TY - JOUR
T1 - Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Sex differences among children with high ADHD symptoms
AU - Mowlem, Florence Daisy
AU - Blais, Jessica Cameron
AU - Taylor, Eric Andrew
AU - Asherson, Philip John Elliot
PY - 2019/2/1
Y1 - 2019/2/1
N2 - We investigate if different factors influence whether girls versus boys meet diagnostic criteria for attention-deficit/hyperactivity disorder(ADHD) among children with high ADHD symptoms. Participants were 283 children aged 7–12 from a population-based study. Girls and boys meeting diagnostic criteria for ADHD, based on an objective investigator-based interview, were compared to children who did not meet criteria despite high symptoms on a rating-scale measure of ADHD. We assessed factors that could differentially relate to diagnosis across girls and boys including ADHD symptoms, co-occurring behavioural/emotional problems and impairment, and sex-effects in rater perceptions of ADHD symptoms. While overall similar factors distinguished girls and boys who met diagnostic criteria from high-symptom peers, effect sizes were larger in girls. Emotional problems were particularly salient to distinguishing diagnosed versus high-symptom girls but not boys. Parents rated boys meeting diagnostic criteria as more impaired than high-symptom boys but did not do so for girls, and under-rated diagnosed girls’ hyperactive/impulsive symptoms compared to more objective interview assessment, with the opposite observed in boys. Results suggest girls’ ADHD may need to be made more prominent by additional behavioural/emotional problems for them to meet full diagnostic criteria and that sex differences in parental perceptions of ADHD behaviours and impairment exist.
AB - We investigate if different factors influence whether girls versus boys meet diagnostic criteria for attention-deficit/hyperactivity disorder(ADHD) among children with high ADHD symptoms. Participants were 283 children aged 7–12 from a population-based study. Girls and boys meeting diagnostic criteria for ADHD, based on an objective investigator-based interview, were compared to children who did not meet criteria despite high symptoms on a rating-scale measure of ADHD. We assessed factors that could differentially relate to diagnosis across girls and boys including ADHD symptoms, co-occurring behavioural/emotional problems and impairment, and sex-effects in rater perceptions of ADHD symptoms. While overall similar factors distinguished girls and boys who met diagnostic criteria from high-symptom peers, effect sizes were larger in girls. Emotional problems were particularly salient to distinguishing diagnosed versus high-symptom girls but not boys. Parents rated boys meeting diagnostic criteria as more impaired than high-symptom boys but did not do so for girls, and under-rated diagnosed girls’ hyperactive/impulsive symptoms compared to more objective interview assessment, with the opposite observed in boys. Results suggest girls’ ADHD may need to be made more prominent by additional behavioural/emotional problems for them to meet full diagnostic criteria and that sex differences in parental perceptions of ADHD behaviours and impairment exist.
KW - Attention-deficit/hyperactivity disorder
KW - Diagnosis
KW - Gender differences
KW - Non-referred/population-based
UR - http://www.scopus.com/inward/record.url?scp=85059610384&partnerID=8YFLogxK
U2 - 10.1016/j.psychres.2018.12.128
DO - 10.1016/j.psychres.2018.12.128
M3 - Article
SN - 0165-1781
VL - 272
SP - 765
EP - 773
JO - Psychiatry Research
JF - Psychiatry Research
ER -