(1) Department of Psychiatry, Vanderbilt University, Nashville, TN 37203, USA
(2) Vanderbilt Kennedy CenterCenter, PMB 40, 230 Appleton Place, Nashville, TN, 37203, USA
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Adolescence, the transition between childhood and adulthood, is a period of remarkable physiological, psychological and social change. A variety of physiological changes coincide with the dynamic transition, which is evident in the regulation and responsivity of the limbic–hypothalamic–pituitary–adrenocortical axis. Specifically, elevations in diurnal basal cortisol levels have been reported as well as higher cortisol in response to perceived stressors. Although this enhanced responsivity may help prepare the individual to adapt to increased demands and new challenges, it may also mark a time of increased vulnerability in populations already prone to enhanced physiological arousal and poor adaption to change, such as autism. To date, most studies investigating the integrity of the limbic–hypothalamic–pituitary–adrenocortical axis in children with autism spectrum disorders have shown more variable diurnal regulation and a pattern of enhanced responsivity to stress. There is also evidence of more marked reactivity over development suggesting that adolescence may be a time of increased risk for enhanced physiological arousal and social stress.
The following critical review briefly summarizes the literature to date on autism, adolescence and salivary cortisol. The current summary suggests that enhanced study of the interplay between social functioning and stress during the adolescent period in autism spectrum disorders is warranted.