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The \naim of the present study was to investigate whether children with \nattention-deficit\/hyperactivity disorder (ADHD) differ from ODD \nchildren with (OD\/AD) or without comorbid ADHD in ANS and HPA axis \nactivity under baseline and stressful conditions. The effects of stress \non cortisol, heart rate (HR), and skin conductance level (SCL) were \nstudied in 95 children (26 normal control [NC] children and \n69 child psychiatric patients referred for externalizing behavior \nproblems [15 ODD, 31 OD\/AD, and 23 ADHD]). No baseline \ndifferences were found in cortisol between the four groups. However, \nthe ODD and OD\/AD groups showed a significantly weaker cortisol \nresponse to stress compared to the ADHD and NC groups; the ADHD group \nhad a similar cortisol response as the NC group. Within the ODD group \nthis pattern of low cortisol responsivity was most clearly present in \nthe more severely affected inpatients. With respect to HR, the ODD \ngroup had a significantly lower HR during baseline and stressful \nconditions. The higher HR levels in the OD\/AD and ADHD groups were \nlikely to be caused by methylphenidate. The externalizing groups had \nsignificantly lower SCL levels, and no differences were found between \nthese groups. It was concluded that differences in cortisol \nresponsivity during stress exposure are important in distinguishing \nwithin a group of children with externalizing behavior between those \nwith ODD and ADHD.<\/jats:p>","DOI":"10.1017\/s0954579404044578","type":"journal-article","created":{"date-parts":[[2008,4,21]],"date-time":"2008-04-21T11:34:06Z","timestamp":1208777646000},"page":"389-406","source":"Crossref","is-referenced-by-count":126,"title":["Stress responsivity in children with externalizing behavior \ndisorders"],"prefix":"10.1017","volume":"16","author":[{"given":"HEDDEKE","family":"SNOEK","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"STEPHANIE H.M.","family":"VAN GOOZEN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WALTER","family":"MATTHYS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JAN K.","family":"BUITELAAR","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HERMAN","family":"VAN ENGELAND","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2004,6,1]]},"reference":[{"key":"S0954579404044578_ref035","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199710000-00029"},{"key":"S0954579404044578_ref046","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-7138(09)60193-X"},{"key":"S0954579404044578_ref032","unstructured":"Raine, A. 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