Physiological and psychological stress responses in adults with attention-deficit/hyperactivity disorder (ADHD)

Lackschewitz, Halina; Hüther, Gerald; Kröner‐Herwig, Birgit

doi:10.1016/j.psyneuen.2008.01.016

Cited by 125 publications

(95 citation statements)

References 49 publications

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“…A wealth of studies in subjects with ADHD reported hypo-aroused heart rate responses in relation to for example stress [30] and reward [15,28]. It is difficult however to compare these findings to those of our study as we did not investigate heart rate in response to such stimuli, under strict laboratory conditions.…”

Section: Discussioncontrasting

confidence: 52%

“…During daytime periods however, low resting heart rate has consistently been reported in aggressive and antisocial behavior [32,39]. This finding may not blindly be generalized to ADHD as studies in this population revealed inconsistent results with most of them describing no difference in resting heart rate [28,30]. Next to possible confounding effects of time of day, these baseline levels may be influenced by varying levels of anticipatory stress as 'resting' assessments were mostly carried out prior to a laboratory experiment investigating the environmental effects on arousal.…”

Section: Discussionmentioning

confidence: 99%

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Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD

Imeraj

Antrop

Roeyers

et al. 2011

Eur Child Adolesc Psychiatry

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Previous studies suggest an altered circadian regulation of arousal in children with Attention-Deficit Hyperactivity Disorder (ADHD) as measured by activity, circadian preference, and sleep-wake patterns.Although heart rate is an important measure to evaluate arousal profiles, to date it is unknown whether 24-hour heart rate patterns differentiate between children with and without ADHD.In this study, 24-hour heart rate data were collected in 30 non-medicated children with ADHD (aged 6-11) and 30 sex-, class-, and age-matched normal controls in their naturalistic home and school setting, during five days. Simultaneously, 24-hour activity patterns were registered. Confounding effects of demographic variables (e.g., age, sex, BMI, pubertal stage) and comorbid internalizing and externalizing problems on heart rate levels were additionally assessed.Longitudinal analysis showed that heart rate levels were overall higher in the ADHD group (p<0.01) -with largest effects during afternoon and night-, in a model controlling for age. Other factors did not significantly contribute to variations in heart rate levels. Compared to controls, children with ADHD showed higher activity levels during daytime (especially early afternoon), but not during nighttime (p<0.05). Post hoc analyses showed that environmental effects may influence daytime variations.Findings suggest an autonomic imbalance in children with ADHD as compared to controls, with higher heart rate levels in the ADHD group. Nighttime tachycardia in this group could not be explained by nighttime activity levels or comorbid externalizing/internalizing problems. Further research on autonomic functioning in ADHD is recommended because of the major impact of higher resting heart rate on health outcomes.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD

Imeraj

Antrop

Roeyers

et al. 2011

Eur Child Adolesc Psychiatry

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“…As the rhythm in cortisol is known to be centrally driven via the SCN master clock, 27 the phase delay observed in our study may further reflect a deficit in the entrainment of the master circadian clock in adult ADHD to appropriate environmental and social stimuli. Seemingly normal diurnal rhythms of cortisol secretion have been reported in adult ADHD, 28,29 but as these studies did not undertake chronometric analysis, these findings may simply reflect the preservation of the rhythmic cortisol levels in adult ADHD (as reported here) but would not be able to detect the alterations in the phasing of the rhythm that we report. Altered neuroendocrine signalling by melatonin or cortisol may affect the entrainment of peripheral clocks, such as the oral mucosa.…”

Section: Melatonin and Cortisolcontrasting

confidence: 48%

Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels

et al. 2011

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Attention-deficit hyperactivity disorder (ADHD) in adults is associated with impaired sleep, and it has been postulated that this impairment may contribute to the psychopathology of this common condition. One key driver of sleep/wake cycles is the circadian system, which at the molecular level consists of a series of transcriptional feedback loops of clock genes, which in turn produce endocrine, physiological and behavioural outputs with a near 24 h periodicity. We set out to examine circadian rhythms at the behavioural, endocrine and molecular levels in ADHD. Adults with ADHD as well as age-and sex-matched controls were recruited. Circadian rhythms were measured by means of actigraphy for the determination of gross motor patterns, by self-sampling of oral mucosa for assessment of rhythmic expression of the clock genes BMAL1 and PER2, and by estimation of salivary cortisol and melatonin levels. Actigraphic analysis revealed significant diurnal and nocturnal hyperactivity in the ADHD group, as well as a significant shorter period of best fit for the locomotor circadian rhythm in ADHD. BMAL1 and PER2 showed circadian rhythmicity in controls with this being lost in the ADHD group. Cortisol rhythms were significantly phase delayed in the ADHD group. These findings indicate that adult ADHD is accompanied by significant changes in the circadian system, which in turn may lead to decreased sleep duration and quality in the condition. Further, modulation of circadian rhythms may represent a novel therapeutic avenue in the management of ADHD.

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“…For example, research suggests that HR and skin conductance values associated with objectively arousing events such as the anticipation of giving a speech, being judged, or intense navy training, tend to be higher than reported here (e.g., de Rooij, Schene, Phillips, & Roseboom, 2010;Hofmann, Moscovitch, & Kim, 2005;Lackschewitz, Huther, Kroner-Herwig, 2008;Strahler, Mueller, Rosenloecher, Kirschbaum, & Rohleder, 2010). In this context, boredom may be considered to be less stressful or anxiety provoking than the kinds of behaviours mentioned above.…”

Section: Discussionmentioning

confidence: 50%

Characterizing the psychophysiological signature of boredom

2013

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Physiological and psychological stress responses in adults with attention-deficit/hyperactivity disorder (ADHD)

Cited by 125 publications

References 49 publications

Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD

Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD

Adult attention-deficit hyperactivity disorder is associated with alterations in circadian rhythms at the behavioural, endocrine and molecular levels

Characterizing the psychophysiological signature of boredom

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