DSM-IV-TR Subtypes of Attention Deficit Hyperactivity Disorder
According to the DSM-IV-TR, five criteria must be present for a person to be diagnosed with ADHD:
- Persistent pattern of inattention and/or hyperactivity and impulsivity more frequent and severe than others of same age or developmental level
- Symptoms present before age 7
- Symptoms present in more than one setting
- Symptoms cause problems in social, academic, or work settings
- Rule out that other psychological disorders are causing symptoms
There are four subtypes of ADHD found in the DSM-IV-TR
- 314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type
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- Six (or more) symptoms of inattention (but fewer than six symptoms of hyperactivity-impulsivity) have persisted for at least six months. Hyperactivity may still be a significant clinical feature in many such cases, whereas other cases are more purely inattentive.
- Characteristics:
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- Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
- Often has difficulty sustaining attention in tasks or play activities
- Often does not seem to listen when spoken to directly
- Often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace
- Often has difficulty organizing tasks and activities
- Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
- Often loses things necessary for tasks or activities
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
- 314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type
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- Six (or more) symptoms of inattention and six (or more) symptoms of hyperactivity-impulsivity have persisted for at least six months.
- 314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type
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- Six (or more) symptoms of hyperactivity-impulsivity (but fewer than six symptoms of inattention) have persisted for at least 6 months. According to the DSM-IV-TR inattention may often still be a significant clinical feature in such cases.
- Characteristics (hyperactivity):
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- Often fidgets with hands or feet or squirms in seat
- Often leaves seat in classroom or in other situations in which remaining seated is expected
- Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents and adults, may be limited to subjective feelings or restlessness)
- Often has difficulty playing or engaging in leisure activities quietly
- Is often "on the go" or often acts if "driven by a motor"
- Often talks excessively
- Characteristics (impulsivity):
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- Often blurts out answers before questions have been completed
- Often has difficulty awaiting turn
- Often interrupts or intrudes on others
- 314.9 Attention-Deficit/Hyperactivity Disorder, Not Otherwise Specified
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- Often blurts out answers before questions have been completed
It should be noted that individuals can present with symptoms of both inattention and hyperactivity-impulsivity, and there are individuals in whom one or the other pattern is predominant. The appropriate subtype should be indicated based on the predominant symptom pattern for the past six months.