Gender Differences in Parent Report of ADHD Symptoms from 3.5 to 6 Years

• In Event: Novel measurement and characterization of disability

Abstract

Historically, the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) has been found to be higher in men than women (Fraticelli et al., 2022). However, recent work suggests that part of this discrepancy may be due to the fact that ADHD may present in women in less disruptive ways and therefore be underdiagnosed (Slobodin & Davidovitch, 2019). This issue is compounded by the fact that some ADHD traits may seem more “normative” at certain ages. To further understand potential biases in parent perception of ADHD symptoms, we examined parent endorsement (N = 103, 51 female) of the 18 DSM-5 criteria for ADHD cross-sectionally in a non-clinical sample from 3.5 to 6 years of age. For overall symptom endorsement (including both inattentive and hyperactive symptoms), it was found that, controlling for race, parents reported a higher level of ADHD symptoms in boys than girls, β = -0.18, t (97) = -2.04, p = 0.045, symptom endorsement decreased with child age, β = -0.52, t (97) = -4.45, p < 0.001, and higher subjective social status was related to lower symptom endorsement, β = -0.19, t (97) = -2.02, p = 0.046. Analysis of the inattention items replicated the effects of gender, β = -0.21, t (97) = -2.36, p = 0.02, age, β = -0.44, t (97) = -3.82, p < 0.001, and subjective social status, β = -0.24, t (63) = -0.23, p = 0.01. In contrast, no gender or subjective social status differences were found when examining the hyperactive items. However, there was a significant effect of age, β = -0.50, t (97) = -4.18, p < .001, and a marginal age X gender interaction whereby the reduction in symptom endorsement across age was more pronounced in boys than girls, β = -0.13, t (97) = -1.73, p = 0.09. The pattern of results for gender differences holds when controlling for effortful control, measured by the Children’s Behavior Questionnaire (Putnam & Rothbart, 2006), which adds additional support for the hypothesis that some of the variation is due to biases in the framing of ADHD symptomology rather than purely differences in executive function. However, concurrently examining observational and subjective measures of ADHD in this age group would be necessary to make definitive statements about the presence of bias. Taken together these results suggest that ADHD symptomology as defined by the DSM may not be equally valid across genders and normative age-related changes should be considered, especially for boys.

Authors

• Hannah White, University of Missouri - St. Louis
  Presenting Author

• Nicole E Shelley, University of Missouri - St. Louis

• Abby Jenson, University of Missouri- St. Louis

• Theresa Allison Moore, University of Missouri-Saint Louis