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Girls With Attention Deficit Disorder: A Silent Minority? A Report on Behavioral and Cognitive Characteristics
Abstract
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.
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“Attention-deficit hyperactivity disorder (ADHD) in women, its characteristics, and its development across the lifespan remain insufficiently studied [1,2,3].”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [1]
In the citing paper
“We developed this female-specific treatment option in response to the dire need expressed by many [1,17,19,23,24,25,26,28,41,55,85], including patients.”
From A Female-Specific Treatment Group for ADHD—Description of the Programme and Qualitative Analysis of First Experiences (2024) · cites this paper as [1]
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GRAETZ, B. W., SAWYER, M. G., & Baghurst, P. (2005) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200502000-00008 · Cited by 141
Is Attention Deficit Hyperactivity Disorder Increasing Among Girls in the US?
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Are tests of frontal lobe functions useful in the diagnosis of attention deficit disorders?
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“As exploratory analyses we also tested at Step 3 the interactions between conduct problems and ADHD and sex and ADHD, and at Step 4 the three-way interaction between conduct problems, sex, and ADHD.”
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“Other research has found that girls with ADHD show more severe visual-spatial, cognitive, and language deficits than boys with ADHD (Berry et al., 1985; Breen, 1989; Brown et al., 1991; Gordon & Mettelman, 1994; James & Taylor, 1990; Kashani et al., 1979; Taylor, 1986).”
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Neurobiological Basis of Attention-Deficit Hyperactivity Disorder (ADHD)
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Gender differences in a clinic-referred sample of attention-deficit-disordered children
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A Comparison of Girls and Boys With Teacher-identified Problems of Attention
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“There are however a number of studies reporting differ- ences between subtypes of ADD or ADHD in various mea- sures of functioning (King and Young, 1982; Berry et al., 1985; Sergeant and Scholten, 1985; Lahey et al., 1988; Barkley et al., 1990; Barkley et al., 1992; Barkley, 1998).”
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“Since childhood referrals are initiated by parents and teachers, girls without the hyperactivity component of ADHD are less likely to be clinically diagnosed [78].”
BackgroundMahendiran, T., Dupuis, A., Crosbie, J., Georgiades, S., Kelley, E. A., Liu, X., Nicolson, R., Schachar, R. J., Anagnostou, E. A., & Brian, J. A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00607 · Cited by 67
Issues in the Classification of Child and Adolescent Psychopathology
Cantwell, D. P., & Baker, L. (1988) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198809000-00001 · Cited by 61
Gender bias and special education referrals
Anderson, K. G. (1997) · Annals of Dyslexia · doi:10.1007/s11881-997-0024-8 · Cited by 61
McBride, M. C. (1988) · The Journal of Pediatrics · doi:10.1016/s0022-3476(88)80548-1 · Cited by 61
Rowe, K. S., & Rowe, K. (1997) · Research on Child and Adolescent Psychopathology · doi:10.1023/a:1022678013979 · Cited by 60
Attributional Styles and Psychosocial Functioning of Adults With ADHD
Rucklidge, J. J., Brown, D., Crawford, S. G., & Kaplan, B. J. (2007) · Journal of Attention Disorders · doi:10.1177/1087054706289942 · Cited by 59
Panagiotidi, M., Overton, P. G., & Stafford, T. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113477 · Cited by 69
Metadata
- Authors
- Berry, C. A., Shaywitz, S. E., & Shaywitz, B. A.
- Affiliations
- Yale University (US)
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 1985-11-01
- Volume
- 76
- Issue
- 5
- Pages
- 801-809
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1907913791
- Cited by
- 262
- References
- 0
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 8 · 2012: 10
- FWCI
- 2.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit disorder, girls, sex differences, hyperactivity, cognitive impairment, language functions, antisocial behavior, impulsivity, self-esteem, peer rejection, underidentification, socioeconomic status
- MeSH terms
- Adolescent, Child, Child Behavior, Child Behavior Disorders, Cognition, Female, Humans, Hyperkinesis, Interpersonal Relations, Learning Disabilities, Male, Peer Group, Psychological Tests, Self Concept, Sex Factors, Socioeconomic Factors
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