Comparing the effects of age, pubertal development, and symptom profile on cortisol rhythm in children and adolescents with autism spectrum disorder

Abstract

Previous studies in children with autism spectrum disorder (ASD) have shown elevated evening cortisol; however, few studies have examined diurnal rhythm in adolescents with ASD. Adolescence is a time of significant physical and psychological change, and dysregulation of the hypothalamic-pituitary-adrenal axis may put adolescents with ASD at increased risk for internalizing disorders, such as anxiety and depression. The extent to which cortisol levels are associated with age, puberty and symptom profile was examined in 113 youth (ages 7-17) with ASD and typical development. Salivary samples were collected over 3 days in the home, 4 times per day (waking, 30-min post-waking, afternoon, evening). Results showed youth with ASD had higher evening cortisol and a blunted diurnal slope relative to TD youth. Pubertal development and age were significant predictors of evening cortisol, and adolescents with ASD had higher evening cortisol levels compared to children with ASD. The study extends previous reports of elevated evening cortisol in children with ASD to reveal high levels in adolescence as well. Adolescents with ASD also show a significantly blunted diurnal slope, which may be associated with risk of internalizing symptoms. Findings suggest elevated evening cortisol persists across development in youth with ASD, thus emphasizing a need to identify potential negative effects of excess cortisol exposure on health in ASD individuals. Autism Res 2018, 11: 110-120. V C 2017 International Society for Autism Research, Wiley Periodicals, Inc.Lay Summary: Elevations in stress hormone, cortisol, during the evening may indicate increased stress from changes throughout the day in youth with autism spectrum disorder (ASD). The current study shows that age and pubertal development are also related to increases in evening cortisol, and this maladaptive elevation in cortisol in ASD is not going away with age. These cortisol elevations may also be associated with other psychological symptoms and warrant further investigation in adolescents with ASD.

Assessing a hyperarousal hypothesis of insomnia in adults with autism spectrum disorder

“…In a large study of 113 adolescents (7–17 years) with ASD, hypersecretion of cortisol was observed in the evening, but not at any other time point in comparison to age‐ and sex‐matched controls. However, the diurnal slope of the ASD group was also blunted [Muscatello & Corbett, ]. Both age and puberty were significant predictors of evening cortisol levels, with increased age and pubertal status being associated with higher cortisol levels [Muscatello & Corbett, ].…”

“…However, the diurnal slope of the ASD group was also blunted [Muscatello & Corbett, ]. Both age and puberty were significant predictors of evening cortisol levels, with increased age and pubertal status being associated with higher cortisol levels [Muscatello & Corbett, ]. Corbett et al [] and Richdale and Prior [] also demonstrated hypersecretion in children with ASD aged 6–12 and 4–14 years, respectively.…”

Comparing stress and arousal systems in response to different social contexts in children with ASD

“…A growing body of research has emerged over the last few decades examining the activation of the HPA axis in children and adolescents with ASD (Muscatello & Corbett, 2018; Taylor & Corbett, 2014). Although the majority of the studies have been conducted on the reactivity of the HPA axis in children (Corbett, Schupp, & Lanni, 2012; Lanni, Schupp, Simon, & Corbett, 2012; Nir et al, 1995; Schupp, Simon, & Corbett, 2013; Tani et al, 2005; Tordjman et al, 2009) studies with adolescents are emerging (Edmiston, Blain, & Corbett, 2017).…”

Identifying Predictors of Momentary Negative Affect and Depression Severity in Adolescents with Autism: An Exploratory Ecological Momentary Assessment Study

“…Parents completed the five-item measure, indicating on a four-point scale ranging from: not yet begun to complete. The PDS was originally developed as a self-report measure of pubertal development; however, it also has been used as a parent-report pubertal development measure (Muscatello & Corbett, 2018 ). While parents were the ones completing the measure, we encouraged all parents to consult with their child to confirm their answers.…”