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Girls With ADHD at Risk for Self-injury, Suicide Attempts as Young Adults

Update Date: Aug 14, 2012 11:38 AM EDT

According to the U.S. Centers for Disease Control and Prevention, as of 200, 5.4 million children 4-17 years of age have ever been diagnosed with ADHD. 

New research has suggested that girls with attention deficit hyperactivity disorder are significantly more likely to attempt suicide or injure themselves as young adults than girls who do not have ADHD. 

The researchers found that young women diagnosed with attention deficit hyperactivity disorder as girls, particularly the type with early signs of impulsivity, were three to four times more likely to attempt suicide and two to three times more likely to report injuring themselves than comparable young women.

The research was published online by the American Psychological Association in the Journal of Consulting and Clinical Psychology.

In the first part of the study, researchers focused on 228 girls ages 6 to 12 in the San Francisco Bay area. They went through extensive diagnostic assessments, after which 140 girls were diagnosed with ADHD, while the rest were part of a control group. Forty-seven girls were diagnosed with ADHD-inattentive, a subtype of ADHD that means the girls are less likely to act out and can sit quietly but have a hard time paying attention.

Ninety three had ADHD-combined, a combination of hyperactive, impulsive and inattentive symptoms. ADHD-combined is the most common subtype of ADHD referred for treatment.

The researchers followed up at year five and at year 10 with a full day of clinical assessments of each girl. They also conducted telephone interviews or home visits if necessary. 

Of the original sample, 95 percent of the girls were retained at the 10-year follow-up, when the participants were between the ages of 17 and 24. They and their families were questioned about a range of life problems, including any substance use, suicide attempts, self-injury and depressive symptoms. The young women were also tested for academic achievement and neuropsychological functioning.

Of the participants diagnosed with ADHD-combined, 22 percent reported at least one suicide attempt at the 10-year follow-up, compared to 8 percent of those with ADHD-inattentive and 6 percent of the control group. Girls in the ADHD-combined group were significantly more likely to injure themselves, with 51 percent reporting actions such as scratching, cutting, burning or hitting themselves. That compared to 19 percent in the control group and 29 percent in the ADHD-inattentive group.

The study's authors said ADHD can signal future psychological problems for girls as they are entering adulthood and the findings reinforce the idea that ADHD in girls is particularly severe and can have serious public health implications.

ADHD in girls and women carries a particularly high risk of internalizing, even self-harmful behavior patterns," the lead author said. "We know that girls with ADHD-combined are more likely to be impulsive and have less control over their actions, which could help explain these distressing findings."

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