Girls are better than boys at detecting their own ADHD symptoms

A study of adolescents with ADHD in Sweden found that boys tended to self-report fewer ADHD symptoms compared to reports by their parents and clinicians. In contrast, girls’ self-reported ADHD symptoms did not differ from ratings provided by their parents and clinicians. Overall, regardless of sex, adolescents’ self-reports were more closely aligned with clinicians’ reports than with those given by parents. The paper was published in the Journal of Psychiatric Research.

Attention-deficit/hyperactivity disorder, or ADHD, is a neurodevelopmental disorder that affects both children and adults. It is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning across various settings. People with ADHD often struggle to focus, follow instructions, organize tasks, or remain still.

Symptoms are often first noticed when a child starts school, as they tend to conflict with school expectations and rules. This is also the period when ADHD is most frequently diagnosed. However, the condition often continues into adulthood. There are three primary types: predominantly inattentive, predominantly hyperactive-impulsive, and combined type. Diagnosis is based on clinical evaluation and typically includes input from parents, teachers, and standardized behavior rating scales.

Study author Matilda A. Frick and her colleagues note that ADHD diagnostic criteria have historically been more tailored to males. Because of this, they sought to investigate sex differences and the role of different informants in ADHD assessments. The researchers aimed to examine agreement and discrepancies between adolescents’ self-rated symptoms and ratings provided by parents and clinicians—and whether these patterns differed between boys and girls.

The study included 159 adolescents between the ages of 15 and 18 who had received a clinical diagnosis of ADHD. Fifty-eight participants were boys. Approximately 71% of the sample had the combined type of ADHD, while 26% had the inattentive type. Participants were recruited from Child and Adolescent Psychiatry outpatient units across seven regions in Sweden: Uppsala, Gävle, Falun, Karlstad, Uddevalla, Västerås, and Växjö.

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To assess ADHD symptoms, researchers collected data from three sources: adolescent self-ratings using the Adult ADHD Self-Report Scale for Adolescents, parent ratings using the same instrument, and clinician ratings based on the Mini International Neuropsychiatric Interview for children and adolescents.

The results showed that boys tended to self-report fewer symptoms than were reported by their parents and clinicians. In contrast, girls’ self-ratings did not significantly differ from either parent or clinician ratings. In general, girls showed higher agreement with both parents and clinicians than boys did. Additionally, adolescents’ self-reports aligned more closely with clinician ratings than with those from parents.

“Our results indicate that adolescent males with ADHD may underestimate their symptoms whereas females may have more insight into their symptoms when compared to other raters. Adolescents are important raters of their own ADHD symptoms and their perspectives need to be taken into account in diagnostic assessments,” the study authors concluded.

The study sheds light on the intricacies of adolescents’ self-reports on their ADHD symptoms. However, it should be noted that all participants of this study were from Sweden, while reporting and self-reporting tendencies often differ between cultures and countries. Findings in other countries and cultural groups may be different.

The paper, “Are adolescent males or females more proficient self-raters of symptoms of AttentionDeficit/Hyperactivity Disorder?,” was authored by Matilda A. Frick, Lin Lindman, Jenny Meyer, and Johan Isaksson.