SPECIAL ARTICLE
Gender Differences in ADHD: A Meta-Analysis and Critical Review

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ABSTRACT

Objective

To quantitatively review and critically evaluate literature examining gender differences in attention-deficit hyperactivity disorder (ADHD).

Method

A meta-analysis of relevant research based on 18 studies meeting inclusion criteria was performed. Domains evaluated included primary symptomatology, intellectual and academic functioning, comorbid behavior problems, social behavior, and family variables.

Results

Gender differences were not found in impulsivity, academic performance, social functioning, fine motor skills, parental education, or parental depression. However, compared with ADHD boys, ADHD girls displayed greater intellectual impairment, lower levels of hyperactivity, and lower rates of other externalizing behaviors; it was not possible to evaluate the extent to which referral bias affected these findings. Some gender differences were clearly mediated by the effects of referral source; among children with ADHD identified from nonreferred populations, girls with ADHD displayed lower levels of inattention, internalizing behavior, and peer aggression than boys with ADHD, while girls and boys with ADHD identified from clinic-referred samples displayed similar levels of impairment on these variables.

Conclusions

The need for future research examining gender differences in ADHD is strongly indicated, with attention to methodological limitations of the current literature, including the potential confounding effects of referral bias, comorbidity, developmental patterns, diagnostic procedures, and rater source.

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Cited by (0)

The authors thank D.J. Veldman for the use of the Pandora software program, Janay Boswell for assistance in data management, and Ron Brown, A. C. James, and Michael Breen, who provided original data and information used in the current analyses. We are also grateful to Jim Swanson, Rich Milich, and Lee Willerman for their comments on earlier versions of this paper.

Correspondence to Dr. Carbon, Department of Psychology, University of Texas at Austin, Austin, TX 78712.

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