Continued from the previous message...

The diagnosis of ADD, now called Attention-Deficit/Hyperactivity 
Disorder (ADHD), is made on the basis of confirming six or more 
specified symptoms of either inattention or hyperactivity-impulsivity 
which have persisted (6 months or more), are maladaptive, and are below 
the individual's overall developmental level. 
Symptoms must be present since childhood, cause impairment in at least 
two settings (e.g., school and home), and significantly impair social 
or academic functioning. Further, a number of other conditions, which 
could account for the symptoms, must be evaluated and either ruled out 
or diagnosed along with ADHD.
DSM-IV categorizes ADHD into 3 main subtypes:
        Attention-Deficit/Hyperactivity Disorder, Predominantly 
           Inattentive Type
        Attention-Deficit/Hyperactivity Disorder, Predominantly 
           Hyperactive-Impulsive Type
        Attention-Deficit/Hyperactivity Disorder, Combined Type 
           (meeting criteria for both inattention and 
           hyperactivity-impulsivity).    
Are girls with ADD hyperactive? Some girls with ADD certainly are 
hyperactive. And girls who are hyperactive, especially if they are 
also defiant and/or aggressive, are more likely to be diagnosed 
with ADD early. These behaviors are generally easy to observe, 
often disruptive, and, in our culture, unusual in little girls. 
In the past, it was almost exclusively these very active and 
disruptive girls who were diagnosed. This was likely related to the 
belief that the essential defining feature of the syndrome was 
hyperactivity. Girls who are "hyperactive" are also often described 
as talkative, impulsive (for example, blurting out comments in class 
and in social situations), and over-controlling in their peer relationships. 
Many, possibly most, girls with ADD, though, likely fall into the 
category of Attention-Deficit/Hyperactivity Disorder, Primarily 
Inattentive Type. They might be described as quiet daydreamers, socially 
awkward or shy, underachievers, underactive, forgetful, disorganized, 
anxious, or depressed. Until recently, accurate and timely diagnoses 
were highly unlikely for these girls. Many were overlooked. Their 
symptoms did not seem severe or did not disrupt classroom or home 
routines. 
If these inattentive girls were evaluated, they were likely to be 
treated for anxiety, depression, mood or learning problems. Rarely 
was the possibility considered that these symptoms accompanied or 
developed in reaction to underlying ADD. The few non-hyperactive girls 
who were diagnosed with ADD during their elementary school years were 
likely to have their attention problems noticed during a learning 
disability evaluation. 
Cautions about gender differences Our understanding of gender issues in 
ADD is complicated by a number of factors. Society has different 
expectations of behavior for boys and girls, and there are also gender 
differences which occur regardless of ADD. 
For example, boys, in general, are known for tendencies to react to 
stress by "acting out" against others or the environment. Girls are more 
likely to turn stress inward, which can result in anxiety, depression, 
withdrawal, guilt, or physical symptoms (e.g., headaches and 
stomachaches). 
In the neurosciences, gender differences continue to be discovered in 
the structure and functioning of the human brain. Thus, some differences 
between girls and boys with ADD may be more closely related to gender 
than to ADD.
Studies of ADD have become more sophisticated and now include larger 
numbers of girls. Some are utilizing high tech brain imaging techniques. 
While we can be more confident about the conclusions reached, there is 
still more to understand about gender differences, ADD, and how they 
interact.
It is also important to remember that research compares groups of girls 
with groups of boys. Even when significant differences between the groups 
are found to exist, the difference does not necessarily apply to any one 
particular girl or boy with ADD.
What else do we need to know? There is still a lot to learn about girls 
with ADD. Is their outcome better, worse, or the same as males? What is 
the risk of these girls becoming pregnant in adolescence, using alcohol 
and street drugs, developing eating disorders, or dropping out of high 
school and college? Will they respond better to particular treatments?

Continued in the next message...
--- Platinum Xpress/Wildcat! v1.3
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