Methodological Considerations for Using Hair Cortisol as a Biomarker Following No Measurable Effects of Tactile Massage in Adolescents With ADHD
Carl-Johan Törnhage, Anna-Carin Robertz, Anne-Katrin Kantzer, Stefan NilssonAims
Dysregulation of the hypothalamic–pituitary–adrenal axis has been proposed as a mechanism in attention‐deficit/hyperactivity disorder (ADHD). Tactile massage is suggested to influence long‐term cortisol secretion in adolescents with ADHD, although it remains unclear whether such an effect occurs. This study examined whether tactile massage alters hair cortisol in adolescents with ADHD.
Methods
Fourteen adolescents aged 15–17 with ADHD received 10 weekly 60‐min standardised tactile massage sessions. Hair samples were collected at five time points and analysed for cortisol using a competitive radioimmunoassay. Perceived stress (the Stress in Children questionnaire), heart rate and blood pressure were assessed. Non‐parametric statistics (Friedman′s ANOVA, Wilcoxon matched‐pairs tests and Spearman′s correlation) evaluated time‐dependent changes and associations.
Results
Hair cortisol showed no significant differences between baseline, intervention and follow‐up ( p = 0.63). After six sessions, boys had higher cortisol levels than girls ( p = 0.029). No significant correlations emerged between hair cortisol and heart rate, blood pressure or total stress, although a negative correlation was found with frustration ( p = 0.028).
Conclusions
Because the intervention did not alter long‐term cortisol output, and hair cortisol shows limited sensitivity to short‐term effects, it does not appear suitable for detecting tactile‐massage effects in adolescents with ADHD.