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Absent or Hidden? Hyperactivity in Females With ADHD
Ravian Wettstein1,2,3, Valentina Navarro Ovando1,2,3, Esra Pirgon1,3
1ADHDcentraal, Amsterdam, The Netherlands.
Journal of Attention Disorders
|August 20, 2024
Summary
Adults with Attention Deficit Hyperactivity Disorder (ADHD) show significantly higher hyperactivity, both basal and provoked, compared to controls. Females with ADHD experience hyperactivity equally to males, challenging sex-based diagnostic biases.
Area of Science:
- Neuroscience
- Psychiatry
- Behavioral Science
Background:
- Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder impacting millions globally.
- Diagnostic criteria and clinical presentation of ADHD may exhibit sex-based differences, potentially leading to underdiagnosis in females.
- Objective measures of hyperactivity are needed to address potential biases in ADHD diagnosis.
Purpose of the Study:
- To objectively quantify hyperactivity in adults with and without ADHD.
- To investigate potential sex differences in the presentation of hyperactivity in ADHD.
- To challenge assumptions about sex-dependent hyperactivity in ADHD.
Main Methods:
- Utilized the Quantified Behavioral Test to measure basal and provoked motor activity in a large cohort of adults.
- Included over 13,000 adults with ADHD and nearly 2,000 controls, with detailed sex distribution analysis.
- Employed analysis of variance to examine sex by group differences in activity measures.
Main Results:
- Significant differences in both basal and provoked activity were observed between individuals with and without ADHD.
- Males consistently showed higher provoked activity than females, regardless of ADHD diagnosis.
- Adults with ADHD exhibited approximately double the basal activity and triple the provoked activity compared to their respective sex-matched controls.
Conclusions:
- Hyperactivity in ADHD is not presentation-dependent on sex; females experience similar levels of hyperactivity as males.
- Findings suggest current diagnostic approaches may overlook hyperactivity in females with ADHD.
- More accurate and timely ADHD diagnoses in females can mitigate associated burdens and comorbidities.
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