Girls with ADHD likely to suffer from multiple mental health problems

Young girls with attention deficit hyperactivity disorder (ADHD) are more susceptible to suffer from multiple mental disorders, which often lead to other problems such as abusive relationships, teenage pregnancies, poor grades and drug abuse, claim researchers.
Young girls with attention deficit hyperactivity disorder (ADHD) are more susceptible to suffer from multiple mental disorders, which often lead to other problems such as abusive relationships, teenage pregnancies, poor grades and drug abuse, claim researchers.
The researchers found that 37.7% of girls with ADHD met criteria for an anxiety disorder compared with only 13.9% of girls without ADHD.
10.3% of girls with ADHD were diagnosed with depression compared with only 2.9% without ADHD.
42% of girls with ADHD were diagnosed with oppositional defiant disorder, compared with just 5% of girls without it.
Oppositional defiant disorder is characterized by angry, hostile, irritable, defiant behaviour.
To meet the diagnosis for oppositional defiant disorder, a child must display at least four of eight symptoms for at least six months that result in significant academic, social and family problems.
12.8% of girls with ADHD were diagnosed with conduct disorder compared with only 0.8% without ADHD.
Conduct disorder is similar to oppositional defiant disorder but with more severe behavioural problems, such as committing violent acts, setting fires and hurting animals.
Senior author of the study, Steve Lee, said “We knew the girls with ADHD would have more problems than the girls without ADHD, but we were surprised that conduct disorder and oppositional defiant disorder were at the top of the list, not depression or anxiety. These conduct disorders, more than anxiety and depression, predict severe adult impairments, such as risky sexual behaviour, abusive relationships, drug abuse and crime.”
Symptoms of ADHD include being easily distracted, fidgeting, being unable to complete a single task and being easily bored.
ADHD can begin in pre-school kids and can persist into high school and into adulthood, especially when it’s accompanied by oppositional conduct disorder.
The psychologists analysed 18 studies of 1,997 girls, about 40% (796) of whom had ADHD.
Most of the girls were between the ages of 8 and 13.Most ADHD studies focused on boys or compared girls with ADHD to boys with ADHD, not to girls without ADHD.
ADHD is often harder to detect in girls than in boys because girls with the disorder may appear disengaged, forgetful or disorganized, and perceived as “spacey” and stay “under the radar” without being referred for assessment and treatment, said lead author Irene Tung.
The team also discussed about the possible steps parents could take.
If a child’s negative behaviour lasts for months and is adversely affecting her or his social relationships and school performance, then it’s worth having your child evaluated by a psychologist or psychiatrist for ADHD and other mental disorders.

Parents of girls with ADHD should carefully monitor signs of disruptive behaviour, anxiety and depression.
Tung said, “Early management of ADHD and related symptoms will be critical in helping young girls function successfully at school and socially, and feel confident.”
“People tend to think of girls as having higher risk for depression and anxiety disorders, and boys as being more likely to exhibit conduct disorders, but we found that ADHD for girls substantially increases their risk for these conduct disorders,” she explained.
“In many cases, the school can provide support, including an evaluation by a school psychologist” she added.
Approximately 5 to 7% of elementary school students have oppositional defiant disorder and approximately one to 2% of elementary school students have conduct disorder.
The good news is that there are effective treatments, some involving pharmaceuticals, and others that involve seeing a therapist, as well as effective parenting strategies to manage the behaviour.
“Kids with ADHD need structure and consistency, more than the average child; they need to know the rules and the rules need to be applied consistently,” Lee said.
Researchers recommended that parents provide positive reinforcement for good behaviour; this does not necessarily have to be monetary.

“For some of these kids, getting negative attention may be their only way of getting attention,” Tung said.
“Catch your child being good, and reward that,” she said.
Children will sometimes react negatively to rewards in the beginning and parents at that point will often stop, but should continue. The child’s behaviour will often get worse before it gets better.
Children with ADHD are two to three times more likely than children without the disorder to develop serious substance abuse problems in adolescence and adulthood, the team reported in 2011.
To receive a diagnosis of ADHD by a child psychologist or psychiatrist, a child must have at least six of nine symptoms of either hyperactivity or inattention, the child’s behaviour must be causing problems in his or her life, and the symptoms must not be explainable by any medical condition or any other mental disorder.
In addition, the symptoms must have started before age 12, must be present in multiple settings, at home and school, adversely affecting functioning.
They must not be explainable by any medical condition or any other mental disorder.
The report appeared in the journal Pediatrics.
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