74 and .97 for CSR severity ratings (Zinbarg et al., 2009).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Baseline Questionnaires and Interviews
What the sources say
- Not checked yetcites Zinbarg et al., 2009
plaincorrelationaln = 69- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Measures were standardized and averaged to form a N composite, with a Cronbach's alpha of .85 (Griffith et al., 2007; Zinbarg et al., 2009).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Baseline Questionnaires and Interviews
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Inter-rater reliability (intraclass correlations examining absolute agreement) was .88 for chronic stress and .79 for episodic stress.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Baseline Questionnaires and Interviews
What the sources say
- Not checked yetcites Hammen et al., 1987 source
- Not checked yetcites Hammen, 1991
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A comprehensive set of covariates was included to ensure that associations between cortisol and later MDD were attributable to baseline cortisol, rather than to other risk factors for MDD or health confounds that may be related to cortisol.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Analysis Plan
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Diagnostic status for clinical MDD required meeting DSM-IV symptom criteria for a Major Depressive Episode (MDE) with no history of manic, hypomanic or mixed episodes.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Baseline Questionnaires and Interviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Some covariates, such as nicotine use and time of waking, were included the model regardless of their level of statistical significance in predicting MDD, as they have been found in past research to have strong associations with diurnal cortisol patterns.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Analysis Plan
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Only cases with a CSR of four or greater were included in the primary analyses because this score corresponded to clinically significant distress or impairment (caseness).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Baseline Questionnaires and Interviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“It is important to note that this study was originally designed to examine multiple elements of the cortisol diurnal rhythm across the day, in addition to the CAR. As a result, in order to reduce participant burden, the protocol for the CAR is less intensive, and thus less precise, than the original CAR protocol, in which cortisol levels were obtained every 10 to 15 minutes after awakening (Pruess”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Cortisol Assessment
What the sources say
- Not checked yetcites Pruessner et al., 1997 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: The CAR protocol used (wake-up and 40 minutes post-waking) is a valid measure of the cortisol awakening response for predicting MDD, despite being less intensive than the original protocol.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, there is no sign that introduction of the CAR variables reduces the coefficients for life stress, suggesting that life stress (or at least life stress within the past year) and the CAR are independently associated with the development of MDD, rather than the CAR being a meditational pathway by which recent life stress influences the development of MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Associations between life stress, the CAR and MDD
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, to increase the sample size of the group considered “depressed” in the follow- up period, and to see whether our results held for less severe cases, we examined a larger outcome group including both the clinical MDD cases and the subclinical cases who, as described above, came close but did not quite meet either the symptom or severity criteria needed to qualify for MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Analysis Plan
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In a secondary analysis, individuals with current MDD at baseline were excluded rather than covaried in order to ensure that cortisol levels were predicting to new episodes of MDD, rather than the continuity of MDD from baseline to follow-up.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Methods > Analysis Plan
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, results appear to generalize both to the prediction of subclinical MDD and appear to be similar for males and females.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prediction to a larger outcome group including both clinical and subclinical MDD
hedgedcorrelationaln = 230 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“It is important to note that the ideal analysis would involve removing all the individuals who had a past history of MDD from the analysis, and thus predicting only to first onsets of clinical MDD. This approach is not possible due to the relatively small number of new onset clinical MDD cases occurring over the followup period (9 cases).”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Results > Prediction of clinical MDD excluding baseline clinical MDD
plainn = 9- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“One disadvantage of our design was the time delay (on average just over one month) between the baseline interview and the cortisol sampling.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Descriptively, our results suggest that elevated CARs prospectively predict both new onsets and recurrences of depression over the year followup period”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the two sample protocol is less precise, and did not allow us to measure the area under the curve of the CAR response, or to separate the CAR increase from the speed of recovery from the CAR peak.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Another disadvantage is that we relied on noninvasive measures of HPA-axis function (i.e., daytime diurnal cortisol rhythm) rather than employing pharmacological challenges (such as the dexamethasone suppression test)(Young et al., 2006) that provide more nuanced insights regarding the integrity of central HPA-axis function.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Results were also robust to the removal of individuals with baseline MDD, the presence vs. absence of the covariates, and to the prediction of subclinical symptoms as well as clinical cases of MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plainn = 230- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Another limitation, as noted earlier, is that we employed a simplified, two-sample protocol for the assessment of the CAR, rather than a more intensive protocol in which measures are gathered every 10 to 15 minutes, or even a moderate intensity CAR protocol in which samples are gathered at 0, 30 and 60 minutes after waking.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Rather, our life events measures and baseline CAR measures appeared to be independent predictors of MDD.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We utilized a large sample size (N=230) and gathered multiple morning cortisol samples timed in relation to person-specific wake-times each day over the course of 3 days.”
§ Prospective prediction of major depressive disorder from cortisol awakening responses in adolescence > Discussion
plainn = 230- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper relies on this without support.
The CAR protocol used (wake-up and 40 minutes post-waking) is a valid measure of the cortisol awakening response for predicting MDD, despite being less intensive than the original protocol.
“It is important to note that this study was originally designed to examine multiple elements of the cortisol diurnal rhythm across the day, in addition to the CAR. As a result, in order to reduce participant burden, the protocol for the CAR is less intensive, and thus less precise, than the original CAR protocol, in which cortisol levels were obtained every 10 to 15 minutes after awakening (Pruess”
The paper relies on this without support.
The baseline cortisol assessment on three consecutive weekdays captures stable individual differences in CAR that are relevant to MDD risk over the following year.
“Salivary cortisol was gathered six times per day over three consecutive typical weekdays during the school year: at wake-up, 40 minutes after waking, at approximately 3, 8, and 12 hours post-awakening (signaled by a programmed watch), and bedtime.”
“Each measure was averaged across the 3 collection days.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Our research has shown that the CAR’s ability to predict depression onset was independent of an index of moderate to severe episodic stressful events occurring in approximately the year prior to cortisol measurement (Adam et al. 2010).”
From The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history (2013) · cites this paper as Adam et al. 2010
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The cortisol awakening response (CAR) has been shown to predict major depressive episodes (MDEs) over a 1-year period.”
From The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history (2013) · cites this paper as Adam et al. 2010
The cited source says what the claim attributes to it.
In the citing paper
“Other basal cortisol indices, namely the diurnal slope and total waking cortisol (area under the curve with respect to ground; AUCg), were not related to MDE onsets during this follow-up period.”
From The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history (2013) · cites this paper as Adam et al. 2010
The cited source says what the claim attributes to it.
In the citing paper
“While our prior report after a 1-year follow-up presented descriptive data supporting that both first onsets and recurrences of MDE were predicted by elevations in the CAR (Adam et al. 2010)”
From The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history (2013) · cites this paper as Adam et al. 2010
The cited source says what the claim attributes to it.
In the citing paper
“The CAR is thought to be an important indicator of risk for major depressive episodes (MDE) in part because it captures a large and rapid increase on top of already elevated waking cortisol levels (Adam et al. 2010)”
From The cortisol awakening response predicts major depression: predictive stability over a 4-year follow-up and effect of depression history (2013) · cites this paper as Adam et al. 2010
The cited source says what the claim attributes to it.
In the citing paper
“There is some evidence that HPA axis dysregulation may precede depression (Adam et al., 2010; Harris et al., 2000)”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Adam et al., 2010
In the citing paper
“in some cases the intensive repeated measurement of psychological and physiological variables together is feasible, such as when obtaining salivary cortisol for the assessment of HPA system functioning (Adam et al., 2010; Havermans et al., 2011; Peeters, Nicolson, Berkhof, Delespaul, et al., 2003).”
From Mood Disorders in Everyday Life: A Systematic Review of Experience Sampling and Ecological Momentary Assessment Studies (2012) · cites this paper as Adam et al., 2010
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentt(228) = -0.62reported p = .54 · recomputed p = .536
“t(228) = -.62, p = .54”
- Consistentt(228) = -0.26reported p = .79 · recomputed p = .795
“t(228) = -.26, p = .79”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Self-check results appear here once an independent check has confirmed them.
Citations
Cites
Carver, C. S., & White, T. L. (1994) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.67.2.319 · Cited by 7,306
Epigenetic programming by maternal behavior
Weaver, I. C. G., Cervoni, N., Champagne, F. A., D'Alessio, A. C., Sharma, S., Seckl, J. R., Dymov, S., Szyf, M., & Meaney, M. J. (2004) · Nature Neuroscience · doi:10.1038/nn1276 · Cited by 6,177
The development of markers for the Big-Five factor structure
Goldberg, L. R. (1992) · Psychological Assessment · doi:10.1037/1040-3590.4.1.26 · Cited by 5,530
Prevalence and development of psychiatric disorders in childhood and adolescence
Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.8.837 · Cited by 4,035
Editorial Office (1997) · Obesity Surgery · doi:10.1381/096089297765555359 · Cited by 3,941
Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997) · American Psychiatric Press eBooks · Cited by 3,101
A revised version of the Psychoticism scale
Eysenck, S. B. G., Eysenck, H. J., & Barrett, P. (1985) · Personality and Individual Differences · doi:10.1016/0191-8869(85)90026-1 · Cited by 3,094
Gender differences in personality traits across cultures: Robust and surprising findings.
Costa, P. T., Terracciano, A., & McCrae, R. R. (2001) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.81.2.322 · Cited by 2,986
The Concepts of Stress and Stress System Disorders: Overview of Physical and Behavioral Homeostasis
Chrousos, G. P. (1992) · JAMA · doi:10.1001/jama.1992.03480090092034 · Cited by 2,689
The Corticosteroid Receptor Hypothesis of Depression
Holsboer, F. (2000) · Neuropsychopharmacology · doi:10.1016/s0893-133x(00)00159-7 · Cited by 2,181
Research works printed but not linked: 1
- Kirschbaum, 2000, Salivary cortisol, vol. 3
Cited by
Sorted by citations
Stress and Health: A Review of Psychobiological Processes
O'Connor, D. B., Thayer, J. F., & Vedhara, K. (2021) · Annual Review of Psychology · doi:10.1146/annurev-psych-062520-122331 · Cited by 948
Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.05.018 · Cited by 905
Self-citationJoseph, J. J., & Golden, S. H. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13217 · Cited by 574
Johnson, J. A. (2014) · Journal of Research in Personality · doi:10.1016/j.jrp.2014.05.003 · Cited by 541
Koss, K. J., & Gunnar, M. R. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12784 · Cited by 489
“A higher CAR prospectively predicted the emergence of MDD 1 year later in adolescence (Adam et al., 2010), and anxiety disorders 6 years later in young adults (Adam et al., 2014).”
Background
Metadata
- Authors
- Adam, E. K., Doane, L. D., Zinbarg, R. E., Mineka, S., Craske, M. G., & Griffith, J. W.
- Affiliations
- Northwestern University (US)
- University of California, Los Angeles (US)
- Corresponding author
- Adam, Emma K.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 35
- Issue
- 6
- Pages
- 921-931
- ISSN
- 0306-4530 (ISSN-L)
- PMC
- PMC2875344
- OpenAlex
- W2097291981
- Semantic Scholar
- 11f41924688e8a0d05917bbe43937f0b848ae34e
- Cited by
- 315
- References
- 64
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 10 · 2023: 12 · 2022: 26 · 2021: 24 · 2020: 15 · 2019: 17 · 2018: 23 · 2017: 21 · 2016: 27 · 2015: 30 · 2014: 25 · 2013: 23 · 2012: 22
- FWCI
- 8.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH065652, R03MH063269, R01MH065651, 1 R01 MH65651-01, R01 MH65652)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- cortisol awakening response, major depressive disorder, depression risk prediction, late adolescence, diurnal cortisol rhythm, basal cortisol, psychosocial stress, etiology of depression, premorbid risk factors
- MeSH terms
- Adolescent, Circadian Rhythm, Major Depressive Disorder, Female, Humans, Hydrocortisone, Male, Pituitary-Adrenal Function Tests, Predictive Value of Tests, Prospective Studies, Risk Factors, Saliva, Stress, Psychological, Wakefulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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