Gender Biases Toward People With Difficulty in Balancing Work and Family Due to ADHD: Two Case Vignette Randomized Studies Featuring Japanese Laypersons and Psychiatrists

Ryuhei So; Misuzu Nakashima; Jane Pei-Chen Chang; Marcus P J Tan; Ryoma Kayano; Yasuyuki Okumura; Toru Horinouchi; Toshitaka Ii; Toshihide Kuroki; Tsuyoshi Akiyama

doi:10.7759/cureus.34243

Gender Biases Toward People With Difficulty in Balancing Work and Family Due to ADHD: Two Case Vignette Randomized Studies Featuring Japanese Laypersons and Psychiatrists

Cureus. 2023 Jan 26;15(1):e34243. doi: 10.7759/cureus.34243. eCollection 2023 Jan.

Authors

Ryuhei So¹, Misuzu Nakashima^{2

3}, Jane Pei-Chen Chang^{4

5}, Marcus P J Tan^{6

7}, Ryoma Kayano⁸, Yasuyuki Okumura⁹, Toru Horinouchi¹⁰, Toshitaka Ii¹¹, Toshihide Kuroki², Tsuyoshi Akiyama¹²

Affiliations

¹ Health Promotion and Human Behavior, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, JPN.
² Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, JPN.
³ Department of Clinical Research, National Hospital Organization Hizen Psychiatric Medical Center, Saga, JPN.
⁴ Department of Psychiatry, China Medical University Hospital, Taichung, TWN.
⁵ Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, GBR.
⁶ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, GBR.
⁷ Department of Child and Adolescent Psychiatry, South London and Maudsley NHS Foundation Trust, London, GBR.
⁸ Center for International Collaborative Research, Nagasaki University, Nagasaki, JPN.
⁹ Epidemiology, Initiative for Clinical Epidemiological Research, Tokyo, JPN.
¹⁰ Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, JPN.
¹¹ Department of Psychiatry, Aichi Medical University, Nagoya, JPN.
¹² Department of Neuropsychiatry, NTT Medical Center Tokyo, Tokyo, JPN.

Abstract

Objective The gender gap in labor force participation is likely larger in adults with attention deficit hyperactivity disorder (ADHD) than that in the general population. Thus, we investigated whether gender affected the perception toward persons displaying ADHD symptoms and experiencing difficulty in balancing work and family. Methods Both Japanese laypersons and psychiatrists were recruited for web-based surveys in March and October 2020 via an online survey company, Cross Marketing Inc., and the secretariat of the Japanese Society of Psychiatry and Neurology, respectively. The participants were randomly assigned to read either a male or female case vignette. The vignettes were identical, except for the gender of the patient in the case. The primary and secondary outcomes were the respondents' opinions on the seriousness of the case and the degree to which the case's wish should be maintained, using sliding scales of 0-100. Results We included 560 laypersons and 585 psychiatrists. Neither cohort differed in most outcomes between the groups assigned to the male and female case vignettes. Among laypersons, the average score of seriousness was 58.8 in the female-vignette group and 58.6 in the male-vignette group (mean difference, 0.15; 95% confidence interval, -4.9 to 5.2). Among psychiatrists, the average score of seriousness was 53.9 in the female-vignette group and 53.7 in the male-vignette group (mean difference, 0.18; 95% confidence interval, -3.1 to 3.4). Similarly, between-group differences in the opinions on the degree to which the case's wish should be maintained were 1.2 in laypersons and 0.63 in psychiatrists. We found no significant interaction between the gender of the case and the respondent's gender in any of the outcomes. Conclusion Our results did not support the hypothesis that women were more likely to be pressured to prioritize family over work than men were when there was difficulty balancing work and family due to ADHD symptoms.

Keywords: adult attention deficit hyperactivity disorder (adhd); gender bias; gender gap; labor force participation; randomized controlled trial.

Grants and funding

RS has received research grants from the Japan Society for the Promotion of Science (JSPS); Ministry of Health, Labor and Welfare, Japan; Japan Agency for Medical Research and Development; and Kobayashi Magobe Memorial Medical Foundation; speaker’s honoraria from Otsuka Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd., and Takeda Pharmaceutical Co., Ltd., outside the submitted work. RS also reports an employment position at CureApp Inc., which develops software as medical devices. YO has received personal fees from MSD K.K., Otsuka Pharmaceutical, and Kurashiki Central Hospital, outside the submitted work. He is also an employee of the Real World Data, Co., Ltd., and president of the Initiative for Clinical Epidemiological Research. TI is the CEO of Mental Compass, Inc. MN, JPCC, MPJT, RK, TH, TK, and TA declare no conflicts of interest.