University Students with Attention-Deficit/Hyperactivity Disorder: Sex Differences in Identification and Diagnosis

University students with attention-deficit/hyperactivity disorder (ADHD) face several risk factors and challenges compared to peers without ADHD that can impede their academic success and graduation. It is important to identify and diagnose ADHD prior to entering postsecondary settings to provide students with the best academic trajectory. This is particularly true as the number of students enrolled at universities with ADHD increases. Historically, ADHD has been considered a disorder with a childhood onset. However, past research primarily focused on males. More recent studies suggest females have a different ADHD etiological presentation than males, and that onset is more likely to occur in adolescence. Despite the implications of ADHD on student academic functioning, limited studies have specifically looked at sex differences in ADHD among university students. The purpose of this study was to examine the relationship between student sex and time of diagnosis, ADHD symptom presentation type, and comorbid internalizing mood disorders (i.e., anxiety, depression) in university students who registered to receive disability services. The following research questions guided this study: Q1 Are female students with ADHD less likely than male students to have a pre-existing ADHD diagnosis when they register for disability services? Q2 Does student sex predict ADHD symptom presentation (i.e., inattentive, hyperactive-impulsive, combined)? Q3 Are female students with ADHD more likely than male students to have a diagnosed comorbid internalizing mood disorder (i.e., anxiety or depression)? If the investigation followed current literature trends, it was hypothesized: H01 Ho: There is no association between student sex and time of diagnosis. Ha: There is an association between student sex and time of diagnosis. H02 Ho: β1 = 0 Ha: β1 ≠ 0 H03 Ho: There is no association between student sex and an anxiety diagnosis. Ha: There is an association between student sex and an anxiety diagnosis. H04 Ho: There is no association between student sex and a depression diagnosis. Ha: There is an association between student sex and a depression diagnosis. H05 Ho: There is no association between student sex and the presence of a depression or anxiety diagnosis. Ha: There is an association between student sex and the presence of a depression or anxiety diagnosis. The analysis used a large student registration data set (n = 6,825) from a top U.S. Midwestern university disability services center collected between 2002-2018. Non-parametric analysis using chi square tests of independence and multinomial logistic regression indicated student sex was not significantly related to time of diagnosis or symptom presentation. There was a significant relationship between student sex and the presence of a diagnosed comorbid internalizing mood disorder of anxiety or depression.