High self-perceived stress and many stressors, but normal diurnal cortisol rhythm, in adults with ADHD (attention-deficit/hyperactivity disorder)
Abstract
Attention-deficit/hyperactivity disorder (ADHD) in adults is associated with significant impairment in many life activities and may thus increase the risk of chronic stress in everyday life. We compared adults with a DSM-IV ADHD diagnosis (n=28) with healthy controls (n=28) regarding subjective stress and amounts of stressors in everyday life, diurnal salivary cortisol in the everyday environment and salivary cortisol before and after cognitive stress in a laboratory setting. The association between cortisol concentrations and impulsivity was also investigated. Consistent with assumptions, individuals with ADHD reported significantly more self-perceived stress than controls, and subjective stress correlated with the amount of stressors in everyday life. The two groups were comparable with respect to overall diurnal cortisol levels and rhythm, as well as in pre- and post-stress cortisol concentrations. Post-stress cortisol (but not baseline cortisol) concentration was positively correlated with impulsivity. The group with high post-stress cortisol also reported more symptoms of depression and anxiety, as well as self-perceived stress and stressors in every-day life. The diagnosis of ADHD significantly increased the risk of belonging to the group with high post-stress cortisol levels. The results in this study warrant a focus not only on the primary diagnosis of ADHD, but also calls for a broader assessment of stressors and subjective stress in everyday life, as well as support comprising stress management and coping skills.
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In 28 adults with ADHD, there is no difference in daily salivary cortisol rhythms compared to controls.
“Daily rhythms in salivary cortisol in 28 adults with ADHD were examined in a case-control study, and no difference was reported in ADHD compared to control (although there was not a complete diurnal sampling procedure utilised in this study, with cortisol assessment taking place at awakening, 30 min after awakening, between 17:00 and 18:00 and at 23:00; Hirvikoski et al. 2009).”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Hirvikoski et al. 2009
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“Demographic data were collected through the questionnaire “Current Life Situation” (Hirvikoski et al., 2009).”
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- Authors
- Hirvikoski, T., Lindholm, T., Nordenström, A., Nordström, A.-L., & Lajic, S.
- Affiliations
- Karolinska University Hospital (SE)
- Stockholm University (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Hirvikoski, Tatja
- Venue
- Hormones and Behavior
- Publisher
- Elsevier BV
- Published
- 2009-03
- Volume
- 55
- Issue
- 3
- Pages
- 418-424
- ISSN
- 0018-506X (ISSN-L)
- OpenAlex
- W2087984389
- Cited by
- 123
- References
- 50
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 6 · 2023: 8 · 2022: 9 · 2021: 9 · 2020: 7 · 2019: 12 · 2018: 6 · 2017: 8 · 2016: 11 · 2015: 5 · 2014: 8 · 2013: 6 · 2012: 7
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hormones and Behavior (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- adult ADHD, attention deficit hyperactivity disorder, chronic stress, perceived stress, diurnal cortisol rhythm, salivary cortisol, cognitive stress, impulsivity, depression, anxiety, stress management
- MeSH terms
- Adolescent, Adult, Anxiety, Attention Deficit Disorder with Hyperactivity, Circadian Rhythm, Depression, Female, Humans, Hydrocortisone, Impulsive Behavior, Life Change Events, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Self Concept, Socioeconomic Factors, Stress, Psychological, Young Adult
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