Wanted: ADHD Research on Women & Girls
→ Оригинал (без защиты от корпорастов) | Изображения из статьи: [1]
It is indefensible how little is known about ADHD in women today. Research is nearly non-existent in the way ADHD symptoms change with the hormonal fluctuations of puberty, pregnancy, menopause, and beyond. And experts who study ADHD are deeply concerned — outraged even — about the persistent lack of research on a population that is chronically underdiagnosed and misdiagnosed. "For decades, girls and women with ADHD have missed out on critical interventions to help manage their ADHD symptoms, primarily because they have largely been left out of ADHD research studies," says Julia Schechter, Ph.D., co-director of the Duke Center for Girls and Women with ADHD. "Females with untreated ADHD have been put at higher risk for depression and anxiety, intimate partner victimization, and risky sexual behaviors resulting in teen and unplanned pregnancies. Research devoted to girls and women with ADHD is not only an issue of equity but of life or death for some." Here, leading experts weigh in on where research is critically needed to guide accurate diagnosis and effective treatment of ADHD in females. There are numerous research topics related to girls and women with ADHD that deserve thorough investigation. Three specific areas of research that span the life course include: 1. Developing more sensitive and precise screening tools that can better identify girls and women who may have ADHD and require comprehensive evaluation. Many screening tools — particularly those that are freely available — ask raters to report on overt behaviors that align with DSM-5 criteria. Yet, this approach may not be as effective for girls and women. Females with ADHD often compensate for and "mask" their symptoms, making it difficult for observers to rate how frequently a symptom is occurring or whether it is present at all. Research can also focus on developing additional prompts that could be incorporated into existing tools to help raters consider how symptoms may present differently in girls and women (e.g., more likely to be hyperverbal rather than hyperactive). Once developed, these gender-sensitive tools need to be free to use, easy to implement, provide gender or sex-based norms, and be interpretable by those without specialty mental health backgrounds (e.g., teachers, pediatricians). 2. Investigating the role of hormones in ADHD symptom expression in girls and women. This research should examine hormonal levels across the reproductive lifespan including puberty onset, menstrual cycle, pregnancy, postpartum period, and menopause, and post-menopause. 3. Assessing the degree to which girls and women with ADHD require additional or unique treatment approaches. For example, studies can investigate the efficacy of ADHD medication type and dose for girls and women and whether medication effectiveness might interact with hormone levels. With regard to behavioral treatments, research questions might include whether additional modules of CBT for ADHD or behavioral parent training potentially targeting emotion dysregulation could enhance the effectiveness of these psychosocial interventions. In addition, research can explore whether there are certain treatment delivery formats, such as group therapy (vs. individual therapy), that might be more effective for girls and women with ADHD. [Join Our Call for Greater Research on Women with ADHD] The overarching research question is: Why does ADHD exact a far greater toll on women? Why have researchers refused to explore the dramatic sex/gender differences in outcomes — and how can we compel researchers to care? Here is the most urgent research needed to improve care for females: These findings will provide a basis for revised, inclusive diagnostic criteria and rating scales to assess internalizing symptoms, functional impairments, masking, and symptom proliferation after puberty. [Survey: How Does Your Menstrual Cycle Impact Your ADHD Symptoms?] An ADDitude survey found that an enormous number of women are diagnosed with ADHD during the perimenopausal and menopausal years and that those who were previously diagnosed experienced a worsening of symptoms. These observations correlate with a period of significant underlying hormonal changes. Since ADHD is a neurodevelopmental disorder thought to be typically present during the childhood or teen years, this apparently 'new onset' or worsening of ADHD implies an important role for sex hormones in the expression of some ADHD symptoms. Such observations also imply that there may even be two types of women who are diagnosed with ADHD during this period: Those who were borderline ADHD their whole lives but did not meet criteria until their symptoms worsened and those who are entirely 'new onset.' Unfortunately, almost no research exists regarding the role of hormones on ADHD during the climacteric. Since women represent 50% of the world's population and all will experience menopause if they live into their 60's the impact of perimenopause and menopause on ADHD symptoms is an enormously unrecognized and important topic in global female health. SUPPORT ADDITUDEADHD Research Priority: Defining Sensitive and Precise Screening Tools
Julia Schechter, Ph.D., co-director of the Duke Center for Girls and Women with ADHD
ADHD Research Priority: Why ADHD Exacts a Greater Toll on Women
Ellen Littman, Ph.D., clinical psychologist and co-author of Understanding Girls with ADHD
ADHD Research Priority: Understanding the Core Symptoms of ADHD in Women
Maggie Sibley, Ph.D., psychologist, and researcher at the University of Washington School of Medicine
ADHD Research Priority: The Impact of Hormonal Fluctuations on Women with ADHD
J.J. Sandra Kooij, M.D., Ph.D., founder, and chair of the European Network Adult ADHD
ADHD Research Priority: Sexual and Reproductive Health for Females with ADHD
Lotta Borg Skoglund, M.D., Ph.D., author, associate professor at Uppsala University, Department for Women's and Children's Health, principal investigator at GODDESS ADHD, and author of ADHD Girls to Women
ADHD Research Priority: Treatment Efficacy for Women with ADHD
Kathleen Nadeau, Ph.D., author of Still Distracted After All These Years
ADHD Research Priority: The Transition Points That Predict Impairment Versus Resilience for Girls
Stephen Hinshaw, Ph.D., distinguished professor of psychology at the University of California, Berkeley, and author of Straight Talk About ADHD in Girls: How to Help Your Daughter Thrive
ADHD Research Priority: Gender Differences in ADHD
Dawn K. Brown, M.D., owner/CEO of ADHD Wellness Center and Mental Healthletics™
ADHD Research Priority: The Impact of Perimenopause and Menopause on ADHD Symptoms
Jeanette Wasserstein, Ph.D., clinical assistant professor of psychiatry, at the Icahn School of Medicine at Mount Sinai
ADHD Research Priority: Diagnostic and Treatment Gaps for Women of Color
Sharon Saline, Psy.D., clinical psychologist and author of What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life
ADHD Research Priority: Early Identification of ADHD in Girls and Women
Andrea Chronis-Tuscano, Ph.D., professor at the University of Maryland and director of the UMD ADHD Program and UMD SUCCEEDS College ADHD Clinic
ADHD Research: Next Steps
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.