Dsm-5 criteria for adhd in adults
Pro Research Analysisby 
Searched over 200M research papers
DSM-5 Criteria for ADHD in Adults
Introduction to DSM-5 ADHD Criteria in Adults
Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition that often persists into adulthood, affecting various aspects of life including work, relationships, and overall quality of life. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), provides specific criteria for diagnosing ADHD in adults, which have been subject to various studies to assess their validity and applicability.
Prevalence and Symptom Thresholds
Increased Prevalence with DSM-5 Criteria
Research indicates that the prevalence of ADHD in adults is higher when using DSM-5 criteria compared to DSM-IV. For instance, a study found that the prevalence of ADHD among young adults increased by 27% when using DSM-5 criteria, with a prevalence rate of 3.55% compared to 2.8% under DSM-IV . Another study reported a significant increase in the number of adults meeting the ADHD criteria, with a 65% rise in prevalence when the symptom threshold was lowered from six to five symptoms .
Symptom Dimensions and Predictive Value
The DSM-5 criteria for ADHD in adults include two main symptom dimensions: inattention and hyperactivity/impulsivity. Studies have shown that inattentive symptoms are the most significant predictors of impairment in adults 12. The best symptomatic thresholds identified were five symptoms of inattention and four symptoms of hyperactivity/impulsivity .
Psychometric Properties and Validity
Construct and Discriminant Validity
The psychometric properties of the DSM-5 ADHD criteria have been evaluated in various studies. One study highlighted that the adult ADHD phenotype is primarily characterized by inattentive symptoms, which are more closely associated with impairment . However, the bi-dimensional structure of ADHD proposed by DSM-5 showed issues with construct and discriminant validity when applied to adults .
Screening Tools and Diagnostic Accuracy
The World Health Organization's Adult ADHD Self-Report Scale (ASRS) has been updated to align with DSM-5 criteria, showing high sensitivity and specificity in distinguishing ADHD cases from non-cases . The French version of the ASRS-5 also demonstrated good diagnostic accuracy, although performance varied depending on clinical variables such as comorbid disorders .
Age-of-Onset Criterion
Impact of Age-of-Onset on Diagnosis
The DSM-5 raised the age-of-onset criterion for ADHD from 7 to 12 years. Studies have shown that adults with late-onset ADHD (onset between 7 and 12 years) exhibit similar levels of functional impairment and quality of life issues as those with early-onset ADHD (onset before 7 years) 48. This suggests that the new age-of-onset criterion does not over-include individuals without impairment and supports its validity 48.
Neuropsychological Functioning
Comparative studies on neuropsychological functioning between early-onset and late-onset ADHD groups found no significant differences, further supporting the adequacy of the DSM-5 age-of-onset criterion .
Conclusion
The DSM-5 criteria for diagnosing ADHD in adults have led to an increased prevalence of diagnosed cases, primarily due to the lowered symptom threshold and revised age-of-onset criterion. While inattentive symptoms are the most significant predictors of impairment, the overall validity of the DSM-5 criteria in adults is supported by various studies. However, the criteria's construct and discriminant validity issues suggest a need for further refinement to ensure accurate diagnosis and effective treatment.
Sources and full results
Most relevant research papers on this topic