Gender Differences in the Diagnosis and Symptom Presentation of Childhood Selective Mutism

• In Event: Poster Session 10
  In Poster Session: PS 10 Topic - Developmental Psychopathology

Abstract

Purpose/Background: Gender differences are well recognized in anxiety disorders, with females at greater risk and having higher levels of anxious responding (Craske, 2003). However, research on gender differences as they pertain to the presence, diagnosis, and treatment of Selective Mutism (SM) has been limited. Some research has found higher rates in males (Elizur & Perednik, 2003; Karakaya et al., 2008), while others have found higher rates in females (Kopp & Gilberg, 1997; Kumpulianen et al., 1998; Bergman et al., 2002). The current study aims to explore the role of gender in SM as it pertains to symptomatology and diagnosis. Such information will aid in the diagnosis and treatment of SM through the childhood years.

Methods: Participants were 224 caregivers of children between 3 and 12 years of age (M = 7.4 years; SD = 2.435 years; 2.1:1 female-to-male ratio) with diagnosed or suspected SM who completed online questionnaires regarding their child’s diagnosis, treatment, and anxiety levels. The questionnaires included the Screen for Childhood Anxiety Related Disorders (Bimaher et al., 1999) and the Selective Mutism Questionnaire (Bergman, 2013).

Results: Independent-samples t-tests were utilized to evaluate gender differences in diagnosis rates, timing of onset and diagnosis, and SM symptoms. Males had a later onset of symptoms (t[219] = 3.29; p < 0.001) in addition to a later diagnosis (t[193] = 2.30; p < 0.05) than females. Males also had a higher frequency of a comorbid speech and language disorder diagnosis (t[221) = 2.07; p < 0.05). While the frequency of comorbid social anxiety diagnoses was not different between groups, males were diagnosed later (t[62]; 1.99; p = 0.05).
A 2-way ANOVA was conducted to compare the effect of age and gender on symptom severity. The age groups were: 3-5, 6-8, and 9-12 year old. There was no main effect for gender or an interaction effect, but there was a significant effect of age (F(2, 206) = 4.290. p < 0.05). Post hoc analyses using the Tukey HSD test indicated that the mean score for the 3-5 year condition (M = 18.88, SD = 8.691) was significantly different from the 6-8 year (M = 23.95, SD = 10.086) and 9-12 year condition (M = 24.65, SD = 10.141). The 6-8 year and 9-12 year conditions did not significantly differ from each other.

Conclusion: This study supports previously identified gender differences with a 2.1:1 female to male ratio of SM diagnosis. Males had a later reported onset of symptoms and a later diagnosis of both SM and comorbid social anxiety. In contrast to the findings of Muris and colleagues (Muris et al., 2016), symptoms did not differ between genders. However, symptoms did differ by age, with children between 3 and 5 years demonstrating more severe symptoms than older children. These findings underscore the importance of evaluating the onset and symptomatology of diagnostic disorders separately for each gender.

Authors

• Patricia C Lasutschinkow, Eastern Michigan University
  Presenting Author

• Kira Boneff, Eastern Michigan University
  Non-Presenting Author

• Kylie A Quinn, Eastern Michigan University
  Non-Presenting Author

• Miriam Goldstein
  Non-Presenting Author

• Carol Freedman-Doan, Eastern Michigan University
  Non-Presenting Author