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BioMed Research International
Volume 2013, Article ID 349530, 9 pages
Clinical Study

Reduced Cortisol in Boys with Early-Onset Conduct Disorder and Callous-Unemotional Traits

1Department of Child and Adolescent Psychiatry, Medical Faculty, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany
2Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
3JARA Translational Medicine, Aachen and Jülich, 52425 Jülich, Germany
4Department of Child and Adolescent Psychiatry, Universitätsklinikum Gießen und Marburg GmbH, Campus Marburg, Hans-Sachs-Straße 4, 35039 Marburg, Germany
5Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany

Received 6 April 2013; Accepted 21 May 2013

Academic Editor: Tomoshige Kino

Copyright © 2013 Georg G. von Polier et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. A growing body of evidence suggests an association between altered hypothalamic-pituitary-adrenal axis reactivity and the development of persistent antisocial behavior in children. However the effects of altered cortisol levels remain poorly understood in the complex context of conduct disorder, callous-unemotional (CU) personality traits, and frequent comorbidities, such as attention deficit hyperactivity disorder (ADHD). The aim of the current study was to investigate associations among CU traits, antisocial behavior, and comorbid ADHD symptomatology with cortisol levels in male children and adolescents. Methods. The study included 37 boys with early-onset conduct disorder (EO-CD, mean age 11.9 years) and 38 healthy boys (mean age 12.5 years). Participants were subjected to multiple daytime salivary cortisol measurements and a psychometric characterization. Results. Subjects in the EO-CD group with elevated CU traits showed a diminished cortisol awakening response compared to healthy participants. In the EO-CD group, high CU traits and impulsivity were associated with decreased diurnal cortisol levels, while associations with antisocial behavior were not detected. The cortisol awakening response was significantly inversely associated with hyperactivity ( ) and marginally significant with CU traits ( ). Conclusions. These results indicate a specific association between CU traits and a diminished stress response, which is not explained by antisocial behavior in general.