Ranking Lived Barriers to ADHD Diagnosis in Adult Women
Keywords:
ADHD, adult women, diagnostic barriers, gender bias, sociocultural stigma, emotional maskingAbstract
Objective: This study aimed to identify, categorize, and rank the lived barriers that adult women experience in obtaining an accurate and timely diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) through an integrated mixed-method approach.
Methods and Materials: A sequential mixed-method design was employed, consisting of an initial qualitative phase followed by a quantitative ranking phase. In the qualitative phase, a systematic literature review was conducted until theoretical saturation, identifying six major thematic categories of diagnostic barriers using NVivo 14 software. These categories encompassed gendered diagnostic bias, emotional and psychological masking, sociocultural stigma and norms, systemic and institutional barriers, self-perception and help-seeking attitudes, and life-stage-specific challenges. In the quantitative phase, a structured questionnaire derived from the qualitative themes was administered to 225 adult women aged 20–55 years residing in Mexico. Participants rated each barrier on a five-point Likert scale. Descriptive and inferential analyses were conducted using SPSS version 26, including calculation of mean scores and Kendall’s W coefficient to assess agreement.
Findings: Results revealed strong concordance among participants regarding the hierarchy of barriers (Kendall’s W = 0.81, p < 0.001). Gendered diagnostic bias ranked as the most significant barrier (M = 4.68, SD = 0.41), followed by emotional and psychological masking (M = 4.52, SD = 0.47) and sociocultural stigma and norms (M = 4.36, SD = 0.56). Systemic and institutional barriers (M = 4.21, SD = 0.63), self-perception and help-seeking attitudes (M = 4.05, SD = 0.59), and life-stage-specific challenges (M = 3.87, SD = 0.68) followed in descending order.
Conclusion: The findings underscore the multidimensional nature of ADHD diagnostic inequities among adult women, revealing the interplay between clinical bias, cultural stigma, emotional masking, and systemic limitations.
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References
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