It only has been fairly recently that researchers have investigated gender differences among individuals with Attention-deficit Hyperactivity Disorder (ADHD). Below is a summary of differences typically found between males and females with ADHD.
Prevalence and Behavioral Differences:
ADHD is much more common among males than females. It is estimated that boys are two to three times more likely to have ADHD than girls. They are up to nine times more likely than girls to be referred for evaluation and treatment.
The difference in referral rates between ADHD boys and girls is likely due to ADHD boys having more behavior problems than ADHD girls.
Studies have found that ADHD girls tend to have more internalizing behaviors such as anxiety, social withdrawal, and depression. Most girls diagnosed with ADHD, tend to cluster in the inattentive subtype. Because they are not a behavior problem, their difficulties are often overlooked. Boys diagnosed with ADHD are usually clinic-referred because of oppositional, aggressive, and conduct behaviors. They tend to be very disruptive in the classroom, drawing the attention of their teachers.
Some researchers have found that ADHD girls referred for treatment have more attentional difficulties than ADHD boys, though they are less hyperactive. Findings regarding intellectual functioning have been inconsistent. A few researchers have found that girls diagnosed with ADHD tend to score lower on IQ tests. However, these studies have been highly criticized because of where the children were recruited. (Editor's Note: A University of Florida doctoral dissertation study conducted by Dr. Radonovich comparing a large group of children from our own clinic at CPANCF failed to find mean IQ differences and found few clear-cut differences in executive functions).
Compared to non-ADHD children, one study has found that ADHD is associated with earlier sexual activity in girls and later sexual activity in boys.
Within the ADHD, predominately inattentive subtype, girls tend to experience more peer rejection than boys. Mothers tend to be more critical of their ADHD daughters than ADHD sons.
One group of researchers believes that girls with ADHD have a higher rate of having a first-degree relative with ADHD than do boys with ADHD. Additional studies are needed to support this.
There is no sex difference in response to medications typically used to treat ADHD.
It is less likely for ADHD females to develop antisocial personality in adulthood. ADHD females are also less likely to abuse drugs or alcohol than ADHD males. However, compared to non-ADHD females, ADHD females tend to have a higher rate of teen pregnancy and substance abuse. (Editor's Note: ADHD outcome is often related to co-existing disorders, family support, and early detection and treatment).
Studies have indicated that females are more likely to admit ADHD symptoms and seek treatment than males.
Some studies have found differences between males and females diagnosed with ADHD. Most parents participate in parent-training groups to deal with oppositional, impulsive, or aggressive behaviors, which is more prevalent in ADHD boys. It seems that parents of ADHD daughters may benefit from participation in parent groups to cope with their daughters internalizing symptoms and to improve their interactions with their daughters. It also seems particularly important for ADHD girls to learn pro-social assertive skills.
Arnold, L.E. Sex differences in ADHD: conference summary; attention deficit- hyperactivity disorder. Journal of Abn. Psy, Vol 24(5).
Barkley, C. Attention Deficit Hyperactivity Disorder;
Update 2/17/2010 by Ernest J. Bordini, Ph.D.
A study published in the by Biederman, Carter, Monuteaux, et. al represents one of the first longitudinal studies of ADHD girls into adulthood. The followed approximately 120 girls with ADHD and 120 without ADHD for a period of 11 years. At the time of follow up the average age was 22, so this represents relatively early adulthood. Findings reflected greater risk for antisocial disorders, mood disorders, anxiety disorders, developmental disorders, addictive disorders and eating disorders. These findings were not correlated with use of ADHD medications. Many similar risks have been previously been documented in longitudinal studies of boys.
Reference: Joseph Biederman, M.D., Carter R. Petty, M.A., Michael C. Monuteaux, Sc.D., Ronna Fried, Ed.D., Deirdre Byrne, B.S., Tara Mirto, B.A., Thomas Spencer, M.D., Timothy E. Wilens, M.D., and Stephen V. Faraone, Ph.D. Adult Psychiatric Outcomes of Girls With Attention Deficit Hyperactivity Disorder: 11-Year Follow-Up in a Longitudinal Case-Control Study, 2010, Am J Psychiatry. 2010 Jan 15