Methods of diagnosis Over the past two decades more research on the functioning of the brain is being done to help support the idea that<unk><unk><unk>  Disorder is an executive dysfunction issue. The brains of males and females are showing differences, which could potentially help to explain why ADHD presents differently in boys and girls. The current way that diagnosis are made is using the DSM-5, along with a possible physical and visual examination. Over- and under-diagnosis Overdiagnosis typically refers to children who are diagnosed with ADHD but should not be. These instances are termed as "false positives". However, the "presence of false positives alone does not indicate overdiagnosis". There may be evidence of overdiagnosis if inaccuracies are shown consistently in the accepted prevalence rates or in the diagnostic process itself. "For ADHD to be overdiagnosed, the rate of false positives (i.e., children inappropriately diagnosed with ADHD) must substantially exceed the number of false negatives (children with ADHD who are not identified or diagnosed)." Children aged 8 to 15 years living in the community, indicated an ADHD prevalence rate of 7.8%. However, only 48% of the ADHD sample had received any mental health care over the past 12 months. Evidence also exists of possible differences of race and ethnicity in the prevalence of ADHD. The prevalence of ADHD dramatically varies across cultures despite the fact that the same methodology has been used. Some believe this may be due to different perceptions of what qualifies as disruptive behavior, inattention and<unk> . It is argued that over-diagnosis occurs more in well-off or more homogeneous communities, whereas under-diagnosis occurs more frequently in poorer and minority communities due to lack of resources and lack of financial access. Those without health insurance are less likely to be diagnosed with ADHD. It is further believed that the "distribution of ADHD diagnosis falls along socioeconomic lines", according to the amount of wealth within a neighborhood. Therefore, the difficulty of applying national, general guidelines to localized and specific contexts, such as where referral is unavailable, resources are lacking or the patient is uninsured, may assist in the establishment of a misdiagnosis of ADHD. Development can also influence perception of relevant ADHD symptoms. ADHD is viewed as a chronic disorder that develops in childhood and continues into adulthood. However, some research shows a decline in the symptoms of ADHD as children grow up and mature into adulthood. As children move into the stage of adolescence, the most common reporters of ADHD symptoms, parents and teachers, tend to focus on behaviors affecting academic performance. Some research has shown that the primary symptoms of ADHD were strong discriminators in parent ratings, but differed for specific age groups.<unk>  was a stronger discriminator of ADHD in children, while inattentiveness was a stronger discriminator in adolescents. Issues with comorbidity is another possible explanation in favor of the argument of overdiagnosis. As many as 75% of diagnosed children with ADHD meet criteria for some other psychiatric diagnosis. Among children diagnosed with ADHD, about 25% to 30% have anxiety disorders, 9% to 32% have depression, 45% to 84% have oppositional defiant disorder, and 44% to 55% of adolescents have conduct disorder. Learning disorders are found in 20% to 40% of children with ADHD. Another possible explanation of over-diagnosis of ADHD is the "relative-age effect", which applies to children of both sexes. Younger children are more likely to be inappropriately diagnosed with ADHD and treated with prescription medication than their older peers in the same grade. Children who are almost a year younger tend to appear more immature than their classmates, which influences both their academic and athletic performance. The debate of underdiagnosis, or giving a "false negative", has also been discussed, specifically in literature concerning ADHD among adults, girls and underprivileged communities. It is estimated that in the adult population, rates of ADHD are somewhere between 4% and 6%. However, as little as 11% of these adults with ADHD actually receive assessment, and furthermore, any form of treatment. Between 30% and 70% of children with ADHD report at least one impairing symptom of ADHD in adulthood, and 30% to 50% still meet diagnostic criteria for an ADHD diagnosis. Research on gender differences also reveals an argument for underdiagnosis of ADHD among girls. The ratio for male-to-female is 4:1 with 92% of girls with ADHD receiving a primarily inattentive subtype diagnosis. This difference in gender can be explained, for the majority, by the different ways boys and girls express symptoms of this particular disorder. Typically, females with ADHD exhibit less disruptive behaviors and more internalizing behaviors. Girls tend to show fewer behavioral problems, show fewer aggressive behaviors, are less impulsive, and are less hyperactive than boys diagnosed with ADHD. These patterns of behavior are less likely to disrupt the classroom or home setting, therefore allowing parents and teachers to easily overlook or neglect the presence of a potential problem. The current diagnostic criteria appear to be more geared towards males than females, and the ADHD characteristics of men have been over-represented. This leaves many women and girls with ADHD neglected. As stated previously, underdiagnosis is also believed to be seen in more underprivileged communities. These communities tend to be poorer and inhabit more minorities. More than 50% of children with mental health needs do not receive assessment or treatment. Access to mental health services and resources differs on a wide range of factors, such as "gender, age, race or ethnicity and health insurance". Therefore, children deserving of an ADHD diagnosis may never receive this confirmation and are not identified or represented in prevalence rates. In 2005, 82 percent of teachers in the United States considered ADHD to be over diagnosed while three percent considered it to be under diagnosed. In China 19 percent of teachers considered ADHD to be over diagnosed while 57 percent considered it to be under diagnosed.
Attention deficit hyperactivity disorder controversies
Sex differences in psychology
Rapid-onset gender dysphoria controversy
Controversies about psychiatry
Autism-friendly
Relationship obsessive–compulsive disorder
Cause of obsessive-compulsive disorder
Causes and origins of Tourette syndrome