ATTEN TIO N -D EFIC IT/
H Y P ER A C TIV ITY
D IS O R D ER
D iagnostic C riteria
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
a. Often fails to give close attention to
details
b. Often has difficulty sustaining
attention in tasks or play activities
c. Often does not seem to listen when
spoken to directly
d. Often does not follow through on
instructions
e. Often has difficulty organizing tasks
f. Often avoids, dislikes, or is reluctant
to engage in tasks that require
sustained mental effort
g. Often loses things necessary for
tasks or activities
h. Is often easily distracted by
extraneous stimuli
i. Is often forgetful in daily activities
2. Hyperactivity and impulsivity
a. Often fidgets with or taps hands or
feet or squirms in seat.
b. Often leaves seat in situations when
remaining seated is expected
c. Often runs about or climbs in
situations where it is inappropriate
d. Often unable to play or engage in
leisure activities quietly.
e. Is often on the go
f. Often talks excessively
g. Often blurts out an answer before a
question has been completed
h. Often has difficulty waiting for his/her
turn
i. 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. The symptoms do not occur
exclusively during the course of
schizophrenia or another psychotic
disorder and are not better
explained by another mental
disorder
D iagnostic Features
The essential feature of ADHD is a
persistent pattern of inattention
and/or hyperactivity-impulsivity
that interferes with functioning or
development.
Inattention
Hyperactivity excessive motor
activity
Impulsivity hasty actions that occur
in the moment without forethought
Manifestations of the disorder must
be present in more than one setting
A ssociated Features Supporting
D iagnosis
May include low frustration tolerance,
irritability, or mood lability
By early adulthood, ADHD is associated
with an increased risk of suicide
attempt, primarily when comorbid with
mood, conduct, or substance use
disorders.
P revalence
ADHD occurs in most
cultures in about 5% of
children and about 2.5% of
adults.
D evelopm ent and Course
Symptoms are difficult to
distinguish form highly variable
normative behaviors before age 4
years
ADHD is most often identified
during elementary school years
Symptoms of motoric hyperactivity
become less obvious in
adolescence and adulthood, but
difficulties with restlessness,
inattention, poor planning, and
impulsivity persist.
Preschool hyperactivity
Elementary school inattention
Adolescence fidgetiness or an
inner feeling of jitteriness,
restlessness, or impatience
Adulthood along with inattention
and restlessness, impulsivity may
remain problematic
Risk and Prognostic Factors
Temperamental
Environmental
Genetic and physiological
Course modifiers
FunctionalConsequences of
AD H D
Reduced school performance and
academic attainment
Social rejection
Poorer occupational performance
(adults)
Children with ADHD are more likely to
develop conduct disorder and antisocial
personality disorder
More likely to be injured
An elevated likelihood of obesity
D iff
erentialD iagnosis
Oppositional defiant disorder
Intermittent explosive disorder
Other neurodevelopmental
disorders
Specific learning disorder
Intellectual disability
Autism spectrum disorder
Reactive attachment disorder
Anxiety disorders
Depressive disorders
Bipolar disorder
Disruptive mood dysregulation disorder
Substance use disorders
Personality disorders
Psychotic disorders
Medication-induced symptoms of
ADHD
Neurocognitive disorders
Com orbidity
Oppositional defiant disorder co-
occurs with ADHD in approximately
half of children with the combined
presentation and about a quarter
with the inattentive presentation
Conduct disorder co-occurs in about
a quarter of children or adolescents
with the combined presentation
Specific learning disorder co-occurs
with ADHD
Anxiety disorders and major
depressive disorder occur in
minority of individuals with ADHD
In adults, antisocial and other
personality disorders may cooccur with ADHD
Obsessive-compulsive disorder,
tic disorders, and autism
spectrum disorder may co-occur
with ADHD.