Though attention deficit behavior hyperactivity disorder (ADHD) is known to affect a child's performance in school, new research suggest ADHD increases the risk in adolescent girls to commit suicide.

Adolescent girls who are diagnosed with ADHD demonstrate early signs of impulsivity, which makes them three to four times more likely to attempt suicide and two to three times more likely to report injuring themselves.

The first stage of the study conducted in the San Francisco area by lead author, Stephen Hinshaw, PhD, a psychology professor at the University of California, Berkeley, monitored 228 girls between the ages of six and 12 years of age.

The girls were recruited from schools, mental health centers, pediatric practices and community advertisements. Each participant underwent extensive diagnostic assessments, which revealed that 140 girls indeed suffered from ADHD. The other 88 girls were used as the control group. Forty-seven girls were diagnosed with ADHD-inattentive, a subtype of ADHD, where the individual is less inclined to act out, but still are confronted with challenges when it comes to paying attention, whereas the other 93 had ADHD-combined, a combination of hyperactive, impulsive and inattentive symptom (the most common subtype of ADHD referred for treatment).

Of the original cohort, 95 percent of participants completed the study including the follow up. Researchers followed up with each individual at the five and 10 year mark. When the girls were in their teenage and young adult years (17-24), researchers questioned their families about an array of life challenges including substance abuse, suicide attempts, self-injury and depressive symptoms. The young ladies were also tested for academic achievement and neuropsychological functioning.

Results demonstrated 22 percent of those who suffered from ADHD-combined had attempted suicide at least once, whereas eight percent of the girls who suffered from ADHD-inattentive and only six percent of the control group attempted suicide. Additionally, 51 percent of the girls who suffered from ADHD-combined reported to inflict self-injury, such as scratching, cutting, burning or hitting oneself, in contrast to the 19 percent control group and 29 percent in the ADHD-inattentive group. Researchers did find there was no difference in substance abuse.

"ADHD in girls and women carries a particularly high risk of internalizing, even self-harmful behavior patterns," said Hinshaw. "We know that girls with ADHD-combined are more likely to be impulsive and have less control over their actions, which could help explain these distressing findings."

This study was published in the Journal of Consulting and Clinical Psychology.