Hypothalamic-pituitary-adrenal axis and autonomic nervous system activity in disruptive children and matched controls

J Am Acad Child Adolesc Psychiatry. 2000 Nov;39(11):1438-45. doi: 10.1097/00004583-200011000-00019.


Objectives: To investigate whether a pattern of lower autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis activity is found in children with disruptive behavior disorders (DBD) under nonstressful and stressful conditions, and whether such a pattern would correspond with their feelings of control and negative emotionality.

Method: The effects of stress were studied by comparing cortisol response, heart rate (HR), skin conductance level (SCL), and subjective feelings of 26 children with DBD and 26 matched normal controls. An additional 12 normal control children were studied in a nonstress control condition.

Results: Baseline HR and SCL but not cortisol were lower in the DBD group. Stress significantly affected cortisol, HR, SCL, and negative moods, although children with DBD showed a weaker HPA stress response and the difference between the groups was greater under stress.

Conclusions: Children with DBD are characterized by lower ANS activity and HPA axis responsivity, but higher levels of emotional arousal. It is possible that in children with DBD the HPA axis and ANS, on the one hand, and their emotional arousal, on the other, are less well coordinated. It is speculated that this could be due to differences in genetic makeup or to stressful conditions during pre- or postnatal life.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affect
  • Arousal / genetics*
  • Attention Deficit and Disruptive Behavior Disorders / physiopathology*
  • Attention Deficit and Disruptive Behavior Disorders / psychology
  • Autonomic Nervous System / physiopathology*
  • Case-Control Studies
  • Child
  • Female
  • Galvanic Skin Response
  • Genetic Predisposition to Disease
  • Heart Rate
  • Humans
  • Hydrocortisone / metabolism
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Male
  • Pituitary-Adrenal System / physiopathology*
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Psychiatric Status Rating Scales
  • Saliva / metabolism
  • Stress, Psychological / genetics
  • Stress, Psychological / physiopathology*


  • Hydrocortisone