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Peer-reviewedCC BYInternational journal of pediatrics

Methodological Considerations for Using Hair Cortisol as a Biomarker Following No Measurable Effects of Tactile Massage in Adolescents With ADHD.

  • Carl-Johan Törnhage1,2,3
  • Anna-Carin Robertz4,5
  • Anne-Katrin Kantzer5
  • Stefan Nilsson4,6,7
7 affiliations
  1. 1Sahlgrenska Academy Institution for Clinical Science University of Gothenburg Gothenburg Sweden gu.se.
  2. 2Department of Paediatrics Skaraborg Hospital Skövde Sweden.
  3. 3Department of Research and Development Skaraborg-Hospital Group Skövde Sweden.
  4. 4Institute of Health and Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden gu.se.
  5. 5Child and Adolescent Psychiatry Clinic NU Hospital Group Trollhättan Sweden.
  6. 6Centre for Person-Centred Care (GPCC) Sahlgrenska Academy University of Gothenburg Gothenburg Sweden gu.se.
  7. 7Queen Silvia Children's Hospital Sahlgrenska University Hospital Gothenburg Sweden sahlgrenska.se.
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Abstract

Aims

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.

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Cite

BibTeXRIS
BibTeX
@article{tornhage2026methodological,
  title = {{Methodological Considerations for Using Hair Cortisol as a Biomarker Following No Measurable Effects of Tactile Massage in Adolescents With ADHD.}},
  author = {Carl-Johan Törnhage and Anna-Carin Robertz and Anne-Katrin Kantzer and Stefan Nilsson},
  journal = {International journal of pediatrics},
  year = {2026},
  month = oct,
  doi = {10.1155/ijpe/5891199},
  url = {https://europepmc.org/article/MED/42909885},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Methodological Considerations for Using Hair Cortisol as a Biomarker Following No Measurable Effects of Tactile Massage in Adolescents With ADHD.
AU  - Carl-Johan Törnhage
AU  - Anna-Carin Robertz
AU  - Anne-Katrin Kantzer
AU  - Stefan Nilsson
PY  - 2026
DA  - 2026/10/21
JO  - International journal of pediatrics
DO  - 10.1155/ijpe/5891199
UR  - https://europepmc.org/article/MED/42909885
AB  - Aims  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.
SN  - 1687-9740
SN  - 1687-9759
ER  -