Adult ADHD Screening Tool: Adult ADHD Self-Report Scale (ASRS v1.1)

ADHD affects 2.5% of adults worldwide, but many people remain undiagnosed because of the persistent misconception that it's a childhood condition people outgrow, coupled with symptoms being mistaken for other psychiatric disorders, gender-based differences in presentation that leave women overlooked, and clinicians' unfamiliarity with adult manifestations of the disorder.

Identifying ADHD in adults becomes more complex because 80% of people with ADHD also have other conditions like depression, anxiety, or bipolar disorder. The DSM-5 lists three distinct types: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined.

The varying presentations of this condition highlight the essential role of appropriate screening in establishing an accurate diagnosis.

This article includes a validated screening tool to screen for adult ADHD and help you spot important symptoms for yourself or someone else.

Recognising Symptoms of ADHD in Adults

ADHD symptoms stand out from regular forgetfulness or restlessness because they persist across different settings. These symptoms consistently disrupt many areas of life, unlike temporary difficulties that everyone faces.

ADHD shows up differently in adults compared to children. Research shows approximately 65% of people diagnosed in childhood still face challenging symptoms as adults. Only about 15% of these adults meet the DSM-5 diagnostic criteria. The symptoms don't go away - their presentations just change over time.

Inattention Symptoms in Adults:

• Tasks and projects remain unfinished

• Organization and priority-setting become challenging

• Appointments and obligations slip through the cracks

• Boring or repetitive work leads to easy distraction

• Items get misplaced often

• Conversations become hard to focus on

Hyperactivity-Impulsivity Symptoms:

• Restlessness feels more internal than physical

• Money decisions happen on impulse

• Talking becomes excessive with frequent interruptions

• Relaxation proves difficult

• Taking turns in conversations becomes challenging

Adults with ADHD tend to leave a "trail of incompletions" behind them - projects fall through, deadlines slip by, and commitments fade away. Time looks different to them, appearing as "a collection of events rather than a sequence".

These symptoms must interfere with normal functioning to qualify as a disorder. Professional assessment will help if you notice ongoing difficulties in multiple areas that started before age 12.

ADHD rarely comes alone. More than half of adults with ADHD also struggle with behavioral health or mood disorders such as depression or anxiety. The connection with autism spectrum disorder runs deep too - about half of people with autism also have ADHD.

Choosing the Appropriate ADHD Test or Quiz for Self-Screening

Researchers have created several validated screening tools for adult ADHD. The World Health Organization's Adult ADHD Self-Report Scale (ASRS v1.1) stands out as the most widely used and scientifically backed option.

The 18-item ASRS examines all DSM-based ADHD symptoms and has two subscales (i.e. Inattentiveness and Hyperactivity/ Impulsivity) that help identify ADHD subtypes. The scoring system uses a 5-point Likert scale from 0 to 4.

Instructions to use ASRS

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, click on the box that best describes how you have felt and conducted yourself over the past 6 months.

Part A: Total scores of 14 or higher suggests your symptoms are highly consistent with ADHD in adults.

Part B: Total scores of 27 or higher suggests significant impact that inattention or hyperactivity/impulsivity has on your life.

Convenient as they may be, online ADHD tests cannot replace professional diagnosis. Screeners are good at correctly identifying non-ADHD individuals but may show false positives. The best positive predictive values in clinical samples reach only 61%, and most fall below 20%.

When to Explore ADHD Clinically

If your scores on ASRS are in the high range, there might be a need for further exploration of how ADHD traits influence daily life and well-being.

ADHD traits may require support when they are accompanied by:

• Persistent struggles with focus, leading to difficulty completing work or personal tasks.

• Impulsivity that results in difficulties with decision-making or social interactions.

• Significant procrastination, disorganisation, or difficulty following through on plans.

Getting a Formal ADHD Diagnosis in Singapore

Singapore requires professional medical evaluation for an official ADHD diagnosis. This process differs from self-screening tools and gives patients access to treatment options and support services.

Who Can Diagnose ADHD

Psychologists and psychiatrists are the only professionals qualified to diagnose ADHD in Singapore. These experts use standardised assessment tools with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria to ensure accurate diagnosis.

The Diagnostic Process

The first step involves a detailed evaluation that has:

• Detailed psychiatric history assessment

• Clinical interviews and structured questionnaires

• Review of childhood and school records

• Interviews with informants (usually parents or close family)

• Objective attention tests or brain scans

Benefits of Formal Diagnosis

Official diagnosis helps patients understand and validate their lifelong challenges. Adults with ADHD often feel emotional relief after receiving a diagnosis as they realise they aren't "lazy" but have a treatable condition. The diagnosis gives access to educational accommodations, specialised support services, and tailored intervention plans.

Conclusion

ADHD in adults goes undiagnosed by a lot, even though it affects millions of people worldwide. This article explored ADHD screening, symptoms, and diagnosis, within the context of Singapore.

Research has shown that ADHD shows up differently in adults than in children, which makes accurate screening vital. The ASRS and similar tools are a great way to get early understanding, but they should be seen as first steps toward professional evaluation rather than final diagnostic tools. A professional diagnosis not only validates your personal challenges but also helps you get targeted treatments and support services.

ADHD can be complex and affect your daily life in many ways. Your first step should be booking an appointment with a qualified healthcare provider to understand and manage your symptoms better. Note that asking for help shows strength, not weakness, and the right diagnosis can make your life much better.

FAQs

Q1. What are some common symptoms of ADHD in adults? Common symptoms include chronic difficulty completing tasks, problems with organization, frequent forgetfulness, easily getting distracted, impulsive decision-making, and internal restlessness. These symptoms must persistently disrupt multiple areas of life to be considered indicative of ADHD.

Q2. How accurate are online ADHD screening tools? While online screening tools like the Adult ADHD Self-Report Scale (ASRS) can provide initial insights, they are not definitive. These tools have high specificity but may produce false positives. A positive result should always be followed up with a professional evaluation for an accurate diagnosis.

Q3. Who can diagnose ADHD in Singapore? In Singapore, only psychologists and psychiatrists are qualified to formally diagnose ADHD. They use standardised assessment tools and follow the DSM-5 criteria to ensure an accurate diagnosis.

Q4. What are the benefits of getting a formal ADHD diagnosis as an adult? A formal diagnosis provides validation for lifelong struggles, access to appropriate treatment options, and eligibility for educational accommodations and support services. It can also bring emotional relief by explaining difficulties that were previously misunderstood as personal shortcomings.