Top critical review
I have misgivings for Inattentive sufferers and/or women
Reviewed in the United States on October 22, 2016
As a young adult woman recently diagnosed with ADHD, I bought several books to help me try and understand my life in this new frame. This was the first book I started reading. My spirits fell, however, as I realized through the first few chapters that Dr. Barkley would probably tell me I don't have ADHD.
I was a bright child and didn't start doing poorly in school until high school. I don't drive aggressively. I am capable of planning, it just takes me longer than most and sometimes the system breaks down. I don't get "bored" doing repetitive tasks (in fact I tend to enjoy them because it means I can daydream). According to Dr. Barkley, this means it is less likely that I have adult ADHD.
In fact, at the little mention Dr. Barkley makes of primarily inattentive ADHD, he actually spends more time explaining his newly ideated disorder "sluggish cognitive tempo," which shares a lot of characteristics with ADHD-PI but seems to involve a more hypoactive personality than a "flighty" one. From other sources, there doesn't seem to be a lot of evidence that this is actually a separate disorder. Above all, he can offer no advice about how to deal with this nor the case of when you're in a gray area between ADHD and not-ADHD -- a sidebar implies that if you don't fit his criteria perfectly, you must be ascribing your normal failure to meet very high standards to a mental disorder you do not have.
However, other sources indicate that ADHD of a significant impairment level in women can look different from that of men -- and they tend to have ADHD-PI -- and Dr. Barkley does not ever mention this, as far as I can tell. Dr. Barkley says that there is no evidence hormones outside of menopause (such as during menstruation) can affect ADHD symptoms, and leaves it at that, but many women have reported noticing a difference during their periods of the efficacy of their ADHD drugs, and scientists are currently researching this question. One of Dr. Barkely's checklists indicates you should have seen significant impairment by middle school, but The National Center for Girls and Women with ADHD has indicated that many women don't experience a significant problem until as late as college.
Above all I resent his statement that "Saying that a person functioning as well as or even better than the average or typical person can still be considered impaired makes a mockery of the concept of 'disorder' and does a disservice to those struggling with really not being able to function as well as the norm." There is some truth in this statement, but an attitude like this would ignore the suffering of many women, where research has shown that many external observers would rate those women as not having a problem, when they do and ADHD treatment makes their lives easier and often also makes secondary depression and anxiety go away. To quote one review of scientific studies, "Knowledgeable informants (eg, families, teachers, colleagues) may be more likely to overlook ADHD symptoms in women and girls and are therefore less likely to refer them for diagnosis or treatment. "
Nothing I can find in this book seems to mention how much of the research he relies on was done on adult women. I'm going to look into this further as well as report back later on whether I find his suggested coping mechanisms helpful, still. In the meantime I hope to find a different resource that will reflect my own experience better.
In short, this book may help you -- but don't be discouraged if you don't match it perfectly. I didn't let myself get discouraged, and now I have a diagnosis and my life has improved considerably with treatment.