ADHD diagnosis and gender-bias

From me to you...online learning has allowed me to spend so much time thinking and writing about contemporary issues in mental health...loving it.

ADHD can appear as early as infancy (Seligman and Rider, 2012) and appears to have neurological foundations resulting in impaired frontal lobes (Seligman et al., 2012). There is some concern that over diagnosing may be occurring; for every two boys diagnosed, one girl is diagnosed (Seligment et al, 2012)—some have wondered what causes the disproportionate number of male diagnoses.

Harrison (2010) suggests that female adolescents with ADHD are an increased risk of “antisocial, addictive, mood, anxiety, and eating disorders” (Harrison, 2010). Harrison’s analysis is particularly relevant because as she points out, the majority of existing research consists of male dominated control groups (Harrison, 2010).  “Despite a possible difference in ADHD symptoms exhibited by boys and girls, our study clearly shows that exactly the same symptom picture is evaluated differently in boys than in girls.” (Bruchmüller, Margraf, Schneider, 2012, p136)

Gender based studies are important for several reasons, mainly because there are such clear behavioural differences between genders, that these variables must be considered in both diagnosing and treating ADHD. ADHD is considered by some to be on the Autism spectrum; females are diagnosed Aspergers far less frequently than males, and it is often attributed to social conventions (that is, it is acceptable for a female to be shy, smart and eccentric). I wonder if this is the case with ADHD; are females better at hiding symptoms, or coping and developing adaptive behaviours to compensate?  There are three times more males diagnosed with ADHD than female and the diagnostic  process is largely heuristic (Bruchmüller et al., 2012) leaving a bit too much grey area.

References

Bruchmüller, K., Margraf, J., & Schneider, S. (2012). Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. Journal Of Consulting And Clinical Psychology, 80(1), 128-138. doi:10.1037/a0026582