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Explaining Gender Differences in the Diagnosis of ADHD in Children

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Shaping Children

Part of the book series: Advances in Neuroethics ((AIN))

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Abstract

The aim of this chapter is to investigate the underlying mechanisms behind the difference in the number of ADHD diagnoses between the two genders during childhood, namely, the overdiagnosis of boys and the underdiagnosis of girls. I propose two hypotheses for explaining this outcome: (1) medical neglect of the way in which ADHD is manifested in girls and (2) social attitudes. In the end, I reject the medical neglect hypothesis and confirm the validity of a version of the social attitude one. I argue that social stereotypes regarding the behavior of schoolchildren influence the medical referral rate of girls and boys. Given that boys are more likely to experience the hyperactive/impulsive ADHD type and to externalize their behavior in a way that may seem disruptive, at least in the disciplined environment of the classroom, more teachers refer boys to medical consultations. My findings show the existence of social biases, but not of effects concerning the patient’s gender.

The chapter expresses the author’s personal opinions and does not engage the position of the European Commission.

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Notes

  1. 1.

    The medical literature on ADHD and notably its criteria for diagnosis are many times contested for failing to account for the significant input of the child’s environment (parental care, security, access to adequate nutrition and medical care, excessive and stressful school demands, etc.) and also for ignoring typical childhood behavior, such as energy bursts. I am not discussing these issues in this section due to the fact that the focus here is on discovering whether the medical literature and practice, in their current unadulterated form, give more attention to boys suffering from ADHD than to girls sharing the same condition.

References

  • Able SL, Johnston JA, Adler LA et al (2007) Functional and psychological impairment in adults with undiagnosed ADHD. Psychol Med 37:97–107

    Article  PubMed  Google Scholar 

  • Adeyemi-Adelanwa O, Barton-Gooden A, Dawkins P et al (2016) Attitudes of patients towards being cared for by male nurses in a Jamaican hospital. Appl Nurs Res 29:140–143

    Article  CAS  PubMed  Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Philadelphia

    Book  Google Scholar 

  • Barkley RA, McMurray MB, Edelbrock CS et al (1990) Side effects of methylphenidate in children with attention deficit hyperactivity disorder: a systemic, placebo-controlled evaluation. Pediatrics 86:184–192

    CAS  PubMed  Google Scholar 

  • Barkley RA (2006) Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. Guilford Press, New York

    Google Scholar 

  • Baron AS, Schmader T, Cvencek D et al (2014) The gendered self-concept: how implicit gender stereotypes and attitudes shape self-definition. In: Leman PJ, Tenenbaum HR (eds) Gender and development. Psychology Press, East Sussex, pp 109–132

    Google Scholar 

  • Bernzweig J, Takayama JI, Phibbs C et al (1997) Gender differences in physician-patient communication. Evidence from pediatric visits. Arch Pediatr Adolesc Med 151:586–591

    Article  CAS  PubMed  Google Scholar 

  • Bruchmueller K, Margraf J, Schneider S (2012) Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. J Consult Clin Psychol 80:128–138

    Article  Google Scholar 

  • Castellanos XF (2015) Is adult-onset ADHD a distinct entity? Am J Psychiatry 172:929–931

    Article  PubMed  Google Scholar 

  • Charlesworth R (2010) Understanding child development. Cengage Learning, Wadsworth

    Google Scholar 

  • Davis E, Beer J, Gligora C et al (2001) Accounting for change in disability and severe restriction, 1981–1998. In: Working papers in social and labour statistics (Np. 2001/1). ACT, Australian Bureau of Statistics, Belconnen

    Google Scholar 

  • Eccles JS, Jacobs JE, Harold RD (1990) Gender role stereotypes, expectancy effects, and parents’ socialization of gender differences. J Soc Issues 46:183–201

    Article  Google Scholar 

  • Elder TE (2010) The importance of relative standards in ADHD diagnoses: evidence based on exact birth dates. J Health Econ 29:641–656

    Article  PubMed  PubMed Central  Google Scholar 

  • Fedele DA, Lefler EK, Hartung CM et al (2012) Sex differences in the manifestation of ADHD in emerging adults. J Atten Disord 16:109–117

    Article  PubMed  Google Scholar 

  • Gaub M, Carlson CL (1997a) Behavioral characteristics of DSM-IV ADHD subtypes in a school-based population. J Abnorm Child Psychol 25:103–111

    Article  CAS  PubMed  Google Scholar 

  • Gaub M, Carlson CL (1997b) Gender differences in ADHD: a meta-analysis and critical review. J Am Acad Child Adolesc Psychiatry 36:1036–1045

    Article  CAS  PubMed  Google Scholar 

  • Gershon J (2002) A meta-analytic review of gender differences in ADHD. J Atten Disord 5:143–154

    Article  CAS  PubMed  Google Scholar 

  • Graf DW, Miller G, Nagel SK (2014) Addressing the problem of ADHD medication as neuroenhancements. Expert Rev Neurother 14:569–581

    Article  CAS  PubMed  Google Scholar 

  • Graham L (2006) From ABCs to ADHD: the role of schooling in the construction of ‘behavior disorder’ and production of ‘disorderly objects’. In: Proceedings Australian Association for Research in Education 2006 annual conference, University of South Australia, Adelaide

    Google Scholar 

  • Haines EL, Deaux K, Lofaro N (2016) The times they are a-changing…or are they not ? A comparison of gender stereotypes, 1983-2014. Psychol Women Q 40(3):353–363. https://doi.org/10.1177/0361684316634081

    Article  Google Scholar 

  • Huang CL, Weng SF, Ho CH (2016) Gender ratios of administrative prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) across the lifespan: a nationwide population-based study in Taiwan. Psychiatry Res 244:382–387

    Article  PubMed  Google Scholar 

  • Isaksson J, Ruchkin V, Lindblad F (2016) Unseen and stressed? Gender differences in parent and teacher ratings of ADHD symptoms and associations with perceived stress in children with ADHD. J Atten Disord. pii: 1087054716658381

    Google Scholar 

  • Jaisoorya TS, Beena KV, Beena M et al (2016) Prevalence of correlates of self-reported ADHD symptoms in children attending school in India. J Atten Disord. pii: 1087054716666951

    Google Scholar 

  • Kiekkas P, Igoumenidis M, Stefanopoulos N et al (2016) Gender bias favors female nursing students in the written examination evaluation: crossover study. Nurse Educ Today 45:57–62

    Article  PubMed  Google Scholar 

  • Lefler EK, Hartung CM, Bartgis J, Thomas DG (2015) ADHD symptoms in American Indian/Alaska native boys and girls. Am Indian Alsk Native Ment Health Res 22:23–40

    Article  PubMed  Google Scholar 

  • McCabe SE, West BT, Cranford JA et al (2011) Medical misuse of controlled medications among adolescents. Arch Pediatr Adolesc Med 165:729–735

    Article  PubMed  PubMed Central  Google Scholar 

  • Neophytou K (2004) ADHD, a social construct? Dissertation, Australian Catholic University

    Google Scholar 

  • Nosek BA, Banaji M, Greenwald AG (2002) Harvesting implicit group attitudes and beliefs from a demonstration web site. Group Dyn Theor Res 6:101–115

    Article  Google Scholar 

  • Oswald DL, Harvey RD (2003) A Q-methodological study of women’s subjective perspective on mathematics. Sex Roles 49:133–142

    Article  Google Scholar 

  • Pantell RH, Lewis CC (1993) Talking with children: how to improve the process and outcome of medical care. Med Encounter 10:3–7

    Google Scholar 

  • Polanczyk G, Silva de Lima M, Horta BL et al (2007) The worldwide prevalence of ADHD: a systematic review and metaregression. Am J Psychiatry 164:942–948

    Article  PubMed  Google Scholar 

  • Regitz-Zagrosek V (2012) Why do we need gender medicine? In: Oertelt-Prigione S, Regitz-Zagrosek (eds) Sex and gender aspects in clinical medicine. Springer, London, pp 1–4

    Google Scholar 

  • Sandel M (2004) The case against perfection. Atl Mon 293(3):51–62

    Google Scholar 

  • Sax L, Kautz KJ (2003) Who first suggests the diagnosis of attention-deficit/hyperactivity disorder? Ann Fam Med 1:171–174

    Article  PubMed  PubMed Central  Google Scholar 

  • Sciutto MJ, Nolfi CJ, Bluhm C (2004) Effects of child gender and symptom type on referrals for ADHD by elementary school teachers. J Emotion Behav Disord 12:247–253

    Article  Google Scholar 

  • Sharpe K (2014) School daze. Lancet Psychiatry 1:118

    Article  PubMed  Google Scholar 

  • Simon V, Czobor P, Balint S et al (2009) Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry 194:204–211

    Article  PubMed  Google Scholar 

  • Singh I (2007) Clinical implications of ethical concepts: moral self-understanding in children taking methylphenidate for ADHD. Clin Child Psychol Psychiatry 12:167–182

    Article  PubMed  Google Scholar 

  • Singh I (2008) ADHD, culture and education. Early Child Dev Care 178:374–361

    Article  Google Scholar 

  • Skogli EW, Teicher MH, Andersen PN et al (2013) ADHD in girls and boys—gender differences in co-existing symptoms and executive function measures. BMC Psychiatry 13:298

    Article  PubMed  PubMed Central  Google Scholar 

  • Sparrow EP, Erhardt D (2014) Essentials of ADHD assessment for children and adolescents. Wiley, Hoboken

    Google Scholar 

  • Treloar L (1992) Attention deficit hyperactivity disorder: a case study. Dissertation, University of British Columbia, Vancouver

    Google Scholar 

  • Tversky A, Kahneman D (1974) Judgment under uncertainty: heuristics and biases. Science 185:1124–1131

    Article  CAS  PubMed  Google Scholar 

  • University of Toronto (2016) One third of women with ADHD have anxiety disorders, almost half have considered suicide, study finds. www.sciencedaily.com/releases/2016/07/160720122838.htm. Accessed 10 Nov 2016

  • World Health Organisation (1992) ICD-10 classifications of mental and behavioral disorders: clinical descriptions and diagnostic guidelines. World Health Organization, Geneva

    Google Scholar 

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Authors and Affiliations

  1. European Commission, Brussels, Belgium

    Ioana Petre

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  1. Ioana Petre
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Correspondence to Ioana Petre .

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Editors and Affiliations

  1. Human Technology Center, RWTH Aachen University, Aachen, Germany

    Saskia K. Nagel

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Petre, I. (2019). Explaining Gender Differences in the Diagnosis of ADHD in Children. In: Nagel, S. (eds) Shaping Children. Advances in Neuroethics. Springer, Cham. https://doi.org/10.1007/978-3-030-10677-5_12

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  • DOI: https://doi.org/10.1007/978-3-030-10677-5_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10676-8

  • Online ISBN: 978-3-030-10677-5

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