Hair cortisol and depressive symptoms in youth: An investigation of curvilinear relationships
Introduction
Nearly 1 in 8 U.S. adolescents reported a major depressive episode in 2016, a proportion that has steadily increased over the past decade. (National Institute of Mental Health, 2017). Early identification of depression is vital as suicide is now the second leading cause of death among adolescents aged 11–17 years (Hedegaard et al., 2018). Stress biomarkers, such as cortisol, have been investigated as potential tools to aid in the diagnosis and management of adolescent depression. (Guerry and Hastings, 2011) Hair cortisol may be a particularly useful biomarker to aid in the diagnosis of depression as it provides a longer term and retrospective measure of cortisol with less collection burden than salivary measures (Short et al., 2016).
However, few studies to date have examined hair cortisol as a predictor of depression for any life stage of development, and of those that have, the findings have been mixed (Caparros-Gonzalez et al., 2017; Dowlati et al., 2010; Gerber et al., 2013; Mayer et al., 2018). Specifically, the association between hair cortisol and depression or depressive symptoms was reported as null in adults with coronary artery disease (Dowlati et al., 2010) as well as in young adult medical interns (Mayer et al., 2018); positive in adult pregnant women in which higher hair cortisol levels during the first and third trimester predicted post-partum depression (Caparros-Gonzalez et al., 2017); and negative in a small young adult sample of university students in which higher hair cortisol levels were associated with fewer depressive symptoms (Gerber et al., 2013). Thus, we build on this research through the investigation of hair cortisol as a predictor of depressive symptoms in a representative community sample of youth. We explore both linear and nonlinear associations due to the mixed findings in the literature and findings from prior research in which urinary cortisol levels at both the low and high end of the distribution were associated with increased depressive symptoms in older adults (Penninx et al., 2007).
Section snippets
Study design and sample
The current study examined data from the Adolescent Health and Development in Context (AHDC) study– a longitudinal cohort study investigating the impact of social and spatial exposures on the health of diverse youth aged 11–17 years (n = 1401) in Franklin County, OH; stress biomarkers, including hair cortisol, were collected on a subsample of youth participating in the first wave of the AHDC study (N = 600). The study design is described in detail elsewhere (Ford et al., 2016; Ford and Stowe,
Discussion
This study is among the first to examine linear and nonlinear relationships between cortisol levels in hair and depressive symptoms finding that hair cortisol levels at the lower and higher end of the sample distribution predicted increased depressive symptoms in this large representative sample of youth. These findings are consistent with a study of older adults in which urinary cortisol levels at the low and high end predicted depressive symptoms (Penninx et al., 2007). Together, these
CRediT authorship contribution statement
Jodi L Ford: Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Writing - original draft, Writing - review & editing. Samantha J. Boch: Conceptualization, Data curation, Methodology, Writing - review & editing. Christopher R. Browning: Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Writing - review & editing.
Declaration of Competing Interest
Drs. Ford, Boch and Browning have no conflicts of interest to disclose.
Acknowledgements
This study was funded by the U.S. National Institutes of Health, National Institute on Drug Abuse (Ford, 1R21DA034960 and Browning, 5R01DA032371) and National Institute of Child Health and Development (Casterline, 2P2CHD058484).
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2023, Journal of Psychiatric ResearchPre-pandemic socio-emotional vulnerability, internalizing and externalizing symptoms predict changes in hair cortisol concentrations in reaction to the COVID-19 pandemic in children
2022, PsychoneuroendocrinologyCitation Excerpt :The latter can be divided into two broad categories: internalizing (e.g., depression, anxiety) and externalizing (e.g., disruptive behaviour, attention problems, hyperactivity) symptoms. Indeed, numerous cross-sectional studies have found that altered HCC was associated with internalizing (Ford et al., 2019; Gray et al., 2018; Lu et al., 2018; Rietschel et al., 2016; Sandstrom et al., 2021; Stalder et al., 2017) and externalizing (Grotzinger et al., 2018; Kao et al., 2018; Pauli-Pott et al., 2017, 2019; Schloß et al., 2018; White et al., 2017) symptoms in youth. Nevertheless, findings regarding the directionality of these effects (positive vs. negative) are inconclusive.
Do subjective and objective measures of stress agree in a clinical sample of youth and their parents?
2022, Comprehensive PsychoneuroendocrinologyCitation Excerpt :Similarly inconsistent findings were reported on the association between HCC and depression, depending on the type of depression (atypical vs melancholic) and the timing of sampling with both low and high levels of HCC associated with depression. Among young adults, HCC has been found to have a negative association with depressive symptoms [24], however, more recent findings have suggested a curvilinear relationship exists such that HCC at the low and high end of the distribution are associated with depressive symptoms [25]. Limited research in children has focused on the association between HCC and posttraumatic stress disorder [26], externalizing disorders [27], and environmental stress from childhood adversities such as maltreatment [28] and chronic physical illness [29].
Longitudinal hair cortisol in low-income young children: A useful biomarker of behavioral symptom change?
2021, PsychoneuroendocrinologyCitation Excerpt :First, the sample size was relatively small, albeit similar to other studies of HCC in low-income children (e.g., Lembcke et al., 2020; Ling et al., 2020; Simmons et al., 2019), and it is the only known study of repeated measures of HCC and behavior problems in young children to examine change. There is some indication that HCC may be related to symptomatology in youth in a non-linear fashion (Ford et al., 2019), and the current study did not have sufficient power to test this possibility. However, the longitudinal HCC data within two understudied, difficult to recruit and retain populations experiencing significant adversity is noteworthy.