Further evidence of HPA-axis dysregulation and its correlation with depression in Autism Spectrum Disorders: Data from girls.

To further describe Hypothalamus-Pituitary-Adrenal (HPA) axis activity in children with Autism Spectrum Disorder (ASD), the Diurnal Fluctuation (DF) and Cortisol Awakening Response (CAR) were investigated in a sample of 39 high functioning girls with ASD. Although group mean data conformed to the DF and CAR models, over half of the participants showed inverse CAR and over 14% had inverted DF cortisol concentrations. Examination of three potential sets of predictor factors (physiological, ASD-related, and mood) revealed that only self-reported Major Depressive Disorder was significantly associated with CAR status, and that the girls' concern about dying or suicide was the most powerful contributor to the variance in CAR status. These findings add to the literature regarding the HPA axis dysfunction in children with ASD.