HPA-axis activity as a predictor of future disruptive behaviors in young adolescents.

Low HPA-axis activity has been proposed as a risk factor for disruptive behaviors. However longitudinal data on this topic are practically lacking. In the present study we investigated if low HPA-axis activity predicted future disruptive behaviors. We included 1,399 boys and girls from the Dutch general population, initially aged 10-12 years. At the first assessment, basal cortisol levels were assessed. At the first assessment and at follow-up 2 years later disruptive behaviors were assessed with parent and self-report questionnaires. The results suggest that the association between low cortisol levels at 8.00 p.m. and future disruptive behaviors according to the parents was only present for boys. More importantly however, the results suggest that low HPA-axis activity is not a good predictor for disruptive behaviors, but could be valuable to identify those with a poor prognosis, once disruptive behaviors are present in preadolescence.

Externalizing and internalizing problems in relation to autonomic function: a population-based study in preadolescents.

OBJECTIVE: To investigate whether externalizing and internalizing problems are related to lower and higher heart rate (HR), respectively, and to explore the relationship of these problems with respiratory sinus arrhythmia (RSA) and baroreflex sensitivity (BRS). Moreover, to study whether problems present at both preschool and preadolescent age show stronger associations with autonomic function than those that were not. METHOD: In a population cohort of 10- to 13-year-old children (N = 931; 11.6 +/- 0.5 years; 47% boys), autonomic measurements in supine and standing position were performed at school. RSA and BRS were determined by spectral analysis. Current externalizing and internalizing problems were assessed by the Child Behavior Checklist and problems at age 4 to 5 retrospectively by the Preschool Behavior Questionnaire. RESULTS: At supine rest, current externalizing problems were associated with lower HR and higher RSA, but not with BRS and current internalizing problems with higher HR and lower RSA, but not with BRS. These results were specifically found in children with problems that were retrospectively reported to have been also present at preschool age. Standing-induced changes in autonomic parameters were unrelated to the behavioral dimensions. CONCLUSIONS: Externalizing and internalizing problems are associated with divergent autonomic patterns, suggesting autonomic underarousal and overarousal, respectively. Problems starting early in life may specifically account for this. This should be confirmed in prospective studies.

Testing the tripartite model in young adolescents: is hyperarousal specific for anxiety and not depression?

BACKGROUND: To clarify the distinction between anxiety and depression, the tripartite model was introduced. According to this model, physiological hyperarousal (PH, i.e. autonomic hyperactivity) is specific for anxiety and not depression. Research on the relation between anxiety, depression and physiological measures representing arousal is lacking. METHODS: Parent- and self-reported anxiety and depressive problems were assessed using the CBCL and RCADS. Heart rate (HR), heart rate variability in the low frequency (HRV LF) and respiratory sinus arrythmia (RSA) were used as indices for autonomic arousal. RESULTS: Parent-reported anxiety was associated with low RSA in supine posture. This association was also found for self-reported anxiety problems, but only in boys. These findings point towards high arousal in anxiety. Self-reported depressive problems were associated with low HRV LF in standing posture and high RSA in supine posture in boys, pointing towards low arousal in depression. However, self-reported depressive problems were also associated with high HR in standing posture and with low HRV LF in supine posture in girls, suggesting high arousal in depression. LIMITATIONS: Although HRV LF in standing posture is primarily sympathetically mediated, and HRV LF in supine posture is primarily vagally mediated, the association between HRV LF and sympathetic versus vagal function is not exclusive. Thus, HRV LF measures are merely approaches of high or low arousal. CONCLUSIONS: Some evidence was found for hyperarousal in anxiety, but also for hyperarousal in depression. Apparently, the idea of hyperarousal in anxiety and not in depression is too simple to reflect the more complex reality.

Disruptive behaviors and HPA-axis activity in young adolescent boys and girls from the general population.

It is important to investigate associations between biological factors and disruptive behaviors in children and adolescents. Antisocial, aggressive, and criminal behaviors in adults often begin early in life. Disruptive behaviors are often thought to be associated with low activity of the hypothalamic-pituitary-adrenal (HPA) axis. Cortisol, the end-product of this axis, can be measured to investigate HPA-axis activity. Previous studies on this topic concerned clinical or high risk samples. The aim of the present study was to investigate to which extent HPA-axis functioning plays a role in disruptive behaviors in pre-adolescents from the general population. One thousand seven hundred and sixty eight 10- to 12-year-olds from the Dutch general population were investigated. Disruptive behaviors were assessed with the Child Behavior Checklist, the Youth Self-Report, and the Antisocial Behavior Questionnaire. Baseline morning and evening salivary cortisol levels were assessed. Unexpectedly, small associations were found between disruptive behaviors, including attention problems, and higher cortisol levels. However, all effect sizes of significant effects were very small. Our study indicated that HPA-axis functioning may be more relevant in clinical or high risk samples than at the general population level. The association between HPA-axis functioning and attention problems, that has gotten less attention than that with aggressive or delinquent behaviors, requires further research. Furthermore, because effect sizes were relatively small, it can be concluded that, in pre-adolescence, the measures of baseline HPA-axis functioning that were used for the present study can not be used as biological markers for disruptive behaviors.

Classes of adolescents with disruptive behaviors in a general population sample.

BACKGROUND: To study disruptive behaviors adequately, we need to distinguish between individuals with different types of problems that may have a different etiology. The availability of a taxonomic system that helps in identifying homogeneous groups of individuals, with similar patterns of disruptive behaviors, is crucial to achieve this goal. Therefore, we examine which classes of preadolescents with symptoms of Attention Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) can be identified in the general population. METHODS: Disruptive behaviors of 2,230 10-12 year olds from the Dutch general population were assessed with the Child Behavior Checklist and Youth Self-Report. RESULTS: Latent class analysis revealed three classes of preadolescents: the first characterized by high scores on ADHD, ODD, and CD items; a second by high probabilities of ADHD and ODD symptoms; a third with low scores on all items. CONCLUSIONS: Because classes of preadolescents with symptoms of only one type of disruptive behavior problems could not be identified, it can be questioned how useful separate diagnostic distinctions are in general population studies.