Protocol - Attention-Deficit Hyperactivity Disorder Symptoms - Adult
The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v1.1) Symptom Checklist is an 18-item, two-part questionnaire designed to determine if the participant exhibits attention-deficit/hyperactivity disorder (ADHD) symptoms.
The shading in the instrument is provided as a guide for scoring and should be removed prior to giving to the respondent for screening.
Ask the patient to complete both Part A and Part B of the Symptom Checklist by marking an X in the box that most closely represents the frequency of occurrence of each of the symptoms.
Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page. As you answer each question, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months.
N e v e r
R a r e l y
S o m e t i m e s
O f t e n
V e r y O f t e n
1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
2. How often do you have difficulty getting things in order when you have to do a task that requires organization?
3. How often do you have problems remembering appointments or obligations?
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?
7. How often do you make careless mistakes when you have to work on a boring or difficult project?
8. How often do you have difficulty keeping your attention when you are doing boring or repetitive work?
9. How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?
10. How often do you misplace or have difficulty finding things at home or at work?
11. How often are you distracted by activity or noise around you?
12. How often do you leave your seat in meetings or other situations in which you are expected to remain seated?
13. How often do you feel restless or fidgety?
14. How often do you have difficulty unwinding and relaxing when you have time to yourself?
15. How often do you find yourself talking too much when you are in social situations?
16. When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?
17. How often do you have difficulty waiting your turn in situations when turn taking is required?
18. How often do you interrupt others when they are busy?
© World Health Organization
If four or more marks appear in the darkly shaded boxes within Part A, then the patient has symptoms highly consistent with ADHD in adults, and further investigation is warranted.
The frequency scores on Part B provide additional cues and can serve as further probes into the patient’s symptoms. Pay particular attention to marks appearing in the darkly shaded boxes. No total score or diagnostic likelihood is utilized for the twelve questions.
Personnel and Training Required
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Self- or proxy-administered questionnaire
Adults aged 18-44 years
The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v1.1) Symptom Checklist was vetted against similar protocols and selected because it is a validated, brief, self-report instrument that is low burden for investigators and respondents.
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|caDSR Common Data Elements (CDE)||Adult Attention Deficit Hyperactivity Disorder Assessment Score||3075460||CDE Browser|
|Logical Observation Identifiers Names and Codes (LOINC)||Attention deficit hyperac adult proto||62750-5||LOINC|
|Human Phenotype Ontology||Attention deficit hyperactivity disorder||HP:0007018||HPO|
Process and Review
Expert Review Panel 4 (ERP 4) reviewed the measures in the Neurology, Psychiatric, and Psychosocial domains.
Guidance from ERP 4 included the following:
· No changes
Protocol Name from Source
The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v1.1)
Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., Howes, M. J., Jin, R., Secnik, K., Spencer, T., Ustun, T. B., & Walters, E. E. (2005). The World Health Organization Adult ADHD Self-Report Scale (ASRS). Psychological Medicine, 35(2), 245-256.
American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Barkley, R. A. (1990). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford Press.
Biederman, J., Faraone, S. V., Spencer, T., Wilens, T., Norman, D., Lapey, K. A., Mick, E., Lehman, B. K., & Doyle, A. (1993). Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. American Journal of Psychiatry, 150, 1792-1798.
Schweitzer, J., Cummins, T., & Kant, C. (2001). Attention-deficit/hyperactivity disorder. Medical Clinics of North America, 85(3), 757-777.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
|PX121501070000||How often do you make careless mistakes when more||N/A|
|PX121501090000||How often do you have difficulty more||N/A|
|PX121501020000||How often do you have difficulty getting more||N/A|
|PX121501080000||How often do you have difficulty keeping more||N/A|
|PX121501030000||How often do you have problems remembering more||N/A|
|PX121501140000||How often do you have difficulty unwinding more||N/A|
|PX121501170000||How often do you have difficulty waiting more||Variable Mapping|
|PX121501060000||How often do you feel overly active and more||N/A|
|PX121501050000||How often do you fidget or squirm with your more||N/A|
|PX121501160000||When you're in a conversation, how often do more||N/A|
|PX121501110000||How often are you distracted by activity or more||N/A|
|PX121501120000||How often do you leave your seat in meetings more||N/A|
|PX121501130000||How often do you feel restless or fidgety?||Variable Mapping|
|PX121501150000||How often do you find yourself talking too more||N/A|
|PX121501180000||How often do you interrupt others when they more||N/A|
|PX121501100000||How often do you misplace or have difficulty more||N/A|
|PX121501040000||When you have a task that requires a lot of more||N/A|
|PX121501010000||How often do you have trouble wrapping up more||N/A|
Attention-Deficit/Hyperactivity Disorder Symptoms
May 12, 2010
A questionnaire to assess attention-deficit/hyperactivity disorder (ADHD), a condition characterized by patterns of inattention, hyperactivity, and impulsivity that is more pronounced than in other individuals at similar developmental levels (APA, 2000).
This measure is used to screen an individual for attention-deficit/hyperactivity disorder (ADHD) and to assess the severity of symptoms. ADHD is found in 3%-7% of school-aged children and demonstrates a familial pattern because first-order relatives of affected individuals are at higher risk for ADHD and other disorders, such as mood, anxiety, and learning disorders. The severity and course of ADHD are also influenced by environmental factors, such as school and family (APA, 2000).
Psychiatric, attention, concentration, impulsivity
|Protocol ID||Protocol Name|
|121501||Attention-Deficit Hyperactivity Disorder Symptoms - Adult|
|121502||Attention-Deficit Hyperactivity Disorder Symptoms - Child|
There are no publications listed for this protocol.