Attention deficit disorder dsm criteria
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DSM Criteria for Attention Deficit Disorder: Core Symptoms and Subtypes
The DSM criteria for Attention Deficit Hyperactivity Disorder (ADHD), which includes what is commonly referred to as attention deficit disorder (ADD), focus on two main symptom domains: inattention and hyperactivity-impulsivity. These symptoms must be present to a degree that is inconsistent with the individual's developmental level and must cause significant impairment in social, academic, or occupational functioning 1269.
The DSM-IV and DSM-5 both define three subtypes of ADHD:
- Predominantly Inattentive Type (ADD)
- Predominantly Hyperactive-Impulsive Type
- Combined Type (both inattention and hyperactivity-impulsivity)
These subtypes are based on the number and type of symptoms present at the time of assessment 1235+1 MORE.
Symptom Criteria and Duration
To meet the DSM criteria, symptoms must:
- Be present for at least six months
- Be observed in two or more settings (e.g., home, school, work)
- Have started before a certain age (DSM-IV: before age 7; DSM-5: before age 12)
- Cause clear evidence of interference with social, academic, or occupational functioning
- Not be better explained by another mental disorder 1469
Inattention Symptoms (Examples)
Symptoms of inattention include:
- Often fails to give close attention to details or makes careless mistakes
- Has difficulty sustaining attention in tasks or play
- Does not seem to listen when spoken to directly
- Does not follow through on instructions and fails to finish tasks
- Has difficulty organizing tasks and activities
- Avoids or dislikes tasks that require sustained mental effort
- Often loses things necessary for tasks
- Is easily distracted
- Is forgetful in daily activities 1269
Hyperactivity-Impulsivity Symptoms (Examples)
Symptoms of hyperactivity-impulsivity include:
- Fidgets or squirms in seat
- Leaves seat in situations when remaining seated is expected
- Runs about or climbs in inappropriate situations (in adolescents/adults, may be limited to feeling restless)
- Unable to play or engage in leisure activities quietly
- Is "on the go" or acts as if "driven by a motor"
- Talks excessively
- Blurts out answers before questions have been completed
- Has difficulty waiting turn
- Interrupts or intrudes on others 1269
Age and Contextual Considerations
The DSM-5 increased the age of onset criterion from 7 to 12 years to better capture cases that may not be recognized early, especially in those with predominantly inattentive symptoms. The criteria also emphasize that symptoms should be interpreted in the context of the individual's developmental stage and should be present in more than one setting 146.
Impairment and Exclusion Criteria
A diagnosis requires that symptoms cause significant impairment in functioning. The symptoms should not occur exclusively during the course of another disorder, such as autism spectrum disorder or schizophrenia 169.
Changes and Controversies in DSM Criteria
The DSM-5 introduced changes such as raising the age of onset and clarifying symptom descriptions for different age groups. These changes have increased the number of individuals who meet criteria for ADHD, especially among adolescents and adults. However, concerns remain about over-diagnosis and the specificity of some newly added symptoms 147.
Conclusion
The DSM criteria for attention deficit disorder (ADHD) require a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, with symptoms present in multiple settings and not better explained by another disorder. The criteria have evolved to better capture the range of presentations across the lifespan, but challenges remain in ensuring accurate and specific diagnosis 1246+2 MORE.
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