Are adolescent males or females more proficient self-raters of symptoms of Attention-Deficit/Hyperactivity Disorder?

J Psychiatr Res. 2025 May 13;187:248-253. doi: 10.1016/j.jpsychires.2025.05.026. Online ahead of print.

ABSTRACT

OBJECTIVES: The current study examined the relation between self-rated and parent- and clinician-rated symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), by estimating rater agreement and rater differences, and whether these differed between the sexes.

METHOD: The sample included N = 159 adolescents with ADHD aged 15-18 years (M^age = 16.59 years, SD = .92) of which n = 58 (36.5 %) were males. Symptoms were assessed using self- and parent-ratings with the adult ADHD Self-Report Scale for Adolescents, whereas clinicians rated symptoms using the Mini International Neuropsychiatric Interview for children and adolescents conducted with the adolescents and their parent. We used intra-class correlation coefficients (ICC) to assess rater agreement and t-tests to assess differences.

RESULTS: Males rated fewer symptoms compared to their parents and clinicians, whereas females’ self-ratings did not differ from parent and clinician ratings. Relatedly, females were in higher agreement with parents and clinicians compared to males. Females had a higher symptom severity than males in self-ratings and clinician-ratings, but not in parent-ratings. Adolescents were in higher agreement with clinicians than parents.

CONCLUSIONS: Our results indicate that adolescent males with ADHD may underestimate their symptoms whereas females may have more insight into their symptoms when compared to other raters. Adolescents are important raters of their own ADHD symptoms and their perspectives need to be taken into account in diagnostic assessments.

PMID:40388853 | DOI:10.1016/j.jpsychires.2025.05.026