Journal of Depression and Anxiety
Open Access

Abstract

The Association of Cortisol Stress Response with Early Adversity and Diabetes Control in Adolescents with Diabetes

Daphne J. Korczak, S. Madigan, K. Manassis, D. Daneman

Objectives: The hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the relationship between increased stress and poor diabetes control in children with type 1 diabetes mellitus (T1DM).

The objectives of this study were two-fold: (1) To evaluate the effectiveness of the Trier Social Stress Test for Children (TSST-C) in inducing psychosocial stress in children with T1DM; (2) To investigate predictors of the cortisol stress response to the TSST-C.

Methods: Seventeen adolescents with T1DM were exposed to the TSST-C. Salivary cortisol was sampled pre- TSST-C and at six 10-minute intervals following the stress procedure. Measures of anxiety, depression, family functioning and early adversity were completed.

Results: The TSST-C induced a significant increase in cortisol response (p<0.01). Early adversity predicted cortisol response to the stressor (p=0.01). Early adversity was also associated with poorer diabetes control (p=0.05).

Conclusion: The TSST-C was effective in producing a stress response in children with diabetes. Whereas previous research has emphasized psychological pathways which contribute to the relationship between psychosocial stressors and poor diabetes control, this study suggests that biological dysfunction may also underlie the association.