ADHD Diagnostic Criteria


The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) contains the Diagnostic Criteria for the most common mental disorders including: description, diagnosis, treatment, and research findings.  Below is the Diagnostic Criteria for diagnosing Attention-Deficit / Hyperactivity Disorder:

A. A persistent pattern of inattention and/or hyperacitivity-impusivity that interferes with functioning or development, as characterized by (1) and/or (2):

1) Inattention: Six (or more) of the following symptoms have persisted for at least six months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:

Note: The symptoms are not solely a manifestation of oppositional behaviour, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.

  1. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
  2. Often has difficulty sustaining attention in tasks or play activities.
  3. Often does not seem to listen when spoken to directly.
  4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
  5. Often has difficulty organizing tasks and activities.
  6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
  7. Often loses things necessary for tasks or activities.
  8. Is often easily distracted by extraneous stimuli.
  9. Is often forgetful in daily activities.

 

2) Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:

Note: The symptoms are not solely a manifestation of oppositional behaviour, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.

  1. Often fidgets with or taps hands or feet or squirms in seat.
  2. Often leaves seat in situations when remaining seated is expected.
  3. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
  4. Often unable to play or engage in leisure activities quietly.
  5. Is often 'on the go,' acting as if 'driven by a motor'.
  6. Often talks excessively.
  7. Often blurts out an answer before a question has been completed.
  8. Often has difficulty waiting his or her turn.
  9. Often interrupts or intrudes on others.

 

B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.

C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g. at home, school, or work; with friends or relatives; in other activities).

D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g. mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

Based on these criteria, three types of ADHD are identified:

  • ADHD, Combined Presentation: If both Criterion A1 (inattention) and Criterion A2 (hyperactivity-impulsivity) are met for the past 6 months.
  • ADHD, Predominantly Inattentive Presentation: If Criterion A1 (inattention) is met but Criterion A2 (hyperactivity-impulsivity) is not met for the past six months
  • ADHD, Predominantly Hyperactive/Impulsive Presentation: If Criterion 2A (hyperactivity-impulsivity) is met and Criterion A1 (inattention) is not met for the past six months.

 

The above information has been printed from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.