Why more boys than girls with ADHD receive treatment: A study of Dutch twins
Why more boys than girls with ADHD receive treatment: A study of Dutch twins
复制标题
DOI：
10.1375/twin.10.5.765
复制
发表时间：
2007-10-01
影响因子：
0.9
通讯作者：
Boomsma, Dorret I.
中科院分区：
文献类型：
--
作者：
Derks, Eske M.;Hudziak, James J.;Boomsma, Dorret I.
患有注意力缺陷多动障碍 (ADHD) 的男孩比女孩更多地接受治疗。对这种偏见的一种解释可能是男孩在破坏性行为量表上的得分高于女孩。尽管临床样本的研究结果支持了这一点，但最近对非参考样本的研究表明，患有多动症的男孩和女孩的破坏性行为水平与母亲报告的相似。在本报告中，我们调查了治疗率的差异是否与患有多动症的男孩比患有多动症的女孩更高的教师问题得分有关。数据来自母亲和教师的非参考样本，其中包括 283 名男孩和 291 名女孩，患有或不患有 ADHD。当儿童在注意力问题上得分低（对照）或高（先证者）时，他们就会被选中。母亲们完成了 DSM-IV 访谈、儿童行为检查表 (CBCL) 和康纳斯评定量表 (CRS)。教师填写教师报告表 (TRF) 和 CRS。根据母亲的报告，患有注意力缺陷多动症的男孩和女孩有相似程度的精神疾病和学校障碍（例如被阻碍、特殊班级安排和学习问题）。母亲们报告说，患有多动症的男孩和女孩都有相似程度的攻击性和注意力问题。相比之下，教师一致认为患有多动症的男孩在注意力问题和攻击性方面的得分高于患有多动症的女孩。性别差异因环境而异：患有多动症的男孩和女孩在学校的行为表现不同，但在家里则不然。教师在学校报告问题行为的比例较高，这可能解释了临床环境中 ADHD 的男女比例较高。这些发现对依赖于参考样本的遗传学研究的结果具有影响，因为这些研究可能会对人群中的性别差异产生扭曲的看法。
M ore boys than girls with attention deficit hyperactivity disorder (ADHD) receive treatment. One explanation for this bias may be that boys score higher on disruptive behavior scales than girls. Although this was supported by findings in clinical samples, recent studies in nonreferred samples showed that boys and girls with ADHD are similar with respect to their levels of disruptive behavior as reported by their mother. In this report, we investigate whether the difference in treatment rate is associated with higher teacher problem scores in boys with ADHD than in girls with ADHD. Data were obtained from mothers and teachers in a nonreferred sample of 283 boys and 291 girls with and without ADHD. Children were selected when they scored either low (controls) or high (probands) on attention problems. Mothers completed DSM-IV interviews, Child Behavior Checklists (CBCL) and the Conners Rating Scale (CRS). Teachers filled in the Teacher Report Form (TRF), and the CRS. Boys and girls with ADHD had similar levels of psychiatric illness and school impairment (such as being held back, special class placement and learning problems) by mother report. Mothers reported similar levels of aggression and attention problems in boys and girls with ADHID. In contrast, teachers consistently rated boys with ADHID as having higher scores on reports of attention problems and aggression than girls with ADHD. Gender differences vary across settings: boys and girls with ADHD are rated as behaving differently at school, but not athome. The higher level of teacher reported problem behavior at school may explain the high male-female ratio for ADHD in clinical settings. These findings have implications for the results of genetic studies that rely on referred samples, as these studies may give a distorted view of sex differences in the population.