First Advisor

Sarah Karalunas

Date of Award


Document Type


Degree Name

Bachelor of Science (B.S.) in Psychology and University Honors






Attention-deficit hyperactivity disorder -- Diagnosis, Attention-deficit hyperactivity disorder -- Sex differences, Biochemical markers




Background: Considerable research has been dedicated to understanding the etiology of Attention-Deficit/Hyperactivity Disorder (ADHD), but the focus has been on a homogeneous subset of the population, and multiple groups go underserved when it comes to support. Previous findings suggest differences in ADHD diagnosis and referral rates based on sex, but it is less clear whether neurophysiological sex differences exist. The current study examines the effect of expert consensus diagnostic practices on rates of diagnosis in males and females, and evaluates sex differences in potential neurophysiological markers of ADHD.

Methods: 860 children and adolescents (Males=519; ADHD=516) were recruited for a longitudinal study. Parents reported whether their child had an ADHD diagnosis from a community practitioner. Children then underwent comprehensive evaluation and a diagnostic team made a consensus diagnosis based on available data. A subset of children (n=272, ADHD=162) also completed 32-channel resting-state EEG assessment.

Results: Males were significantly more likely than females to have received a prior ADHD diagnosis and were also more likely to receive an expert consensus diagnosis of ADHD. Females with ADHD had significantly more inattention symptoms than males with ADHD; there was no sex effect for hyperactive symptoms. There was a marginal sex effect on frontal alpha asymmetry, but no other significant effects. Posterior analysis yielded similar results.

Conclusions: Results confirm significant sex differences in rates of ADHD diagnosis in both community and expert consensus diagnosis. There may also be a sex effect on alpha asymmetry and sex-specific biomarkers require further evaluation.


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