Issues Which Marginalize Females with ADHD - A Mixed Methods Systematic Review
Keywords:
ADHD, females, marginalization, mixed methods systematic review, convergent integrated design
Abstract
Background
Marked disadvantages of females with ADHD were identified by previous narrative reviews. Factors side-lining females with ADHD appear to be both biological and sociological in nature. Some published systematic reviews have focused on circumscribed aspects of female ADHD. An all-inclusive systematic review of the inequities which confer a status of marginalization to females with ADHD is required, to comprehensively understand all implications of female ADHD.
Objectives
The aim of this review was to identify and synthesize quantitative and qualitative evidence of issues which marginalize females with ADHD.
Methods
A mixed methods systematic review following a convergent integrated approach, as outlined by the Joanna Briggs Institute’s manual for evidence synthesis was undertaken. Databases were accessed through the Hydro Data Initiative platform of the University of Malta. All types of studies were considered for inclusion. Extracted quantitative findings were transformed into qualitative findings prior to synthesis. The review protocol was registered with PROSPERO CRD42022384055.
Results
34 papers were included in the review. Synthesis led to the emergence of five themes, namely ‘The gender gap in ADHD recognition, diagnosis and treatment’, ‘ADHD-related problems in females’, ‘Female ADHD and negative mental health sequelae’, ‘ADHD and female sexual and reproductive health issues’ and ‘The influence of ADHD on motherhood’.
Conclusions
Critically appraised, synthesized findings conclude that females with ADHD are disadvantaged in a number of ways. Clinicians and policy makers have access to latest evidence on all issues marginalizing females with ADHD in this mixed methods systematic review. Recommendations for policy and practice are advanced, together with directions future research ought to follow.
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Eryılmaz, E., & Üstündağ-Budak, A. M. (2019). Gender bias in early recognition of ADHD. Turk Psikoloji Yazilari, 22(43), 102-104. https://doi.org/10.31828/tpy1301996120180710m000007
Evans-Agnew, R. A., & Strack, R. W. (2022). Photovoice: the little method that could change the world. Health Promotion Practice, 23(2), 201-204. https://doi.org/10.1177/15248399211069151
Fuller‐Thomson, E., Lewis, D. A., & Agbeyaka, S. K. (2016). Attention‐deficit/hyperactivity disorder casts a long shadow: findings from a population‐based study of adult women with self‐reported ADHD. Child: Care, Health and Development, 42(6), 918-927. https://doi.org/10.1111/cch.12380
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Gelaye, B., Rondon, M. B., Araya, R., & Williams, M. A. (2016). Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. The Lancet Psychiatry, 3(10), 973-982. https://doi.org/10.1016/S2215-0366(16)30284-X
Guendelman, M. D., Ahmad, S., Meza, J. I., Owens, E. B., & Hinshaw, S. P. (2016). Childhood attention-deficit/hyperactivity disorder predicts intimate partner victimization in young women. Journal of abnormal child psychology, 44, 155-166. https://doi.org/10.1007/s10802-015-9984-z
Hayashi, W., Suzuki, H., Saga, N., Arai, G., Igarashi, R., Tokumasu, T., ... & Iwanami, A. (2019). Clinical characteristics of women with ADHD in Japan. Neuropsychiatric Disease and Treatment, 3367-3374. http://doi.org/10.2147/NDT.S232565
Henry, E., & Hill Jones, S. (2011). Experiences of older adult women diagnosed with attention deficit hyperactivity disorder. Journal of women & aging, 23(3), 246-262. https://doi-org.ejournals.um.edu.mt/10.1080/08952841.2011.589285
Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M., & Rosenthal, E. A. (2022). Annual Research Review: Attention‐deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry, 63(4), 484-496. https://doi-org.ejournals.um.edu.mt/10.1111/jcpp.13480
Holthe, M. E. G., & Langvik, E. (2017). The strives, struggles, and successes of women diagnosed with ADHD as adults. Sage Open, 7(1), 2158244017701799. https://doi.org/10.1177/2158244017701799
Hong, Q. N., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., ... & Pluye, P. (2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Education for information, 34(4), 285-291. https://doi.org/10.3233/EFI-180221
Hylan, T. R., Sundell, K., & Judge, R. (1999). The impact of premenstrual symptomatology on functioning and treatment-seeking behavior: experience from the United States, United Kingdom, and France. Journal of women's health & gender-based medicine, 8(8), 1043-1052. https://doi.org/10.1089/jwh.1.1999.8.1043
Jones, H. A., Eddy, L. D., Rabinovitch, A. E., Snipes, D. J., Wilson, S. A., Parks, A. M., ... & Svikis, D. S. (2018). Attention‐deficit/hyperactivity disorder symptom clusters differentially predict prenatal health behaviors in pregnant women. Journal of Clinical Psychology, 74(4), 665-679. https://doi.org/10.1002/jclp.22538
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