From the Guidelines
The Adult ADHD Self-Report Scale (ASRS-V1.1) is the most recommended screening tool for identifying ADHD in adults, as it is a widely used and effective tool for assessing the frequency of ADHD symptoms, with a positive screen indicated by 4 or more "often" or "very often" responses out of 6 questions 1. When screening for ADHD in adults, it is essential to use a comprehensive approach that includes clinical interviews, medical history review, and ruling out other conditions that may mimic ADHD symptoms. The ASRS-V1.1 is a valuable tool in this process, as it assesses the frequency of symptoms such as inattention, hyperactivity, and impulsivity, which are key diagnostic criteria for ADHD 1. Some key points to consider when using the ASRS-V1.1 include:
- The scale consists of 6 questions that ask patients to indicate the frequency of various symptoms, with a positive screen indicated by 4 or more "often" or "very often" responses 1.
- The ASRS-V1.1 is a self-report scale, which means that patients complete it themselves, making it a useful tool for initial screening and assessment 1.
- The scale is based on the diagnostic criteria for ADHD outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which includes symptoms such as poor attention to detail, difficulty concentrating, and organizational challenges 1. It is crucial to note that no single test can definitively diagnose ADHD, and the ASRS-V1.1 should be used as part of a comprehensive evaluation that includes clinical interviews, medical history review, and ruling out other conditions that may mimic ADHD symptoms 1.
From the Research
Screening Tools for ADHD in Adults
- The Conners' Adult ADHD Rating Scales (CAARS) is a commonly used screening tool for ADHD in adults, as seen in studies 2, 3, 4, 5.
- The CAARS has been found to have a wide range of internal consistency estimates, with lowest values for the Diagnostic and Statistical Manual of Mental Disorders (DSM)-Hyperactive/Impulsive Symptoms subscale when completed by women 2.
- The diagnostic accuracy of the CAARS in a postsecondary population was found to be 69%, with an unacceptably high false positive and false negative rate 4.
- The CAARS can be considered a useful clinical instrument to survey ADHD in adults with intellectual disability, with a resulting prevalence of "ADHD-positive" of 19.6% in one study 5.
- Other rating scales, such as the Wender-Reimherr Adult Attention Deficit Disorder Scale, can also be used to assess ADHD symptoms in adults 3.
- Rating scales can be valuable tools in both assessment and treatment monitoring of ADHD, but caution is indicated due to potential rater errors 6.
Limitations of Screening Tools
- The CAARS should not be the main method by which a diagnosis is made, as it frequently misidentifies individuals with other psychological complaints as having ADHD 4.
- The use of rating scales in adults with intellectual disability may require additional consideration and validation 5.
- The diagnostic accuracy of screening tools may vary depending on the population being studied and the specific tool being used 2, 4.