Gaub M, Carlson C L
Department of Psychology, University of Texas at Austin 78712, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Aug;36(8):1036-45. doi: 10.1097/00004583-199708000-00011.
To quantitatively review and critically evaluate literature examining gender differences in attention-deficit hyperactivity disorder (ADHD).
A meta-analysis of relevant research based on 18 studies meeting inclusion criteria was performed. Domains evaluated included primary symptomatology, intellectual and academic functioning, comorbid behavior problems, social behavior, and family variables.
Gender differences were not found in impulsivity, academic performance, social functioning fine motor skills, parental education, or parental depression. However, compared with ADHD boys, ADHD girls displayed greater intellectual impairment, lower levels of hyperactivity, and lower rates of other externalizing behaviors; it was not possible to evaluate the extent to which referral bias affected these findings. Some gender differences were clearly mediated by the effects of referral source; among children with ADHD identified from nonreferred populations, girls with ADHD displayed lower levels of inattention, internalizing behavior, and peer aggression than boys with ADHD, while girls and boys with ADHD identified from clinic-referred samples displayed similar levels of impairment on these variables.
The need for future research examining gender differences in ADHD is strongly indicated, with attention to methodological limitations of the current literature, including the potential confounding effects of referral bias, comorbidity, developmental patterns, diagnostic procedures, and rater source.
对研究注意缺陷多动障碍（ADHD）性别差异的文献进行定量综述和批判性评价。
基于18项符合纳入标准的相关研究进行荟萃分析。评估的领域包括主要症状、智力和学业功能、共病行为问题、社会行为以及家庭变量。
在冲动性、学业成绩、社会功能、精细运动技能、父母教育程度或父母抑郁方面未发现性别差异。然而，与ADHD男孩相比，ADHD女孩表现出更严重的智力损害、更低的多动水平以及更低的其他外化行为发生率；无法评估转诊偏倚对这些结果的影响程度。一些性别差异显然是由转诊来源的影响所介导的；在非转诊人群中确诊的ADHD儿童中，ADHD女孩比ADHD男孩表现出更低的注意力不集中、内化行为和同伴攻击水平，而在诊所转诊样本中确诊的ADHD女孩和男孩在这些变量上表现出相似的损害水平。
强烈表明未来需要研究ADHD的性别差异，同时关注当前文献的方法学局限性，包括转诊偏倚、共病、发育模式、诊断程序和评估者来源的潜在混杂效应。
