DSM-5 ADHD Diagnostic Criteria: Real-Life Examples in Adults

🧠 Quick Study Guide: DSM-5 ADHD in Adults

• 🗓️ Onset Criteria: Several inattentive or hyperactive-impulsive symptoms must be present before age 12. For adults, this often relies on retrospective recall.
• 🔢 Symptom Count: For adults (age 17 and older), at least 5 symptoms from either the Inattention domain OR the Hyperactivity-Impulsivity domain are required. (Note: Children require 6+ symptoms).
• 🌐 Pervasiveness: Symptoms must be present in two or more settings (e.g., home, work, social situations, school). This highlights that ADHD isn't just situational.
• 📉 Functional Impairment: Clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning. It's not just having symptoms, but how they impact life.
• 🚫 Exclusion Criteria: The symptoms are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, psychotic disorder, substance intoxication or withdrawal).
• 🔍 Inattention Examples (Adults):
  • 📝 Often fails to give close attention to details or makes careless mistakes (e.g., overlooking details in reports).
  • 🎯 Often has difficulty sustaining attention in tasks or play activities (e.g., struggles to focus during long meetings).
  • 👂 Often does not seem to listen when spoken to directly (e.g., mind wandering during conversations).
  • ⏳ Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., procrastinating on complex projects).
  • 🔑 Often loses things necessary for tasks or activities (e.g., keys, wallet, documents).
• 🏃 Hyperactivity & Impulsivity Examples (Adults):
  • 🪑 Often fidgets with or taps hands or feet, or squirms in seat (e.g., restless during quiet activities).
  • 🗣️ Often talks excessively (e.g., dominating conversations, blurting out thoughts).
  • 🛑 Often has difficulty waiting their turn (e.g., interrupting others in lines or conversations).
  • 🚗 Often "on the go," acting as if "driven by a motor" (e.g., feeling restless, difficulty relaxing).
  • 💬 Often interrupts or intrudes on others (e.g., cutting into conversations, taking over tasks).

📝 Practice Quiz: Test Your Knowledge!

1. According to DSM-5, an adult (age 17+) seeking an ADHD diagnosis must present with at least how many symptoms from either the inattention or hyperactivity-impulsivity domain?

   A) 3

   B) 4

   C) 5

   D) 6

2. Sarah, 35, reports struggling with focus and organization her whole life, but only noticed significant impairment after starting a demanding career at age 28. For a DSM-5 ADHD diagnosis, when must several of her symptoms have been present?

   A) Before age 6

   B) Before age 12

   C) Before age 18

   D) Before the onset of significant impairment

3. David, 40, experiences severe inattention only when he's at work, struggling to complete tasks. At home and in social settings, his focus is generally fine. What DSM-5 criterion for ADHD might this presentation not meet?

   A) Functional impairment

   B) Symptom count

   C) Pervasiveness across settings

   D) Exclusion of other disorders

4. Emily, 30, has several symptoms of inattention, like difficulty organizing and forgetfulness. However, she manages her work and personal life effectively and feels her symptoms don't cause her any significant distress or problems. Which DSM-5 criterion would likely prevent an ADHD diagnosis?

   A) Symptom onset before age 12

   B) Presence in multiple settings

   C) Functional impairment

   D) Exclusion of other disorders

5. Mark, 45, frequently misses deadlines because he gets sidetracked by minor details in his reports, often forgets appointments, and leaves tasks unfinished because he gets bored. Which core DSM-5 ADHD symptom domain do these behaviors primarily represent?

   A) Hyperactivity

   B) Impulsivity

   C) Inattention

   D) Emotional dysregulation

6. During a team meeting, Lisa, 38, constantly taps her pen, fidgets in her chair, and frequently interrupts colleagues before they've finished speaking. She often feels an inner restlessness that makes it hard to sit still. These behaviors are most indicative of which DSM-5 ADHD symptom domain?

   A) Inattention

   B) Hyperactivity and Impulsivity

   C) Executive dysfunction

   D) Oppositional defiance

7. A 50-year-old client reports new-onset difficulty concentrating and restlessness over the past year, coinciding with job loss and marital issues. Prior to this, they had no history of such symptoms. What is a crucial next step in considering a DSM-5 ADHD diagnosis?

   A) Immediately diagnose ADHD due to current symptoms.

   B) Focus solely on symptom count, ignoring life circumstances.

   C) Rule out other potential causes like depression, anxiety, or adjustment disorder.

   D) Assume the symptoms are normal aging effects.