A Comprehensive Examination of Sex-Differentiated Correlates of Attention-Deficit/Hyperactivity Disorder Symptoms in Late Childhood and Early Adolescence

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is often characterized as having clinically relevant sex-differentiated correlates. We revisited this popular conjecture and examined, in exploratory fashion, whether ADHD symptoms’ associations with 88 theoretically relevant external validators (e.g., psychopathology, neurocognitive tasks) varied by sex. To do so, we used four waves of data from a large community sample of youths ( N  = 11,878, ages: 9–13). Only 4.1% of tests (157/3,760) supported significant sex-differentiated correlates of ADHD or its individual symptoms. ADHD and some of its symptoms (e.g., inattentive, impulsive, hyperactive) were more strongly associated with externalizing in boys than girls, but ADHD and other symptoms (i.e., inattentive, acted young) were also more associated with internalizing and thought problems in boys than girls. Most observed sex-differentiated correlates were very small to small in magnitude, suggesting sex-differentiated correlates of ADHD may be the exception rather than the rule across youths’ development.