Neuropsychiatric Differences Between Boys and Girls With ADHD

By E. Mark Mahone, PhD | October 3, 2012

Dr Mahone is Director of Neuropsychology, Kennedy Krieger Institute in Baltimore, and Associate Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine in Baltimore. He reports no conflicts of interest concerning the subject matter of this article.

The neuropsychiatric signature of ADHD in girls

The research literature has only begun to identify a signature pattern of brain anomalies and behavioral deficits associated with ADHD in girls, in part because girls “age-out” of many symptoms earlier than boys. For example, motor development follows an earlier-maturing developmental course in girls than in boys. The developmental status of the motor system in 144 typically developing children (72 boys and 72 girls, aged 7 to 14 years) was examined by Larson and colleagues.³⁹ They found significant sex effects for atypical subtle signs (involuntary movements) and motor speed. In all cases, girls showed fewer subtle signs and were faster and more proficient than boys. Moreover, by age 7 years, many of the motor skills assessed reached “adult” level in girls, but not in boys.

A pattern of prolonged motor dysfunction emerges in boys, but not in girls, with ADHD. In a study that examined age-related reduction in motor subtle signs (overflow, dysrhythmia) in 268 children aged 7 to 14 years, boys with ADHD had more overflow and dysrhythmia than controls, while girls with ADHD did not differ from controls. Also, during this age range, girls with ADHD showed significant reduction in overflow (associated) movements, while boys showed little change during this period. This suggests that the frontal-striatal and cerebellar brain systems implicated in motor overflow and dysrhythmia mature earlier in girls.⁴⁰

In a study that examined executive functions in school-aged children with ADHD, O’Brien and colleagues¹⁷ found that both boys and girls showed similar patterns of deficit on tasks involving response preparation and working memory; however, they manifested different patterns of executive dysfunction. On tasks related to response inhibition, boys were more impaired; on tasks related to strategic planning, girls were more impaired.

Summary

The well-established sexual dimorphism in human neurobiological development extends to the patterns of behavior observed along the developmental course of ADHD. Current research suggests that the prevalence of ADHD among females is approaching that of males. Given the proposed changes in the ADHD diagnostic criteria for DSM-5 (which will raise the required age of onset of symptoms from 7 to 12), it is likely that the rate of diagnosis among girls will continue to increase. Cross-sectional research that compared boys and girls with ADHD has yielded inconsistent findings, because adolescent girls are at a different point in their development than boys of the same age.¹⁹

More recent longitudinal studies highlight the pattern of adolescent and adult risks associated with ADHD in females and bring to fo-cus the importance of making clinical judgments in assessment and treatment of ADHD on the basis of sex-specific comparisons. Continued work examining the sex differences in expression of ADHD from early childhood (ie, preschoolers) through adulthood is encouraged.⁴¹

Pages: 1 2 3 4

by Paul Jaconello | May 06, 2013 2:32 PM EDT

http://www.currentconcerns.ch/index.php?id=1608

According to the inventor of ADHD - psychiatrist, Leon Eisenberg - "ADHD is a prime example of a fictitious disease". Link is above

Sept, Oct 2012 SR on Gender Differences

Working With Transgender Persons

The Role of Gender in Disease Expression: A Literature Review

How Gender Plays a Role in Disease Expression

Eating Disorders in Males

Neuropsychiatric Differences Between Boys and Girls With ADHD

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