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Repeated exposure to stress might lead to the dysfunction of the hypothalamic\u2013pituitary\u2010adrenocortical\u2010axis and be a vulnerability factor for developing mental health difficulties. Previous studies show contradictory findings on salivary cortisol in autism. In the current study, we investigated diurnal cortisol profiles in autistic adolescents and young adults, as well as their associations with social difficulties, stress exposure, and mental health symptoms. Autistic (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200948,\n                    <jats:italic>M<\/jats:italic>\n                    <jats:sub>age<\/jats:sub>\n                    \u2009=\u200917.6) and nonautistic (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200951,\n                    <jats:italic>M<\/jats:italic>\n                    <jats:sub>age<\/jats:sub>\n                    \u2009=\u200918.4) participants collected salivary cortisol at home six times a day for 2\u2009days. Social difficulties, exposure to stressful life events\/bullying, and mental health symptoms were assessed with questionnaires and clinical interviews. Similar diurnal cortisol slopes (DCS) and cortisol awakening responses were observed between the groups, but autistic participants showed higher total cortisol output (AUC\n                    <jats:sub>G<\/jats:sub>\n                    , area under the curve with respect to ground) during the day (\n                    <jats:italic>b<\/jats:italic>\n                    \u2009=\u200919.09,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009). In the autistic group, more severe social difficulties were associated with flatter DCS (\n                    <jats:italic>b<\/jats:italic>\n                    \u2009=\u20090.01,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007). Finally, cortisol alterations were associated with self\u2010reported mental health symptoms, especially in autistic females in analyses uncorrected for multiple comparisons. In conclusion, our results do not indicate autism\u2010related group\u2010level alterations in most diurnal cortisol measures, but autistic youth showed higher total cortisol (AUC\n                    <jats:sub>G<\/jats:sub>\n                    ) compared with nonautistic peers. More detailed investigation of interindividual variability in cortisol profiles within autistic people might give us important insights into vulnerability to developing stress\u2010related mental health difficulties.\n                  <\/jats:p>","DOI":"10.1002\/aur.3184","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T06:59:49Z","timestamp":1720421989000},"page":"1601-1615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diurnal cortisol profiles in autistic adolescents and young adults: Associations with social difficulties and internalizing mental health symptoms"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-5874","authenticated-orcid":false,"given":"Laura","family":"Ilen","sequence":"first","affiliation":[{"name":"Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farnaz","family":"Delavari","sequence":"additional","affiliation":[{"name":"Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-1257","authenticated-orcid":false,"given":"Cl\u00e9mence","family":"Feller","sequence":"additional","affiliation":[{"name":"Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Zanoletti","sequence":"additional","affiliation":[{"name":"Behavioral Genetics laboratory Swiss Federal Institute of Technology Lausanne (EPFL)  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Sandi","sequence":"additional","affiliation":[{"name":"Behavioral Genetics laboratory Swiss Federal Institute of Technology Lausanne (EPFL)  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maude","family":"Schneider","sequence":"additional","affiliation":[{"name":"Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Manual for the ASEBA school\u2010age forms and profiles","author":"Achenbach T. 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