View Full Version : Diagnostic Criteria for ADHD
stanzen 11-15-05, 10:10 AM The year 2000 Diagnostic & Statistical Manual for Mental Disorders (DSM-IV-TR) provides criteria for diagnosing ADHD. The criteria are presented here in modified form in order to make them more accessible to the general public. They are listed here for information purposes and should be used only by trained health care providers to diagnose or treat ADHD.
DSM-IV Criteria for ADHD
I. Either A or B:
1. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:
Inattention
1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
2. Often has trouble keeping attention on tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
5. Often has trouble organizing activities.
6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
8. Is often easily distracted.
9. Is often forgetful in daily activities.
2. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:
Hyperactivity
1. Often fidgets with hands or feet or squirms in seat.
2. Often gets up from seat when remaining in seat is expected.
3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
4. Often has trouble playing or enjoying leisure activities quietly.
5. Is often "on the go" or often acts as if "driven by a motor".
6. Often talks excessively.
Impulsivity
1. Often blurts out answers before questions have been finished.
2. Often has trouble waiting one's turn.
3. Often interrupts or intrudes on others (e.g., butts into conversations or games).
2. Some symptoms that cause impairment were present before age 7 years.
3. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).
4. There must be clear evidence of significant impairment in social, school, or work functioning.
5. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
Based on these criteria, three types of ADHD are identified:
1. ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months
2. ADHD, Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months
3. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion 1B is met but Criterion 1A is not met for the past six months.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.
From:
http://www.cdc.gov/ncbddd/adhd/symptom.htm
Types of Professionals Who Make the Diagnosis
<table border="2"> <tbody><tr><th>Specialty </th> <th>Can Diagnose ADHD </th> <th> Can prescribe medications, if needed </th> <th> Provides counseling or training </th> </tr> <tr> <td> Psychiatrists </td> <td> yes </td> <td> yes </td> <td> yes </td> </tr> <tr> <td> Psychologists</td> <td> yes</td> <td> no</td> <td> yes</td> </tr> <tr> <td> Pediatricians or family physicians</td> <td> yes</td> <td> yes</td> <td> no</td> </tr> <tr> <td> Neurologists</td> <td> yes</td> <td> yes</td> <td> no</td></tr></tbody> </table>
stanzen 11-18-05, 01:50 AM What are characteristics of adult ADD?
An adult with ADHD has a different complex of symptoms than a child does. As a person matures, the childhood symptoms of ADHD may evolve:
Hyperactivity may evolve into
uncontrolled arousal
feeling overwhelmed
talking excessively.
Inattentiveness may evolve into
unwilled tuning-out
the inability to focus on mundane tasks.
Impulsiveness may evolve into
irritability
quick anger
inadequate censorship of rude or insulting thoughts
poor timing in interactions.
Gabor Maté, and Hallowell and Ratey (authors of Driven to Distraction) also include these characteristics of Adult ADD:
may be perceived as aloof and arrogant or tiresomely talkative and boorish
compulsive joking, often about personal life history and feelings
pressured rapid-fire speech, seemingly random and aimless hopping from one topic to the next
procrastination - difficulty starting tasks
incompletions - tasks or book reading begun but not finished before new projects or new books are started, leaving a never-ending to-do list
insecurity and self-esteem issues because of unmet high personal expectations
often high achiever, even overachiever, but with poor self-image because of beliefs that more could be accomplished if not for disorganization
What other conditions may accompany ADHD?
A number of other psychiatric conditions may accompany ADHD (such accompaniment is called "comorbidity"). These conditions can mask or magnify ADHD, which must be treated on its own.
Some possible accompanying disorders are:
learning disabilities
Tourette's syndrome
oppositional defiant disorder
conduct disorder
bipolar disorder
anxiety
depression
Might the inability to focus on mundane tasks include counting, performing simple arithmetic, or perhaps mixing up the meaning of words?
geckogirl 03-26-06, 06:17 AM Having trouble with arithmetic is a problem of working memory which is compromised in AD/HD. The other stuff i am not sure about. Counting might be a problem of sustained attention? I have trouble finding the right words and it has gotten better on meds. Though I am not sure if it is generally a prob to do with AD/HD. Word retrieval is definately a function of the frontal lobes though.
meadd823 05-29-06, 02:13 PM Might the inability to focus on mundane
Yes a lot of ADDers find it impossible to focus on things they consider boaring!
sss180b 08-18-06, 09:00 PM thanks for the info on adult ADHD most of the info out there is on children. so it is good to see this stuff posted.
SDspedTEACHER 08-25-06, 09:06 PM Why does the diagnosis never discuss something to the effect of not being able to self regulate our mental state? I am either to hyper and have many of these sympotms from above...or feel like a Zombie and could fall asleep even in the middle of the day or an hour after an 8 hour sleep. By self regulate I don't mean with Caffeine or Red Bull (like I've read many of us do)etc, I mean why is it all or nothing?
meadd823 01-18-07, 12:00 PM Here is a site that has one of those ADD on-line test that you don't have to register to take. Some may find it helpful
Do you have ADD (https://healthmanager.webmd.com/webmd/advHQ/GuestUser.aspx?StartID=1003)
mhyper790 04-04-07, 09:52 AM Meadd823 I tried going to the site you posted "Do you have ADD" but it said I needed to be logged in...
As for the post on ADD I was hyper as a kid and lot of the hyperness and symptoms I had as a kid stil exists today. I have imporved in that I'm now more able to control myself and my actions. So I don't tell tupid jokes that make no sense. Though I still shake my leg constently. Sometimes I get so hyper at owrk that I have to realease my enegry some how so I start shaking my leg.
I just wish more people would understand that I have ADHD and quit telling me that ADHD is an excuse that you come up with for not being able to control yourself. It drives me NUTS :)
FightingBoredom 04-04-07, 03:35 PM Meadd823
I just wish more people would understand that I have ADHD and quit telling me that ADHD is an excuse that you come up with for not being able to control yourself. It drives me NUTS :)
When people say that just ask them if acting stupid is the ploy they use to get out of being asked to do intelligent things or is it something they can't control? :D
wellwell 04-28-07, 12:27 PM When I read dianosis criteria, I see a lot of myself. But a lot of it is controlled, sometime with difficulty, but I've learnt to curb a lot of my reflexes. But it's not easy and it's stressful to do. Could I be hiding my ADD???
I'm considered as having very good attention to details, but whether people see them or not, I've often made significant mistakes, omissions ... careless I'm not sure because I always read things over and over to make sure I didn't miss anything (and usually find I have) and even then things get by me. I definitely miss things when I read. I know I do. Often lots of things, especially if my concentration is not at its best. And I'm not saying this because I'm a perfectionist. In my line of work (computers), I know I've done things that I really should not have done. Either it didn't get noticed or I was able to make up an excuse. I work with very little supervision from people who understand what I do. So I think my mistakes often go unnoticed.
I think I often lose things, but I will search for things endlessly so I find them again a lot of the time. But it's an exhausting thing, both searching when things are lost, or the prospect of not being able to find things I need. And I spend an inordinate amount of time looking for things. It's not at all infrequent. And the knowledge that I lose things makes me nervous... what will I lose next, when, what will it be, will it cause me issues???
I do sit still, or fairly still, but it's really hard for me to remain seated for a long period of time. It gets uncomfortable and I need to move. Once I've been sitting for a while, I "itch" to move and do have to switch position. I seem to have an issue with that more than others around me. BUT I TRY AND COMPLY AND STAY PUT. AND I STAY PUT AS MUCH AS I CAN. I PUT UP WITH IT EVEN THOUGH I'M GOING NUTS INSIDE. When things are like that, needless to say my concentration on what's going on in the room isn't at its best...
One thing I've ALWAYS done and that I cannot control well at all is, especially when under stress, I bite the inside of my mouth, raw, till it hurts and bleeds. I may not be moving externally, but the inside of my mouth is being torn to bits. Very hard for me to control. Very. I'm in my late 40s and have always done that. My parents tried to stop me, I've tried to stop.
I used to move my legs lots in school. I still do sometime, usually when stressed. I chew pens. When in meetingts, I draw, write things on paper... especially if I'm disconnecting, but as a rule, I make lines on paper, draw different faces, different things. Sometime several pages. I do tune out unless I'm being directly addressed. Although I work on paying attention, sometime a question is asked of me and I'm not too sure what is being discussed. But I work hard at not doing that.
As an adult, I try to have proper behavior. But I have improper imaginary behavior A LOT. I escape mentally.
I tend to be always busy. Always things to do. One thing I'm not is bored. I'm just tired, stressed, exhausted, though. I think I'm managing my time poorly which partly causes that, and I'm managing priorities poorly too, another cause. I'm not good at dropping stuff, deciding that one priority has to go...
I am a HUGE talker (though I curb it). Always have been very talkative. And I'm a fast talker too. As a kid I talked all the time, drove some people crazy. Once, coming home from school, I missed the city bus (I talked a lot on the bus.) A friend on the bus got up to tell the driver that I was running behind trying to catch it but some people threated him because they didn't want me on (because I talked too much.) These were strangers. But I drove them crazy.
And I spoke very, very fast. Someone at work once told me that in order to speak that fast my brain must be going at a phenomenal speed. I don't think it was meant as an insult actually. I work on that hard and have managed to do better, but my mind is still going very fast.
My acute sense of guilt and responsibility (my family was fairly strict in a moral sense) helps me curb a lot of impulsive behaviors. But yes, I sometime say (or really want to say things) I ought to not say. I write long angry emails, but I've learnt not to always send them right away. It is extremely hard for me to wait my turn in a group. I interrupt people all the time when they speak. I realize it. I know I shouldn't. I don't like doing it. But I do it anyway.
If I curb so many things, do I need help? At like to be able to control things, maybe even a bit better, but not feel so stressed out about it. There are so many things I could tell my psychiatrists, but his questions were so specific the first time we met and he allowed me so little time to answer in between each question.
I wonder if externally I appear so normal that even for him it's hard to tell how my mind spins and spins and spins. It feels like O'Hare up there.
Can anyone relate to some of what I'm saying? Could these be symptoms of ADD. The more I think about this, the more agitated I feel. It's almost as though I'm throwing oil on the fire right now. Like I've managed to find a balance in my life and that reminding myself of all of this is agitating me and bringing me back to where I was. The problem tough is that in my head I rarely feel like things are balanced. I do, sometime, but most of the time I don't. Things always fluctuate a great deal. My mood has a tendency to fluctuate a lot. Extremes sometime. Again, I work at controlling things.
Anyway, anyone's comments would be appreciated. I'm only trying to figure things out and the reading helps, but at the same time confuses me...
QueensU_girl 04-28-07, 12:51 PM I'm glad to see that it is not written in stone that all criteria must exist before age 6 or 7 or whatever.
Meadd823 I tried going to the site you posted "Do you have ADD" but it said I needed to be logged in...
As for the post on ADD I was hyper as a kid and lot of the hyperness and symptoms I had as a kid stil exists today. I have imporved in that I'm now more able to control myself and my actions. So I don't tell tupid jokes that make no sense. Though I still shake my leg constently. Sometimes I get so hyper at owrk that I have to realease my enegry some how so I start shaking my leg.
I just wish more people would understand that I have ADHD and quit telling me that ADHD is an excuse that you come up with for not being able to control yourself. It drives me NUTS :)
I feel the exact same way. From time to time when add symptoms seemed to be particularly bad I would bring it up with friends. I just stopped mentioning it because of the harsh critiques some of them would issue. It seems only people that have it, really understand what I go through.
TiffanyM 09-14-07, 03:48 PM I am not too sure of how to respond to people's blogs. I hope that I am suppose to add it under Quote. As a response to Well Well, I am exactly the same way and I do have ADD and I have realized that I need some meds. I tried Strattera for six weeks and my mind was so clear and I was at peace like never before. My mind goes a hundred miles a minute and I want it to stop....I had to get off of Strattera because my blood pressure is elevated and now I am very irritible, hopefully that will go away soon. I am considering trying stimulants because I have heard that it could make a total life changing difference and I am at an age where I need some help, I do not want to deal or fight to feel better on my own. This is why God made doctors and I am taking advantage of it finally, after 30+ years....it is time that I changed.
I think I fit all of that. Sweet.
mhyper790 04-02-08, 11:55 AM Might the inability to focus on mundane tasks include counting, performing simple arithmetic, or perhaps mixing up the meaning of words?
This sounds like symptoms of aLearning disability, which can be associated with ADHD.
mctavish23 04-12-08, 09:15 PM I've posted on this several times in the past, so I won't bore you with repitition.
Please keep in my that ADHD is, among other things, a Developmental Disability;
in that the symptoms represent developmental delays; when compared to same age/gender, non-ADHD peers.
ADHD is also over 80+ % genetic/ inherited.
Most importantly, it is a Dimensional Disorder of Human Behavior, in that the symptoms are behaviors that every human being enages in.
Therefore,what makes it ADHD, as compared to something else?
The answer is : The clinical threshold is "impairment."
" No impairment, No disorder."
The "gold standard" definition of a "Disorder ( Any disorder, not just ADHD)" is by Rutgers Ethics Professor , Jerome Wakefield.
The most succinct presentation is available in the landmark research study : International Consensus 2002.
It's signed off on by over 80 of the world's foremost scientists, and has 19 pages of references on ADHD being a "real" disorder.
There's certainly more than one place to view it, however, it's readily available at :
www.russellbarkley.org
tc
mctavish23
(Robert)
meadd823 05-24-08, 09:47 AM Meadd823 I tried going to the site you posted "Do you have ADD" but it said I needed to be logged in...
sorry they must have changed it - try this one
Attention Deficit Disorder (ADHD) Test
(http://psychcentral.com/addquiz.htm)
|
|