Higher cortisol awakening response in young adolescents with persistent anxiety problems

Acta Psychiatr Scand. 2007 Aug;116(2):137-44. doi: 10.1111/j.1600-0447.2007.01001.x.


Objective: The aims of the present study were to test the association between current anxiety problems and basal cortisol levels in a large population sample of young preadolescents, and to test if HPA-axis activity differs between individuals with no, only current, or persistent anxiety problems.

Method: Cortisol levels of 10- to 12-year olds (n = 1,768) from the general population were measured on three time points during the day. A self-report questionnaire (RCADS) was used to assess current anxiety, a parent-report questionnaire (TPBQ) to assess anxiety problems at age 4.

Results: Associations between cortisol levels and current anxiety problems were not found. However, individuals with persistent anxiety problems had higher morning cortisol levels and a higher cortisol awakening response.

Conclusion: Apparently, only persistent, and not current, anxiety problems are associated with higher HPA-axis activity. Alterations in HPA-axis activity might underlie persistent anxiety problems, or result from the stress accompanied by persistent anxiety problems.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety Disorders / blood*
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Arousal / physiology
  • Child
  • Child, Preschool
  • Chronic Disease
  • Circadian Rhythm / physiology*
  • Female
  • Health Surveys
  • Humans
  • Hydrocortisone / blood*
  • Hypothalamo-Hypophyseal System / physiopathology
  • Male
  • Netherlands
  • Pituitary-Adrenal System / physiopathology
  • Retrospective Studies
  • Wakefulness / physiology*


  • Hydrocortisone