Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: Longitudinal and concurrent associations with cortisol

• Published in: Hormones and behavior 2011-01, Vol.59 (1), p.123-132
• Main Authors: Ruttle, Paula L., Shirtcliff, Elizabeth A., Serbin, Lisa A., Ben-Dat Fisher, Dahlia, Stack, Dale M., Schwartzman, Alex E.
• Format: Article
• Language: English
• Subjects: Adolescent; Aggression - physiology; Anxiety - metabolism; Arousal - physiology; Behavior disorders; Behavioral psychophysiology; Biological and medical sciences; Blunted; Child Behavior Disorders - metabolism; Children & youth; Circadian Rhythm - physiology; Depression - metabolism; Diurnal cortisol; Emotions; Externalizing behavior; Fundamental and applied biological sciences. Psychology; Hierarchical linear modeling; Hormones and behavior; Humans; Hydrocortisone - analysis; Hydrocortisone - metabolism; Hypothalamo-Hypophyseal System - metabolism; Internalizing behavior; Longitudinal Studies; Models, Statistical; Personality Development; Pituitary-Adrenal System - metabolism; Psychobiology; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Saliva - chemistry; Steroids
• ISSN: 0018-506X; 1095-6867; 1095-6867
• DOI: 10.1016/j.yhbeh.2010.10.015

Research examining cortisol dysregulation is seemingly contradictory with studies showing that both internalizing and externalizing behaviors are related to high and low cortisol. One extant theory to explain divergent findings in the stress literature is that both hypo- and hyper-arousal of the hypothalamic–pituitary–adrenal (HPA) axis may be present depending on time since onset of the stressor. This theory may extend to the onset of internalizing and externalizing behaviors. Data from 96 youth participating in a longitudinal project were used to examine this possibility. Composite measures of internalizing and externalizing behaviors at both childhood and early adolescence were formed using mother and teacher reports. Multiple salivary cortisol samples were also collected over two consecutive days during early adolescence. Problematic behaviors were associated with cortisol and the direction of the association was dependent on amount of time passed since onset of the behaviors. When examined concurrently in adolescence, youth with more internalizing behaviors had higher morning cortisol; however, when examined longitudinally, youth with more internalizing behaviors in childhood had lower morning cortisol levels as adolescents. Youth with more externalizing behaviors in childhood had flattened diurnal cortisol rhythms as adolescents, and this finding persisted when examined in adolescence. Cortisol dysregulation was greatest in children with the most severe behavior problems. Findings support the theoretical model of blunting of the HPA axis over time. While the HPA axis may show hyper-arousal when youth first display behaviors, long-term exposure may lead to a hypo-arousal of the HPA axis which culminates in a dysregulated diurnal rhythm. ► Youth with high levels of internalizing behaviors for a short period of time demonstrate elevated levels of morning cortisol. ► Youth with high levels of internalizing behaviors for a long period of time demonstrate blunted levels of morning cortisol. ► Youth with high levels of externalizing behaviors demonstrate a blunted diurnal cortisol slope regardless of amount of time passed. ► Youth with the most extreme levels of internalizing or externalizing behavior had distinct cortisol profiles marked by more dysregulation throughout the day.