Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources
Abstract
Objective The scientific literature about attention-deficit hyperactivity disorder (ADHD) is based almost exclusively on male subjects, and girls with ADHD may be underidentified and undertreated. The aim of this study was to examine clinical correlates of ADHD in females using comprehensive assessments in multiple domains of functioning.Method Subjects were 140 girls with ADHD and 122 comparison girls without ADHD ascertained from pediatric and psychiatric referral sources of the same age and social class. Subjects were assessed with structured diagnostic interviews, psychometric tests assessing intellectual functioning and academic achievement, as well as standardized assessments of interpersonal, school, and family functioning by raters who were blind to clinical diagnosis.Results Compared with female controls, girls with ADHD were more likely to have conduct, mood, and anxiety disorders; lower IQ and achievement scores; and more impairment on measures of social, school, and family functioning.Conclusions These results extend to girls previous findings in boys indicating that ADHD is characterized by prototypical core symptoms of the disorder, high levels of comorbid psychopathology, and dysfunction in multiple domains. These results not only support findings documenting phenotypic similarities between the genders but also stress the severity of the disorder in females.
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ADHD is diagnosed more often in males, but females with ADHD become notably impaired and develop comorbid disorders starting in adolescence.
“Although Attention-Deficit/Hyperactivity Disorder shows (ADHD) male predominance, females are significantly impaired and exhibit additional comorbid disorders during adolescence.”
From Reproductive steroids and ADHD symptoms across the menstrual cycle (2018) · cites this paper as Biederman et al., 1999
Children with ADHD frequently have social difficulties, but these are usually attributed to ADHD symptoms rather than to ASD-like social-communicative impairments.
“Social difficulties are often reported in children with ADHD but these difficulties are typically interpreted as resulting from ADHD symptoms rather than reflecting the qualitative impairments in social-communicative functioning characteristic of ASD (Biederman et al., 1999; Greene et al., 1996; Hoza et al., 2005; Matthys, Cuperus, & van Engeland, 1999; Bagwell, Molina, Pelham, Jr., & Hoza, 2001;”
From Examining autistic traits in children with ADHD: does the autism spectrum extend to ADHD? (2011) · cites this paper as Biederman et al., 1999
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Executive Function Oculomotor Tasks in Girls With ADHD
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Self-citation
- Authors
- BIEDERMAN, J., FARAONE, S. V., MICK, E., WILLIAMSON, S., WILENS, T. E., SPENCER, T. J., WEBER, W., JETTON, J., KRAUS, I., PERT, J., & ZALLEN, B.
- Affiliations
- Harvard University (US)
- Corresponding author
- BIEDERMAN, JOSEPH
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 1999-08
- Volume
- 38
- Issue
- 8
- Pages
- 966-975
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2037739604
- Cited by
- 364
- References
- 34
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 8 · 2017: 11 · 2016: 12 · 2015: 10 · 2014: 9 · 2013: 17 · 2012: 21
- FWCI
- 9.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01 MH-50657-04)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, girls, comorbid psychopathology, conduct disorder, mood disorders, anxiety disorders, intellectual functioning, academic performance, social functioning, school functioning, family functioning, gender differences, underdiagnosis
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Female, Humans, Massachusetts, Sex Factors, Comorbidity, Linear Models, Logistic Models, Odds Ratio, Case-Control Studies
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