Temperament Dimensions and Awakening Cortisol Levels in Attention-Deficit/Hyperactivity Disorder

Alessandra Carta; Isabella Vainieri; Anna-Sophie Rommel; Alessandro Zuddas; Jonna Kuntsi; Stefano Sotgiu; Nicoletta Adamo

doi:10.3389/fpsyt.2022.803001

Temperament Dimensions and Awakening Cortisol Levels in Attention-Deficit/Hyperactivity Disorder

Front Psychiatry. 2022 Apr 25:13:803001. doi: 10.3389/fpsyt.2022.803001. eCollection 2022.

Authors

Alessandra Carta^{1

2}, Isabella Vainieri^{2

3}, Anna-Sophie Rommel^{2

4}, Alessandro Zuddas^{5

6}, Jonna Kuntsi², Stefano Sotgiu¹, Nicoletta Adamo^{2

3}

Affiliations

¹ Child Neuropsychiatry Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
² Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
³ South London and Maudsley National Health Service Foundation Trust, London, United Kingdom.
⁴ Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
⁵ Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
⁶ Child and Adolescent Neuropsychiatry Unit, 'A.Cao', Paediatric Hospital, 'G. Brotzu' Hospital Trust, Cagliari, Italy.

Abstract

Objective: To investigate whether temperament dimensions, Effortful Control (EC), Surgency-Extraversion (SE), and Negative Affectivity (NA), are associated with attention-deficit/hyperactivity disorder (ADHD) and how they relate to awakening cortisol levels, as a proxy measure of peripheral arousal.

Methods: Parent-rated temperament and saliva samples were collected from 55 children with ADHD and 65 age-matched controls.

Results: Compared to controls, youths with ADHD showed lower EC, higher NA, and lower awakening cortisol levels but did not differ in SE. Similar findings emerged in dimensional analyses linking temperament traits to inattention and hyperactivity-impulsivity symptoms. The results remained unchanged when controlling for the presence of co-occurring opposition-defiance and anxiety traits, as well as medication status. Temperament dimensions were not associated with cortisol levels.

Conclusions: Poor temperamental emotional and cognitive self-regulation showed significant associations with ADHD but did not appear to be linked to the under-arousal typically seen in ADHD.

Keywords: ADHD; arousal; biomarkers; cortisol; temperament.