Increased Cortisol after Stress is Associated with Variability in Response Time in ADHD Children

PURPOSE: Children with attention-deficit/hyperactivity disorder (ADHD) often perform poorly during cognitive tests. We sought to evaluate cortisol as potential moderator of performance in mentally challenging tasks in children with ADHD. MATERIALS AND METHODS: Ninety clinic-referred children with ADHD were studied. Cortisol contents in saliva were measured before and after administration of a continuous performance test (CPT). RESULTS: Pre and post CPT cortisol levels were similar in 68 children. Children whose cortisol level increased after testing ( n = 22 ) displayed a significantly longer response time and increased response time variability scores as compared to children who did not display increase of cortisol after the CPT test. Even after controlling for the effects of response time and anxiety, the changes in cortisol levels were associated with effect on response time variability. CONCLUSION: The patients who showed an increased cortisol level after stress displayed a higher variability in response time than the patients who showed no change or a decreased cortisol level. The result of the current study suggests that stress-induced high norepinephrine (NE) release may accompany poorer attention performance in patients with ADHD.

Maternal Depression Predicts Maternal Use of Corporal Punishment in Children with Attention-Deficit/Hyperactivity Disorder

PURPOSE: We sought to determine if maternal depression contributed to the use of corporal punishment in children with attention-deficit/hyperactivity disorder (ADHD). PATIENTS and METHODS: The data were gathered through chart review of clinic-referred children with ADHD and their mothers who were evaluated at a psychiatric clinic located in a large academic medical center in Seoul, Korea. Daily records kept by parents and 13 items from the Physical Assault of the Parent-Child Conflict Tactics Scales (CTSPC) were used to assess corporal punishment. Ninety-one children with ADHD and their mothers were included in this study. RESULTS: Mothers who used corporal punishment showed significantly higher scores on the Beck Depression Inventory (t = -2.952, df = 89, p < 0.01) than mothers who did not. Moreover, maternal depression contributed to the use of corporal punishment in ADHD children (Nagelkerke R(2) = 0.102, p < 0.05). CONCLUSION: Maternal depression contributes to the use of corporal punishment with children with ADHD. Assessment and management of the maternal depression should be an important focus of evaluation of children with ADHD.