Hyper- and hypocortisolism: Latent profiles of diurnal cortisol underlying depressive symptoms in adolescents

Abstract

A secular trend of increased depressive symptoms among adolescents and early adults has received both scientific and media attention (Office of the Surgeon General, 2021). Research on cortisol and depression has revealed the important role of the HPA axis in internalizing disorders. But evidence remains mixed regarding the direction of effects, with findings of both higher and lower levels of diurnal cortisol associated with depressive symptoms. There is a need for new approaches to study the biological underpinnings of depressive symptoms. We analyzed diurnal cortisol among 141 adolescents (Mage = 15.0; 59.7% female; 50.8% white). Latent Profile Analysis (LPA) was used to characterize cortisol rhythms identified from four daily salivary samples (at waking, 30 minutes after waking, after school, and bedtime) taken over five days. Resulting profiles were examined in relation to reported stress, depressive symptoms, and other measures of psychosocial functioning. Analyses identified two cortisol profiles associated with elevated depressive symptoms. One had the lowest average cortisol levels at each sampling time throughout the day. The other corresponded to highly elevated diurnal cortisol, with both waking and bedtime levels exceeding 0.8 μg/dL. However, they diverged in associations with other aspects of psychosocial functioning. We will present the correlates of each diurnal profile and discuss implications for longitudinal work. Both elevated and suppressed cortisol rhythms were associated with higher depressive symptoms than those among adolescents with more typical rhythms. Using LPA to characterize diurnal cortisol may allow for better understanding of youth risk for depression.