ADHD Test for Adults (ASRS-v1.1)
The ASRS (Adult ADHD Self-Report Scale) is an 18-item self-report questionnaire that screens adults for ADHD by rating how often each DSM symptom occurred over the past 6 months. Its first 6 items form the Part A screener, where 4 or more responses in the shaded range is a positive screen.
For professional reference, research, and education only. Not for diagnosis or medical advice.
ASRS Part A Screener Interpreter
Enter a total score to see its range.
Count how many of the 6 Part A items fall in the shaded (elevated frequency) range. 4 or more is a positive screen.
Part A items in the shaded range Interpretation 4+ Positive screenSymptom pattern is consistent with adult ADHD and warrants a full clinical evaluation. A positive screen is not a diagnosis. 0–3 Negative screenBelow the 4-item threshold. In the 2005 validation the screener's sensitivity was 68.7%, so a negative screen does not rule out ADHD when symptoms are present. Kessler RC et al. Psychol Med. 2005;35(2):245-256 (PMID 15841682); ≥4 of 6 rule as applied in Silverstein et al. Fam Pract. 2018 (PMID 29177453).
The ASRS-v1.1 (Adult ADHD Self-Report Scale) is a World Health Organization screening scale for adult ADHD. In its 2005 validation, the 6-item Part A screener had sensitivity of 68.7% and specificity of 99.5% against blind DSM-IV clinical diagnoses in a community sample [1]. The full 18-item version maps to the DSM-5-TR inattention and hyperactivity/impulsivity symptom domains.
ADHD in adults: what to expect
A WHO World Mental Health survey screened adults aged 18 to 44 in ten countries:
- Across countries. Estimated prevalence of adult ADHD averaged 3.4%, ranging from 1.2% to 7.3% [5].
- By country income. Estimates were lower in lower-income countries (1.9%) than in higher-income countries (4.2%) [5].
- Treatment. Few of those cases were treated for ADHD [5].
Women and adults with mainly inattentive rather than hyperactive symptoms are often identified later. ADHD is a neurodevelopmental disorder that persists from childhood, though presentations evolve significantly with age: overt hyperactivity typically decreases while inattention, executive dysfunction, and emotional dysregulation often remain prominent or intensify.
In adults, ADHD commonly presents as chronic difficulty with sustained attention, task completion, organization, and time management; impulsive decision-making; emotional dysregulation; inner restlessness; and difficulty with long-term planning. Rejection Sensitive Dysphoria (RSD), intense emotional pain in response to perceived criticism or failure, is a clinically significant feature in many adults with ADHD not yet included in formal diagnostic criteria.
What does the ASRS measure?
The ASRS includes 18 questions about the frequency of recent DSM Criterion A symptoms of adult ADHD, spanning the inattention and hyperactivity/impulsivity domains. The full 18-item version maps to the DSM-5-TR symptom domains; the 6-item Part A screener was selected from the 18 questions by stepwise logistic regression to best match clinical classification [1].
How do you give the ASRS?
The ASRS is self-administered. You rate how often each symptom occurred over the past 6 months using a 5-point scale from Never to Very Often. Part A (items 1–6) is the screener; Part B (items 7–18) adds a fuller view of symptom frequency.
How do you score and interpret the ASRS?
The first 6 items (Part A) are the validated screener. 4+ items shaded = positive screen. Responses in the shaded zone (Often or Very Often for most items) count as positive indicators.
The 18-item Symptom Checklist requires a licence from NYU for electronic and commercial use; the 6-item ASRS screener is available for clinical and commercial use with attribution.
A positive ASRS screen does not diagnose ADHD; a full evaluation is required. DSM-5-TR requires ≥5 symptoms per domain (adults ≥17) with onset before age 12 and cross-setting impairment.
Psychometric properties
- Screening accuracy. Against blind clinical DSM-IV diagnoses in 154 respondents from the US National Comorbidity Survey Replication, the unweighted 6-item screener outperformed the full 18-item ASRS: sensitivity 68.7% v. 56.3%, specificity 99.5% v. 98.3%, total classification accuracy 97.9% v. 96.2% [1].
- Health-plan sample. In 668 health plan subscribers, the screener had an area under the ROC curve of 0.90 against clinician diagnoses; internal consistency was 0.63–0.72 and test-retest reliability 0.58–0.77 [2].
- Symptom checklist. In 60 adults with ADHD, the pilot 18-item checklist had high internal consistency (Cronbach's α 0.88) and agreed closely with clinician ratings on the ADHD Rating Scale (intraclass correlation 0.84) [3].
- Test-retest in non-ADHD adults. In 104 primary care adults who screened negative, the screener total score was stable over time (Spearman's rho = 0.78; ICC = 0.75) [4].
Limitations
- Screening, not diagnosis. A positive screen warrants a full evaluation; DSM-5-TR diagnosis also requires onset before age 12 and impairment across settings, which the ASRS does not assess.
- Moderate sensitivity. With 68.7% sensitivity in the 2005 validation, roughly 1 in 3 adults with ADHD may screen negative [1].
- Self-report bias. Responses can be shaped by mood, stress, insight and coping strategies, and conditions such as anxiety, depression, PTSD and sleep disorders share overlapping symptoms.
- Validation populations. The cut-point was calibrated in US community and health-plan samples against DSM-IV criteria.
Adult ADHD presentations
DSM-5-TR recognizes three presentations. Adults most commonly have Predominantly Inattentive or Combined presentations. Hyperactive-Impulsive presentation alone is less common in adults.
ADHD vs common mimics
Many conditions share symptoms with ADHD. Differential diagnosis and comorbidity assessment are critical components of ADHD evaluation. The table below outlines the most frequent overlapping conditions.
| Condition | Shared features with ADHD | Key distinguishing features |
|---|---|---|
| Generalized anxiety disorder | Difficulty concentrating, restlessness, sleep disturbance | Anxiety is the primary driver of concentration problems; worries are future-oriented and ego-dystonic. ADHD concentration failures are situational (boredom, low novelty). |
| Major depression | Low energy, poor concentration, motivation difficulties | Episodic course; concentration impairment fluctuates with mood. ADHD concentration difficulties are chronic and cross-situational from early development. |
| Bipolar disorder | Elevated impulsivity, decreased need for sleep (hypomania), distractibility | Episodic; between episodes executive function may normalize. ADHD is persistent and onset is in childhood. |
| PTSD | Hypervigilance, concentration difficulties, emotional dysregulation | Symptoms tied to trauma history and triggered by reminders. ADHD onset precedes trauma exposure in most cases. |
| Sleep disorders | Inattention, fatigue, poor memory | Symptoms may remit with treatment of the primary sleep disorder. ADHD inattention is present even when well-rested. |
| Autism spectrum conditions | Executive dysfunction, sensory sensitivities, social difficulties | Communication and social reciprocity differences are more central; stimming/restricted interests distinguishing. High comorbidity — both can co-occur. |
Adult ADHD assessment tools
A comprehensive ADHD evaluation draws on tools serving different purposes: initial screening, detailed symptom rating, and structured diagnostic interviewing. No single tool is sufficient for diagnosis; the ASRS Part A is designed for case-finding, not diagnostic confirmation.
| Tool | Type | Purpose | Notes |
|---|---|---|---|
| ASRS-v1.1 Part A (6 items) | Self-report screener | Community/clinical case-finding | Sensitivity 68.7%, specificity 99.5% vs DSM-IV clinical diagnosis [1]; AUC 0.90 in a health-plan sample [2]. Binary positive/negative output. |
| ASRS-v1.1 Full (18 items) | Self-report symptom checklist | Symptom frequency across inattention and hyperactivity/impulsivity domains | Maps directly to DSM-5-TR Criterion A symptoms; used as a symptom-frequency checklist and dimensional severity supplement, not a standalone screen. |
| Conners' Adult ADHD Rating Scales (CAARS) | Self-report and observer rating | Broad symptom assessment; norm-referenced | Includes DSM-IV subscales and infrequency index; validated short and long forms. Observer version helps document cross-setting impairment. |
| DIVA 2.0 / DIVA-5 | Semi-structured diagnostic interview | Full diagnostic evaluation per DSM-IV/DSM-5 criteria | Covers current symptoms and childhood onset across multiple life domains; DIVA 2.0 matched CAADID diagnoses in all 40 outpatients in a validation study [6]; DIVA-5 is the DSM-5 update. |
| ADHD Rating Scale (ADHD-RS) | Clinician-administered | Symptom severity and treatment monitoring | Widely used in clinical trials; covers all 18 DSM symptoms with clinician prompts. |
| Wender Utah Rating Scale (WURS) | Self-report retrospective | Retrospective childhood symptom confirmation | Assesses presence of childhood ADHD symptoms in adults; useful adjunct when developmental history is unavailable. |
For individuals: This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
Related
Billing
In the US, the ADHD Test for Adults (ASRS-v1.1) is usually billed under these CPT codes. Payer rules vary.
- First published
- 2005
- Terms
- Created by Dr. Lenard Adler (NYU) and Dr. Ronald Kessler (Harvard).
Assessments
- Aberrant Behavior Checklist
- ADHD Clinical Outcome Scale, Self-Report (ACOS-SR)
- ASRS v1.1 Scoring · Adult ADHD Self-Report Scale
- AQ Scoring & Cutoffs · Autism Spectrum Quotient
- Autism Spectrum Quotient, Brief (AQ-10)
- CARS-2 (Childhood Autism Rating Scale)
Dot size shows how strongly each scale's condition is linked to this one in HiBoop's co-occurrence map.
Common paths
- Cognitive Behavioural Therapy
CBT reduced core ADHD symptoms versus waiting list and when added to medication in a Cochrane review of 14 RCTs (700 adults); evidence quality was low.
Lopez PL, et al. Cochrane Database Syst Rev. 2018;3(3):CD010840.
FAQ
What is the ASRS-v1.1 and how does it work?
The Adult ADHD Self-Report Scale (ASRS-v1.1) is an 18-item questionnaire developed by Ronald Kessler and colleagues in collaboration with the World Health Organization. You rate how often each symptom occurred over the past 6 months using a 5-point scale from Never to Very Often. The first 6 items form the validated Part A screener, where responses in the shaded zone (Often or Very Often for most items) count as positive indicators.
What does a positive ASRS screen mean?
A positive screen (4 or more shaded responses in Part A) indicates that your symptom pattern is consistent with adult ADHD and warrants a full clinical evaluation. A positive ASRS result is not a diagnosis — ADHD diagnosis requires a structured clinical interview, developmental history, and ruling out other conditions. Many adults with positive screens benefit significantly from evaluation and, if confirmed, from treatment.
Can adults have ADHD if they were never diagnosed as children?
Yes, though DSM-5-TR requires symptom onset before age 12 for an ADHD diagnosis. Many adults were never identified in childhood — particularly women and girls, who more often present with inattentive rather than hyperactive symptoms and are less frequently referred for evaluation. Retrospective developmental history and collateral information from parents or early school records can help establish childhood onset during an adult diagnostic evaluation.
How is adult ADHD different from childhood ADHD?
The core neurobiological features are the same, but adult presentation often looks quite different. Overt physical hyperactivity typically diminishes with age and manifests instead as inner restlessness, difficulty sitting through meetings, or a need to stay constantly busy. Inattention and executive dysfunction — time management, organization, task completion, and working memory — often remain prominent or increase in impact as adult responsibilities grow more complex.
References
- 1.Kessler RC, Adler L, Ames M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med. 2005;35(2):245-56.
- 2.Kessler RC, Adler LA, Gruber MJ, et al. Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. Int J Methods Psychiatr Res. 2007;16(2):52-65.
- 3.Adler LA, Spencer T, Faraone SV, et al. Validity of pilot Adult ADHD Self-Report Scale (ASRS) to Rate Adult ADHD symptoms. Ann Clin Psychiatry. 2006;18(3):145-8.
- 4.Silverstein MJ, Alperin S, Faraone SV, et al. Test-retest reliability of the adult ADHD Self-Report Scale (ASRS) v1.1 Screener in non-ADHD controls from a primary care physician practice. Fam Pract. 2018;35(3):336-341.
- 5.Fayyad J, De Graaf R, Kessler R, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190:402-9.
- 6.Ramos-Quiroga JA, Nasillo V, Richarte V, et al. Criteria and concurrent validity of DIVA 2.0: a semi-structured diagnostic interview for adult ADHD. J Atten Disord. 2019;23(10):1126-1135.
ASRS v1.1 © New York University and the President and Fellows of Harvard College. Created by Dr. Lenard Adler (NYU) and Dr. Ronald Kessler (Harvard).
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