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      ADHD and Gender: subjective experiences of children in Chile Translated title: TDA-H y género: experiencias subjetivas de niños y niñas en Chile

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          Abstract

          Abstract Although research on ADHD has tended to ignore gender differentials, recent contributions produced mainly from epidemiology have revealed that this diagnostic category seems to be strongly related to gender. However, these contributions seem to limit their scope to the study of the symptoms as well as cognitive, affective and social functioning of children, leaving aside subjective aspects associated with the ADHD practices of diagnosis and treatment. Thus, this article aims to explore how the gender dimension crosses the subjective experience of children diagnosed with ADHD. Based on open interviews conducted with children between the ages of 7 and 13, we show general trends that articulate gender and characteristics associated with the ADHD diagnosis, while at the same time, with children’s experiences that dislocate such trends. The findings were grouped according to four emerging axes: (1) locations, (2) abilities, (3) approches, (4) interactions. Thus, we will show how the experience of boys and girls is multiple in relation to the diagnosis and it is not possible to be reduced to a gender binary perspective.

          Translated abstract

          Resumen Si bien las investigaciones sobre TDA-H han tendido a dejar los aspectos diferenciales de género en un lugar secundario, recientes contribuciones emanadas principalmente desde la epidemiología han revelado que esta categoría diagnóstica parece estar fuertemente relacionada con el reparto de los géneros. Sin embargo, dichas contribuciones parecen limitar sus alcances al estudio de la sintomatología y funcionamiento cognitivo, afectivo y social de los(as) niños(as), dejando de lado aspectos subjetivos asociados a las prácticas de diagnóstico y tratamiento de TDA-H. De este modo, el objetivo de este artículo es explorar cómo la dimensión de género configura la experiencia subjetiva de niños(as) diagnosticados(as) con TDA-H. A partir de la realización de entrevistas abiertas realizadas a niños entre 7 y 13 años, damos cuenta de tendencias generales que articulan género y características asociadas al diagnóstico de TDA-H, a la vez que, con experiencias infantiles que dislocan tales tendencias. Los resultados se agruparon en función de cuatro dimensiones emergentes del material producido en las entrevistas: (1) localizaciones; (2) habilidades; (3) abordajes; (4) interacciones. Así, mostraremos cómo la experiencia de niños y niñas es múltiple en relación al diagnóstico y no es posible reducirla a una perspectiva binaria en torno al género.

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          Most cited references28

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          Gender differences in adults with attention-deficit/hyperactivity disorder: A narrative review.

          Certain characteristics of attention-deficit/hyperactivity disorder (ADHD) in children have long been known to differ by gender. What has not been as widely studied is whether gender is similarly associated with ADHD differences in adults. In this review, the relation between gender and adult ADHD prevalence, persistence, impairment, comorbidity, cognitive functioning, and treatment response was examined across 73 studies. Although gender was related to several characteristics and correlates of adult ADHD, it appeared that many of these gender differences may be at least be partially attributed to methodological artifacts or social and cultural influences, rather than fundamental differences in the expression of ADHD in men and women. We highlight how understanding the nature of the relation between gender and ADHD across the lifespan is complicated by a number of methodological difficulties, and offer recommendations for how emerging research and clinical practice can better incorporate gender into the conceptualization of ADHD in adulthood.
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            Doing their jobs: mothering with Ritalin in a culture of mother-blame.

            In debates over diagnoses of Attention Deficit/Hyperactivity Disorder (ADHD) and use of the drug Ritalin among the American school age population, discussion often centers around who is to blame for rising diagnoses and increasing use of Ritalin. Parents have come under particular scrutiny by critics who associate ADHD behaviors in children with poor parenting and view Ritalin as a "quick-fix" for socially situated problems. Biologically oriented researchers of ADHD, on the other hand have posited organically based dysfunction as the cause of ADHD behaviors. This paper explores the problem of blame in relation to ADHD diagnoses and Ritalin use from the perspective of mothers of boys with ADHD. Qualitative interviews with mothers suggest that medicalization of problematic behaviors in young boys includes an inherent narrative of blame transformation; this transformation can be expressed as a binarism: mother-blame-brain-blame. The first two sections of the paper document mothers' experiences of blame for their sons' symptomatic behaviors against the background of a cultural mothering ideology. The third section considers the promise of absolution from mother-blame inherent in the transformative binary structure. I argue that medicalization of boys' problem behaviors supports and reconstitutes the potential for mother-blame and does little to pierce oppressive cultural mothering ideals. Copyright 2004 Elseiver Ltd.
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              Symptom profiles in children with ADHD: effects of comorbidity and gender.

              To examine ratings and objective measures of attention-deficit/hyperactivity disorder (ADHD) symptoms to assess whether ADHD children with and without comorbid conditions have equally high levels of core symptoms and whether symptom profiles differ as a function of comorbidity and gender. Four hundred ninety-eight children from the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) were divided into comorbid groups based on the parent Diagnostic Interview Schedule for Children and assessed via parents' and teachers' Swanson, Nolan, and Pelham (SNAP) ratings and a continuous performance test (CPT). Comorbidity and gender effects were examined using analyses of covariance controlled for age and site. CPT inattention, impulsivity, and dyscontrol errors were high in all ADHD groups. Children with ADHD + oppositional defiant or conduct disorder were rated as more impulsive than inattentive, while children with ADHD + anxiety disorders (ANX) were relatively more inattentive than impulsive. Girls were less impaired than boys on most ratings and several CPT indices, particularly impulsivity, and girls with ADHD + ANX made fewer CPT impulsivity errors than girls with ADHD-only. Children with ADHD have high levels of core symptoms as measured by rating scales and CPT, irrespective of comorbidity. However, there are important differences in symptomatology as a function of comorbidity and gender.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                sausoc
                Saúde e Sociedade
                Saude soc.
                Faculdade de Saúde Pública, Universidade de São Paulo. Associação Paulista de Saúde Pública. (, SP, Brazil )
                0104-1290
                1984-0470
                March 2019
                : 28
                : 1
                : 75-91
                Affiliations
                [1] Santiago Santiago de Chile orgnameUniversidad de Chile Chile maria.pia.uribe@ 123456gmail.com
                [2] London orgnameKing's College London United Kingdom
                Article
                S0104-12902019000100006
                10.1590/s0104-12902019181144
                981dd5b6-7ba8-4d4b-a6ed-151c3dc4a110

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 03 January 2019
                : 08 December 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 52, Pages: 17
                Product

                SciELO Brazil

                Categories
                Dossier

                Subjective Experience,Childhood,ADHD,Gender,Niñez,Experiencia Subjetiva,Género,TDA-H

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