Gender and Age Differences in ADHD Symptoms and Co-occurring Depression and Anxiety Symptoms Among Children and Adolescents in the BELLA Study
Martha Gilbert, Maren Boecker, Franziska Reiß, Anne Kaman, Michael Erhart, Robert Schlack et al. · 2023 · 44 citationsRead the paper
Attention-deficit/hyperactivity disorder (ADHD) is one of the most diagnosed neurodevelopmental disorders of childhood. Current studies addressing gender and age differences in ADHD are lacking. The present study aims to fill this research gap by dimensionally evaluating gender and age differences in ADHD symptoms, as measured by a DSM-5-based parent rating scale, in children and adolescents who participated in the two-year follow-up of the community-based BELLA study (n = 1326). Associations between ADHD symptoms and depression symptoms and anxiety symptoms were also examined. Multiple linear regressions revealed significant associations between gender and all ADHD symptoms. Age was significantly associated with hyperactive/impulsive symptoms. Additional multiple linear regressions demonstrated significant positive associations between depression and anxiety symptoms and ADHD symptoms. Further, female gender was found to be positively associated with both depression and anxiety symptoms. These findings may suggest a need for more gender-specific approaches to ADHD diagnosis and treatment, as well as more research into the intersections of ADHD and depression and anxiety symptoms in children and adolescents.
What the full text shows
Tested in real conditions- Female gender is significantly negatively associated with total ADHD symptoms. — ß = -0.16, p < 0.001 (Community-based sample of children and adolescents (9-17 years))
- ADHD symptoms are strongly positively correlated with depression and anxiety symptoms. — r = 0.382 (depression), r = 0.369 (anxiety), p < 0.01 (Community-based sample of children and adolescents (9-17 years))
- Gender has a small effect on the Total ADHD Score and Inattention subscale, but no significant effect on the Hyperactive/Impulsive subscale. — d = 0.32 (Total), d = 0.37 (Inattention), d = 0.19 (Hyperactive/Impulsive) (Comparison between boys and girls)
- Age is significantly associated with hyperactive/impulsive symptoms, with scores decreasing as age increases. — Lowest mean score 0.29 (SD = 0.37) for 14-17 year olds (Hyperactivity/Impulsivity subscale)
- Female gender is positively associated with both depression and anxiety symptoms. — ß = 0.081 (depression), ß = 0.154 (anxiety), p < 0.001 for anxiety (Multiple linear regression analysis)
- Higher parental education is significantly negatively associated with total ADHD symptoms. — ß = -0.16 (medium), ß = -0.24 (high), p < 0.001 (Parental education levels compared to low education)
- Setup
- n = 1326 children and adolescents aged 9-17 years from the community-based BELLA study (52.5% male).
- How
- The researchers conducted a dimensional evaluation of ADHD, depression, and anxiety symptoms using parent-reported rating scales (FBB-ADHS and CES-DC). They employed bivariate correlations and multiple linear regression analyses to examine the associations between gender, age, socioeconomic status, and symptom severity.
- Limitations
- Data relied solely on parent-reported ratings rather than clinical diagnoses. · Small effect sizes for gender differences may be due to the use of a population sample rather than a clinical sample. · The study did not find a significant interaction between age and gender, contrary to some previous research.
Summarized by Gemma 4 from the open-access full text · 9 Oct 2026. Read it