Opinion

Do we have Diagnostic Instruments for Neurodevelopmental Disorders, like ADHD, that are Sensitive to the Gender Perspective?

Perez-Beltran M^1,2,*

¹1Campus Sant Joan de Déu de Barcelona-Fundació Privada, Spain

²Facultat de Psicologia, University of Barcelona, Spain

³Neuropsychologist at Avan Neurology Center, Spain

Submission: November 06, 2024; Published: November 20, 2024

*Corresponding author: Perez-Beltran M, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Facultat de Psicologia, University of Barcelona, Neuropsychologist at Avan Neurology Center, Spain

How to cite this article: Perez-Beltran M. Do we have Diagnostic Instruments for Neurodevelopmental Disorders, like ADHD, that are Sensitive to the Gender Perspective?. Psychol Behav Sci Int J. 2024; 22(4): 556091. DOI: 10.19080/PBSIJ.2024.22.556091.

Abstract

This paper aims to contribute to advancing research on neurodevelopmental disorders in general, and specifically on ADHD. There is already a significant body of scientific literature that informs about gender differences and their impact on the expression of neurodevelopmental disorders. Now, with the intention of improving interventions in psychology and psychiatry, we must commit to developing instruments that allow for accurate and reliable diagnosis.

Keywords: ADHD Diagnosis; Gender Perspective; Neurodevelopment; Assessment

Abbreviations: LUCA: Last Universal Common Ancestor; ADHD: Attention Disorder and Hyperactivity

Introduction

The evolution refers to the phenotypic and genetic changes of the individuals of a species that coexist in a space, time and environment that share certain biological properties for generations. This process donates everything to biodiversity, the diversity of life forms that has come to Earth from a last universal common advance, linked to LUCA (last universal common ancestor), which will exist for 3,800 million years [1]. From LUCA to the current situation, they surprise vertiginously the changes in the world and in our society with individuals, without knowing how to arrive at this curious concept of evolution. The change in our society over the generations is evident, which leads us to be able to differentiate humanity, including all the elements of a society, and virtual society, based on online identity. To understand further, our current society has focused on controlling, delimiting, ordering and classifying our lives, determining the good and the bad, the correct and the incorrect, based on an insurmountable standard that will represent them. social networks, which encroaches on our whole world. Psychology has followed this path, enumerating and categorizing each aspect of our life and our mind. As if it is commonplace to compartmentalize the mind, it is mandatory that biodiversity still exists rather than vegetation. Our mind and our conduct have been categorized so much that it is a dangerous paradox, since each time the group of individuals who do not complicate the established norm becomes more extensive. When things happen, when individuals do not fit into their own society, what is the problem? Are we really understanding each other as individuals? Or do we follow a superegoic fantasy of the one who represents the human being and his continued existence?

Leaving these assumptions, which although necessary are too abstract, I focus on how this process of evolution has an effect on childhood.

The children of our society are paying all the consequences of this distance, and many of them end up defined as "disconnections", a group in which children with very different psychic characteristics, children with attention disorder and hyperactivity can enter. (ADHD), ASD, Asperger's (AS), other abilities (AC), which form a tailor-made drawer for all children who do not adapt to the norm, the norm that has been established without meeting their needs and wants. its development. And this is where the girls come in, in a second oblivion. Girls who do not share certain criteria are left in no man's land. As a neuropsychologist with more than 10 years of experience in clinical practice with children and adolescents, I have been able to learn in depth how a disorder breaks out in children and their families. More concretely, to analyze the diagnosis and symptomatology of ADHD in girls and create a diagnostic guide for ADHD that allows them to be identified. Staller and Faraone stated that ADHD prevalence estimates for adult women worldwide were equivalent to 32 million women, falling to 5.29% in childhood stages [2]. With these estimates, knowing the gender similarities and differences associated with the diagnosis of ADHD, it is essential to be able to provide professionals with tools that allow them to refine the diagnosis to correctly identify the affected minors. This will also affect the subsequent intervention and its relationship with the subsequent development trajectory. Different studies show that minors diagnosed with ADHD present comorbidity with other disorders, relational difficulties and behavioral problems that directly affect their studies, their family, and their relationships in adulthood.

Several studies [3-6] affirm that the ratio in the diagnosis of ADHD in boys and girls at an early age is in the range of 2:1 to 10:1; with higher ratios in the clinical population. These ratios may suggest that ADHD in girls may be underdiagnosed or poorly identified. Currently, various recent studies [6-11] report that the symptomatologic basis of ADHD in boys and girls differs, with a tendency in boys to hyperactive and impulsive symptoms and in girls more symptoms of inattention and anxiety. This also seems to be related to the stereotype recognizable for parents and teachers of ADHD, this being that of a “disruptive child”, which is consistent with the diagnostic criteria perceived by parents and teachers of the DSM-IV [12]. Based on the scientific literature [12,13,5] in the evaluation of ADHD, although instruments for measuring symptomatology and executive functions are essential, interviews with the patient and family and self-administered scales and questionnaires are important to know, for example, the intensity of the symptoms. and its specificities. The currently reliable and validated instruments, both in Spain and abroad, used for the detection and diagnosis of ADHD do not consider the gender perspective and therefore, the need for instruments that are sensitive to the symptoms presented in girls described in the extensive literature. What's more, some of the most used and specific scales for the detection and diagnosis of ADHD do not have a differentiated norm between boys and girls. The observed sex bias in ADHD diagnoses is partly due to under-recognition of the disorder in females, resulting in late or missed diagnoses [14-18].

Conclusion

Here it is important to attend to human neurodiversity, which, like the aforementioned biodiversity, cannot be seen but exists. It is crucial to understand the specific condition we are dealing with. As mental health professionals, we have a significant responsibility to accurately identify and diagnose diseases and conditions. Making mistakes in diagnosis means condemning the patient to a long and difficult road to recovery. Few studies so far include a gender perspective in the development of instruments [19]. Promoting and fine-tuning diagnostic tools for developmental disorders in their gender expression will aid and facilitate the work of all professionals. Most importantly, it will help avoid or minimize the erratic life trajectories that depend on accurate diagnosis. Let's try.

Compliance with Ethical Standards

This research received no external funding. The author declares no conflict of interest. This study complies with the requirements of Compliance and Ethical Standards. The study does not involve human participants and/or animals.

Acknowledgment

Thanks to my female patients who have shown me the way.

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