ebook_ADHD2019_engl.

44 Rohde, Buitelaar, Gerlach & Faraone was transposed. In this scenario, extensive knowledge on normal human develop- ment is crucial for diagnosing ADHD. For example, a lack of knowledge on the ac- ceptable levels (i.e. normal range) of hyperactivity and impulsivity of a preschooler might bias the assessment towards a false positive diagnosis. 7 DSM-5 has also introduced a new requirement in the preamble. Symptoms should not be best accounted by intellectual disabilities or ODD symptoms. It is clinically important to investigate, for instance, whether a persistent difficulty following instructions is due to inattention or if it is derived by either oppositio- nality or difficulty in understanding rules owing to a certain level of intellectual disability. CRITERION A – LIST OF SYMPTOMS The list of ADHD symptoms in DSM-5 is organized in two dimensions – inattenti- ve and hyperactive/impulsive domains based on previous literature that supported a bidimensional construct for the disorder. 2,7 Nine symptoms are described for Box 3.1 SYNTHESIS OF DSM-5 CRITERIA FOR ADHD A. Either (1) or (2): Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. 1. Inattention: Six (or more) symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: For older adolescents and adults (age 17 and older), at least five symptoms are required. 2. Hyperactivity and impulsivity: Six (or more) symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: For older adolescents and adults (age 17 and older), at least five symptoms are required. B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years. C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings. D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning. E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder.