The female side of pharmacotherapy for ADHD-A systematic literature review

ObjectiveThis comprehensive review examined sex differences in prescription rates and efficacy or effectiveness of pharmacotherapy treatment in girls and women with attention deficit hyperactivity disorder (ADHD), while identifying gaps in the scientific knowledge on this topic.MethodA rigorous electronic database search was carried out in order to identify all published studies on female-specific effects of stimulants and non-stimulants in the treatment of ADHD. In total, 2672 studies were screened of which 21 studies (seven on prescription rates, 14 on effects of pharmacotherapy) met the inclusion criteria and were included for analysis.ResultsIn all seven studies on ADHD prescription rates, girls received significantly less prescriptions than boys, a difference however no longer seen in adults with the exception of one study. Each of the 14 studies on effectiveness / efficacy found at least one sex-difference in the effects of ADHD pharmacotherapy.ConclusionSeveral sex-differences are demonstrated in the prescription, usage and efficacy /effectiveness of both stimulant and non-stimulant ADHD pharmacotherapy. A single daily use of MPH may possibly not be optimal for girls with ADHD and ATX may be a promising medication for girls and women with ADHD. The robustness of this result requires further investigation

Stigma in attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed disorder in child- and adulthood with a high impact affecting multiple facets of social life. Therefore, patients suffering from ADHD are at high risk to be confronted with stigma, prejudices, and discrimination. A review of the empirical research in the field of ADHD with regard to stigma was performed. The findings of investigations in this field were clustered in different categories, including stigma in children with ADHD, stigma in adults with ADHD, stigma in relatives or in people close to a patient with ADHD, and the influence of stigma on authorities’ attitudes toward patients with ADHD. Variables identified to contribute to stigma in ADHD are public’s uncertainty concerning the reliability/validity of an ADHD diagnosis and the related diagnostic assessment, public’s perceived dangerousness of individuals with ADHD, socio-demographical factors as age, gender, and ethnicity of the respondent or the target individual with ADHD, stigmatization of ADHD treatment, for example public’s skepticism toward ADHD medication and disclosure of diagnostic status as well as medication status of the individual with ADHD. The contribution of stigma associated with ADHD can be conceptualized as an underestimated risk factor, affecting treatment adherence, treatment efficacy, symptom aggravation, life satisfaction, and mentally well-being of individuals affected by ADHD. Public as well as health professionals’ concepts about ADHD are highly diverse, setting individuals with an ADHD diagnosis at greater risk to get stigmatized

Nine everyday situations, nine different forms of attention

1. ObjectivesThe aim of the present study was to develop a questionnaire for the assessment of everyday attentional capacities in adults: the Everyday Life Attention Scale (ELAS). Its developmental was inspired by multi-component theories of attention and clinical neuropsychology guidelines for the assessment of attention. The items ask about multiple components of attention in nine common everyday situations, including Reading, Movie, Activity, Lecture, Conversation, Assignment, Cooking, Cleaning up, and Driving.2. MethodsTwo validation studies were conducted. Study 1 investigated the factor structure, validity, and reliability of the ELAS in 1206 healthy participants by means of an online survey. Study 2 further investigated the sensitivity of the ELAS in 80 adults with ADHD compared to 80 matched healthy controls and a mixed clinical group of 56 patients diagnosed with other psychiatric disorders. 3. ResultsStudy1: Confirmatory factor analysis supported a situation-specific approach which categorizes everyday attention into nine situation scales. Within each of these nine situations, ratings of sustained, selective, focused, and divided attention as well as motivation constituted reliable subscales. Study 2: We found convincing evidence that adult patients with ADHD have clearly reduced attention scores (with large effect sizes) on all nine situation scales of the ELAS compared to matched healthy controls. Instead, a mixed clinical group of psychiatric patients (including depression and schizophrenia) without ADHD deviated from the healthy sample only on three situations with medium to large effect sizes (Assignment, Cooking, and Cleaning up). Patients with ADHD showed particularly strong attentional difficulties in comparison to both the control and the mixed clinical group regarding Reading, Assignment, Activity, and Conversation. 4. ConclusionsTesting the psychometric properties of the ELAS revealed that attention in everyday life can be reliably measured by situation-specific scales (Study 1) and that these scales are sensitive for attentional difficulties in patients with ADHD (Study 2), particularly for Reading, Assignment, Activity, and Conversation. The ELAS can be used as part of a battery assessment approach or in the context of treatment evaluation.<br/

Self-reported empathy in adult women with Autism Spectrum Disorders:A systematic mini review

IntroductionThere is limited research on Autism Spectrum Disorders (ASD) in females. Although the empathy construct has been examined thoroughly in autism, little attention has been paid to empathy in adult women with this condition or to gender differences within the disorder.ObjectiveSelf-reported empathy in adult women with ASD was examined and compared to that of typically developed men and women as well as to men with this condition.MethodsOnline databases were searched for articles investigating self-reported empathy among adult women with ASD. Only six studies comparing women to men were identified.ResultsAll studies found women with an ASD to report lower levels of empathy than typically developed women, and typically developed men, but similar levels to men with this condition.ConclusionThe self-reported empathic ability of women diagnosed with ASD resembles that of their male counterparts most closely; they show a hypermasculinisation in empathy. This is particularly surprising considering the large gender difference in empathy in the general population.DiscussionOne of the limitations of this review is that the current diagnostic criteria for ASD are oriented towards male-specific behaviour and fail to integrate gender specific characteristics. Hence, women diagnosed with ASD are likely to be at the male end of the continuum. The suggested hypermasculinisation of women on the spectrum, as evident from this review, may therefore be exaggerated due to a selection bias