To examine whether HPA-axis activity mediates the relationship between obstetric complications (OCs) and externalizing behavior problems, and to investigate whether this model is different for boys and girls. In a population-based cohort of 1,768 10- to 12-year-old early adolescents, we assessed the cortisol awakening response and evening cortisol levels. Externalizing behavior problems were assessed using the Child Behavior Checklist and the Youth Self-Report. OCs were retrospectively assessed in a parent interview. OCs significantly predicted externalizing behavior problems, but OCs did not predict HPA-axis activity. Thus, the mediation model was not supported. In addition to the relationship between HPA-axis activity and externalizing behavior problems, which is specific for girls, there is also a relationship between OCs and externalizing behavior problems. However, these two mechanisms are not related to each other indicating that HPA-axis activity is not a mediator in the relationship between OCs and externalizing behavior problems. Future research should focus on understanding the mechanism through which OCs cause externalizing behavior problems.

Additional Metadata
Keywords Cortisol, Early adolescence, Externalizing behavior problems, General population, Pre- and perinatal risk factors
Persistent URL dx.doi.org/10.1007/s00787-009-0014-y, hdl.handle.net/1765/16895
Citation
Marsman, R., Rosmalen, J.G.M., Oldehinkel, A.J., Ormel, J., & Buitelaar, J.K.. (2009). Does HPA-axis activity mediate the relationship between obstetric complications and externalizing behavior problems? the TRAILS study. European Child and Adolescent Psychiatry, 18(9), 565–573. doi:10.1007/s00787-009-0014-y