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患有注意力缺陷多动症的女性?

ADHD in women?
患有注意力缺陷多动症的女性?
946字
2019-10-13 22:00
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火星译客

For a long time, most people saw ADHD — or attention deficit/hyperactivity disorder — as "a boy thing."

很长一段时间以来,大多数人把注意力缺陷多动症(ADHD)看作是“男孩的事情”。

Yes, the occasional woman or girl got diagnosed, but this condition was mostly about hyperactive dudes misbehaving in the backs of classrooms, or guys who couldn't focus on their work for very long.

是的,偶尔会有女性或女孩被诊断出患有此病,但这种疾病主要的患者是教室后面过度活跃、行为不端的男生,或者是那些长时间不能专心工作的男生。

Today, that mindset has started to shift, but even now, studies report that males get diagnosed significantly more often than females — anywhere from two to sixteen times more often, depending on the study and country.

如今,这种观念已经开始转变。但即便是现在,研究报告仍然显示,男性被诊断的频率明显高于女性——根据研究和国家的不同,男性确诊的频率是女性的2到16倍。

Frequently, women and girls are told they have an anxiety or mood disorder instead, and aren't diagnosed with ADHD until later in life.

通常,女性和女孩会被告知患有焦虑症或情绪障碍,直到晚年才被诊断为注意力缺陷多动症。

This probably isn't because the disorder is way more likely in males, either.

这可能并不是因为男性患这种疾病的可能性更大。

Evidence suggests that these two groups should be about equally likely to experience symptoms.

有证据表明,这两组人出现症状的可能性应该差不多相同。

So, what's going on? Well, some of this might happen because of misconceptions.

那到底是怎么回事?嗯,有些可能是因为误解。

But it could also be because, for some reason, ADHD may present differently in different sexes.

但这也可能是因为,由于某些原因,注意力缺陷多动症在不同性别中的表现可能不同。

And if you don't know what you're looking for, you could miss the symptoms entirely. Unfortunately, there are very few studies about how ADHD affects those who are intersex or who don't identify with their sex assigned at birth.

如果你不知道自己在寻找什么,就可能会完全忽略症状。不幸的是,关于注意力缺陷多动症对于如何影响那些双性人,或不认同自己出生时性别者的研究很少。

When most studies report results in males and females, they seem to be referring to people who are cisgender.

大多数研究报告男性和女性的结果时,似乎指的是本性别者。

So out of necessity, that's what we'll be referring to when we say "male" and "female" in this episode. That being said, researchers have noticed some distinct differences between these two groups.

所以,出于必要性,这就是我们在这一集节目中说到“男性”和“女性”时所指的内容。也就是说,研究人员已经注意到这两组之间存在着一些明显的差异。

For one, surveys show that females with ADHD are more likely to also have anxiety or depression.

一方面,调查显示患有注意力缺陷多动症的女性更容易焦虑或抑郁。

Additionally, other studies have found that female participants with the disorder displayed less outward aggression than males with the same diagnosis. But what's especially interesting is that the actual ADHD symptoms also seem to be different.

此外,其他研究发现,患有这种疾病的女性参与者比确诊的男性表现出更少的外向攻击性。但特别有趣的是,注意力缺陷多动症的症状似乎也有所不同。

When most people think of this condition, they probably tend to focus on the hyperactive or impulsive symptoms — things like restlessness, fidgeting, or being disruptive.

当大多数人想到这种疾病时,他们可能会把注意力集中在过度活跃或冲动的症状上,比如烦躁、坐立不安或心烦意乱。

And those are legitimate symptoms.

这些都是合理的症状。

But they aren't the only ones. Because according to the manual doctors use to diagnose ADHD, the symptoms can be broken into two categories: one called hyperactivity impulsivity... and one called inattention.

但它们并不唯一。因为根据医生用来诊断注意力缺陷多动症的手册,这些症状可以分为两类:一类叫做多动症冲动,还有一类叫做注意力不集中。

The inattentive symptoms include things like making careless mistakes, having trouble listening, and being easily distracted or forgetful.

注意力不集中的症状包括疏失犯错、听不清楚、容易分心或健忘。

And you can be diagnosed with ADHD only by having these symptoms.

只有出现这些症状,才能被诊断为注意力缺陷多动症。

The hyperactive ones aren't actually required. This is important for multiple reasons.

实际上并不真的需要过度活跃。这一点很重要,原因有很多。

But in this case, a big one is that a number of studies have found that males are more likely to exhibit those hyperactive symptoms, and females are more likely to display inattentive ones.

但在这种情况下,一个很大的问题是,许多研究发现,男性更容易表现出这些过度活跃的症状,而女性则更容易表现出注意力不集中的症状。

So although a common picture of ADHD is a disruptive, aggressive boy, it's possible that a girl with the disorder could be quiet and anxious instead.

因此,尽管注意力缺陷多动症的常见情况是具有破坏性和攻击性的男孩,但患有这种疾病的女孩可能会是安静又焦虑。

Of course, it is important to note that studies about ADHD and sex or gender are still relatively uncommon.

当然,值得注意的是,关于注意力缺陷多动症,以及性或性别的研究仍然相对较少。

And while a variety of research methods are used, symptoms are often either self-reported in interviews, or are reported by parents and/or physicians.

虽然使用了多种研究方法,但症状通常是在访谈中自我报告,要么就是由父母和/或医生报告。

So it's always possible that results could be skewed.

所以,结果总是有可能被扭曲。

There are even a few studies that found no different in symptoms between males and females — or that found that the only differences were the prevalence of anxiety or the frequency of rule-breaking behaviors.

甚至有一些研究发现,男性和女性在症状上没有差异,或者发现唯一的区别是焦虑的普遍程度或出现违反规则的行为的次数。

This doesn't mean the pattern doesn't exist, though. It just means we need more study.

不过,这并不意味着这种模式不存在。这意味着我们需要更多地学习。

In the meantime, there does seem to be enough of a trend that scientists are investigating why this difference would exist.

与此同时,目前的趋势显示,科学家正在调查为什么会存在这种差异。

And so far, they've found a few ideas.

到目前为止,他们已经发现一些观点。

One idea supported by clinical studies is that sex hormones — like hormone and estradiol, which is a type of estrogen — can affect ADHD symptoms, which would explain the different presentations.

临床研究支持的一个观点是性激素,如激素和雌二醇,雌二醇是一种雌激素,可以影响注意力缺陷多动症的症状,这可以解释症状表现的不同。

One 2009 study even suggested that hormone could somehow affect certain neurons before birth, which could place those kids at risk of developing ADHD.

2009年的一项研究甚至表明,睾丸激素在出生前可能会影响某些神经元,这可能会使这些孩子具有患上注意力缺陷多动症的风险。

Alternatively, a handful of small studies suggest there's some kind of biological difference between males and females with the disorder — like, that they might have slightly different brain structures.

或者一些小型研究表明,患有这种疾病的男性和女性之间存在某种生物学上的差异,他们的大脑结构可能略有不同。

But the sample sizes in those papers were small, so it remains controversial how true that is or how much it would affect things.

但这些论文中的样本量都很小,所以有关这点的真实性和影响程度仍然存在着争议。

On a totally different note, there's even a chance that this could be more of a social issue.

完全不同的是,这甚至有可能是一个更大的社会性问题。

After all, females tend to show more internalizing symptoms when it comes to ADHD — including things like depression and anxiety.

毕竟,说到注意力缺陷多动症时,女性往往表现出更多的内化症状,包括抑郁和焦虑等。

And males tend show more externalizing ones, like aggression.

男性则更倾向于表现出外在化的一面,比如攻击性。

This could be because of something like hormones, but it could also be influenced by societal pressure and gender roles, or also, both of those things.

这可能是因为荷尔蒙之类的因素,但也可能受到社会压力和性别角色的影响,或者两者兼而有之。

At least in the United States, girls are often discouraged from expressing things like anger, so that could play into all of this somehow.

至少在美国,人们经常劝阻女孩不要表达愤怒等情绪,这可能会以某种方式发挥作用。

Ultimately, this is something scientists will continue researching, so it's likely that we'll keep learning more about why these differences show up.

归根结底,这将是科学家们继续研究的问题,所以我们很可能会继续了解到有关这些差异出现的原因。

For now, though, the fact that people are starting to realize that ADHD isn't just a boy's disorder is a great start.

不过,现在人们开始意识到注意力缺陷多动症不仅是男孩患有的一种疾病,这是一个很好的开始。

Mental health is complicated, and the more people understand what symptoms look like, the more likely someone is to get treatment.

心理健康是复杂的,人们越了解症状的情况,就越有可能得到治疗。

If you want to learn more about ADHD, you can watch our episode about stimulants.

如果你想了解更多关于注意力缺陷多动症的知识,可以收看我们制作兴奋物的有关的节目。

It seems weird that they'd be prescribed to help people with this condition, but they are.

给人们开这款药来治疗注意力缺陷多动症,这似乎很怪异,但它们确实有效。

And there are some good reasons for it.

这样做具有一些很好的理由。

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