{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:29:19Z","timestamp":1790468959303,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,2,10]],"date-time":"2012-02-10T00:00:00Z","timestamp":1328832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:p>\n                    <jats:bold>Background:\u2002<\/jats:bold>\n                    Fluctuations in attention\u2010deficit hyperactivity disorder (ADHD) symptoms related to regulatory deficits in arousal states are themselves characterized by circadian rhythms. Although cortisol is an important circadian arousal\u2010related marker, studies focusing on across\u2010the\u2010day cortisol variations in ADHD are scarce. There is no study with multiple measurements to take into account interday and intraday variability.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:\u2002<\/jats:bold>\n                    Salivary cortisol was sampled five times a day (awakening, 30\u2003min after awakening, noon, 4\u2003p.m., 8\u2003p.m.) across five consecutive days in 33 children with ADHD (22 with and 11 without oppositional defiant disorder; ODD) and 33 class\u2010 and sex\u2010matched controls (aged 6\u201312). The cortisol awakening response (increase from awakening to 30\u2003min after awakening) and the diurnal cortisol profile (across\u2010the\u2010day variations) were compared for ADHD with ODD (ADHD\u2003+\u2003ODD) and without ODD (ADHD) subgroups and the control group.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:\u2002<\/jats:bold>\n                    The cortisol awakening response was not significantly different between groups. However, longitudinal analyses to evaluate cortisol profiles across the day revealed a significant Group\u2003\u00d7\u2003Time effect (\n                    <jats:italic>p<\/jats:italic>\n                    \u2003&lt;\u2003.001). More specifically, compared to each other, the ADHD subgroup showed a flatter slope with relative morning hypo\u2010arousal and evening hyperarousal, whereas the ADHD\u2003+\u2003ODD subgroup showed a steeper slope with relative morning hyperarousal and evening hypo\u2010arousal (\n                    <jats:italic>p<\/jats:italic>\n                    \u2003&lt;\u2003.001).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:\u2002<\/jats:bold>\n                    Findings support time\u2010related arousal disruptions in children with ADHD associated with the presence or absence of ODD comorbidity. We recommend research on cortisol in larger samples for a better understanding of arousal mechanisms involved in ADHD not only with and without ODD but also with other comorbidities which may have implications for timing of arousal\u2010based treatments.\n                  <\/jats:p>","DOI":"10.1111\/j.1469-7610.2012.02526.x","type":"journal-article","created":{"date-parts":[[2012,2,10]],"date-time":"2012-02-10T12:09:44Z","timestamp":1328875784000},"page":"782-789","source":"Crossref","is-referenced-by-count":34,"title":["Time\u2010of\u2010day effects in arousal: disrupted diurnal cortisol profiles in children with 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