Is ADHD Putting Young Women in Danger?

ADHD and self harming found to be connected in young female adults

(RxWiki News) Did you know that ADHD affects people past childhood? For young women, the disorder could be potentially harmful.

Doctors have recently found a correlation between ADHD and self-harming/suicidal tendencies for women in early adulthood.

"Talk to your doctor if you have thoughts about hurting yourself."

Most people are under the impression that ADHD, or attention deficit hyperactivity disorder, goes away once children grow up. However, this is not always the case.

A study conducted at the University of California at Berkeley, and published on August 14, shows otherwise -- specifically for girls entering into young adulthood.

Research has found that girls with a history of ADHD are more likely to keep their struggles and feelings of failure inside; these internalized feelings could likely lead to self-injury and suicidal behaviors.

The lead researcher was Stephen Hinshaw -- a professor of psychology at UC Berkeley -- and his study was ten years long and examined the largest ever sample of girls who were diagnosed with ADHD in childhood.

He explains that both girls and boys with ADHD diagnosed in childhood continue to have academic and relationship problems, but that girls specifically face unique problems such as, "... extremely high rates of cutting and other forms of self-injury, along with suicide attempts, [that] show us that the long-term consequences of ADHD females are profound."

According to the Centers for Disease Control and Prevention, more than five million children between ages 3-17, or around one in 11, are diagnosed with ADHD.

The disorder "is characterized by poor concentration, distractibility, hyperactivity, impulsiveness and other symptoms that are inappropriate for the child's age. Evidence-based treatment includes stimulant medications and various forms of behavior therapy."

The results of the study are consistent with earlier findings by the UC Berkeley team that visible ADHD symptoms become less and less as girls grow older, while the hidden symptoms continue and grow.

And while it is often assumed that girls will grow out of their ADHD, these findings both challenge that assumption and highlight the need for long-term monitoring and treatment of the disorder.

The study observed a group of girls with ADHD since 1997 when they were ages 6-12. That leg of the study -- published in 2002 -- observed the girls at five week camps and monitored their behavior in art and drama classes and outdoor activities.

The girls that were taking ADHD medication volunteered to stop taking their medication for most of the summer camp study. The counselors and staff that observed the girls did not know about their ADHD diagnosis. 

Hinshaw and his team tracked the group -- which was a racially and socio-economically diverse group located in the San Francisco Bay Area -- starting in these early childhood summers camps, then their adolescent period and most recently their early adulthood phase.

The team has continued to publish findings from the study every five years with the same group of girls.

This most recent part of the study assessed the girls ten years after it began and examined 140 of them, ages 17-24; it compared their behavioral, emotional and academic development to that of a group of 88 girls without ADHD that had a similar demographic.

It also compared the symptoms of two major ADHD subtypes: Those who entered the study with poor attention alone versus those who had a combination of inattention and high rates of impulsivity and hyperactivity.

The study's most important finding had to do with the group that had the combined symptoms of inattention and hyperactivity-impulsivity during childhood; these girls were more likely to engage in self-injury and suicidal behavior in early adulthood.

According to the results, more than half of this observed subgroup were found to have engaged in self-injurious behavior, and more than one-fifth had attempted suicide.

"A key question is why, by young adulthood, young women with ADHD would show a markedly high risk for self-harm … Impulse control problems appear to be a central factor," the study said.

The earliest leg of the study found the girls with ADHD to be more likely to struggle in school and to be rejected by their peers.

And in the follow-up study that occurred five years later when the girls were ages 12-17 and going through their early to mid adolescent phase it was found that the fidgety and impulsive symptoms were likely to decrease in the early teen years, while the learning gap between the girls with ADHD and their peers (without ADHD) had widened.

Eating disorders and substance abuse were also found to occur with most of the girls.

The most recent study -- where the girls are ages 17-24 -- is based off of 95 percent of the original sample of girls. This time around the researchers conducted in-depth interviews with both the subjects and their families; the interviews included personal reports on self-harming and suicidal behaviors, drug use, eating habits and driving behavior.

Key cognitive functions such as executive planning skills were also measured, such as: goal setting and monitoring, planning and keeping on task despite distractions.

Many girls improved during this ten-year research period, but certain problems persisted and new ones emerged. This fact suggests that careful monitoring and treatment are essential according to Hinshaw.

The study concluded that ADHD in girls could make for continuing problems through early adulthood -- especially self-harm.

Researchers strive to keep up public ADHD awareness and stress the need for ongoing examination in girls and young women.

Hinshaw states that ADHD is a treatable condition, but only as long as interventions are monitored carefully and pursued over many years.

This longitudinal study -- an observational study conducted over a long period of time -- was published on August 14 in the Journal of Consulting and Clinical Psychology, and it was funded by grants from the National Institute of Mental Health.

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Review Date: 
September 24, 2012