As a psychologist who has worked with children and adolescents for over 30 years, I am often asked whether I think that ADHD is over-diagnosed or if ADHD really exists. Contrary to public opinion, Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed and undertreated. According to the National Institute of Mental Health, current prevalence rate of adolescents with ADHD is 9%. Yet only about 50% of those adolescents with ADHD have actually been diagnosed with ADHD, and only about 40% of individuals with ADHD have been treated with medication.
While the incidence of ADHD in females is less than that in males, females are also less likely to be diagnosed with ADHD if they have the condition. Multiple research studies have shown that that girls with ADHD have higher rates of depression and dysthymia, anxiety, cigarette smoking, substance use, academic difficulties, impairment in driving, eating disorders and relationship difficulties than their non-ADHD peers. To further underscore the negative impact that ADHD can cause in females, a recent article published in the APA Journal of Consulting and Clinical Psychology (http://www.apa.org/news/press/releases/2012/08/girls-adhd.aspx) revealed that females with ADHD are at increased risk of harming themselves. The results of this prospective study of girls diagnosed with Attention Deficit Hyperactivity Disorder—Combined Type (ADHD) as children indicated that they were three to four times more likely to attempt suicide by young adulthood than those without ADHD. Girls with ADHD were two to three times more likely to engage in self-injury. Fortunately, diagnosis and treatment of ADHD can minimize the impact of ADHD on the long-term outcome for an individual.
In order to recognize the symptoms of ADHD, these are the top 10 things that parents, teachers, and other professionals should keep in mind:
- Poor impulse control is usually recognized before attention problems.
- ADHD is not just an academic problem and many students with ADHD can do well in school until the need for organization and time management outstrip their cognitive capabilities.
- Those with ADHD typically have about a 30% delay in the acquisition of independent skills and social-emotional development. Thus, a 12-year-old may only be as responsible as a typical 9 year old.
- For individuals with ADHD, time is the enemy. If they are doing something they enjoy, there is not enough time. If they are to do something they don’t enjoy, they will procrastinate or just not do it.
- Individuals with ADHD have difficulty sustaining mental effort.
- They also have trouble remembering to do what they need to do when they need to do it.
- Those with ADHD live in the moment—they don’t reflect on the past to remember what happened last time or look to the future to think of the consequences of their behavior.
- ADHD causes individuals to have trouble stopping a behavior in the middle of a behavior.
- Most of what we know about ADHD is based on research on males but females with ADHD are just as much at risk for problems in all areas of functioning.
Kudos to APA for highlighting this important research on ADHD in females and to the researchers who continue to identify the areas of need in the area of ADHD.
Read PART II of Dr. Steck’s article Underdiagnosed and Misunderstood: Girls with ADHD.