What does the Adult Self-Report Scale (ASRS) indicate?

Understanding the Adult ADHD Self-Report Scale (ASRS)

The Adult ADHD Self-Report Scale (ASRS) is a validated screening tool that helps identify adults who may have Attention-Deficit/Hyperactivity Disorder (ADHD) and require further comprehensive evaluation.

What the ASRS Measures

The ASRS is designed to assess the presence and severity of ADHD symptoms in adults based on DSM criteria. There are different versions of the ASRS:

• Original ASRS v1.1: Contains 18 items corresponding to the DSM-IV ADHD symptoms
• Expanded ASRS: Includes the original 18 items plus additional items assessing executive function deficits (EFDs) and emotional dyscontrol (EC), for a total of 31 items 1

Key Components of the ASRS

The ASRS measures three primary symptom domains:

• Inattention: Difficulty sustaining attention, organizational problems, forgetfulness
• Hyperactivity: Restlessness, excessive talking, difficulty engaging in quiet activities
• Impulsivity: Interrupting others, difficulty waiting turn, blurting out answers

Interpreting ASRS Scores

Research validates the following interpretation guidelines:

• ASRS-18 (original version):

  • Scores of 23-26 or higher suggest a high likelihood of ADHD 2

• ASRS-31 (expanded version):

  • Scores of 70-82 or higher suggest a high likelihood of ADHD 1
  • The expanded version has high internal consistency (Cronbach's alpha) for all sections 1

Clinical Significance and Validity

The ASRS has demonstrated:

• High reliability: Internal consistency (Cronbach's alpha 0.88-0.89) 3
• Strong validity: High concurrent validity with clinician-administered scales 3, 2
• Consistent structure: Research supports a bifactor model with one general ADHD factor and three specific factors (inattention, hyperactivity, and impulsivity) 4
• Measurement invariance: The scale performs consistently across gender and age groups 4

Clinical Application

The ASRS is valuable for:

1. Initial screening: Identifying adults who may need comprehensive ADHD evaluation
2. Monitoring treatment response: Tracking symptom changes over time
3. Research purposes: Standardized assessment of ADHD symptoms

Important Considerations

• The ASRS is a screening tool, not a diagnostic instrument. Positive results require follow-up with a comprehensive clinical evaluation including:

  • Detailed developmental history
  • Assessment of functional impairment
  • Evaluation of comorbid conditions
  • Ruling out alternative explanations for symptoms

• Self-reported symptoms show strong agreement with clinician ratings. Studies show high correlation (Spearman's ρ's = 0.78-0.89) between self-reported ASRS and clinician-rated AISRS (Adult ADHD Investigator Symptom Rating Scale) 2

• Early identification is critical due to the significant personal, familial, and societal costs associated with untreated adult ADHD 5

Conclusion

The ASRS is a psychometrically sound, efficient screening tool for identifying potential adult ADHD. Positive screens should prompt comprehensive evaluation by qualified healthcare professionals to confirm diagnosis and guide appropriate treatment planning.