A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls

Quinn, Patricia O.; Madhoo, Manisha

doi:10.4088/pcc.13r01596

Cited by 165 publications

(177 citation statements)

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“…Overall, girls score lower on symptom severity of inattention, hyperactivity/impulsivity and total ADHD symptoms than boys [3]. In girls, internalising symptoms and inattentiveness are the more prominent ADHD symptoms, while boys tend to present with externalising symptoms such as impulsiveness and hyperactivity [5,7,8]. Girls also display a different pattern of comorbidity than boys; comorbid internalising disorders (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…In general, due to the unique presentation of ADHD in girls, they meet fewer ADHD diagnostic criteria as per DSM-5 [7], as such criteria are derived from predominantly male samples. They also tend to receive a diagnosis of ADHD, significantly later than do their male counterparts [7,27].…”

Section: Introductionmentioning

confidence: 99%

“…They also tend to receive a diagnosis of ADHD, significantly later than do their male counterparts [7,27]. Further, they are less likely to be referred for assessment and diagnosis in the first place[28]; it has been shown that referral rates for ADHD are much lower for girls than for boys, and also much lower for “gender-typical” girls than for “boyish” girls who present with more externalising symptoms [29].…”

Section: Introductionmentioning

confidence: 99%

“…Due to this referral bias, delayed diagnosis, and lower rates of pharmacotherapy use, ADHD has generally been under-identified and under-treated in girls [18,30]. Added to this mix is the finding that girls with ADHD tend to have better coping skills than boys in this population, which may mask their ADHD symptoms [31,32]. …”

Section: Introductionmentioning

confidence: 99%

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Problematic Peer Functioning in Girls with ADHD: A Systematic Literature Review

et al. 2016

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ObjectiveChildren with attention deficit hyperactivity disorder (ADHD) experience many peer interaction problems and are at risk of peer rejection and victimisation. Although many studies have investigated problematic peer functioning in children with ADHD, this research has predominantly focused on boys and studies investigating girls are scant. Those studies that did examine girls, often used a male comparison sample, disregarding the inherent gender differences between girls and boys. Previous studies have highlighted this limitation and recommended the need for comparisons between ADHD females and typical females, in order to elucidate the picture of female ADHD with regards to problematic peer functioning. The aim of this literature review was to gain insight into peer functioning difficulties in school-aged girls with ADHD.MethodsPsychINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing school-aged girls with ADHD to typically developing girls (TDs) in relation to peer functioning. The peer relationship domains were grouped into ‘friendship’, ‘peer status’, ‘social skills/competence’, and ‘peer victimisation and bullying’. In total, thirteen studies were included in the review.ResultsAll of the thirteen studies included reported that girls with ADHD, compared to TD girls, demonstrated increased difficulties in the domains of friendship, peer interaction, social skills and functioning, peer victimization and externalising behaviour. Studies consistently showed small to medium effects for lower rates of friendship participation and stability in girls with ADHD relative to TD girls. Higher levels of peer rejection with small to large effect sizes were reported in all studies, which were predicted by girls’ conduct problems. Peer rejection in turn predicted poor social adjustment and a host of problem behaviours. Very high levels of peer victimisation were present in girls with ADHD with large effect sizes. Further, very high levels of social impairment and social skills deficits, with large effect sizes, were found across all studies. Levels of pro-social behaviour varied across studies, but were mostly lower in girls with ADHD, with small to large effect sizes. Overall, social disability was significantly higher among girls with ADHD than among TD girls.ConclusionCongruous evidence was found for peer functioning difficulties in the peer relationship domains of friendship, peer status, social skills/competence, and peer victimisation and bullying in girls with ADHD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Problematic Peer Functioning in Girls with ADHD: A Systematic Literature Review

et al. 2016

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“…29,71 Some studies suggest that ADHD may be underdiagnosed in girls, 27,72 whereas others suggest that ADHD is overdiagnosed in boys. 73 The assumption of underdiagnosis of ADHD in girls may suggest that the comorbidity estimates derived in this study are inflated, because they are based on girls with particularly severe (ie, impairing) ADHD symptoms.…”

Section: Figurementioning

confidence: 99%

Patterns of Comorbidity Among Girls With ADHD: A Meta-analysis

Tung

Meza

et al. 2016

Pediatrics

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CONTEXT: Although children with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for comorbid psychopathology, the clinical correlates of ADHD in girls are far less understood relative to boys, despite ADHD being one of the most common childhood disorders in girls.OBJECTIVE: To meta-analytically summarize rates of comorbid internalizing (anxiety, depression) and externalizing (oppositional defiant disorder [ODD], conduct disorder [CD]) psychopathology among girls with and without ADHD.DATA SOURCES: Literature searches (PubMed, Google Scholar) identified published studies examining comorbid psychopathology in girls with and without ADHD. STUDY SELECTION:Eighteen studies (1997 participants) met inclusion criteria and had sufficient data for the meta-analysis. DATA EXTRACTION:Odds ratios for each comorbid disorder were calculated from available data. Demographic (eg, age, race/ethnicity) and study characteristics (eg, referral source, diagnostic method) were also coded. RESULTS:Compared with girls without ADHD, girls with ADHD were significantly more likely to meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for each comorbid disorder assessed. Relative odds were higher for externalizing (ODD: 5.6×; CD: 9.4×) relative to internalizing disorders (anxiety: 3.2×; depression: 4.2×). Meta-regression revealed larger effect sizes of ADHD on anxiety for studies using multiple diagnostic methods, featuring younger children, and including clinic-referred (versus communityreferred) girls; the effect of ADHD on ODD varied based on diagnostic informant. LIMITATIONS:Findings were derived from cross-sectional studies, precluding causal inferences.CONCLUSIONS: Girls with ADHD frequently exhibit comorbid externalizing and internalizing disorders. We discuss future research priorities and consider intervention implications for ADHD and comorbid psychopathology in girls. Ms Tung collected and coded studies for inclusion, supervised the acquisition of data, carried out the analyses, and drafted the initial manuscript; Dr Li conceptualized and designed the study, supervised the acquisition of data, assisted with interpretation of analyses, and critically reviewed and revised the manuscript; Ms Meza and Ms Jezior collected and coded the studies for inclusion, assisted with drafting the initial manuscript, and reviewed and revised the manuscript; Ms Kianmahd, Mr Hentschel, and Mr O'Neil collected and coded the studies for inclusion and reviewed and revised the manuscript; Dr Lee supervised the acquisition of data, assisted with interpretation of analyses, and critically reviewed and revised the manuscript; and all authors approved the fi nal manuscript as submitted.

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