Sunday, February 24, 2013

Women, Girls and ADHD - Part I (children)

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As promised (although slightly delayed), I am going to share some basic literature review information regarding gender and ADHD.  In other words, I am trying to find a functional outlet for my addiction to reading journal articles ;)  A simple term search for 'girls and ADHD' into Ebsco Host yields a multitude of articles.  Mental health researchers are continually looking to define and further understand the manifestations of ADHD - how exciting?!?!?

Some interesting tidbits:

1.  ADHD can present differently in girls than in boys (Adams, 2007).

2.  Some studies have estimated 50-75% of girls just don't get diagnosed - we overlook    
     them (Adams, 2007).

3.  Research is beginning to tease out the gender differences of ADHD in regards to  
     symptoms, course over lifespan and neuropathology (Nussbaum, 2012).

4.  There just isn't enough active/published research regarding if treatments should differ  
     between boys and girls (Nussbaum, 2012).

What should we look for in girls?  According to Adams (2007), there are 6 signs that may alert a teacher, parent or caregiver to the presence of ADHD in girls.  They are as follows:

1.  Nonstop Talking
2.  Difficulty Initiating and Maintaining Frienships
3.  Difficulty Maintaining Attention 
4.  Exceptional Messiness
5.  Unfinished Work
6.  Emotionality

Why should we care?

Well, the research lays out many reasons.  Among these are factors for the child's lifespan which include:

Increased family burden
Negative discipline
Detrimental impacts on the relationship between the parent-child

All of these factors can easily translate into increased healthcare costs as well as diminished quality of life for those affected.

A little more detail...

A wonderful study published by the Journal of Child Psychology and Psychiatry in 2007 yielded a descriptive analysis regarding differences between genders.  Interestingly, their information poses the idea that the sub-type of ADHD is where we find the greatest gender differences.  Their information translates into two valuable pieces of information for clinicians (Bauermeister, Shrout, Chavez, Rubio-Stipec, Ramirez, Padilla and Canine, 2007).  These are:

1.  Girls with the Inattentive Type of ADHD are more likely to be diagnosed with Anxiety     

2.  Boys, in general, are more likely to be diagnosed with mood disorders, specifically    
     Major Depressive Disorder.  

It is EXTREMELY important for diagnosing clinicians to have an active awareness of these findings.  This turns into a chicken and egg problem - one must not overlook the ADHD because of  the more frequently diagnosed Mood or Anxiety Disorder to present (Bauermeister et al., 2007).  

Further questions...

Boys, in general, are more likely to be diagnosed with a mood disorder.  Correlation based information was found to suggest the likelihood that failing a grade and/or being suspended/expelled increased the likelihood of a depression diagnosis in boys.  However, girls were much less likely to be expelled or fail a grade - this leads me to be curious about the possible mood effects found for children failing academic grades and/or being penalized with suspension/expulsion from their school community.  


Adams, C. (2007). Girls and ADHD: Are You Missing the Signs?. Instructor116(6), 31-35.

Bauermeister, J. J., Shrout, P. E., Chavez, L., Rubio-Stipec, M., Ramirez, R., Padilla, L., & ... Canino, G. (2007). ADHD and Gender: Are Risks and Sequela of ADHD the Same for Boys and Girls?. Journal Of Child Psychology And Psychiatry48(8), 831-839.

Nussbaum, N. L. (2012). ADHD and Female Specific Concerns: A Review of the Literature and Clinical Implications. Journal Of Attention Disorders16(2), 87-100.

Soffer, S. L., Mautone, J. A., & Power, T. J. (2008). Understanding Girls with Attention-Deficit/Hyperactivity Disorder (ADHD): Applying Research to Clinical Practice. International Journal Of Behavioral Consultation & Therapy4(1), 14-29.

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