Perceived Gender Roles and ADHD: An Explanation for the Diagnosis Gap

Abstract

In pursuit of explaining the diagnosis gap, in which more boys are diagnosed with ADHD than girls, two broad schools of thought emerge throughout the literature-one suggests the gap is due to inherent sex differences, and the other attributes the gap to a gender bias in stakeholders' perception and identification of ADHD symptoms. Data supporting inherent sex differences are drawn from flawed and unrepresentative clinic-based studies. As such, discrepancies exist in community samples that suggest girls may be underdiagnosed with ADHD. Several promising studies highlight the validity of a gender bias in ADHD referrals and treatment; however, to date, no known studies explore the specific mechanisms behind this bias. The current study pulls from gender schema theory and social role theory in order to provide a novel interdisciplinary conceptual framework for understanding why stakeholders perceive and attribute the same behaviors differently according to gender. Results were generally inconclusive; however, girls with ADHD were perceived as less feminine by parents than girls without ADHD, and as displaying a narrower range of gender role expression, providing tentative support for the current theoretical framework. Implications call for greater attention and awareness to internal biases that contribute to the undervaluing of girl's and women's health in society.