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Does the cortisol response to stress mediate the link between expressed emotion and oppositional behavior in attention-deficit/hyperactivity-disorder (ADHD)?

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Abstract
Background: Expressed Emotions (EE) are associated with oppositional behavior (OPB) in children with Attention Deficit/Hyperactivity Disorder (ADHD). EE has been linked to altered stress responses in some disorders, but ADHD has not been studied. We test the hypothesis that OPB in ADHD is mediated by altered stress-related cortisol reactivity to EE. Methods: Two groups of children (with/without ADHD) and their respective parents were randomly assigned to two different conditions with/without negative emotion and participated in an emotion provocation task. Parents' EE, their ratings of their children's OPB and their children's salivary cortisol levels were measured. Results: Low parental warmth was associated with OPB in ADHD. High levels of parental EE elicited a larger cortisol response. Stress-related cortisol reactivity mediated the EE-OPB link for all children. This highlights the general importance of parent-child interactions on externalizing behavior problems. Conclusion: High EE is a salient stressor for ADHD children that leads to increased levels of cortisol and OPB. The development of OPB might be mediated by the stress-response to high EE.
Keywords
DEFICIT HYPERACTIVITY DISORDER, DISRUPTIVE BEHAVIOR, PSYCHOPHYSIOLOGICAL REACTIVITY, PSYCHIATRIC-DISORDERS, ANTISOCIAL-BEHAVIOR, SALIVARY CORTISOL, NORMAL-CHILDREN, YOUNG-CHILDREN, OLDER-ADULTS, BOYS

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Chicago
Christiansen, Hanna, Robert D Oades, Lamprini Psychogiou, Berthold P Hauffa, and Edmund Barke. 2010. “Does the Cortisol Response to Stress Mediate the Link Between Expressed Emotion and Oppositional Behavior in Attention-deficit/hyperactivity-disorder (ADHD)?” Behavioral and Brain Functions 6 (45).
APA
Christiansen, Hanna, Oades, R. D., Psychogiou, L., Hauffa, B. P., & Barke, E. (2010). Does the cortisol response to stress mediate the link between expressed emotion and oppositional behavior in attention-deficit/hyperactivity-disorder (ADHD)? BEHAVIORAL AND BRAIN FUNCTIONS, 6(45).
Vancouver
1.
Christiansen H, Oades RD, Psychogiou L, Hauffa BP, Barke E. Does the cortisol response to stress mediate the link between expressed emotion and oppositional behavior in attention-deficit/hyperactivity-disorder (ADHD)? BEHAVIORAL AND BRAIN FUNCTIONS. 2010;6(45).
MLA
Christiansen, Hanna, Robert D Oades, Lamprini Psychogiou, et al. “Does the Cortisol Response to Stress Mediate the Link Between Expressed Emotion and Oppositional Behavior in Attention-deficit/hyperactivity-disorder (ADHD)?” BEHAVIORAL AND BRAIN FUNCTIONS 6.45 (2010): n. pag. Print.
@article{1141662,
  abstract     = {Background: Expressed Emotions (EE) are associated with oppositional behavior (OPB) in children with Attention Deficit/Hyperactivity Disorder (ADHD). EE has been linked to altered stress responses in some disorders, but ADHD has not been studied. We test the hypothesis that OPB in ADHD is mediated by altered stress-related cortisol reactivity to EE.
Methods: Two groups of children (with/without ADHD) and their respective parents were randomly assigned to two different conditions with/without negative emotion and participated in an emotion provocation task. Parents' EE, their ratings of their children's OPB and their children's salivary cortisol levels were measured.
Results: Low parental warmth was associated with OPB in ADHD. High levels of parental EE elicited a larger cortisol response. Stress-related cortisol reactivity mediated the EE-OPB link for all children. This highlights the general importance of parent-child interactions on externalizing behavior problems.
Conclusion: High EE is a salient stressor for ADHD children that leads to increased levels of cortisol and OPB. The development of OPB might be mediated by the stress-response to high EE.},
  author       = {Christiansen, Hanna and Oades, Robert D and Psychogiou, Lamprini and Hauffa, Berthold P and Barke, Edmund},
  issn         = {1744-9081},
  journal      = {BEHAVIORAL AND BRAIN FUNCTIONS},
  keyword      = {DEFICIT HYPERACTIVITY DISORDER,DISRUPTIVE BEHAVIOR,PSYCHOPHYSIOLOGICAL REACTIVITY,PSYCHIATRIC-DISORDERS,ANTISOCIAL-BEHAVIOR,SALIVARY CORTISOL,NORMAL-CHILDREN,YOUNG-CHILDREN,OLDER-ADULTS,BOYS},
  language     = {eng},
  number       = {45},
  pages        = {11},
  title        = {Does the cortisol response to stress mediate the link between expressed emotion and oppositional behavior in attention-deficit/hyperactivity-disorder (ADHD)?},
  url          = {http://dx.doi.org/10.1186/1744-9081-6-45},
  volume       = {6},
  year         = {2010},
}

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