Attention-deficit hyperactivity disorder and the stress response

Background: Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder whose three main symptoms are impulsiveness, inattention, and hyperactivity. Researchers have proposed that the central deficit in ADHD is one of poor response inhibition. The present studies were designed to look at the functioning of the hypothalamic–pituitary–adrenal (HPA) axis in response to mental stress in aggressive ADHD subjects participating in a longitudinal study of various psychosocial treatments. Methods: Pretest and posttest morning salivary samples for cortisol determination were collected from subjects given a battery of tests. Results: The study shows that ADHD subjects who maintained their diagnosis over the first year of the study had a blunted response to the stressor in comparison to those ADHD subjects who no longer retained the disorder 1 year later. Conclusions: The data suggest that an impaired response to stress may be a marker for the more developmentally persistent form of the disorder.