Why Outdated ADHD Diagnostic Practices Fail Women

WE have to PROVE adhd is present in childhood

Hello Advocates.

I hope this message finds you well. I recently came across a journal article that sparked significant concern. This article, published in the Journal of Clinical and Experimental Neuropsychology, makes several recommendations about diagnosing ADHD in adults that are not only outdated but also potentially harmful, especially for women.

The Problem with Current Diagnostic Criteria

The journal article suggests that clinicians are overdiagnosing ADHD in adults and emphasizes the necessity of verifying childhood symptoms before making a diagnosis. However, this perspective fails to consider the unique ways ADHD presents in women. Many women do not exhibit noticeable symptoms in childhood or until they undergo significant hormonal changes such as puberty, pregnancy, post-pregnancy, perimenopause, or menopause.

Stressful periods in life can also trigger ADHD symptoms, which means the rigid requirement for childhood symptom verification is inherently biased and discriminatory against women.

Why Gender Matters in ADHD Diagnosis

ADHD diagnostic criteria, as they currently stand, do not account for gender differences in symptom manifestation.

Girls and women often mask their symptoms or are socialized to manage them differently, making it less likely that their struggles will be noticed and documented during childhood.

Consequently, many women do not receive an ADHD diagnosis until adulthood, when their symptoms become more pronounced due to hormonal changes or increased life stressors.

But now, when their symptoms are evident to them, professionals say they WEREN’T noticed before and thus cannot be diagnosed. So they can’t now be diagnosed, what?!

Recommendations from the Article and Why They’re Misguided

The journal article makes several recommendations that I believe are misguided:

• Verifying Childhood Symptoms: Insisting on childhood evidence can exclude many deserving women from receiving a diagnosis.

• Considering Anxiety and Depression Over ADHD: While it's essential to rule out other conditions, many individuals have comorbid conditions, and prioritizing anxiety or depression over ADHD can lead to incomplete treatment.

• Overemphasizing the motive to get a false diagnosis: The article suggests that people may be trying to get disability benefits and medication much more often than is the case. These people are outliers, and suggesting this is common is misleading.

The Real Issue: , Insufficient Diagnostic Criteria, Not Overdiagnosis

Contrary to the article’s claims, the real issue is not overdiagnosis but poor criteria. Because the diagnostic criteria are not inclusive of adult-onset symptoms or the unique ways ADHD manifests in women, many go undiagnosed and unsupported for decades.

Self-Diagnosis: A Symptom of Systemic Failures

This flawed diagnostic approach leads many to self-diagnose, as they are aware of their struggles but cannot get a formal diagnosis.

While self-diagnosis can be empowering, it highlights the system's failure to recognize and accommodate the diverse presentations of ADHD.

References

1. Lovett, B. J., & Harrison, A. G. (2021). Assessing adult ADHD: New research and perspectives. Journal of Clinical and Experimental Neuropsychology, 43(4), 333-339. DOI: 10.1080/13803395.2021.1950640.

2. Barkley, R. A. (2019). Neuropsychological testing is not useful in the diagnosis of ADHD: Stop it (or prove it)! The ADHD Report, 27(2), 1-8.

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