ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures (original) (raw)
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Gender-Related Clinical Characteristics in Children and Adolescents with ADHD
Journal of Clinical Medicine
Attention Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed neurodevelopmental disorder in school-age children, and it is usually associated with a significant impairment in global functioning. Traditionally, boys with ADHD are more likely to be referred for clinical assessments due to a higher prevalence of externalizing symptoms. However, as regards gender-related differential clinical characteristics between boys and girls with ADHD, further investigation is warranted in light of conflicting results found in currently available literature. In fact, a more precise clinical characterization could help increase appropriate diagnoses and treatment planning. In this context, we carried out a retrospective observational study on 715 children and adolescents diagnosed with ADHD from 2018 to 2020 at our center, in order to describe their gender-related clinical characteristics. Boys displayed higher average IQs, but they were comparable to girls in functional impairm...
Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood and adolescence. Rating the severity of psychopathology and symptom load is essential in daily clinical practice and in research. The parent and teacher ADHD-Rating Scale (ADHD-RS) includes inattention and hyperactivity/impulsivity subscales and is one of the most frequently used scales in treatment evaluation of children with ADHD. An extended version, mADHD-RS, also includes an oppositional defiant disorder subscale. The partial credit Rasch model, which is based on item response theory, was used to test the psychometric properties of this scale in a sample of 566 Danish school children between 6 and 16 years of age. The results indicated that parents and teachers had different frames of reference when rating symptoms in the mADHD-RS. There was support for the unidimensionality of the three subscales when parent and teacher ratings were analyzed independently. Nonetheless, evidence for differential item functioning was found across gender and age for specific items within each of the subscales. The findings expand existing psychometric information about the mADHD-RS and support its use as a valid and reliable measure of symptom severity when used in age- and gender-stratified materials.
Sex differences in ADHD symptom severity
Background: Males show higher rates of attention deficit hyperactivity disorder (ADHD) than do females. Potential explanations include genuine etiological differences or artifact. Methods: 2,332 twin and sibling youth participated in behavioral and cognitive testing. Partially competing models of symptom severity distribution differences, the mean difference, and variance difference models, were tested within a randomly selected subsample. The Delta method was used to test for mediation of sex differences in ADHD symptom severity by processing speed, inhibition and working memory. Results: The combined mean difference and variance difference models fully explained the sex difference in ADHD symptom severity. Cognitive endophenotypes mediated 14% of the sex difference effect. Conclusions: The sex difference in ADHD symptom severity is valid and may be due to differing genetic and cognitive liabilities between the sexes.
The impact of sex and subtypes on cognitive and psychosocial aspects of ADHD
Developmental Medicine & Child Neurology, 2006
We compared the effect of sex and attention-deficithyperactivity disorder (ADHD) subtyping in groups of females and males. One hundred and one females with ADHD (mean age 10y 4mo [SD 2y 8mo]; range 5y-18y) were classified according to subtype by Diagnostic and Statistical Manual of Mental Disorders (4th edn) criteria (inattentive [ADHD-I]; combined [ADHD-C]) and balanced by subtype to 101 males (mean age 10y 5mo [SD 2y 9mo]; range 5y 4mo-17y 6mo). All children underwent IQ and reading assessment, and 109 underwent the continuous performance task (Test Of Variables of Attention [TOVA]). Parents completed the Conners' Abbreviated Rating Scale (ABRS), the Child Behavior Checklist (CBCL), learning disability* questionnaires, and reported use and efficacy of methylphenidate. Teachers completed the Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) rating scale. Sex differences were found only on the CBCL; females were more impaired on the attention (p<0.001) and somatization (p=0.028) subscales but not for IQ, other questionnaires, TOVA scores, methylphenidate treatment, or demographics. Females with ADHD-C, but not males, had significantly higher T-scores than females with ADHD-I on social, attention, delinquent, and aggressive behaviours. Regardless of sex, children with ADHD-C had higher scores on all CBCL subscales (p=0.047), ABRS (p<0.001), and SKAMP (p=0.03) than children with ADHD-I. The results support the supposition that ADHD in females is the same disorder as in males. ADHD subtyping was the important determinant of ADHD core symptoms; females with ADHD were found to have significant risk of psychopathology.
ADHD and gender: are risks and sequela of ADHD the same for boys and girls?
2007
Background: Research comparing treatment-referred boys and girls with attention-deficit/hyperactivity disorder (ADHD) has yielded equivocal results. Contradictory findings may be associated with differential referral practices or unexplored interactions of gender with ADHD subtypes. Method: We examined possible gender differences in ADHD and its subtypes among children aged 4 to 17 in a representative community sample (N ¼ 1896) in Puerto Rico. Caretakers provided information through the Diagnostic Interview Schedule for Children (version IV) and a battery of impairment, family relations, child problems, comorbidity and treatment measures. Results: ADHD was 2.3 times more common in boys than girls, but with one exception there was little evidence that the patterns of associations of ADHD with correlates were different for boys and girls. The exception was school suspension, which was more common among ADHD boys than girls. Additional gender interactions were found when ADHD subtypes were considered. Among those with combined type (n ¼ 50), boys were more likely to be comorbid with mood disorders than girls. For those with the inattentive type (n ¼ 47), girls were more likely to be comorbid with anxiety disorders than boys. Conclusions: Our findings lend cross-cultural generalizability to recent reports that gender does not interact with correlates for ADHD overall, but that it may play a role in subtypes.
Sex-specific trajectories of ADHD symptoms from adolescence to young adulthood
European child & adolescent psychiatry, 2018
Reports of current ADHD symptoms in adults with a childhood diagnosis of ADHD are often discrepant: While one subgroup reports a particularly high level of current ADHD symptoms, another reports-in contrast-a very low level. The reasons for this difference remain unclear. Although sex might play a moderating role, it has not yet been examined in this regard. In an epidemiological cohort study from birth to young adulthood, childhood ADHD diagnoses were assessed at the ages of 4.5, 8, and 11 years based on parent ratings. Sex-specific development of ADHD symptoms was analyzed from the age of 15 to 25 years via self-reported ADHD symptoms in participants with (n = 47) and without childhood ADHD (n = 289) using a random coefficient regression model. The congruence between parent reports and adolescents' self-ratings was examined, and the role of childhood ADHD diagnosis, childhood OCC/CD, and childhood internalizing disorder as possible sex-specific predictors of self-reported ADHD...
Journal of Clinical Child & Adolescent Psychology
We assessed the predictive validity of attention-deficit=hyperactivity disorder (ADHD) in 20 girls and 98 boys who met the Diagnostic and Statistical Manual for Mental Disorders (4th ed., American Psychiatric ssociation, 1994) criteria for ADHD at 4 to 6 years of age compared to 24 female and 102 male comparison children. Over the next 8 years, both girls and boys who met criteria for ADHD in Year 1 exhibited more ADHD symptoms and impairment than same-sex comparison children. Effect sizes were consistently large, ndicating that the diagnosis of ADHD at 4 to 6 years of age has predictive validity for both sexes. Both girls and boys with ADHD in Year 1 also exhibited higher levels of symptoms of conduct disorder, major epression, and anxiety disorders in early adolescence than same-sex comparison children, controlling levels of the same symptoms in Year 1. This indicates both substantial homotypic and heterotypic continuity for ADHD in both sexes, but significant interactions with ti...
Psychiatric, Psychosocial, and Cognitive Functioning of Female Adolescents With ADHD
Journal of The American Academy of Child and Adolescent Psychiatry, 2001
Objective: To characterize the psychiatric, psychosocial and cognitive functioning of adolescent ADHD females in comparison with female controls and ADHD males. Female controls were also compared to male controls to verify gender differences in a nonclinical sample.