Patterns of cortisol and DHEA secretion and relationships with attachment style and psychosocial variables in female adolescents: a developmental psychopathology approach

Oskis, A. 2009. Patterns of cortisol and DHEA secretion and relationships with attachment style and psychosocial variables in female adolescents: a developmental psychopathology approach. PhD thesis University of Westminster School of Social Sciences, Humanities and Languages

TitlePatterns of cortisol and DHEA secretion and relationships with attachment style and psychosocial variables in female adolescents: a developmental psychopathology approach
TypePhD thesis
AuthorsOskis, A.
Abstract

This programme of research used a developmental psychopathology approach to

investigate females across the adolescent period. A two-sided story is presented; first,

a study of neuroendocrine and psychosocial parameters in a group of healthy female

adolescents (N = 63), followed by a parallel study of female adolescents with

anorexia nervosa (AN) (N = 8).

A biopsychosocial, multi-method measurement approach was taken, which utilised

self-report, interview and hypothalamic-pituitary-adrenocortical (HPA) axis

measures. Saliva samples for the measurement of cortisol and DHEA were collected

using the best-recommended methodology: multiple samples over the day, strict

reference to time of awakening, and two consecutive sampling weekdays. The

research was adolescent-orientated: specifically, by using creative and ageappropriate

strategies to ensure participant adherence to protocol, as well as more

generally by adopting various procedures to facilitate engagement with the research

process.

In the healthy females mean (± SD) age 13.9 (± 2.7) years, cortisol and DHEA

secretion exhibited typical adult-like diurnal patterns. Developmental markers of

chronological age, menarche status and body mass index (BMI) had differential

associations with cortisol and DHEA secretory activity. The pattern of the cortisol

awakening response (CAR) was sensitive to whether participants had experienced first

menses, but not to chronological age or BMI. Those who were post-menarche

generally reached their peak point of cortisol secretion at 45 minutes post-awakening,

in contrast to the pre-menarche group who were more evenly spread. Subsequent

daytime cortisol levels were also higher in post-menarche females, and this effect was

also noted for increasing age and BMI. Both morning and evening DHEA were

positively associated with developmental markers. None of the situational or self-report

psychosocial variables that were measured modulated any of the key findings regarding

cortisol and DHEA secretion. The healthy group of girls were within age-appropriate

norms for all the self-report measures used, however just under half of this group

were insecurely attached (as assessed by interview). Only attachment style was associated with neuroendocrine parameters. In particular, those with an anxious

insecure style exhibited a higher awakening sample (levels were 7.16 nmol/l, 10.40

nmol/l and 7.93 nmol/l for secure, anxious and avoidant groups, respectively) and a

flatter CAR (mean increases over the awakening period were 6.38 nmol/l, 2.32

nmol/l and 8.61 nmol/l for secure, anxious and avoidant groups, respectively). The

afore-mentioned pattern is similar to that consistently associated with psychological

disorder in adults, and so this may be a pre-clinical vulnerability factor for

subsequent mental health problems.

A group of females with AN, mean (± SD) age 15.1 (± 1.6) years, were recruited

from a specialist residential clinic and compared to the above group of healthy

control (HC) female adolescents. A general picture of cortisol and DHEA

hypersecretion was revealed in those with AN. The mean (± SD) change exhibited in

cortisol levels over the 30 minute post-awakening period was 7.05 nmol/l (± 5.99)

and 8.33 nmol/l (± 6.41) for HC and AN groups, respectively. The mean (± SD)

evening cortisol level for the HC girls was 1.95 nmol/l (± 2.11), in comparison to

6.42 nmol/l (± 11.10) for the AN group. Mean (± SD) morning DHEA

concentrations were 1.47 nmol/l (± 0.85) and 2.25 nmol/l (± 0.88) for HC and AN

groups, respectively. The HC group’s mean (± SD) concentration of 12 hour DHEA

was 0.55 nmol/l (± 0.46) and the AN group’s mean level was 0.89 nmol/l (± 0.90).

This adrenal steroid hypersecretion evidenced by the AN group was not associated

with BMI or eating disorder symptomatology.

Insecure attachment characterised by fearfulness and anger was most apparent; a

style which was unparalleled in the healthy group of female adolescents. The causal

directions of the AN group findings remain unclear. Examining some of the

participants with AN as case studies one year post-discharge from the clinic

illustrated that for one participant who was recovered, in terms of returning to

ordinary school life and no longer exhibiting clinical levels of eating disorder

symptomatology, her CARs were no longer inconsistent over sampling days and her

DHEA levels were also now generally comparable to the healthy control group. For

another participant who had not recovered from her AN one year later, the profile of

her CAR continued to be inconsistent over sampling days and her DHEA

concentrations over the diurnal period were significantly higher in comparison to the

healthy control group.

In its entirety, this work’s unique contribution lies in its consideration of

methodological and developmental issues specifically pertaining to adolescents.

Findings also contribute to knowledge of AN and understanding of vulnerability

factors, and how these may be used to develop interventions dedicated to improving

adolescent health.

Year2009
Publication dates
Completed2009

Related outputs

Biological Stress Regulation in Female Adolescents: A Key Role for Confiding
Oskis, A., Clow, A., Loveday, C., Hucklebridge, F. and Sbarra, D.A. 2015. Biological Stress Regulation in Female Adolescents: A Key Role for Confiding . Journal of Youth and Adolescence. 44 (5), pp. 1066-1077.

Understanding alexithymia in female adolescents: the role of attachment style
Oskis, A., Clow, A., Hucklebridge, F., Bifulco, A., Jacobs, C. and Loveday, C. 2013. Understanding alexithymia in female adolescents: the role of attachment style . Personality and Individual Differences . 54 (1), pp. 97-102.

Diurnal patterns of salivary cortisol and DHEA in adolescent anorexia nervosa
Oskis, A., Clow, A., Thorn, L., Loveday, C. and Hucklebridge, F. 2012. Diurnal patterns of salivary cortisol and DHEA in adolescent anorexia nervosa. Stress. 15 (6), pp. 601-607.

Differences between the diurnal patterns of salivary cortisol and DHEA in healthy female adolescents
Oskis, A., Clow, A., Thorn, L., Loveday, C. and Hucklebridge, F. 2012. Differences between the diurnal patterns of salivary cortisol and DHEA in healthy female adolescents. Stress. 15 (1), pp. 110-114.

Differences between diurnal patterns of salivary cortisol and dehydroepiandrosterone in healthy female adolescents
Oskis, A., Clow, A., Thorn, L., Loveday, C. and Hucklebridge, F. 2012. Differences between diurnal patterns of salivary cortisol and dehydroepiandrosterone in healthy female adolescents. Stress. 15 (1), pp. 110-114.

Anxious attachment style and salivary cortisol dysregulation in healthy female children and adolescents
Oskis, A., Loveday, C., Hucklebridge, F., Thorn, L. and Clow, A. 2011. Anxious attachment style and salivary cortisol dysregulation in healthy female children and adolescents. Journal of Child Psychology and Psychiatry. 52 (2), pp. 111-118.

Diurnal patterns of salivary cortisol across the adolescent period in healthy females
Oskis, A., Loveday, C., Hucklebridge, F., Thorn, L. and Clow, A. 2009. Diurnal patterns of salivary cortisol across the adolescent period in healthy females. Psychoneuroendocrinology. 34 (3), pp. 307-316.

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