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Psychiatric, Psychosocial, and Cognitive Functioning of Female Adolescents With ADHD
Abstract
To characterize the psychiatric, psychosocial, and cognitive functioning of female adolescents with attention-deficit/hyperactivity disorder (ADHD) in comparison with female controls and males with ADHD. Female controls were also compared with male controls to verify gender differences in a nonclinical sample.
One hundred seven adolescents from Southern Ontario aged 13 to 16 were included: 24 females with ADHD, 35 males with ADHD, 28 control females, and 20 control males. All were assessed with semistructured interviews, questionnaires, and tests of achievement and intellectual functioning.
After controlling for parental education and estimated Full Scale IQ, females with ADHD were more impaired than control females in depression, anxiety, distress, teacher relationships, stress, attributional styles, and locus of control and on all cognitive and achievement measures. Females with ADHD were more impaired than males with ADHD in self-reported anxiety, distress, depression, locus of control, and vocabulary scores. These group differences were confirmed by higher ratings by parents and teachers in symptoms of psychopathology. Males with ADHD were more impaired in processing speed. Some gender differences (locus of control and vocabulary scores) were eliminated when controlling for ADHD severity. The absence of any differences between male and female controls indicates gender differences were specific to the clinical groups.
Females with ADHD are at high risk for more psychological impairment than both males with ADHD and control females. The identified psychosocial problems point to areas for intervention.
... It is likely that these deficits may compromise the school readiness of preschoolers who display ADHD symptoms and may make transition from preschool to school particularly challenging. dissatisfaction in their relationships with teachers than female controls (Rucklidge and Tannock, 2001). ...
... It is estimated that between 15% and 20% of children with ADHD also have a comorbid mood disorder and approximately 25% have a comorbid anxiety disorder (Tannock, 1998). This association seems particularly marked for girls with ADHD (Rucklidge & Tannock, 2001 ). ...
... Studies have found differential patterns of comorbidity between males and females with ADHD. Females show an increased risk for internal ising disorders such as anxiety and depression (Rucklidge & Tannock, 2001); and males an increased risk for externalising disorders (Levy, Hay, Bennett & McStephen, 2005). It is suggested that as girls with ADHD are not disruptive in the classroom, they are less likely to be referred to mental health services for ADHD or behavioural difficulties, but may present with depression or anxiety as adolescents or young adults (Quinn, 2005). ...
p>The aims of this thesis were threefold. First, medication related attitudes and behaviours were identified using in-depth qualitative interviews with parents of children with ADHD. Second, a questionnaire was developed to assess medication related attitudes and behaviours drawing from the data collected in the interview study. Third, the relationships between ADHD related attitudes and behaviours with family factors and cultural factors between the UK and the USA were examined. Parent and child version ADHD Medication Related Attitudes and Behaviours (AMRABs) questionnaires were developed to assess parents’ and children’s perceptions of the benefits, costs, stigma associated with ADHD medication and whether children resisted taking medication. Parents were also asked about the stigma they experience as parents, how flexible they are in administering medication and how competent they are in administering medication consistently. The questionnaires were piloted in ADHD clinics in the UK and USA, on the internet and through ADHD support groups. Participants in the UK consistently reported markedly higher levels of child stigma than participants in the USA. The final study examined relationships between the AMRABs subscales and family factors. The results indicated that child conduct problems were associated with resistance to taking medication. Maternal mental health difficulties were associated with maternal perception of the benefits and costs of taking medication, and with resistance to taking medication. Maternal ADHD and poor parenting self-efficacy were associated with difficulties in administering medication consistently. Family cohesion was predictive of child stigma in the USA, and paternal warmth and high maternal criticism were associated with child stigma in both countries. However, the most significant predictor of child stigma was being from the UK. High SES was associated with higher parental stigma.</p
... Cognitive functioning Adolescent girls with ADHD scored higher for cognitive impulsivity and motor impulsivity [47]; they made made more errors of omission and had more deficits in design memory, general visual memory, verbal arithmetic skills, and working memory skills [56]; they also had higher processing and encoding speed scores, greater inhibitory control, and lower vocabulary scores than boys with ADHD [57]. Compared to boys, girls with ADHD had a more impaired neuropsychological profile in terms of executive functions [58]. ...
... Academic functioning ADHD was associated with poor academic performance (course repetitions, low grades, etc.) in both girls and boys [50]. No sex differences were found in any of the WISC-III subtests (block design, digits, symbol search, and arithmetic) [57]. ...
... We identified sex differences among individuals with ADHD in terms of cognitive functioning (especially executive functioning) and, within this, in impulsivity and attention deficit problems. Adolescent girls had higher levels of cognitive impulsiveness and motor impulsivity [47]; made more errors of omission (deficits in attentional control); had more deficits in design memory, general visual memory, verbal arithmetic skills, and working memory skills [56]; and had higher processing and encoding speed scores, greater inhibitory control, and lower vocabulary scores than adolescent boys with ADHD [57]. These findings are consistent with those obtained in two meta-analyses. ...
Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13–18 years) diagnosed with ADHD (according to the DSM-IV, DSM-IV-TR and DSM-5 criteria) in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases (PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.
... An alternative model proposed to account for ADHDrelated underachievement postulates intellectual functioning as a primary contributing factor. The intellectual deficit model is based on previous research demonstrating that (a) children with ADHD tend to have lower measured intelligence relative to typically developing peers (Crosbie and Schachar 2001;Frazier et al. 2004;Kuntsi et al. 2004;Mariani and Barkley 1997;Rucklidge and Tannock 2001); and (b) intelligence is strongly correlated with (r = .87; Wechsler 2003) and a causal antecedent to academic achievement ). ...
... The co-occurrence of lower full-scale intellectual abilities (FSIQ) and academic achievement deficits in children with ADHD is well established (Crosbie and Schachar 2001;Frazier et al. 2004;Kuntsi et al. 2004;Mariani and Barkley 1997;Rucklidge and Tannock 2001); however, the extent to which the relation reflects the influence of a general factor (g) deficiency or deficiencies in one or more specific intellectual abilities remains speculative and was the focus of the current study. Establishing this relation is warranted in light of empirical evidence demonstrating that (a) intellectual abilities are an antecedent of and contribute significantly to children's academic achievement ); (b) specific intellectual abilities exhibit differential relations with foundational learning (Alloway and Alloway 2010;Gathercole et al. 2006;Swanson and Alloway 2012); and (c) early intellectual abilities are the only significant predictor of multiple Fig. 1 Unique Contributions of WMI and VCI. ...
... Consistent with past investigations (Crosbie and Schachar 2001;Frazier et al. 2004;Kuntsi et al. 2004;Mariani and Barkley 1997;Rucklidge and Tannock 2001) and intellectual deficit model hypotheses, our results revealed that FSIQ was significantly lower in children with ADHD relative to neurotypical (NT) community control children. Examination of the four WISC-IV index scores, however, revealed that the group level difference in FSIQ resulted from lower scores on two of the four specific intellectual ability indices-viz., Working Memory (WMI) and Verbal Comprehension (VCI)-corroborating previous findings of lower WMI and VCI scores in children with ADHD (Anastopoulos et al. 1994;Andreou et al. 2005;Ek et al. 2013;Fenollar-Cortés et al. 2015;Calhoun 2006, 2007). ...
The co-occurrence of lower full-scale intellectual abilities (FSIQ) and academic achievement deficits in children with ADHD is well established; however, the extent to which the relation reflects the influence of a general factor (g) deficiency or deficiencies in one or more specific intellectual abilities remains speculative and was the focus of the current investigation. Twenty-eight boys with ADHD-combined presentation and 26 neurotypical (NT) boys between 8 and 12 years of age were administered the WISC-IV and standardized measures of reading and math. FSIQ and achievement scores in both reading and math were significantly lower for the ADHD relative to the NT group; however, examination of WISC-IV index scores revealed that group level differences in FSIQ resulted from lower scores on two of the four specific intellectual ability indices—Working Memory (WMI) and Verbal Comprehension (VCI). Bias-corrected bootstrapped mediation analyses revealed that both WMI and VCI contributed uniquely to the ADHD-Academic Achievement relation. The contribution of WMI to ADHD-related academic underachievement reflected lower scores on the Letter-Number Sequencing (LNS) but not the Digit Span (DS) subtest. Both LNS and VCI explained ADHD-related differences in reading, whereas LNS alone explained ADHD-related differences in math. Collectively these findings suggest that strengthening deficient higher-level WM abilities, in conjunction with empirically based academic instruction, is needed to improve learning outcomes in children with ADHD.
... Si bien los niños tenderían a presentar síntomas como la hiperactividad y la desatención -cuestión que los llevaría a desarrollar un perfil de socialización "más desajustado", con mayor negativismo y menor consideración con los demás (Biederman et al., 2002) -, al mismo tiempo mostrarían mayor facilidad a nivel de las relaciones interpersonales, mejores habilidades de comunicación y expresión asertiva de opiniones (Garza-Morales; Núñez-Villaseñor; Vladimirsky-Guiloff, 2007;Newcorn et al., 2001), además de una mejor autoestima y autoconcepto Tannock, 2001). ...
... De acuerdo a variados estudios, las niñas estarían más propensas a sufrir patologías psiquiátricas, concretamente depresión y ansiedad (Dalsgaard et al., 2002;Gershon, 2002;Tannock, 2001), así como presentarían mayores tasas de ideación suicida que la población sin TDA-H Tannock, 2001). En la misma línea, niñas adolescentes con TDA-H se percibirían a sí mismas como más ineficientes, con baja autoestima, y se mostrarían más afectadas por eventos negativos de la vida comparados con los niños adolescentes diagnosticados con TDA-H Tannock, 2001). ...
... De acuerdo a variados estudios, las niñas estarían más propensas a sufrir patologías psiquiátricas, concretamente depresión y ansiedad (Dalsgaard et al., 2002;Gershon, 2002;Tannock, 2001), así como presentarían mayores tasas de ideación suicida que la población sin TDA-H Tannock, 2001). En la misma línea, niñas adolescentes con TDA-H se percibirían a sí mismas como más ineficientes, con baja autoestima, y se mostrarían más afectadas por eventos negativos de la vida comparados con los niños adolescentes diagnosticados con TDA-H Tannock, 2001). ...
Although research on ADHD has tended to ignore gender differentials, recent contributions produced mainly from epidemiology have revealed that this diagnostic category seems to be strongly related to gender. However, these contributions seem to limit their scope to the study of the symptoms as well as cognitive, affective and social functioning of children, leaving aside subjective aspects associated with the ADHD practices of diagnosis and treatment. Thus, this article aims to explore how the gender dimension crosses the subjective experience of children diagnosed with ADHD. Based on open interviews conducted with children between the ages of 7 and 13, we show general trends that articulate gender and characteristics associated with the ADHD diagnosis, while at the same time, with children’s experiences that dislocate such trends. The findings were grouped according to four emerging axes: (1) locations, (2) abilities, (3) approches, (4) interactions. Thus, we will show how the experience of boys and girls is multiple in relation to the diagnosis and it is not possible to be reduced to a gender binary perspective.
... This similarity in the pattern of psychopathology expressed by AD/HD males and females has also been documented in studies with adults (Biederman et al., 1994). DeHaas and Young (1984) However, in a more recent study by Rucklidge & Tannock (2001), female adolescents with AD/HD were found to be more impaired than n^ile adolescents with AD/HD in self-reported anxiety, distress, depression, locus of control, and vocabulary scores. ...
... Although rated as more untypical for girls, DBDs were not rated as severe for them as well. In a study conducted by Rucklidge & Tannock (2001), in order to investigate the psychosocial and cognitive functioning of AD/HD females, a similar finding was revealed. Despite endorsing more items of psychopathology in the females, teachers did not view the girls as being more impaired than the boys. ...
p>This thesis tested the first part of a new theoretical model, aiming to contribute to the understanding of sex differences in the prevalence of Disruptive Behaviour Disorders (DBDs) in boys and girls. Specifically, gendered perceptions of DBDs, as expressed by parents and prospective educators, were examined.
An analogue methodology using written descriptions of child disruptive behaviour followed by rating scales assessing several perceptual dimensions like severity and untypicality was used, along with the SDQ (Goodman, 1997) and rating scales of adults’ emotional reactions and sense of self-efficacy.
The first of four studies demonstrated that perspective educators consider DBDs as more untypical in girls rather than boys. This finding was replicated in all studies. The second study showed that prospective educators consider hyperactivity as more severe in boys, whereas the third study established that mothers rate DBDs as equally severe in both sexes. The fourth study showed that correlates of severity and untypicality are different in quality and strength for mothers and prospective educators. For mothers, ratings of severity are mostly related to the emotions evoked by the child’s behaviour, whereas, for prospective educators, they are mostly related to their sense of self-efficacy to handle the child’s behaviour, which is lower in the case of hyperactive boys.
To summarise, this thesis has shown that parents and prospective educators have several gendered perceptions of child disruptive behaviour, with higher untypicality conferred to girls’ hyperactive behaviour. Moreover, the role of the adult toward the child and the specific DBD subtype examined seem to influence these differences. Implications of these findings for socialisation practices and referral attitudes that might relate to the reported sex difference in the prevalence of DBDs are discussed.</p
... Males have more severe symptoms as children, but females have more severe symptoms as adolescents and adults (Mahendiran et al. 2019) Externalizing behavior (hyperactivity, aggression) Males more severe (Gershon 2002;Carlson et al. 1997) Internalizing behavior (anxiety, depression, suicidality) Females more severe (Gershon 2002;Ottosen et al. 2019;Rasmussen and Levander 2009;Rucklidge and Tannock 2001;Chronis-Tuscano et al. 2010) social skills, and social cognition compared to males (Harrop et al. 2019;McLennan et al. 1993;Mahendiran et al. 2019), but manifest more severe symptoms as they age (Kaat et al. 2021;McLennan et al. 1993). This is possibly because females' social skills appear to decline with age while males' social skills improve (Mahendiran et al. 2019). ...
... These trends continue into adulthood, as adult males with ADHD display higher rates of criminality (Rasmussen and Levander 2009) and have greater impairment on complex cognitive tasks (Balint et al. 2009). Conversely, females with ADHD tend to display more internalizing problems such as anxiety, depression, and suicidality (Gershon 2002;Ottosen et al. 2019;Rasmussen and Levander 2009;Rucklidge and Tannock 2001;Chronis-Tuscano et al. 2010), though a recent study did not replicate this finding (Mayes et al. 2020). ...
Sex differences are prominent defining features of neurodevelopmental disorders. Understanding the sex biases in these disorders can shed light on mechanisms leading to relative risk and resilience for the disorders, as well as more broadly advance our understanding of how sex differences may relate to brain development. The prevalence of neurodevelopmental disorders is increasing, and the two most common neurodevelopmental disorders, Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) exhibit male-biases in prevalence rates and sex differences in symptomology. While the causes of neurodevelopmental disorders and their sex differences remain to be fully understood, increasing evidence suggests that the immune system plays a critical role in shaping development. In this chapter we discuss sex differences in prevalence and symptomology of ASD and ADHD, review sexual differentiation and immune regulation of neurodevelopment, and discuss findings from human and rodent studies of immune dysregulation and perinatal immune perturbation as they relate to potential mechanisms underlying neurodevelopmental disorders. This chapter will give an overview of how understanding sex differences in neuroimmune function in the context of neurodevelopmental disorders could lend insight into their etiologies and better treatment strategies.
... Both research and clinical experience have shown that, compared with men, women with ADHD are more likely to experience anxiety and depression concurrently, and these secondary internalising disorders are more likely to be diagnosed rather than underlying ADHD. 62 A study by Rucklidge and Tannock showed that adolescent women with ADHD have more psychological distress than men with ADHD. 62 Also, compared to women without ADHD, women with ADHD have twice the prevalence of insomnia, anxiety, drug abuse, current smoking and depression. ...
... 62 A study by Rucklidge and Tannock showed that adolescent women with ADHD have more psychological distress than men with ADHD. 62 Also, compared to women without ADHD, women with ADHD have twice the prevalence of insomnia, anxiety, drug abuse, current smoking and depression. 63 Kozak et al. found that the association between anxiety disorders and cannabis use might indicate that mental illness inclusive of ADHD can contribute to the increased likelihood of cannabis use -indicating that to cope with stressors and anxiety, females are more vulnerable to self-medicate with cannabis and are susceptible to developing and maintaining cannabis use. ...
Background: Substance use disorders (SUDs) continue to be a public health problem. Attention-deficit/hyperactivity disorder (ADHD) is seen as a risk factor for SUD. Prevalence of alcohol and cannabis use amongst adults with SUD and comorbid ADHD impacts both disorders cognitively and behaviourally.
Aim: Our study aimed to compare alcohol and cannabis use between treatment-seeking SUD patients with ADHD and SUD patients without ADHD symptomatology.
Setting: Various rehabilitation centres, including the South African National Council on Alcoholism and Drug Dependence (SANCA) Centres, and Private and Provincial Government Substance Abuse Treatment Centres.
Methods: A cross-sectional study of adults on drug rehabilitation was conducted. Data on socio-demographic information and alcohol and cannabis use from 185 post-detox inpatients were collected. Diagnoses were based on DSM-IV criteria. Attention-deficit/hyperactivity disorder diagnosis was confirmed by the Diagnostic-Interview for ADHD in Adults (DIVA 2.0). SUD+ADHD (n = 52) and SUD-ADHD (n = 128) groups were compared on alcohol and cannabis use as a function of gender.
Results: No significant differences in the use of alcohol between the SUD+ADHD and SUD-ADHD groups were found. However, the SUD+ADHD group showed increased cannabis consumption. Especially, the SUD+ADHD females showed an earlier age of onset of cannabis use than the SUD-ADHD females and revealed that they use cannabis for a longer period compared with the SUD-ADHD females and SUD+ADHD and SUD-ADHD males.
Conclusion: The results revealed the relationship between ADHD and cannabis use, especially amongst females with ADHD and reinforce the need to consider ADHD in cannabis use SUD in clinical interventions.
... Females with ADHD are reported to be more than twice as likely to be admitted into a psychiatric institution compared with males with ADHD (Dalsgaard, Mortensen, Frydenberg, & Thomsen, 2002). Females with ADHD have also been found to have poorer coping and social skills than males with ADHD (Rucklidge & Tannock, 2001). However, males with ADHD are more likely to use illegal substances and engage in criminal activity compared with females with ADHD (Groß-Lesch et al., 2016;Rasmussen & Levander, 2009). ...
... The sex difference found in our study may highlight a further need to differentiate how ADHD is diagnosed and assessed across males and females. It has been reported that boys are 3 times as likely to get diagnosed with ADHD compared with girls, despite the fact that girls can have worse outcomes in many domains (Gershon, 2002;Rucklidge & Tannock, 2001;Vasiliadis et al., 2017). Females who are at risk of ADHD may in the future benefit from assessments that are more tailored to the symptoms and issues associated with ADHD females, and degree of discounting may provide a unique diagnostic domain for further investigation of their difficulties. ...
Objective:
To examine whether males and females with ADHD differ in their preferences for delayed rewards, since there is some evidence that suggests a sex difference with typically developing (TD) samples.
Method:
We used meta-analyses to examine sex differences on delay of gratification and temporal discounting tasks in both TD and ADHD samples. We identified 28 papers with 52 effect sizes for children and adults, and calculated the average effect size for sex comparisons within TD and ADHD samples.
Results:
The estimated mean difference between TD males and TD females was negligible, but males with ADHD were more likely to choose the larger delayed rewards than females with ADHD. Meta-regressions indicated that task type, age, and reward type did not significantly predict sex differences.
Conclusion:
These findings suggest that females referred for ADHD may make less adaptive choices by preferring smaller immediate rewards over larger delayed rewards more often than males with ADHD. Implications of our findings are discussed.
... Adolescent women with ADHD are reported to show more internalizing symptoms than their male counterparts [11]. Often other diagnoses are made long before the diagnosis of ADHD is assessed in female clinical populations because of less overt ADHD symptoms [12,13]. Furthermore, boys with ADHD have been found to have more externalizing disorders than normal developing boys and by comparison, more overt acting out behavior seems to drive referral for ADHD assessment in boys [8,9]. ...
... In terms of psychiatric comorbidities, although the psychiatric diagnoses were more encountered in boys (19%) than girls (6.9%); yet there was no statistically significant difference between them. We attempted to explain this by the fact that boys with ADHD have been found to have more externalizing disorders like oppositional defiant disorder and conduct disorder than females who tended to show more internalizing disorders as depression and anxiety disorders [5,6,12,46]. Less disruptive behavior in females with ADHD may contribute to referral bias causing under-identification and lack of treatment for females with ADHD [47][48][49]. ...
... Comorbidities are often different for females with ADHD compared to males (Quinn, 2008). Rucklidge and Tannock (2001) found that when comparing females with ADHD to males with ADHD, females were more psychosocially impaired than males. Females reported more overall distress, anxiety, and depression, as well as a greater external locus of control. ...
Objective:
The aim of this review was to explore the impact of living with undiagnosed ADHD and adult diagnosis on women.
Method:
A systematic literature search was completed using three databases. Eight articles were considered relevant based on strict inclusion criteria. Thematic analysis was used to analyze the results of the articles.
Results:
Four key themes emerged: Impacts on social-emotional wellbeing, Difficult relationships, Lack of control, and Self-acceptance after diagnosis.
Conclusion:
This knowledge can be used to advance the understanding of ADHD in adult women and the implications for late diagnosis in women.
... The way in which girls express their difficulties may preclude diagnoses, or make their challenges more difficult to detect. Girls with ADHD often present with predominantly inattentive and internalising symptoms (Biederman et al., 2002;Levy et al., 2005;Rucklidge & Tannock, 2001). In contrast, boys typically present with hyperactive/impulsive symptoms and externalising behaviours (Abikoff et al., 2002;Quinn, 2008). ...
Background:
Fewer girls than boys are identified as struggling at school for suspected problems in attention, learning and/or memory. The objectives of this study were to: i) identify dimensions of cognition, behaviour and mental health in a unique transdiagnostic sample of struggling learners; ii) test whether these constructs were equivalent for boys and girls, and; iii) compare their performance across the dimensions.
Methods:
805 school-aged children, identified by practitioners as experiencing problems in cognition and learning, completed cognitive assessments, and parents/carers rated their behaviour and mental health problems.
Results:
Three cognitive [Executive, Speed, Phonological], three behavioural [Cognitive Control, Emotion Regulation, Behaviour Regulation], and two mental health [Internalising, Externalising] dimensions distinguished the sample. Dimensions were structurally comparable between boys and girls, but differences in severity were present: girls had greater impairments on performance-based measures of cognition; boys were rated as having more severe externalising problems.
Conclusions:
Gender biases to stereotypically male behaviours are prevalent among practitioners, even when the focus is on identifying cognitive and learning difficulties. This underscores the need to include cognitive and female-representative criteria in diagnostic systems to identify girls whose difficulties could go easily undetected.
... A striking feature of ADHD is its differential incidence in males and females. The vast majority of the studies that have been conducted to examine gender difference on ADHD have been with clinical samples (Biederman et aI., 2002b;Rucklidge & Tannock, 2001). Thus, prevalence rates vary, with male to female ratios in clinic-referred samples ranging 9:1 to 6:1 (Biederman et aI., 2002;Lahey et aI., 1994;Sandberg, 1996), while ratios from population-based studies are approximately 3: 1 (for review see Jud & Faraone, 2006). ...
p>Attention deficit/hyperactivity disorder (ADHD) has been characterised as a clinically and genetically heterogenous disorder. Over the past decades, researchers have studied the neuropsychological causal factors associated with this heterogeneity. Neuropsychological deficits such as inhibitory control (Barkley, 1997) and delay aversion (Sonuga-Barke et al., 1992) have been associated with ADHD. However, none of these unitary causal models can fully explain the aetiology of the disorder. In fact, there is a theoretical and empirical focus on identifying multiple causal pathways (Sonuga-Barke, 2002). Up to date, very few studies have been conducted to distinguish these different causal pathways to ADHD by using multiple indicators of these neuropsychological domains. In the present thesis 71 pairs of children with ADHD and their unaffected siblings and 50 children were examined on inhibitory control and delay aversion tasks as part of the Southampton site of the International Multicentre ADHD Genetics Study (IMAGE project). First, these two neuropsychological deficit domains were found to be two separate latent constructs. Secondly these latent factors of inhibitory control and delay aversion deficits were found to be associated with ADHD. Third, a comparison of probands and their siblings found little evidence of familial effects on either construct. Confounding effects such as age, gender, non-executive processes, IQ, and comorbid ODD were also investigated in a secondary analysis. The current thesis provides strong support for the dual pathway model of ADHD – but leaves open the question of whether these effects are familial or genetic in nature. Based on the present results, clinical and research implications on using neuropsychological subtypes, as part of the clinical diagnosis, are discussed.</p
... Moreover, additional organic process dilemma than authority [24,25,26]. Impersonally specific women seldom retain simply high-strung /offhand issues [27] as a consequence, this leans as legitimate in medical specialty teams also [28,29]. Thus women's square measure is mostly precluded. ...
The organic process standing of Attentiveness deficit/hyperactivity disorder (ADHD) is principal to the estimation of whether the fashionable community has generated it, either mundanely or culturally, and is doubtless helpful in the apprehension of biological sciences’ cornerstone and foundation. The high widespread of the syndrome (5–10%) and its intrinsic coalition with the 7-repeat citrons of DRD4, which is entirely elite in advancement, augment the chance that the syndrome will increase the procreative robustness of the individual and the cluster. Nevertheless, preceding recommendations of organic process roles for syndrome haven't reckoned for its restrain to a considerable minority. As a result of one among the pointer options of the syndrome is its divergences, and plenty of edges of diverging community area unit well conceded (as in exemption), we tend to analyze the influence of bands' activity diversification is shown on their health. Diversity happens to several extents, and just for intangibility, we elect unforeseeable (or changeable), way over that may be a well-orthodox attribute of the syndrome. Counterfeit of the dynamic Food cluster charge puts before you the uncertain behavior by the outnumbered optimizing results shown from the cluster. The trait of such cluster inspection chore area unit peril danger-taking, within which prices area unit borne principally by a discrete individual; and statics-sharing, within which edges ensure the complete cluster due to previous knowledge of evolved selflessness. We conclude that even singly impairing combos of genes, like syndrome, will carry particular edges for the community, which may be elite at that stage, instead of simply genetic fortuity with outcomes limited to the individual. The communal edges presented by diversity occur within and outdoors. The ‘normal’ varies, and these could also be definite. This read has the extra advantage of clarifying the usual sexuality and age distribution, asperity dispersal, and no uniformity of syndrome.
... The way in which girls express their difficulties may preclude diagnoses, or make their challenges more difficult to detect. Girls with ADHD often present with predominantly inattentive and internalising symptoms (Biederman et al., 2002;Levy et al., 2005;Rucklidge & Tannock, 2001). In contrast, boys typically present with hyperactive/impulsive symptoms and externalising behaviours (Abikoff et al., 2002;Quinn, 2008). ...
Objectives: Fewer girls than boys are identified as struggling at school. The objectives of this study were to: i) identify dimensions of cognition, behaviour and mental health in a unique transdiagnostic sample of struggling learners; ii) test whether these constructs were equivalent for boys and girls, and; iii) compare their performance across the dimensions. Methods: 805 school-aged children, identified by practitioners as experiencing problems in cognition and learning, completed cognitive assessments, and parents/carers rated their behaviour and mental health problems. Results: Three cognitive, three behavioural, and two mental health dimensions distinguished the sample. Dimensions were structurally comparable between boys and girls, but differences in severity were present: girls had greater cognitive impairments; boys had more severe externalising problems. Conclusions: Gender biases to stereotypically male behaviours are prevalent among practitioners, even when the focus is on identifying cognitive and learning difficulties. This underscores the need to include cognitive and female-representative criteria in diagnostic systems to identify girls whose difficulties could go easily undetected.
... Yet both referral source and informant (e.g., parent vs. teacher) were crucial moderators, as opposite patterns of findings for the two types of samples and raters sometimes emerged. Additional clinical samples yield contradictory outcomes regarding whether girls with ADHD have equivalent social impairment as boys (Greene et al., 2001) or greater social/ academic deficits (Rucklidge & Tannock, 2001; see also Elkins, Malone, Keyes, Iacono, & McGue, 2011). If girls with ADHD actually have fewer/less severe symptoms than boys, a core tenet of the gender paradox would be violated, obviating the need for polygenetic multiple threshold versus constitutional variability explanations. ...
Attention-deficit/hyperactivity disorder (ADHD) – and its underlying behavioral dimensions of inattention and hyperactivity–impulsivity – have been understudied in females. We first cover the conceptual issues of prevalence, diagnostic practices, diversity, comorbidity, and causal factors, plus forces limiting awareness of ADHD in females. After a narrative review of cross-sectional and longitudinal findings, we conclude the following. (a) Girls meet diagnostic criteria for ADHD at just under half the rates of boys, a ratio that becomes much closer to equal by adulthood. (b) Girls and women with ADHD show a predominance of inattention and associated internalizing problems; boys and men display greater levels of hyperactive–impulsive symptoms and associated externalizing problems. (c) Sex differences in ADHD symptoms and related outcomes depend heavily on the clinical versus nonreferred nature of the samples under investigation. (d) Females with ADHD experience, on average, serious impairments, with a particularly heightened risk for problems in close relationships and engagement in self-harm. (e) Clinicians may overlook symptoms and impairments in females because of less overt (but still impairing) symptom manifestations in girls and women and their frequent adoption of compensatory strategies. Our review of predictors and mediators of adult outcomes highlights (a) the potential for heterotypically continuous pathways in females with childhood ADHD and (b) developmental progressions to self-harm, intimate partner violence, unplanned pregnancy, and comorbid psychopathology. Focusing on ADHD in females is necessary to characterize causal and maintaining mechanisms with accuracy and to foster responsive interventions, as highlighted in our closing list of clinical implications and research priorities.
... We hypothesize that verbal working memory and processing speed are correlated with the severity of attention deficits and emotional dysregulation, even after controlling for covariates. The covariates that may affect the associations between neurocognitive test results and the clinical features of ADHD include age (Ardila, 2007), sex (Rucklidge & Tannock, 2001), education level (Reitan & Wolfson, 1995), and depression (Gorlyn et al., 2006). ...
Objectives:
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), emphasizes symptoms severity with regard to the diagnosis of attention deficit hyperactivity disorder (ADHD). Many clinicians use neuropsychological test results as objective measures of cognitive functions as part of the diagnostic work-up. The aim of this study was to investigate whether the psychometric test results regarding verbal working memory and processing speed are useful as indicators of the severity of attention deficits and emotional dysregulation in adults with ADHD.
Methods:
This observational cross-sectional clinical study included 418 adults diagnosed with ADHD according to the DSM-5. Attention deficit severity was defined based on the inattentive subscale of the Adult ADHD Self-Report Scale. Emotional dysregulation was assessed with the Deficient Emotional Self-Regulation scale. Verbal working memory was measured with the Working Memory Index (WMI), and processing speed was measured with the Processing Speed Index (PSI) from the Wechsler Adult Intelligence Scale, third edition.
Results:
The full-scale intelligence quotients of the participants were in the normal range, with expected reductions in verbal working memory and processing speed. Only processing speed was associated with attention deficits (β = -.056, p = .003). The association between the psychometric test result for verbal working memory and processing speed and that between the severity of attention deficits and emotional dysregulation were weak (R2 < .1) and mostly non-significant.
Conclusion:
The psychometric index scores for verbal working memory (WMI) and processing speed (PSI) seem to have limited utility as indicators of the severity of attention deficits and emotional dysregulation in adult ADHD patients.
... It should be recalled that children with ADHD who exhibited lower cortical activation during the first HEG BFB session than neurotypical children declared lower levels of intrinsic motivation and internal LOC at that time, which also supports these findings. Motivation deficits and differences in LOC are thought to be co-occurring with attention deficit (Reijnen & Opwis, 2008;Rucklidge & Tannock, 2001). In the regression analysis, we obtained a moderate effect size. ...
Commonly proven abnormalities in the structure and functioning of the prefrontal cortex (PFC) are related to cognitive deficits in children with ADHD. The purpose of the randomized controlled study was to assess the efficacy of intervention using hemoencephalographic biofeedback (HEG BFB) in PFC in ADHD and neurotypical children. The final cohort consisted of 120 children aged 9–15 years, including 60 children with ADHD. The individuals were randomized in 10 HEG BFB or physical activity (PA) training sessions. Children with ADHD exhibited lower cognitive capacity in terms of vigilance, visual search, multitasking, inhibitory control and working memory compared to neurotypical children. The performance of children with ADHD and neurotypical children in cognitive functions improved under the influence of HEG BFB (the PA training did not have a statistically significant impact on the results). The important gain predictors in HEG BFB involved: intrinsic motivation, internal locus of control and positive mood.
Highlights:
- It was the first randomized controlled study aimed at assessing the efficacy of hemoencephalographic (HEG) biofeedback.
- HEG biofeedback proved to be effective in treating cognitive deficits in children with ADHD and in enhancing cognitive capacity in neurotypical children.
-Intrinsic motivation, internal locus of control and the positive mood turned out to be significant predictors of gain in HEG biofeedback.
... The results of this study were generalizable to a broader population because they measured the behaviors and symptoms of children with and without ADHD who were clinically and community referred for the study. On the other hand, a couple of studies (Rucklidge & Tannock, 2001;Yang, Chen, Chung, & Jong, 2004) used only clinical samples, which limited their results to a single group in a population. Furthermore, an issue with using only one type of sample is that the statistics may not accurately reflect the actual prevalence of a disorder. ...
... Therefore, it is important to emphasize that ASD diagnosis represents a challenge when considering the current disorder available knowledge, not only because of the complexity of the phenotype but also because of the diversity in clinical manifestations, especially in early ages, in less severe ASD cases [39] and in more complex ASD cases that are more frequently observed in girls compared with boys [40]. Thus, many studies confirmed that ASD diagnosis for women arises later than in men [41][42][43][44], similar to other neurodevelopmental disorders (e.g., ADHD (attention deficit and hyperactivity disorder)) [45,46]. These data can be explained, in part, because in boys, symptoms are in general more disturbing with more externalizing behaviors. ...
Studies on the prevalence of autism spectrum disorders have shown gender disproportion. In recent years, there has been an increasing interest in this investigation area. There are two main research lines; the first is focused mostly on gender-related biological reasons that could account for low ASD prevalence in women (i.e., related to some protective factors related to hormones or the immune system, among others), and the second research line studies possible diagnostic biases. In the present study, a review of the latter line of research is made based on two main objectives: (a) analysis of possible biases in diagnostic tools and (b) other nonbiological ASD prevalence explained
by gender differences. As a result of our theoretical review, we found that the articles reviewed showed contradictory results and possible diagnostic biases, not only in their design but also in their assessment standards. We concluded that specific or complementary diagnostic tools and procedures differentiated by gender should be developed in order to reduce these biases.
... Therefore, it is important to emphasize that ASD diagnosis represents a challenge to the current disorder available knowledge, not only because of the complexity of the phenotype but also because of the diversity of forms of clinical manifestation; especially, in early ages, in less severe ASD cases [38]and in more complex ASD cases that are more frequently observed in girls compared with boys [39]. Thus, many studies confirm that the diagnosis in women is later than in men [40,41,42,43], in the same way as other neurodevelopmental disorders such as ADHD (Attention Deficit and Hyperactivity Disorder) [44,45]. The difference can be explained, in part, because in boys the behavior is in general more disturbing, with more externalizing behaviors. ...
Studies on the prevalence of Autism Spectrum Disorders show a gender disproportion. In the last years, there has been an increasing interest in the search for an explanation. There are two main lines of research; the first one looks for sex-related biological reasons that justifies the low prevalence of ASD in women (some protective factor related to hormones or immune system among others), and the second line of studies is related to the possible biases introduced in the diagnostic tools or procedures. In this article, a review of the latter line of research is made. Theoretical analysis following two objectives: a) Analysis of possible biases in diagnostic tools and b) Other non-biological explanations for gender differences in the prevalence of ASD. The literature analyzed provides contradictory results although it evidences the possible bias both in the construction of the diagnostic tools and in the assessment and determination of their standards. It is necessary to develop specific or complementary tools and diagnostic procedures differentiated by gender in order to control for this bias.
... Similar gender discrepancy was reported in adults with ADHD in a recent Norwegian populationbased study [21]. In addition, female adolescents with ADHD have been shown to suffer more peer rejection, poorer perceived locus of control and were more likely to be admitted for psychiatric issues in adulthood than their male counterparts [22,23]. ...
Background
Studies on gender differences in attention-deficit/hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed.
Methods
A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the largest public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher’s Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires.
Results
Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Gender remained a significant predictor of externalizing problem after controlling for other factors. Lower socioeconomic status and parental use of physical punishment were significant predictors of both internalizing and externalizing problems.
Conclusions
Gender differences in ADHD comorbidities do exist in the Asian clinical population. The lack of externalizing symptoms in females with ADHD has made timely referral and diagnosis challenging. More research is needed in understanding the gender differences in ADHD and the biopsychosocial mechanism underlying the differences in order to improve the detection of ADHD in females.
... Roy et al. (2015) note that although boys have a higher likelihood of experiencing social impairment, girls show a greater sensitivity to peer problems. This sensitivity may explain the high rate of internalizing problems in adolescent girls in populationbased and non-clinical samples (Rucklidge and Tannock, 2001;Modin et al., 2011;Lundervold et al., 2016). Of clinical importance, girls tend to experience stronger barriers to mental health services than boys, with biases at every level from parents/teachers to health personnel. ...
Introduction : Previous findings that inattention (IA) and hyperactive/impulsive (HI) symptoms predict later peer problems have been mixed. Utilizing two culturally diverse samples with shared methodologies, we assessed the predictive power of dimensionally measured childhood IA and HI symptoms regarding adolescent peer relationships.
Methods : A US-based, clinical sample of 228 girls with and without childhood diagnosed attention-deficit/hyperactivity disorder (ADHD; M age = 9.5) was assessed and followed 5 years later. A Norwegian, population-based sample of 3,467 children (53% girls; M age = 8.3) was assessed and followed approximately 4 years later. Both investigations used parent and teacher reports of ADHD symptoms and peer relations. Multivariate regression analyses examined the independent contributions of IA and HI symptoms to later peer problems, adjusting for baseline childhood peer problems. We also examined childhood sex as a potential moderator within the Norwegian sample.
Results : Higher levels of childhood HI symptoms, but not IA symptoms, independently predicted adolescent peer problems in the all-female clinical sample. Conversely, higher levels of IA symptoms, but not HI symptoms, independently predicted preadolescent peer problems in the mixed-sex population sample. Results did not differ between informants (parent vs. teacher). Associations between ADHD symptom dimensions and peer problems within the Norwegian sample were not moderated by child sex.
Discussion : Differential associations between childhood hyperactive/impulsive and inattention symptoms and adolescent peer problems were found across two diverse samples using a shared methodology. Potential explanations for different findings in the clinical vs. population samples include symptom severity as well as age, sex, and cultural factors. We discuss implications for future research, including the importance of dimensional measures of ADHD-related symptoms and the need for shared methodologies across clinical and normative samples.
... Similar gender discrepancy was reported in adults with ADHD in a recent Norwegian population-based study [21]. In addition, female adolescents with ADHD have been shown to suffer more peer rejection, poorer perceived locus of control and were more likely to be admitted for psychiatric issues in adulthood than their male counterparts [22,23]. ...
Background: Studies on gender differences in attention-deficit/ hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed.
Methods: A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the largest public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher’s Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires.
Results: Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Gender remained a significant predictor of externalizing problem after controlling for other factors. Lower socioeconomic status and parental use of physical punishment were significant predictors of both internalizing and externalizing problems.
Conclusions: Gender differences in ADHD comorbidities do exist in the Asian clinical population. The lack of externalizing symptoms in females with ADHD has made timely referral and diagnosis challenging. More research is needed in understanding the gender differences in ADHD and the biopsychosocial mechanism underlying the differences in order to improve the detection of ADHD in females.
... Our small sample size also prohibited us from separating our participants into those with a predominantly inattentive presentation, a predominantly hyperactive presentation or a combined presentation and from examining gender differences. Gender differences have been documented in self-reports of child, adolescent and young adults with ADHD (Gaub & Carlson, 1997;Gershon, 2002;Rucklidge & Tannock, 2001;Waite, 2007), and examining differences between males and females is necessary to assure the generalizability of the findings of psychopathology research (Hartung & Lefler, 2019;Howard et al., 2017). Because the current sample only included seven males in the unmedicated condition, future research will be necessary to determine whether gender influences subjective symptoms and the relationships they share with medication state. ...
Objectives:
This study examined the effect of whether participants were on or off their medications and the effect of questionnaire wording on self-reported symptoms in young adults with ADHD. Additionally, this research evaluated the relationships between these self-reported symptoms and objective performance on measures of working memory.
Design:
This experimental study utilized a mixed factorial design with one between-subjects factor (whether participants were unmedicated or medicated at the time they completed their assessment) and one within-subjects factor (whether participants reported their on-medication or off-medication symptoms when describing their ADHD subjective symptomatology).
Methods:
Forty-five young adults with ADHD (ages 18-23) completed a brief neuropsychological evaluation and several self-report questionnaires.
Results:
Although being medicated or unmedicated while completing the questionnaires did not directly affect self-reported symptoms or their accuracy, questionnaire wording exerted a statistically significant effect on subjective symptomatology; participants described themselves as substantially more symptomatic at times when they are off than at times when they are on their medications. More importantly, their general self-perceptions (symptoms when medication state was not specified) of their Inattention/Memory Problems and their Hyperactivity/Restlessness aligned with their descriptions of their off-medication symptoms, whereas their general self-perceptions of their Impulsivity/Emotional Lability and Problems with Self-Concept related to both their self-reported off-medication and on-medication symptoms.
Conclusions:
These results highlight the necessity of specifying medication state when asking patients to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications as they may describe the extent of their unmedicated, rather than medicated, symptomatology.
Practitioner points:
Being medicated or unmedicated while completing questionnaires about subjective symptomatology did not directly affect self-reported symptoms of young adults with ADHD or the accuracy of these self-reports. When medication state was not specified on a questionnaire, young adults with ADHD reported symptoms similar to those they experience when they are not medicated. These results highlight the importance of specifying medication state when asking young adults with ADHD to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications. These findings open the door for further research with larger and more diverse and representative samples of adults with ADHD to evaluate the accuracy of their subjective symptomatology relative to their objective abilities. Future studies should also examine whether gender affects subjective symptoms, their accuracy, or the influence of question wording and medications on self-reported symptomatology of adults with ADHD, as the current study was unable to address this important issue.
... Similar gender discrepancy was reported in adults with ADHD in a recent Norwegian population-based study [21]. In addition, female adolescents with ADHD have been shown to suffer more peer rejection, poorer perceived locus of control and were more likely to be admitted for psychiatric issues in adulthood than their male counterparts [22,23]. ...
Background: Studies on gender differences in attention-deficit/ hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed.
Methods: A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the largest public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher’s Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires.
Results: Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Older age, lower socioeconomic status and parental use of physical punishment were associated with higher internalizing and externalizing problems after controlling for other factors.
Conclusions: Gender differences in ADHD comorbidities do exist in the Asian clinical population. The lack of externalizing symptoms in females with ADHD has made timely referral and diagnosis challenging. More research is needed in understanding the gender differences in ADHD and the biopsychosocial mechanism underlying the differences in order to improve the detection of ADHD in females.
... These results are consistent with the findings from previous studies showing that adolescent females with ADHD are more socially impaired than typically developing girls including difficulties with social skills, peer rejection, and overt and relational peer victimization (Mikami et al., 2008). Furthermore, adolescent girls with ADHD report that they have low self-esteem, depression, anxiety, substance use, and eating disorders (e.g., Babinski et al., 2011;Rucklidge & Tannock, 2001). These difficulties may make it difficult for them to have close friends at school, which might compound their social and emotional problems. ...
The purpose of this study was to determine whether adolescents with and without attention-deficit/hyperactivity disorder (ADHD) differ regarding their friendships. The sample comprised 107 adolescents (59 ADHD, 48 typically developing comparison), ages 13 to 18 years. Adolescents and their parents completed questionnaires that measured the number and duration of the adolescents’ friendships, the frequency of contact they had with their friends, and the characteristics of their friends. Adolescents with and without ADHD did not differ in the number of friends they nominated, the duration of their friendships, and the frequency of contact with friends. Adolescents with ADHD were more likely to have friends who were younger or older by two or more years and close friends with behavior problems than comparison adolescents. Girls with ADHD had fewer of their friendships corroborated by parents than girls without ADHD, and fewer of their best friends attending their school. Only girls with ADHD had friends whom they initially met online.
... processing speed and potential confounds. In line with previous research [84][85][86]94 , females generally had higher PS scores than males, and sex was a significant predictor of PS in all analyses. This was found to be true even after accounting for all dimensional measures of psychopathology. ...
Introduction:
The present study examines the relationships between processing speed (PS), mental health disorders, and learning disorders. Prior work has tended to explore relationships between PS deficits and specific diagnoses in isolation of one another. Here, we simultaneously investigated PS associations with five diagnoses (i.e., anxiety, autism, ADHD, depressive, specific learning) in a large-scale, transdiagnostic, community self-referred sample.
Method:
843 children, ages 8-16 were included from the Healthy Brain Network (HBN) Biobank. Principal component analysis (PCA) was employed to create a composite measure of four PS tasks, referred to as PC1. Intraclass correlation coefficient (ICC) between the four PS measures, as well as PC1, were calculated to assess reliability.
Results:
ICCs were moderate between WISC-V tasks (0.663), and relatively modest between NIH Toolbox Pattern Comparison and other PS scales (0.14-0.27). Regression analyses revealed specific significant relationships between PS and reading and math disabilities, ADHD-inattentive presentation (ADHD-I), and ADHD-combined presentation (ADHD-C). After accounting for inattention, the present study did not find a significant relationship with Autism Spectrum Disorder.
Discussion:
Our examination of PS in a large, transdiagnostic sample suggested more specific associations with ADHD and learning disorders than the literature currently suggests. Implications for understanding how PS interacts with a highly heterogeneous childhood sample are discussed.
... Bellek yetersizliği yeni bilgi ediniminde ve bilgiyi uzun süreli kullanmada düşük performansa neden olmaktadır. Önceki araştırmalarda da (Erdoğan-Bakar vd., 2005;Fenollar-Cortes vd., 2015;Mayes & Calhoun, 2006;Naglieri vd., 2003;Rucklidge & Tannock, 2001;Snow & Sapp, 2000;Styck & Watkins, 2014;Thaler vd., 2012) DEHB'li bireylerin işleyen bellek, kazanılmış bilgi ve kısa süreli bellek alanlarını ölçen alt testlerde düşük performans gösterdikleri saptanmıştır. ...
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders in childhood. Intelligence scales are widely used as a supplement to other instruments in the diagnosis of ADHD because ADHD can inhibit some cognitive processes related to intelligence. The purpose of this study was to investigate cognitive profiles of children with ADHD on Anadolu Sak Intelligence Scale (ASIS). The participants were 102 children with ADHD. Between-groups analyses showed that children with ADHD had significantly lower scores than the normative sample in all indexes and subscales of the ASIS. Within group analysis showed that the mean score of the ADHD group on the Memory Capacity Index was significantly lower than their scores on the Verbal Potential Index and Visual Potential Index. The subscale analyses showed that ADHD group performed significantly lower in the Visual Sequential Processing subtest and Words Meanings subtest than the other subtests. The children with ADHD were observed to have weak working memory performance which may impact their learning capacity, especially during language acquisition.
... Language problems (expressive and receptive), may be present in as many as 90% of children with ADHD (Camarata, Hughes, & Ruhl, 1988;Gualtieri, Koriath, van Bourgondien, & Saleeby, 1983;Love & Tompson, 1988;Tirosh & Cohen, 1998;Trautman, Giddan, & Jurs, 1990 as cited by Mueller & Tomblin, 2012),although this overlap may vary depending on the domain of language that is the focus of the investigation (e.g., vocabulary, grammar (i.e., morphology and syntax and discourse comprehension). For instance, vocabulary is one domain of impairment among many possible areas of language comprehension impairment in children and youth with ADHD (Redmond, 2004;Rucklidge & Tannock, 2001;Van Neste, Hayden, Lorch, & Milich, 2015). Studies have also documented poorer grammatical understanding in individuals with ADHD (Mathers, 2006;Papaeliou, Maniadaki, & Katouros, 2015) and weakness in forming inferences (McInnes et al., 2003;Van Neste et al., 2015), most notably explanatory inferences (e.g., casual antecedents and goals) (Magliano, Dijkstra & Zwaan, 1996;Van Neste et al., 2015). ...
Reading comprehension may be an area of challenge for youth with ADHD but is currently understudied. The overarching goal of this study was to examine reading comprehension (RC) performance drawing on the Simple View of Reading (Gough & Tunmer, 1986). The first objective was to compare reading comprehension proficiency and related reading measures between youth with ADHD and typically developing youth. Findings showed that there were no statistically significant differences between the two groups on the measure of RC, word level decoding, and oral language comprehension. In contrast, youth with ADHD performed significantly lower than their peer group on the word level reading fluency measure and on a verbal working memory measure. Next, I explored predictors of performance on the RC measures. Multiple regression analyses revealed that only word level decoding and language comprehension proficiency were unique predictors of performance on each of the RC measures. A supplementary analysis revealed that the contribution of working memory to RC was mediated by the language comprehension composite. Finally, I tested the convergent validity of the two RC measures using latent profile analysis. As the latent profile analysis iii showed that profiles of performance converged across the three latent profile groups (lowest, middle, and highest performers), the findings supported the convergent validity of the two measures of RC. Further analyses of the three latent profile subgroups using a multinomial regression analysis revealed that language comprehension and word level decoding differentiated the low-performing group compared to the middle-and highest-performing groups. Overall, these findings suggest that youth with ADHD and their typically developing peers are more likely to demonstrate weaker RC if they have less proficiency in oral language comprehension skills and/or word level decoding ability, supporting the Simple View of Reading. iv
... As for the rest of the abilities assessed by the WISC-IV, some discrepancies between our results and those produced by other studies can be observed. For instance, although some authors reported similar performance of working memory in boys and girls (O'Brien et al., 2010), others suggested lower vocabulary scores-related to verbal comprehension functioning-in girls and worse processing speed in boys (Rucklidge and Tannock, 2001). The greater intellectual impairment in girls with ADHD (relative to boys) indicated by the results of some investigations (Gaub and Carlson, 1997;Gershon, 2002;Rucklidge, 2010) is not borne out by our results, in terms of total scores on the WISC-IV, an index of overall cognitive or intellectual ability. ...
Cognitive impairments are often reported in research on children with attention-deficit/hyperactivity disorder (ADHD). However, studies analyzing sex differences in this context are still sparse. This study aimed to compare the neuropsychological performance of boys and girls with ADHD across several cognitive domains. Verbal comprehension, perceptual reasoning, working memory, processing speed, and general cognitive performance were assessed in 240 children aged 6-17 years: 120 children (65 boys) with a clinical diagnosis of ADHD and 120 typically developing children (60 boys). Underperformance of children with ADHD compared to controls was observed in all the evaluated cognitive domains, except for verbal comprehension. Significantly lower scores in perceptual reasoning, with a medium effect size, were found in girls with ADHD relative to boys, although the sexes did not significantly differ in terms of the remaining variables. Children's ADHD subtypes did not correlate significantly with any performance measure, and no significant interaction effects between children's age and sex were noted in the results. The performance commonalities found between boys and girls with ADHD outweighed the differences, which highlights the importance of further research on cognitive dysfunction in girls with ADHD, regardless of sex differences in the prevalence of the disorder.
... This conclusion was similar to other done about ADHD in which the gender effect on ADHD was evaluated. It was found that ADHD was more prevalent in males yet, more severe in females (Rucklidge, 2001;Biederman, 2005a). ...
Objective: Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder
of childhood. In this study we have evaluated the antioxidant activity in ADHD. Methods: Thirty ADHD
patients from the outpatient clinic at the institute of postgraduate childhood studies, Ain Shams University,
were diagnosed according to the DSM based diagnostic screening scale with thirty normal age and sex matched
controls. Blood samples were collected: superoxide dismutase (SOD), glutathione peroxidase (GPX), glutathione
s-transferase (GST), catalase (CAT), Ferritin and hemoglobin (Hb) were measured. Results: The mean level
of SOD, GST, GPX, CAT were significantly lower in cases than controls indicating low antioxidant activity
in children with ADHD. Conclusion: Remarkable low antioxidant activity in ADHD suggested that, oxidative
imbalance plays a role in the pathogenesis and prognosis of ADHD and should be taken in consideration in
the therapeutic plans.
Many empirically validated tools and measures have been created for us in attention-deficit/hyperactivity disorder (ADHD) assessment in child and adolescent populations. This chapter reviews multiple evidence-based assessment techniques including interviews, questionnaires, and neuropsychological tests commonly used in ADHD assessment. Furthermore, assessment protocols for administering and evaluating the results of these methods as well as recommendations and considerations for youth ADHD assessment are reviewed.
Introdução: Este estudo visa esclarecer a associação entre o Transtorno de Déficit de Atenção e Hiperatividade (TDAH) na infância e adolescência e o comportamento autolesivo – em especial, a autolesão não suicida -, investigando-se a relevância diagnóstica e terapêutica dessa comorbidade no curso do TDAH. Metodologia: Realizou-se revisão narrativa da literatura, na plataforma digital PubMed, com descritores extraídos da plataforma Descritores em Ciências da Saúde, do Portal Regional da Biblioteca Virtual em Saúde - BIREME. Resultados: Dentre os oito estudos analisados, seis destacaram associação positiva entre TDAH e autolesão na infância/adolescência. Também apresentaram importante papel fatores como sexo feminino, impulsividade, idade, comorbidades psiquiátricas, disfunção familiar e problemas comportamentais e emocionais na infância. Discussão/Conclusão: Em crianças e adolescentes com TDAH, propõe-se vigilância ativa com relação a autolesão e seus fatores de risco. Há necessidade de atenção especial às meninas, principalmente àquelas com mais sintomas impulsivos/hiperativos ou apresentação combinada.
Se realiza una revisión de la bibliografía obtenida, tras una búsqueda sistemática en las principales bases de datos, para responder a algunas preguntas clínicas relacionadas con el trastorno por déficit de atención con/sin hiperactividad (TDAH) y sobre todo con su tratamiento. El texto trata de establecer los principales factores de la etiopatogenia, epidemiología, diagnóstico y modos de tratamiento. Se concluye y se cuestiona el sobrediagnóstico de muchos niños/as que actualmente están diagnosticados con TDAH y bajo el tratamiento del metilfenidato (concerta, ritalín) por causa de la presión insaciable de la BigPharma, obviando otros posibles diagnósticos y/o terapias psicoeductivas o sistémicas.
Previous studies have shown that Attention-Deficit/Hyperactivity disorder (ADHD) is marked by impairments in academic functioning in reading, writing, and mathematics. Yet, virtually no studies have examined academic functioning in terms of both basic skills (e.g., word recognition, handwriting/spelling, arithmetic calculations) and more complex advanced skills (e.g., reading comprehension, writing composition, and mathematical problem-solving) within the same sample. In the present study, 518 children with ADHD were compared to a control group of 851 children without ADHD (ages 8-18) and assessed on a comprehensive battery of reading, writing, and math assessments. It was hypothesized that ADHD diagnostic status would uniquely predict performance on advanced skill measures even after controlling for performance on basic skills in that academic domain. ADHD status was associated with worse performance across all academic tests. Results also indicated that ADHD independently predicted performance for measures of writing composition and one measure of reading comprehension, even after controlling for performance on basic skills in those domains. However, ADHD did not independently predict mathematical problem-solving performance. These findings add to the literature on ADHD and academic functioning and indicate that inattention may weaken skills necessary for effective reading comprehension and writing composition.
This study examined whether girls and boys with ADHD show similar impairments in cognitive control from childhood into adolescence and the developmental relationship between cognitive control and ADHD symptoms. Participants include 8-17-year-old children with ADHD (n = 353, 104 girls) and typically developing (TD) controls (n = 241, 86 girls) with longitudinal data obtained from n = 137. Participants completed two go/no-go (GNG) tasks that varied in working memory demand. Linear mixed-effects models were applied to compare age-related changes in cognitive control for each GNG task among girls and boys with ADHD and TD controls and in relation to ADHD symptoms. Boys with ADHD showed impaired response inhibition and increased response variability across tasks. In contrast, girls with ADHD showed impaired response inhibition only with greater working memory demands whereas they displayed increased response variability regardless of working memory demands. Analysis of age-related change revealed that deficits in cognitive control under minimal working memory demands increase with age among girls with ADHD and decrease with age among boys with ADHD. In contrast, deficits in cognitive control with greater working memory demands decrease with age among both boys and girls with ADHD compared to TD peers. Among children with ADHD poor response inhibition during childhood predicted inattentive symptoms in adolescence and was associated with less age-related improvement in inattentive symptoms. These findings suggest that girls and boys with ADHD show differential impairment in cognitive control across development and response inhibition in childhood may be an important predictor of ADHD symptoms in adolescence.
Attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders are among the most common psychological problems in adolescence. It is not surprising that a large number of teens experience both ADHD and anxiety together. In fact, one in four teenagers with ADHD also has a co-occurring or “comorbid” anxiety disorder. While comorbidity rates vary depending on the population, the rates are estimated between 20% and 40% in epidemiological and clinical samples (Anderson JC, Williams S, McGee R, Silva PA, Arch Gen Psychiatry 44:69–76, 1987; Hammerness P, Geller G, Petty A, Lamb P, Bristol C, Biederman J, Eur Child Adolesc Psychiatry 19:107–12, 2010; Tung I, Li JJ, Meza JI, Jezior KL, Kianmahd JS, Hentschel PG, Pediatrics 138:e20160430). These rates confirm that adolescents with ADHD are at a higher risk for developing an anxiety disorder than those without ADHD. An analysis of 21 different research studies published between 1987 and 1999 found that children with ADHD were over three times more likely to have an anxiety disorder compared to children without ADHD (Angold A, Costello EJ, Erkanli A, J Child Psychol Psychiatry 40:57–87).
The purpose of this study was to investigate the self-perception bias (SPB) in adolescents with attention-deficit hyperactivity disorder (ADHD). The SPB was defined as adolescent underestimation of their learning and behavior problems in comparison to parent- or teacher-reports or a standardized achievement test. The sample comprised 74 adolescents, ages 13 to 18 (40 ADHD; 34 comparison). Compared to adolescents without ADHD, adolescents with ADHD underreported their symptoms and impairment when parent-reports, but not teacher-reports were the indicator of performance. Adolescents with ADHD, however, reported more difficulties in all areas of functioning than adolescents without ADHD. In the sample of adolescents with ADHD, self- and parent-reports of learning problems, but not teacher-reports, were significantly associated with adolescent total academic achievement test score. Adolescents with learning problems as measured by the achievement test, and social problems as rated by parents, reported higher levels of these difficulties than adolescents whose functioning was in the average range; however, adolescents with clinical levels of oppositional behaviors, as rated by parents or teachers, did not report elevated levels of these behaviors. Depressive symptoms were associated with a lower SPB. Implications of these findings for psychologists’ use of self-report measures with adolescents with ADHD are discussed.
This study investigated attributions and stigmatization self-perceptions of 40 adolescents with and 34 adolescents without ADHD for their problematic behaviors and ADHD as a disorder. Adolescents identified behaviors that they believed described them, indicated which of these behaviors was most problematic for them, and responded to a questionnaire regarding the extent to which this behavior was internally caused, controllable, pervasive, and stigmatizing. Compared to participants without ADHD, participants with ADHD endorsed more problematic behaviors including behaviors that are symptoms of ADHD, the impairment associated with ADHD, and commonly co-occurring disorders. They viewed the behavior that they identified as most problematic for them as more pervasive (stable and occurring in more contexts), uncontrollable, and stigmatizing than participants without ADHD. Adolescents with ADHD were less likely to view their most problematic behavior as pervasive and more likely to view it as stigmatizing than the disorder itself. Although adolescents with and without ADHD did not differ in the extent to which they attributed their most problematic behavior to internal causes, adolescents with ADHD were more likely to view the disorder itself as being caused by something inside them than their most problematic behavior.
Objective: A meta-analysis was carried out to determine whether there are sex differences among children and adolescents with ADHD on the primary symptoms of ADHD and on executive and attentional functioning. Method: Studies published from 1997 to 2017 comparing boys and girls with a valid ADHD diagnosis were retained. Results: The meta-analysis found boys with ADHD to be more hyperactive than girls with ADHD and boys to have more difficulties in terms of motor response inhibition and cognitive flexibility. Results also confirm that youths with ADHD have more executive deficits than non-ADHD peers have, but there is no sex difference in this regard. Conclusion: Results show that there are sex differences in the behavioral expression of the difficulties related to ADHD. This highlights the importance of pursuing research to refine the profile of girls with ADHD and to develop diagnostic criteria adapted to each sex.
Objective:
This study aimed to compare the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) profiles of children with attention deficit/hyperactivity disorder (ADHD) and typically-developing children (TC) in Korea.
Methods:
The Korean version of the WISC-IV and the Advanced Test of Attention (ATA) were administered to 377 children and adolescents: 224 with ADHD (age 8.2±2.1 years, 182 boys) and 153 TC (age 8.7±2.4 years, 68 boys). Partial correlation and an analysis of covariance were used to investigate the relationship between the scores of the WISC-IV and the ATA.
Results:
The mean score of the full-scale intelligence quotient was lower in ADHD children than in TC (p<0.001). In analyses controlling for gender and with the full-scale intelligence quotient as a covariate, the working memory index (WMI) (p<0.001) and values of the Digit span subtest (p=0.001) of the WISC-IV were lower in the ADHD group than in TC. The WMI (r=-0.26, p<0.001) and its subtest Arithmetic scores (r=-0.25, p<0.001) were negatively correlated with Commission errors on the auditory ATA.
Conclusion:
Children with ADHD have significantly lower WMI scores, which were clinically correlated with Commission errors on the auditory task of the ATA. Thus, the WMI is an indicator of attention deficit in children with ADHD.
Comorbid psychiatric disorders are present in the vast majority of adults with ADHD, and ADHD is frequently undiagnosed in people who are in treatment for other disorders. In fact, 50–75% of adults with ADHD suffer from at least another neurodevelopmental or psychiatric condition, and have six times the likelihood to suffer from another disorder throughout the lifespan. People with ADHD are four times more likely to suffer from a mood disorder, three times more likely to develop major depressive disorder, six times more likely to develop dysthymia, and twice as likely to develop a substance dependence. Interestingly, up to 43% of gamblers have a history of childhood ADHD.
Background: Sex differences in the prevalence of neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are well documented, but studies examining sex differences in social and communication function remain limited and inconclusive. Objectives: The objective of this study is to conduct a meta-analysis of sex differences in social-communication function in children with ASD or ADHD and typically developing controls. Methods: Using PRISMA, a search was performed on Medline and PSYCHINFO on English-language journals (2000–2017) examining sex differences in social and communication function in ASD and ADHD compared to controls. Inclusion criteria: 1) peer reviewed journal articles, 2) diagnosis of ASD or ADHD and controls, 3) age 6–18 years, 4) measures of social–communication function, and 5) means, standard deviations, and sample sizes reported in order to calculate standardized mean differences (SMD). Results: Eleven original/empirical studies met inclusion criteria for ASD and six for ADHD. No significant sex differences were found between ASD and controls in social (SMD = −0.43; p = 0.5; CI: −1.58–0.72), or communication function (SMD = 0.86; p = 0.5 CI; −1.57–−3.30) and between ADHD and controls in social function (SMD = −0.68: p = 0.7, CI: −4.17–2.81). No studies evaluated sex differences in communication in ADHD. Significant heterogeneity was noted in all analyses. Type of measure may have partially accounted for some variability between studies. Conclusions: The meta-analysis did not detect sex differences in social and communication function in children with ASD and ADHD; however, significant heterogeneity was noted. Future larger studies, controlling for measure and with adequate numbers of female participants are required to further understand sex differences in these domains.
Objective
The present study sought to examine the relationships between processing speed (PS), mental health disorders, and learning disorders. Prior work has tended to explore relationships between PS deficits and individual diagnoses (i.e., anxiety, autism, ADHD, depressive) in isolation of one another, often relying on relatively modest sample sizes. In contrast, the present work simultaneously investigated associations between PS deficits and these diagnoses, along with specific learning disabilities (i.e., reading, math), in a large-scale, transdiagnostic, community self-referred sample.
Method
A total of 843 children, ages 8-16 were included from the Healthy Brain Network (HBN) Biobank. Given the presence of four PS tasks in HBN, principal component analysis (PCA) was employed to create a composite measure that represented the shared variance of the four PS tasks, referred to as PC1. Intraclass correlation coefficient (ICC) between the four PS measures, as well as PC1, were calculated to assess reliability. We then used multiple linear regression models to assess specific relationships between PS deficits and psychiatric diagnoses.
Results
ICCs were moderate between WISC-V tasks (0.663), and relatively modest between NIH Toolbox Pattern Comparison and other PS scales (0.14-0.27). Regression analyses revealed specific significant relationships between PS and reading and math disabilities, ADHD-inattentive type (ADHD-I), and ADHD-combined type (ADHD-C). Secondary analyses accounting for inattention dimensionally diminished associations with ADHD-C, but not ADHD-I or specific learning disability subtypes. The present study did not find a significant relationship with Autism Spectrum Disorder after accounting for inattentive symptoms. Consistent with prior work, demographic variables, including sex, socioeconomic status, and motor control exhibited independent relationships with PC1 as well.
Discussion
This study provided a comprehensive examination of PS, mental health disorders, and learning disabilities through a transdiagnostic approach. Implications for understanding how PS interacts with a highly heterogeneous childhood sample, as well as the need for increased focus on detection of affected populations are discussed.
Children of parents with depression are at increased risk for developing psychopathology. The purpose of the current longitudinal study was to examine the dynamic relations between parents’ depressive symptoms and children’s cognitions, specifically their attributions for the causes of life events. Participants were 227 parent–child dyads with one parent (Mage = 42.19, SD = 6.82; 76% female) and one child (Mage = 12.53, SD = 2.33; 53% female) per family. Parents either were diagnosed with a current major depressive disorder (n = 129; 72.9% female) or were lifetime-free of mood disorders (n = 98; 79.6% female). The Beck Depression Inventory-II was used to obtain a dimensional measure of parents’ depressive symptoms, and the Children’s Attributional Style Questionnaire–Revised was used to assess children’s attributions of negative and positive events. Evaluations were conducted 5 times across 22 months. We used latent difference score (LDS) modeling to examine the relations between changes in parents’ depressive symptoms and changes in children’s attributional style over time. The final model provided a close fit to the data: χ2(30) = 35.22, p = .24; comparative fit index = .995, root mean square error of approximation = .028, 90% confidence interval (CI) [.000, .060], standardized root mean square residual = .024. Parents’ levels of depressive symptoms significantly predicted the worsening of children’s attributions (i.e., becoming more pessimistic) over the 22 months, whereas children’s attributions did not significantly predict changes in parents’ depressive symptoms at the next time point. Preventive interventions should aim to both reduce parents’ depression and teach children strategies for examining the accuracy of their beliefs regarding the causes of life events.
U Priručniku za rad s djecom s teškoćama u razvoju u srednjim školama
prvenstveno smo htjeli prikazati postojeće stanje na području Slavonije kada
je riječ o inkluziji djece s teškoćama u razvoju u srednje škole, a za koje vjerujemo
da se može u dobrom dijelu primijeniti i na ostatak Republike Hrvatske, a njegov
najvažniji doprinos smatramo upravo u davanju smjernica stručnim suradnicima,
nastavnicima kao i roditeljima u radu s učenicima s teškoćama u razvoju koji
su uključeni u redovne srednje škole.
Le Trouble Déficitaire de l’Attention avec ou sans Hyperactivité (TDA/H) est l’un des
troubles neurodéveloppementaux le plus fréquemment trouvé dans l’enfance. Depuis les
dernières années, nous assistons à une augmentation du taux de prévalence du trouble qui varie de 3 % (American Psychiatric Association, 2000) à 12% selon certaines études (Brown, Freeman & Perrin, 2001). Quant à sa répartition, les études épidémiologiques ont montré que le TDA/H affecte de quatre à neuf garçons pour une fille (Barkley, 1998; Cantwell, 1996), une
prédominance masculine qui pourrait être le reflet soit d’un biais de référence, puisque les
garçons sont généralement plus hyperactifs, soit de facteurs biologiques fondamentaux
(Rowland, Lesesne et Abramawitz, 2002; Silverthorn, Frick, Kuper & Ott, 1996). La fréquence
du trouble serait également plus élevée dans les populations urbaines et caucasiennes (Rowland, et al., 2002).
There are many adults being identified with Attention-Deficit/Hyperactivity Disorder (ADHD) who were not diagnosed as children. The current study investigated psychological functioning in women identified in adulthood as having ADHD. Participants were 102 women, aged 26 to 59, fulfilling (N = 51) and not fulfilling (N = 51) the criteria for ADHD. Home interviews were conducted, consisting of both structured questionnaires and semi-structured interviews. Results revealed that the women with ADHD reported more depressive symptoms, were more anxious and more stressed, had more external loci of control, had lower self-esteem, and engaged more in emotion-oriented and less in task-oriented coping strategies. This study emphasized the need to focus more research on females with ADHD and highlighted possible effects of a late diagnosis.
This study examines the psychometric properties of the Children's Attributional Style Questionnaire—Revised (CASQ–R; N. J. Kaslow & S. Nolen-Hoeksema, 1991), a 24-item shortened measure derived from the 48-item CASQ designed to assess children's causal explanations for positive and negative events. The data for this study come from 1,086 children, 9 to 12 years old, with equal representation of boys and girls and African American and Caucasian children. Approximately one half (
n = 475) of the youths also completed the CASQ–R 6 months later. Results revealed that although the CASQ-R was somewhat less reliable than the original CASQ, with moderate internal consistency reliability and fair test-retest reliability, it demonstrated equivalent criterion-related validity with self-reported depressive symptoms. Psychometric properties of the CASQ-R showed some variation by race, such that the overall composite demonstrated better internal consistency and criterion-related validity among Caucasian youths than among African American youths. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Presents reliability and validity evidence concerning a new measure of a generalized locus of control for children. Construction procedures (with an initial sample of 152 3rd through 9th grade children and a validating sample of 1,017 3rd through 12th grade Ss) leading to the final 40-item scale are described. Preliminary work showed that scores were not related to social desirability or intelligence test scores but to achievement. Continued research with the instrument conducted over a wide range of S populations has provided additional construct validation across variables such as popularity, ability to delay gratification, and prejudice. (22 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We present a revision of the 1978 reformulated theory of helplessness and depression and call it the
hopelessness theory of depression. Although the 1978 reformulation has generated a vast amount of empirical work on depression over the past 10 years and recently has been evaluated as a model of depression, we do not think that it presents a clearly articulated theory of depression. We build on the skeletal logic of the 1978 statement and (a) propose a hypothesized subtype of depression—
hopelessness depression, (b) introduce hopelessness as a proximal sufficient cause of the symptoms of hopelessness depression, (c) deemphasize causal attributions because inferred negative consequences and inferred negative characteristics about the self are also postulated to contribute to the formation of hopelessness and, in turn, the symptoms of hopelessness depression, and (d) clarify the diathesis—stress and causal mediation components implied, but not explicitly articulated, in the 1978 statement. We report promising findings for the hopelessness theory and outline the aspects that still need to be tested. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Three experiments were conducted to explore the effects of methylphenidate (MPH), attention-deficit hyperactivity disorder (ADHD) diagnosis, and age on performance on a complex visual-memory search task. Results showed that the effects of MPH varied with information load. On low-processing loads, all doses of MPH helped children with ADHD to improve accuracy with no cost to reaction time (RT), whereas on high loads, higher MPH doses improved error rates while slowing RT. Without medication, children with ADHD showed high error rates and slow RTs across both low and high loads, as did younger, normal control children. Because MPH slowed performance on only the most difficult, high-load conditions, it is argued that the drug improves self-regulatory ability, enabling children with ADHD to adapt differentially to high and low loads.
Approximately 5% of children are affected by attention-deficit/hyperactivity disorder (ADHD), and more boys are affected than girls. This study examined the magnitude of genetic and environmental influences on ADHD and several questions regarding sex differences in its prevalence and liability. The participants were 2,391 twin and sibling pairs from Australia, ages 3-18. ADHD symptoms in the general population were highly heritable (h2 = .85-.90), as were deviant ADHD scores in the selected population. The magnitude of familial influences was similar for boys and girls, although there were shared environmental influences on ADHD in girls but not boys and dominance genetic influences on ADHD in boys but not girls. Specific genetic and environmental influences were highly similar for boys and girls. Evidence supported the polygenic multiple threshold model rather than the constitutional variability model of sex differences in ADHD.
The relationships of attention deficit hyperactivity disorder (ADHD), conduct disorder, and gender to substance abuse were studied in a large population-based sample of adolescent twins.
Structured interviews were administered to 626 pairs of 17-year-old twins (674 girls and 578 boys) and their mothers to generate lifetime psychiatric diagnoses, and computerized measures of current substance use were obtained. Hierarchical logit analyses were performed to assess the independent effects of ADHD, conduct disorder, and gender on current substance use, frequency of substance use, and DSM-III-R diagnoses of substance use disorders.
Conduct disorder was found to increase the risk of substance use and abuse in adolescents regardless of gender. In contrast, independent of its association with conduct disorder, an ADHD diagnosis did not significantly increase the risk of substance use problems.
This study found no significant gender differences in the effects of ADHD and conduct disorder on substance use and abuse, although there was some suggestion that girls with ADHD might be at slightly higher risk than boys for substance abuse. In addition, increased risk of substance abuse among adolescents with conduct disorder may be primarily confined to those with persistent conduct disorder.
This study examines the psychometric properties of the Children's Attributional Style Questionnaire—Revised (CASQ–R; N. J. Kaslow & S. Nolen-Hoeksema, 1991), a 24-item shortened measure derived from the 48-item CASQ designed to assess children's causal explanations for positive and negative events. The data for this study come from 1,086 children, 9 to 12 years old, with equal representation of boys and girls and African American and Caucasian children. Approximately one half ( n = 475) of the youths also completed the CASQ–R 6 months later. Results revealed that although the CASQ-R was somewhat less reliable than the original CASQ, with moderate internal consistency reliability and fair test-retest reliability, it demonstrated equivalent criterion-related validity with self-reported depressive symptoms. Psychometric properties of the CASQ-R showed some variation by race, such that the overall composite demonstrated better internal consistency and criterion-related validity among Caucasian youths than among African American youths. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The 1956 adaptation for children of Taylor's Manifest Anxiety Scale, the Children's Manifest Anxiety Scale, was revised to meet current psychometric standards. A 73-item revision draft was administered to 329 school children from grades 1 to 12. Based on item-analysis criteria for rbis greater than or equal to .4 and .30 less than or equal to p less than or equal to .70, 28 anxiety items were retained along with 9 of the original 11 Lie scale items. A cross-validation sample of 167 children from grades 2, 5, 9, 10, and 11 produced a KR20 reliability estimate of .85. Anxiety scores did not differ across grade or race. Females scored significantly higher than males. For the Lie scale, significant differences appeared by grade and race. No sex differences were obtained on the Lie scale. The resulting scale appears useful for children in grades 1 to 12 and may aid in future studies of anxiety as well as assisting the clinician in the understanding of individual children.
Rotter's formulation of locus of control as the attribution of control over reinforcements to oneself (internal control) or to others (external control) is discussed in relation to the individual's belief in such supernatural powers as luck, chance, fate, superstition, God, astrology, etc. The validity of the Nowicki-Strickland Locus of Control Scale for Children in measuring levels of attribution to such external sources of control is assessed. For 182 high school students, a significant positive correlation was obtained between locus of control scores and magical beliefs scores, with an external orientation associated with higher levels of magical beliefs. No significant correlation was obtained between locus of control scores and belief in God. The results indicate that attribution of control to supernatural powers is a small, but relevant, component of an individual's control orientation and provide support for the continued study of the Nowicki-Strickland children's scale as a measure of locus of control.
The Children's Manifest Anxiety Scale (CMAS) originally created in 1956, has been revised by Reynolds and Richmond (1978). New validity data on the scale were needed, and Reynolds (1980, 1982) has provided promising validity data on the Revised Children's Manifest Anxiety Scale (RCMAS) for elementary school aged children. Since little validity data are available for the RCMAS with adolescents, this study was designed to examine the concurrent validity of the RCMAS for adolescents. The expected relationships between the RCMAS and similar measures from the MMPI were found, indicating that the RCMAS may indeed be a valid measure of anxiety for adolescents. Aspects of discriminant validity (Campbell and Fiske, 1959) were evaluated and directions for future validity studies presented.
A factor analysis of the Children's Nowicki-Strickland Locus of Control Scale was conducted with a biracial sample of children over a wide age range. The Scale was analyzed for 368 10 to 17 year old students in a rural community. Three factors had sufficient item loadings to be interpretable. They were related to Personal Control and Helplessness, Achievement and Friendship, and Luck. These three factors corresponded to the three dimensions identified by Nowicki (1976). Race, sex, and age relationships are also reported for these three factors.
This article presents the socioeconomic index based on 1981 Census data) and reviews the problems aand criticisms of indexes of this kind, and attempts to specify the meaning of socioeconomic scales and the uses to which they may be legitimately put. The present index is most applicable in situations where access to data is limited to occupational titles and where one desires a unidimensional contextual indicator which locates individuals in the Canadian occupational structure at a given point in time. Sociological analysis of structured inequality, however, may be advanced most effectively if, where feasible, a full range of methodological options is considered, including the assessment of conditions on the level of the individual, the use of other contextual levels such as the workplace, and the investigation of occupation, gender and class as interdependent historical products. -from Authors
Now that it is recognized that Attention-Deficit/Hyperactivity Disorder (ADHD) often persists into adulthood, there are many adults being identified with ADHD who were not diagnosed as children. Individuals identified with ADHD during adulthood may be at risk for maladaptive attributional styles based on the notion that they were exposed to more negative feedback during childhood than adults without identified ADHD. This study examined current attributions and perceptions of childhood of 51 women identified in adulthood with ADHD symptomatology and 51 nonADHD women. Women with ADHD symptomatology had more uncontrollable, stable, and global attributions, reported more dissatisfaction in their childhood parent, peer, and teacher relationships, and felt less in control of negative childhood events as compared with the nonADHD women. Both depression and ADHD contributed significantly to these group differences, suggesting that negative perceptions and attributions are more than reflections of current thinking and mood. ADHD symptomatology also may be an important risk factor for maladaptive attributions. © 2000 John Wiley & Sons, Inc. J Clin Psychol 56: 711–722, 2000.
Objective:
To examine noradrenergic (NA) function in children with attention-deficit hyperactivity disorder (ADHD) by replicating and expanding upon a previous finding that ADHD children with and without reading disabilities (RD) differ in plasma levels of the NA metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG).
Method:
Plasma levels of MHPG were compared in ADHD children who were subdivided on the basis of the presence or absence of RD. Subsequently, this replication sample was combined with a previously studied sample to further explore the relationship between plasma MHPG levels and measures of cognitive function in children with ADHD.
Results:
Plasma levels of MHPG were significantly lower in ADHD children without RD, compared with those with RD, replicating a published finding. Analyses in the combined sample indicated that, among children with ADHD, plasma MHPG levels were inversely associated with measures of academic achievement and verbal processing, but not parent or teacher ratings of behavior or continuous performance test measures of attention and impulsivity.
Conclusions:
These data indicate that children with ADHD are not homogeneous with regard to NA function and that neurochemical variation is closely associated with differences in clinical characteristics of the children.
The present investigation examined differential patterns in executive functions of children with attention-deficit hyperactivity disorder (ADHD; no diagnosed comorbid disorders) according to subtype and gender, and identified instrumentation sensitive to executive function in children aged 6 to 12 years with ADHD. Data were obtained from 94 children diagnosed with ADHD (predominantly inattentive, n = 32, ADHD combined, n = 62), and from 28 controls. Participants with ADHD, who were unmedicated at the time of testing, were administered five tests of executive function (the Wisconsin Card Sorting Test, the Stroop Color-Word Test, the Matching Familiar Figures Test, the Trail Making Test, and the Tower of London). A two-way multivariate analysis of covariance with age as the covariate and subtype and gender as the independent variables was conducted on all of the tests administered. While children with ADHD predominantly inattentive and those with ADHD combined differed from controls, it was only the latter subtype that differed significantly in perseveration and response inhibition. The absence of diagnosed comorbidity in the children with ADHD at the time of test administration demonstrates that the impairments in executive function are clearly located in ADHD, particularly in the ADHD combined subtype, thus providing support for Barkley's proposed unifying theory of ADHD.
Three experiments investigated the hypothesis that high doses of methylphenidate (MPH) are particularly effective in enabling boys with Attention-Deficit Hyperactivity Disorder (ADHD) to regulate the allocafion of effort and persistence under high information processing demands. In Experiment 1, the performance of boys with ADHD, ages 7 to 13, was investigated on placebo and three dosages of MPH, on a visual-memory search (VMS) task across a wide range of processing loads. Accuracy increased with dosage in a linear fashion. Findings on reaction times (RTs) revealed, however, that MPH dosage had a differential effect depending on processing load. All doses of MPH improved accuracy on low loads without a concomitant increase in processing times. When both processing load and (MPH) dosage were high, however, the ADHD boys shifted to a more cautious, time comsuming strategy, apparently in order to achieve continuing gains in accuracy. Experiment 2 compared the performance of ADHD and control boys on the VMS. It established that the ADHD group had difficulty meeting the processing demands of the VMS across all of the information loads studied, as revealed by higher error rates and slower RTs. The ADHD-control comparison also established that the effects of high doses of MPH at high loads in Experiment 1 constituted a further slowing of the ADHD boys' already slow RTs. A third, normal developmental study of boys ages 7 to 13 showed that both error rates and RTs on the VMS task decreased with age. This study also revealed considerable similarity between the performance patterns of ADHD boys and those of younger control boys on the VMS.
This study tested the hypotheses that perceptions of childhood dissatisfaction with parents are associated with higher scores on measures of intensity and chronicity of loneliness, anxiety, neuroticism, psychoticism, misanthropy, and external locus of control and lower scores on measures of self-esteem and sociability. The subjects were 537 Iranian students studying in American and Iranian universities. Both hypotheses were confirmed in a multivariate statistical model. We also found that dissatisfaction with parents was related to a lack of satisfactory relationships with peers.
There is evidence that adult substance abusers tend to have high rates of psychiatric symptomatology and diagnosable psychiatric disorders and that those with more severe psychiatric problems show lower levels of improvement. This paper examines whether these same two findings also hold for adolescent substance abusers. The outcome of treatment, in a day treatment center in a private vocational high school setting, for 130 court-referred substance-abusing delinquent boys aged 14 to 18 years was studied in relation to their psychic symptomatology at admission, as measured by the Brief Symptom Inventory and the Emotional Reaction Inventory. The unexpected finding, although not conclusive, shows that there is a slight tendency among these young clients for those who report more psychiatric symptoms to improve more, rather than less, with treatment. For example, a greater score on the borderline psychotic subscale of the Emotional Reaction Scale predicted to more improvement as measured by reduction in drug use. A response set explanation was postulated for this finding: those clients who were more self-evaluative and more open and self-revealing about their disturbing inner thoughts and feelings might have been more trusting, more ready, and better motivated for counseling. The following are some possible explanations for the fact that the findings are different from those of some studies reported for adult substance abusers: adolescent drug abusers have, or are aware of having, or report, less psychiatric symptomatology, than adult abusers or addicts; our study sample included only court-referred delinquents; and there are differences in research methodology, specifically in the types of instruments and measures used.(ABSTRACT TRUNCATED AT 250 WORDS)
The developmental tasks associated with adolescence pose a unique set of stressors and strains. Included in the normative tasks of adolescence are developing and identity, differentiating from the family while still staying connected, and fitting into a peer group. The adolescent's adaptation to these and other, often competing demands is achieved through the process of coping which involves cognitive and behavioral strategies directed at eliminating or reducing demands, redefining demands so as to make them more manageable, increasing resources for dealing with demands, and/or managing the tension which is felt as a result of experiencing demands. In this paper, individual copying theory and family stress theory are reviewed to provide a theoretical foundation for assessing adolescent coping. In addition, the development and testing of an adolescent self-report coping inventory, Adolescent Coping Orientation for Problem Experiences (A-COPE) is presented. Gender differences in coping style are presented and discussed. These coping patterns were validated against criterion indices of adolescents' use of cigarettes, liquor, and marijuana using data from a longitudinal study of 505 families with adolescents. The findings are discussed in terms of coping theory and measurement and in terms of adolescent development and substance use.
Evaluated psychometric features and correlates of the Hopelessness Scale for Children, developed by the 1st author and colleagues (see record 1983-32820-001), among 262 6–13 yr old psychiatric inpatients. Ss also completed or were evaluated on the Child Behavior Checklist, the Children's Depression Inventory, and the Self-Esteem Inventory. Results indicate that the scale was internally consistent, that item–total score correlations and test–retest reliability (over a 6-wk period) were moderate, and that individual items discriminated high- and low-hopelessness children. As predicted, hopelessness correlated positively with depression and negatively with self-esteem and social behavior. Overall, the relation of hopelessness to selected facets of affective and social functioning closely paralleled results obtained with adults. This scale may be useful in investigating antecedents of negative expectations toward the future, the developmental course of these expectations, and the extent to which they predict subsequent dysfunction (e.g., suicidal behavior) in adolescence and adulthood. (26 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A sample of girls and boys with attention deficit disorder (ADD) were examined for within-group sex differences and compared with control boys and girls on historical, behavioral, and cognitive characteristics. Profiles of essential and secondary features of ADD support the Diagnostic and Statistical Manual of Mental Disorders nosology for ADD with and without hyperactivity as clinically distinct subtypes of ADD, with the girls and boys with ADD with hyperactivity exhibiting attentional, behavioral, and cognitive impairments, and the children with ADD without hyperactivity exhibiting deficits along an attentional/cognitive axis. Management problems and antisocial behaviors were correlates of hyperactivity, and increased impulsivity was not associated with attentional deficits in the absence of hyperactivity. Within the ADD with hyperactivity group, the girls demonstrated more severe cognitive impairments, particularly in the area of language function, were younger at the time referral for medical attention, and tended to come from families of lower socioeconomic status. Disruptive, uncontrolled behaviors were more frequent among the boys with ADD with hyperactivity. The girls with ADD without hyperactivity demonstrated poorer self-esteem and were significantly older than the boys with ADD without hyperactivity at referral. Girls in both ADD with and without hyperactivity groups were more likely to suffer peer rejection than their male counterparts. The results of this study suggest that girls with ADD may be underidentified and that cognitive deficits have a more prominent role in the identification of girls, whereas behavioral disturbances increase the likelihood of identification for boys.
This article describes the development and evaluation of the revised Ontario Child Health Study (OCHS) scales to measure conduct disorder, oppositional disorder, attention-deficit hyperactivity disorder, overanxious disorder, separation anxiety and depression based on DSM-III-R symptom criteria. Problem checklist assessments were obtained from parents and teachers of children aged 6-16 and youths aged 12-16 drawn from: (1) a general population sample (N = 1751); and (2) a mental health clinic sample (N = 1027) in the same industrialized, urban setting. Evaluation of the revised OCHS scales indicates that they possess adequate psychometric properties and provide an efficient means to obtain measurements of childhood psychiatric disorder, in general population studies, that correspond to DSM-III-R classification of disorder.
Clinical samples of attention deficit hyperactivity disorder (ADHD) have been dominated by males. Consequently, female manifestations and sex differences have been relatively neglected in the extensive ADHD research. Because ADHD is so common (3% to 5% of school children) and chronic (lifelong in many cases), even a small proportion of females multiplied by such a large base means hundreds of thousands of girls and women with ADHD, a significant public health problem. An NIMH conference concluded that research is needed not only on sex differences related to ADHD, but also on manifestations of ADHD in females as such. Areas of focus should include differences in life course (sex-differential age effects); effects of hormones; effects of ADHD parenting (in utero and postnatal) on the next generation; response to and implications for design of psychosocial treatment; effects of differential comorbidity; normative "background" sex differences that influence the manifestation of ADHD; differences in development of verbal fluency and social behavior; possible interactions of sex and ethnicity; a prospective study of both sex offspring of ADHD adults; and such methodological issues as appropriate instruments and diagnostic thresholds, power to prevent false negatives, valid impairment measures, validity and reliability of child self-reports, and more inclusive samples (all three subtypes: inattentive, hyperactive-impulsive, and combined).
Attention-deficit hyperactivity disorder (ADHD) is overrepresented among adults and adolescents in treatment for substance abuse. This study was designed to assess the prevalence of ADHD and to elucidate differences among adolescent substance abusers relative to ADHD symptomatology.
The Wender Utah Rating Scale and the Self-Evaluation (Teenager's) Self-Report were used to evaluate childhood history of ADHD and current symptoms, respectively, and the Child Attention Problems Scale was completed by treatment program clinicians. A quantitative substance use history and a subjective substance use interview were also administered.
A total of 50% of 14 females and 16 males, ranging in age from 14 to 19, met study criteria for ADHD. ADHD subjects began drug use at an earlier age, had more severe substance abuse, and had a more negative self-image prior to drug use and improved self-image with drug use. They experienced more negative affective responses related to substance use and more drug craving and attentional difficulties in treatment than control subjects.
The results support a substantial comorbidity of ADHD among adolescent substance abusers, with indications of drug use for self-medication. Counseling for ADHD and medication may be indicated to improve treatment outcome and future functioning.
Attention-deficit hyperactivity disorder (ADHD) is known to have neuropsychological consequences that are evident from psychological tests and from measures of school failure. However, most available data are based on studies of boys. Our goal was to assess, in this pilot study, whether ADHD in girls expressed neuropsychological features similar to those found in boys.
Subjects were 43 girls, aged 6 to 17 years, with DSM-III-R ADHD and 36 comparison girls without ADHD. Information on neuropsychological performance was obtained in a standardized manner blind to clinical status.
Girls with ADHD were significantly more impaired on estimated IQ than comparison girls despite being matched on other demographic variables. Relative to comparison girls, the girls with ADHD were also significantly more impaired on the Freedom From Distractibility subtests of the WISC-R and on arithmetic and reading achievement scores. Although their mean performance on executive function tests was generally poorer than that of control girls, there were no statistically significant differences on these measures.
Girls with ADHD have impairments in some tests of attention and achievement. However, neuropsychological performance on tests of executive function was less impaired than that previously documented in boys with ADHD. If confirmed in a larger sample, these findings suggest that girls with ADHD may be less vulnerable to executive function deficits than boys.
The 1956 adaptation for children of Taylor's Manifest Anxiety Scale, the Children's Manifest Anxiety Scale, was revised to meet current psychometric standards. A 73-item revision draft was administered to 329 school children from grades 1 to 12. Based on item-analysis criteria for r
bis ≥ .4 and .30 ≤ p ≤ .70, 28 anxiety items were retained along with 9 of the original 11 Lie scale items. A cross-validation sample of 167 children from grades 2, 5, 9, 10, and 11 produced a KR20 reliability estimate of .85. Anxiety scores did not differ across grade or race. Females scored significantly higher than males. For the Lie scale, significant differences appeared by grade and race. No sex differences were obtained on the Lie scale. The resulting scale appears useful for children in grades 1 to 12 and may aid in future studies of anxiety as well as assisting the clinician in the understanding of individual children.
The associations between symptoms of attention-deficit hyperactivity disorder (ADHD), conduct disorder, anxiety, or depression and no disorder in relation to driving offenses were examined in 916 adolescents.
Self-report and parent report were used to assess a birth cohort of New Zealand adolescents' mental health status at age 15 years. Adolescents who scored 1.5 SD above the mean on the DSM-III total ADHD symptom scale were identified as reporting significant ADHD symptomatology. Self-report data and official traffic conviction records were used to identify adolescents who had committed driving offenses between ages 15 and 18 years.
ADHD symptomatology and conduct disorder were strongly associated with driving offenses. ADHD symptomatology in females was significantly associated with driving offenses and more traffic crashes compared with other disorder or no disorder.
Adolescents with a history of ADHD and conduct problems are significantly more likely than their peers to commit traffic offenses. Research in ADHD and risky driving should include female adolescents, as those with attentional difficulties are at a high risk for being involved in traffic crashes than females who do not experience attentional difficulties.
To describe the psychometric properties of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) interview, which surveys additional disorders not assessed in prior K-SADS, contains improved probes and anchor points, includes diagnosis-specific impairment ratings, generates DSM-III-R and DSM-IV diagnoses, and divides symptoms surveyed into a screening interview and five diagnostic supplements.
Subjects were 55 psychiatric outpatients and 11 normal controls (aged 7 through 17 years). Both parents and children were used as informants. Concurrent validity of the screen criteria and the K-SADS-PL diagnoses was assessed against standard self-report scales. Interrater (n = 15) and test-retest (n = 20) reliability data were also collected (mean retest interval: 18 days; range: 2 to 36 days).
Rating scale data support the concurrent validity of screens and K-SADS-PL diagnoses. Interrater agreement in scoring screens and diagnoses was high (range: 93% to 100%). Test-retest reliability kappa coefficients were in the excellent range for present and/or lifetime diagnoses of major depression, any bipolar, generalized anxiety, conduct, and oppositional defiant disorder (.77 to 1.00) and in the good range for present diagnoses of posttraumatic stress disorder and attention-deficit hyperactivity disorder (.63 to .67).
Results suggest the K-SADS-PL generates reliable and valid child psychiatric diagnoses.
To quantitatively review and critically evaluate literature examining gender differences in attention-deficit hyperactivity disorder (ADHD).
A meta-analysis of relevant research based on 18 studies meeting inclusion criteria was performed. Domains evaluated included primary symptomatology, intellectual and academic functioning, comorbid behavior problems, social behavior, and family variables.
Gender differences were not found in impulsivity, academic performance, social functioning fine motor skills, parental education, or parental depression. However, compared with ADHD boys, ADHD girls displayed greater intellectual impairment, lower levels of hyperactivity, and lower rates of other externalizing behaviors; it was not possible to evaluate the extent to which referral bias affected these findings. Some gender differences were clearly mediated by the effects of referral source; among children with ADHD identified from nonreferred populations, girls with ADHD displayed lower levels of inattention, internalizing behavior, and peer aggression than boys with ADHD, while girls and boys with ADHD identified from clinic-referred samples displayed similar levels of impairment on these variables.
The need for future research examining gender differences in ADHD is strongly indicated, with attention to methodological limitations of the current literature, including the potential confounding effects of referral bias, comorbidity, developmental patterns, diagnostic procedures, and rater source.
To examine gender differences among children with disruptive behavior disorders (DBDs) from an ethnically diverse school sample.
From 2,984 children, children with attention-deficit/hyperactivity disorder, combined type (ADHD-C) (46 boys, 11 girls), oppositional defiant disorder (ODD) (59 boys, 35 girls), and co-occurring ADHD-C/ODD (76 boys, 27 girls), diagnosed by teacher-rated DSM-IV symptoms, were compared with each other and with 254 controls on teacher ratings of symptoms, social functioning and Achenbach Teacher's Report Form scales.
Children with ADHD-C/ODD received the poorest ratings on all variables. In "pure" groups, children with ODD were rated as learning more, working harder, and being less inattentive than children with ADHD-C; only the ODD group showed more internalizing problems than controls. For ADHD-C and ODD groups, ratings of aggression and some individual symptoms were higher in boys than girls. Girls with ODD were rated as more appropriate and less inattentive, but unhappier and more socially impaired than boys with ODD. Overall, girls received higher peer dislike scores than boys.
Comorbidity and gender issues affect the correlates of DBDs, with learning problems higher in ADHD-C, internalizing problems associated only with ODD, and greatest impairment for ADHD-C/ODD groups. Despite having similar or less behavioral dysfunction, girls with DBDs may have more social problems than boys with DBDs.
This study examined possible gender differences in children and adults with attention-deficit/hyperactivity disorder. Results indicated that adult self-ratings differed significantly by gender. Adult women reported fewer assets and more problems than did male counterparts, but there was no gender difference with respect to age at referral, intelligence quotient, indicators of neuropsychological performance, or parent or teacher ratings of behavior. Referral bias against girls is a possible reason for previously reported gender differences, so we interpreted our results in light of the participants' referral patterns. There was a nonsignificant trend for girls with relatively more severe ratings of hyperactivity, conduct disorder, or inattention to be referred earlier than were boys. Overall, our results suggest no evidence of cognitive or neuropsychological differences by gender in samples that are sensitive to behavioral deviance in girls (as evidenced by early referral), but adult women's self-perception is comparatively poorer than that of adult men.