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Developmental pathways from preschool irritability to multifinality in early adolescence: the role of diurnal cortisol

Published online by Cambridge University Press:  20 December 2019

Ellen M. Kessel Open the ORCID record for Ellen M. Kessel [Opens in a new window] ,
Allison Frost ,
Brandon L. Goldstein Open the ORCID record for Brandon L. Goldstein [Opens in a new window] ,
Sarah R. Black ,
Lea R. Dougherty ,
Gabrielle A. Carlson  and
Daniel N. Klein
Ellen M. Kessel*
Affiliation:
Division of Child and Adolescent Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY
Allison Frost
Affiliation:
Department of Psychology, Stony Brook University, Stony Brook, NY
Brandon L. Goldstein
Affiliation:
Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
Sarah R. Black
Affiliation:
Department of Psychology, The University of New Orleans, New Orleans, LA
Lea R. Dougherty
Affiliation:
Department of Psychology, University of Maryland, College Park, MD
Gabrielle A. Carlson
Affiliation:
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
Daniel N. Klein
Affiliation:
Department of Psychology, Stony Brook University, Stony Brook, NY
*
Author for correspondence: Ellen M. Kessel, E-mail: ellen.kessel@nyspi.columbia.edu
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Abstract

Background

Early irritability predicts a broad spectrum of psychopathology spanning both internalizing and externalizing disorders, rather than any particular disorder or group of disorders (i.e. multifinality). Very few studies, however, have examined the developmental mechanisms by which it leads to such phenotypically diverse outcomes. We examined whether variation in the diurnal pattern of cortisol moderates developmental pathways between preschool irritability and the subsequent emergence of internalizing and externalizing symptoms 9 years later.

Method

When children were 3 years old, mothers were interviewed about children's irritability and completed questionnaires about their children's psychopathology. Six years later, children collected saliva samples at wake-up and bedtime on three consecutive days. Diurnal cortisol patterns were modeled as latent difference scores between evening and morning samples. When children were approximately 12 years old, mothers again completed questionnaires about their children's psychopathology.

Results

Among children with higher levels of irritability at age 3, a steeper diurnal cortisol slope at age 9 predicted greater internalizing symptoms and irritability at age 12, whereas a blunted slope at age 9 predicted greater externalizing symptoms at age 12, adjusting for baseline and concurrent symptoms.

Conclusion

Our results suggest that variation in stress system functioning can predict and differentiate developmental trajectories of early irritability that are relatively more internalizing v. those in which externalizing symptoms dominate in pre-adolescence.

Keywords

Cortisolexternalizinginternalizingirritabilitymultifinality
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 5 , April 2021 , pp. 761 - 769
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Copyright
Copyright © Cambridge University Press 2019

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