Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder that is estimated to affect 3.5% the United States (Hinshaw et al., 2022). It has three different subtypes each with unique symptoms, in addition to some shared ones. Some commonalities include issues with focusing, attention, and inhibition. The executive functions are notably impacted. ADHD has largely been referred to as a childhood disorder, but this is not true. It begins in childhood, but symptoms can continue through adulthood. ADHD affects boys 2.5 times more than girls, but this disparity lessens with age and is almost even by adulthood (Hinshaw at al., 2022). While ADHD has been around for decades, it was not always thought to affect girls at the same rate as boys. Additionally, some textbooks and websites still claim that ADHD is a childhood disorder, although research has shown otherwise. ADHD is still sometimes misrepresented mostly due to the lack of diverse research subjects.
While today we recognize that ADHD can affect someone of any sex or age, this was not always the case. The first systematic research on ADHD in females wasn’t until 1979 (Hinshaw et al., 2022). For the last 40 plus years since females were included in research, studies have continued to lack in numbers of females included in comparison to males. This can skew results to appear like less females are affected by ADHD. This problem still continues today.
In his annual research review of ADHD in girls and women, Stephen Hinshaw cites 6 reasons as to why females are still underrepresented in ADHD research. He hits on a few main points. First, there is an insistence of the scientific community that ADHD in rare in girls and more so in women (2022). This leads to less of a push to research ADHD in females. Next, there is the less obvious symptom manifestation in females since many symptoms are internal. This might look like a girl having attention and focus problems which cause her to space out and miss details in a lesson or in instructions. In a boy, those same problems with attention and focus may manifest as speaking out of turn in class or not being able to sit still. In the example, the boy’s manifestation of ADHD is much more outward and disruptive. Related to this, Hinshaw references a clinician bias toward recognizing typical male symptoms as ADHD symptoms and not female (2022). Teachers and parents also underreport females (Hinshaw et al., 2022). Lastly, females are more likely to engage in compensatory behaviors, which would effectively mask the ADHD symptoms (Hinshaw et al., 2022). An example of this would be a school age girl realizing she is always late and missing assignments, so she swings to the other extreme and begins overplanning and stressing over deadlines. While research on ADHD in females has greatly improved over the last 50 years, it is mainly to the inclusion of them in studies at all. This isn’t the only problematic scientific practice associated with ADHD.
ADHD was not recognized to extend past childhood until the 4th edition of the Diagnostic & Statistical Manual of Mental Disorders was released in 1994 (Lange et al., 2010). In textbooks published in the last 10 years, ADHD is referred to as a childhood disorder. This may be because the symptoms change as one ages. ADHD looks different in 22-year-old than it does in a 10-year-old. As more inclusive research has been done on ADHD, it was able to be recognized in adults as well. In the future I expect the classification of ADHD as a “childhood disorder” to become obsolete.
ADHD is a good example of how poor research practices and probably some biases, can greatly impact your results. Nowadays, studies utilize a diverse data set, often including both sexes. While studies may only focus on children or adults, usually studies will be done in both age groups when trying to answer a research question. As illustrated by the ongoing misrepresentation of ADHD, having a diverse data set and following sound research practices are integral for all patients to receive proper diagnosis and treatment.
Works Cited
Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M., & Rosenthal, E. A. (2022). Annual Research
Review: Attention-deficit/hyperactivity disorder in girls and women:
underrepresentation, longitudinal processes, and key directions. Journal of Child
Psychology and Psychiatry, and Allied Disciplines, 63(4), 484–496.
https://doi.org/10.1111/jcpp.13480
Lange, K. W., Reichl, S., Lange, K. M., Tucha, L., & Tucha, O. (2010). The history of attention
deficit hyperactivity disorder. Attention Deficit and Hyperactivity Disorders, 2(4),
King Lab at Creighton University 