Document Type
Dissertation
Degree
Doctor of Nursing Practice
Major
Nursing
Date of Defense
7-19-2024
Graduate Advisor
Brittania Phillips, DNP, APRN, PMHNP-BC
Committee
Jessica Newby, MSN, APRN, PMHNP-BC, FNP-BC
Lisa SItler, PhD, RN
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.
Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous system dysregulation and impulse inhibition, which are also associated with non-suicidal self-harm (NSSI). However, impulsive self-harm is often overlooked in ADHD assessments, despite the American Academy of Pediatrics (AAP) recommending evaluation for children with impulsivity who display academic or behavioral problems.
Although literature supports ADHD screening for youth with behavioral concerns and a history of NSSI, this has not been routinely implemented in clinical practice. This project aimed to address the gap in ADHD diagnosis in females by implementing routine ADHD screening for female youth with a history of NSSI in a Midwest outpatient community telehealth setting. The Conners 4™ assessment tools, known for their reliability and validity, were used. Screening involved administering the ADHD Index and Self-Report tool, followed by a comprehensive evaluation for those who screened positive.
The study included six female patients aged 10 to 13 with a history of NSSI. Results showed that 50% of participants had a High or Very High probability of ADHD, all of whom were subsequently diagnosed with ADHD after further evaluation. These findings suggest that the ADHD screening method is significantly better than random chance at identifying ADHD cases. The project highlights the importance of early ADHD screening and diagnosis, particularly in females with self-harm behaviors, to improve patient outcomes and address gender disparities in ADHD diagnosis. Further research with larger, more diverse samples is recommended to validate these findings and inform clinical practices and guidelines.
Recommended Citation
Woodard, Roselie M., "Self-Harm in Female Youth with Undiagnosed ADHD: Implementing American Academy of Pediatrics Screening Guidelines" (2024). Dissertations. 1474.
https://irl.umsl.edu/dissertation/1474
Included in
Behavioral Medicine Commons, Behavior and Behavior Mechanisms Commons, Child Psychology Commons, Clinical Psychology Commons, Diagnosis Commons, Educational Psychology Commons, Gender Equity in Education Commons, Mental Disorders Commons, Nervous System Diseases Commons, Neurology Commons, Neurosciences Commons, Pathological Conditions, Signs and Symptoms Commons, Pediatric Nursing Commons, Pediatrics Commons, Psychiatric and Mental Health Commons, Psychiatric and Mental Health Nursing Commons, Quality Improvement Commons, Telemedicine Commons