Table 1.

Diagnostic and Statistical Manual of Mental Disorders-IV criterion A symptoms of attention-deficit/hyperactivity disorder and examples of adult clinical presentations.

Diagnostic criteria*	Examples of adult clinical presentations
Inattention
Often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities	Misses important details in tasks at work or important steps in completing tasks. Submits incomplete forms
Often has difficulty sustaining attention in tasks or play activities	Moves on to another project or task without completing the first task. Becomes ‘bored’ easily by the task at hand. Complains of a ‘short attention span’
Often does not seem to listen when spoken to directly	Appears ‘spacey’ and distracted to others. Has to be given verbal instructions repeatedly. Spouse/partner complains that individual ‘doesn’t listen’
Often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace	Chronic difficulty completing the last few steps necessary to finish a project. Has multiple half-completed projects around the house. Low workplace productivity. Difficulty keeping promises or fulfilling obligations for others
Often has difficulty organizing tasks and activities	Often cannot figure out where to start on a project and the appropriate order of steps. Physical space is messy and disorganized. Focuses on less important details of a task. Difficulty seeing the ‘big picture’ and the steps necessary to get there
Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)	Low tolerance for even brief boring, nonstimulating tasks. Avoids tedious tasks, resulting in neglecting to take care of important responsibilities (e.g., filing taxes)
Often loses things necessary for tasks or activities	Constantly misplaces keys, wallet, cell phone or other important objects. Often cannot find important papers or computer files necessary to complete tasks
Is often easily distracted by extraneous stimuli	Constantly off-task due to distractions from others, the internet or anything else more interesting than the task at hand. Complains of often being distracted by unrelated, irrelevant thoughts during tasks or conversations
Is often forgetful in daily activities	Chronically late to appointments because he or she forgets them. Misses time-sensitive obligations to others. Often forgets to complete important tasks later in the day. Poor prospective memory
Hyperactivity–impulsivity
Often fidgets with hands or feet or squirms in seat	Appears more restless than the average adult, especially in nonstimulating situations. Fidgeting persists across several types of situations. Others complain that the person is constantly tapping things, in motion, etc.
Often leaves seat in classroom or in other situations in which remaining seated is expected	Finds it difficult to sit through a work meeting, college lecture or religious service without finding an excuse to get up (e.g., going to the bathroom)
Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)	Complains of almost constant urge to get up and move around. Endorses ‘mental restlessness’. Mounting discomfort when physical movement is not possible
Often has difficulty playing or engaging in leisure activities quietly	Others complain about excessive noisiness (e.g., loud talking and ‘banging around’). Cannot engage in quiet, solitary activity for extended periods of time (e.g., reading a book)
Is often ‘on the go’ or often acts as if ‘driven by a motor’	Constantly moving from one activity to another. Can’t seem to sit down and ‘just relax’
Often talks excessively	Difficulty inhibiting talking when it is inappropriate or in relation to the social context. Others complain they can’t ‘get a word in edgewise’. The adult notices that others become annoyed and disinterested when they are talking
Often blurts out answers before questions have been completed	Constantly finishing others’ sentences. Answers questions before he or she has fully understood what is being asked
Often has difficulty awaiting turn	Will avoid standing in lines because it is almost painful to have to wait. Low frustration tolerance in situations requiring waiting (e.g., in traffic and standing in line at the bank). Will sometimes leave situations, such as stores, if there is a line
Often interrupts or intrudes on others (e.g., butts into conversations or games)	Dominates conversations and may appear disinterested in what others have to say, waiting for his or her next turn to talk. Asks socially inappropriate questions. Interrupts others while they are talking or while they are busy with another task. Others complain that he or she seems inconsiderate or pushy. May report that he or she must ‘work hard’ to resist these urges and show restraint

^*Six or more inattentive and/or hyperactive–impulsive symptoms that have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level.

Note: An adult ADHD diagnosis is not based on symptom counts alone. A diagnosis of ADHD also requires onset of symptoms with impairment in childhood, impairment present in two or more settings, clear evidence of clinically significant impairment and that symptoms are not better accounted for by another disorder. For adults, relevant settings can include home, work, educational settings, romantic relationships, social settings, parenting role, driving a motor vehicle and dealing with others in the community. DSM-IV also specifies that, for individuals who have symptoms that no longer meet full criteria (but did in the past), ADHD in partial remission may be diagnosed.

ADHD: Attention-deficit/hyperactivity disorder; DSM: Diagnostic and Statistical Manual of Mental Disorders.