Girls with ADHD more likely to inflict self-harm, attempt suicide, study shows

A study, published Tuesday and led by UC Berkeley researchers and psychologists, reveals girls who suffer from Attention Deficit Hyperactivity Disorder show higher rates of self-inflicted injury and suicide attempts compared to girls who do not have the disorder.

ADHD is a chronic psychiatric disorder characterized by problems with attention and hyperactivity that is commonly diagnosed in children.

The study, done over a period of 20 years and funded by the National Institute of Mental Health, found that 22 percent of the girls in the study who were diagnosed as both ADHD-inattentive and ADHD-impulsive reported at least one attempt at suicide at the 10-year follow up mark. For the girls who were only diagnosed with ADHD-inattentive, 8 percent reported at least one attempt, whereas only 6 percent of the control group attempted suicide at some point.

Meanwhile, in the category of self-inflicted harm, 51 percent of the ADHD-combined group reported actions such as scratching, cutting, burning or hitting themselves, compared to 29 percent in the ADHD-inattentive group and 19 percent in the control group who reported these actions.

Initially, most of the girls in the study were from the East Bay and were age 6 to 12. One hundred forty girls diagnosed with ADHD and 88 girls without the disorder were followed from their childhood up to their teen and young adult years in order to track the effects of the disorder.

“These findings are big news,” said Stephen Hinshaw, UC Berkeley Psychology professor and lead researcher on the study. “The reality is that ADHD is a highly genetic condition with a strong biological basis, and from our study, we can see that it follows girls into their young adult years and continues to impact their lives.”

Hinshaw’s research team conducted diagnostic tests and collected information directly from the girls, but also spoke with parents and educators about the girls’ developmental histories.

Director of the study Christine Zalecki, who is also a member of the UC Berkeley psychiatry department and a clinical psychologist, said the study is unique for being the first large, long-term study regarding girls with ADHD.

“It is important for practitioners to know and be more aware of the possibility that their patients and girls with ADHD might be inflicting damage to themselves,” Zalecki said.

Hinshaw said a combination of good parenting and good teaching is often the most effective treatment for patients with ADHD, although medication is often prescribed as well.

“There are a lot of factors that contribute to self-inflicted harm and suicide, and those factors also need to be a part of the next analysis that we do to understand what exactly contributes to these actions besides simply having ADHD, ” Zalecki said.

Elizabeth Owens, a UC Berkeley psychologist working on the study, said the team is now waiting on another grant application, which would allow them to continue the study and follow the girls through the ages of 22 to 27.

“Their lives are far from over at this point and we can learn a lot more about how symptoms of ADHD manifest later on in their lives,” Owens said.

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  • Skeptical_sally

    Couldn’t there be some other third environmental factor responsible for both the “ADD”/”ADHD” symptoms and the self-harm behaviors in these young girls? Say, an abusive home environment? Lack of emotional and/or peer support? Borderline personality disorder? Economic factors? A socio-cultural environment that holds them to a laundry list of wildly unrealistic standards and oft-conflicting demands (e.g. be sexy/be demure, be smart/don’t be intimidating to men, be assertive/be nice, be curvy/be skinny, etc.).

    Were I to observe self-harm behaviors in a seemingly impulsive young woman, I’d immediately question whether her “ADD” were a manifestation of an intolerable living environment, or by extension, a personality disorder. I’d wonder whether she were depressed, a victim of sexual abuse (like nearly a quarter of all female children), or going through a family trauma such as a divorce.

    Why is it that most of the ADD-inattentive symptoms mimic so closely symptoms of depression (inability to concentrate, lack of interest, social problems, etc.)? Has anyone studied whether bog standard clinical depression is now being mislabelled ADD in girls? Recent evidence out of Germany suggests that ADD/ADHD are being overdiagnosed at alarming rates in the U.S. We’ve known for a long time that depression is much more prevalent in females than males, and that it becomes markedly so around puberty. Looking around at the media teens are bombarded with, I don’t think we need to call in Sherlock to figure out why our young women are suffering.

    I sense a wee bit of diagnostic slippage in the rush to diagnose female children with ADD. Like the commenter below, I also wonder to what extent ADD, like “hysteria” and so many “psychiatric” illnesses before it, has been socially constructed.

  • univ of phail

    ADHD is a convenient fiction, only the historically illiterate could believe in such nonsense.
    Herding all the children into classrooms all day everyday under an increasingly constrictive educational/behavioral regime (eg standardized testing, zero tolerance for various behaviors and speech, etc.) is a post-industrial revolution phenomenon. Even today this forced and unnatural restructuring of childhood does not exist across the globe; only in the ‘1st world’. For thousands of years humanity existed w/o anything remotely resembling mass schooling.

    ADHD/ADD and ‘related disorders’ are conceived of and promoted as pathological for 3 reasons:
    1) the inability of society to admit to its own faulty assumptions about the educational/socialization systems, and
    2) absolving individual students of the (perceived) responsibility of conforming to the demands of those systems, and
    3) to sell speed to kids under the guise of “objective, evidence-based medicine”.

    the study cited in the article is a pathetic joke, in large part b/c it begins with the obviously idiotic premise that ADHD exists as a pathological condition.

  • I_h8_disqus

    Are there girls with only ADHD-impulsive, and did they have high rates, or is it the combination that causes the high rates?