Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria:
A. A persistent pattern of inattention and/or hyperactivity-impulsivity 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 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 behavior, 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 (e.g., overlooks or misses Details, work is inaccurate).
2. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty
remaining focused during lectures, conversations, or lengthy reading).
3. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even
in the absence of any obvious distraction).
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or
duties in the workplace (e.g., starts tasks but quickly loses focus and is easily
sidetracked).
5. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential
tasks; difficulty keeping materials and belongings in order; Messy, disorganized work;
has poor time management; fails to meet deadlines).
6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental
effort (e.g., schoolwork homework; for older adolescents and adults, preparing reports,
completing forms, reviewing lengthy papers).
7. . Often loses things necessary for tasks or activities (e.g., school materials, pencils, books,
tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
8. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may
include unrelated thoughts).
9. Is often forgetful in daily activities (e.g., doing chores, running errands; for older
adolescents and adults, returning calls, paying bills, keeping appointments).
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 behavior, Defiance, hostility,
or a 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 (e.g., leaves his or her
place in the classroom, in the office or other workplace, or in other situations that
require remaining in place).
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” (e.g., is unable to be or
uncomfortable being still for extended time, as in restaurants, meetings; may be
experienced by others as being restless or difficult to keep up with).
6) Often talks excessively.
7) Often blurts out an answer before a question has been completed (e.g. Completes
people’s sentences; cannot wait for turn in conversation).
8) Often has difficulty waiting his or her turn (e.g., while waiting in line).
9) Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities;
may start using other people’s things without asking or receiving permission; for
adolescents and adults, may intrude into or take over what others are doing).
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. E. The symptoms do not occur exclusively during the course of schizophrenia or
F. Another psychotic disorder and are not better explained by another mental
G. Disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality
H. Disorder, substance intoxication or withdrawal).
Specify current severity:
Mild: Few, if any, symptoms in excess of those required to make the diagnosis Are present, and
symptoms result in no more tha minor impairments in social or Occupational functioning.
Moderate: Symptoms or functional impairment between “mild” and “severe” are Present.
Severe: Many symptoms in excess of those required to make the diagnosis, or Several
symptoms that are particularly severe, are present, or the symptoms Result in marked
impairment in social or occupational functioning.
Diagnostic Features:
The essential feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of
Inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
Inattention manifests behaviorally in ADHD as wandering off task, failing to follow through on
Instructions or finishing work or chores, having difficulty sustaining focus, and being
disorganized and is not attributable to defiance or lack of comprehension. Hyperactivity refers
to excessive motor activity (such as a child running about) when it is not appropriate, or
excessive Fidgeting, tapping, or talkativeness. In adults, hyperactivity may manifest as extreme
restlessness or wearing others out with their activity. Impulsivity refers to hasty actions that
occur in the moment without forethought, which may have potential for harm to the individual
(e.g., darting into the street without looking). Impulsivity may reflect a desire for immediate
rewards or an inability to delay gratification. Impulsive behaviors may manifest as social
intrusiveness (e.g. Interrupting others excessively) and/or as making important decisions
without consideration of Long-term consequences (e.g., taking a job without adequate
information).
Associated Features:
Delays in language, motor, or social development are not specific to ADHD but often co-occur.
Emotional dysregulation or emotional impulsivity commonly occurs in children and adults with
ADHD. Individuals with ADHD self-report and are described by others as being quick to anger,
easily frustrated, and overactive emotionally. Even in the absence of a specific learning disorder,
academic or work performance is often Impaired. Individuals with ADHD may exhibit
neurocognitive deficits in a variety of areas, Including working memory, set shifting, reaction
time variability, response inhibition, vigilance,
And planning/organization, although these tests are no sufficiently sensitive or specific to serve
as diagnostic indices.
Prevalence:
Population surveys suggest that ADHD occurs worldwide in about 7.2% of children; however,
Cross-national prevalence ranges widely, from 0.1% to 10.2% of children and adolescents.
Prevalence is higher in special populations such as foster children or correctional settings. In a
cross-national meta-analysis, ADHD occurred in 2.5% of adults.
Sex- and Gender-Related Diagnostic Issues:
ADHD is more frequent in males than in females in the general population, with a ratio of
approximately 2:1 in children and 1.6:1 in adults. Females are more likely than males to present
Primarily with inattentive features. Sex differences in ADHD symptom severity may be due to
differing genetic and cognitive liabilities between sexes.
Association With Suicidal Thoughts or Behavior:
ADHD is a risk factor for suicidal ideation and behavior in children. Similarly, in adulthood, ADHD
is associated with an increased risk of suicide attempt, when comorbid with mood,
Conduct, or substance use disorders, even after controlling for comorbidity. Suicidal thoughts
are also more common in ADHD populations than in non-ADHD control subjects. ADHD
predicted
Persistence of suicidal thoughts in U.S. Army soldiers.
Comorbidity:
Although ADHD is more common in males, females with ADHD have higher rates of a number of
comorbid disorders, particularly oppositional defiant disorder, autism spectrum disorder, and
Personality and substance use disorders.
