ADHD girls exhibit serious social, behavioral problems

Long considered largely a "boys' problem," attention deficit hyperactivity disorder (ADHD) affects many girls and causes them significant academic and social difficulty, according to a study by Stephen Hinshaw and colleagues.

The researchers recruited 228 6- to 12-year-old girls to attend six- week summer camps, held over three successive years. Of the girls, 140 were diagnosed with ADHD. The ADHD girls were taken off their medications prior to the camps, so that the researchers could evaluate their natural behavior patterns. Counselors, unaware of which girls were diagnosed as ADHD, observed the interactions and behavior of the campers.

Compared to the non-ADHD controls, Hinshaw says, the ADHD girls "are very impaired, academically and socially." He notes, "The girls with ADHD were less likely to follow the directions of the teacher than the comparison girls. They were also more likely to tease their peers and show aggressive behavior, though not at the same rate as boys with ADHD in previous summer camps. They were also more likely to display social isolation-wandering and failing to become engaged in activities."

Evaluating the ADHD girls' social relationships, the researchers found that they "had fewer mutual friends and were more likely to have no friends." Overall, they say, "although girls with ADHD were able to make friends to some extent, they differed from comparison girls in terms of the likelihood of doing so, the ability to maintain the friendships that they did form, and the levels of negative features found in their friendships."

When Hinshaw and colleagues administered neuropsychological tests to a group of the ADHD girls, the tests revealed significant deficits in executive function-skills, associated with the brain's frontal lobes, that include self-control, goal-setting, long-range planning, and flexible responses to changing situations. "These functions are crucial for long- term academic, social and occupational success," Hinshaw says. "Deficits in executive functions are seen in other disorders, such as autism, but they may well be the core underlying problems for youth and adults with ADHD."

Although little long-term research has been conducted on females with ADHD, ADHD in males is a risk factor for delinquency, criminality, and social, academic, and career problems (see related article, Crime Times, 1997, Vol. 3, No. 3, Page 1).

"Patterns of friendship among girls with and without attention- deficit/hyperactivity disorder," D. R. Blachman and S. P. Hinshaw, Journal of Abnormal Child Psychology, Vol. 30, No. 6, December 2002, 625-40; and, "Preadolescent girls with attention- deficit/hyperactivity disorder: II. Neuropsychological performance in relation to subtypes and individual classification," S. P. Hinshaw, E. T. Carte, N. Sami, J. J. Treuting, and B. A. Zupan, Journal of Consulting and Clinical Psychology, Vol. 70, No. 5, October 2002, 1099-111; and, "New studies of girls with ADHD led by UC Berkeley professor reveal overlooked and serious situation," press release, University of California at Berkeley, October 1, 2002.

Address for all: Stephen Hinshaw, Department of Psychology, University of California, Berkeley, CA 94720-1650.