The Adult ADHD Self-Report Scale (ASRS v1.1) is an 18-item self-report questionnaire designed to assess Attention Deficit Hyperactivity Disorder (ADHD) symptoms in adults (18+).
This scale is based on the World Health Organization Composite International Diagnostic Interview (2001), and the questions are consistent with both DSM-IV and DSM-5-TR criteria, specifically worded to reflect symptom manifestation in adults (Kessler et al., 2005).
The ASRS scale is useful for screening and diagnosis of ADHD among adults 18+ and should be used in conjunction with a clinical interview to provide additional clinical information.
Part A contains 6 items that are most predictive of ADHD diagnosis (Kessler et al., 2007). Part B contains 12 additional questions based on DSM criteria that provide additional cues and can serve as further probes into the client’s symptoms. The scoring was updated at the suggestion of the authors (Harvard Medical School, 2024) to enhance clinical utility and diagnostic accuracy, moving from a dichotomous scoring system to a more nuanced Likert-based approach.
The ASRS has two subscales that can be used to identify ADHD subtypes (Stanton et al., 2018):
ASRS results are presented as Part A, Part B, Total Score and the subscale scores. The primary scoring method is a 5 point Likert scale, from 0 to 4. Older variations of the ASRS use a dichotomous scoring method (0 or 1) which continues to be utilised when calculating the percentage of items endorsed for each sub-type.
Part A scores are most predictive of an ADHD diagnosis (Kessler et al., 2007) and therefore have the most screening and diagnostic utility. However, other aspects of the ASRS can aid in the considerations around applying an ADHD diagnosis based upon overall consistency or differences observed between parts or subscales.
A plot is displayed that shows the client’s Part A score in relation to non-ADHD and ADHD samples (Adler et al., 2018). This plot shows the middle two quartiles (25th to 75th percentiles) as they related to a group of individuals who had been independently assessed as having ADHD, and typical adults without an ADHD diagnosis (the community sample). The cutoff for ADHD is marked at 14, indicating that individuals who score 14 or above show symptoms that are consistent with an ADHD diagnosis.
If the respondent scores 14 or more in Part-A, then the symptom profile of the individual is consistent with a DSM-5-TR ADHD diagnosis in adults (Adler et al., 2006; Kessler et al., 2007). The Part A descriptor provides an indication of whether the respondent meets the DSM criteria, with scores in the high or very high range being considered clinically significant:
The scores on Part B provide additional information about a broader set of ADHD symptom severity and the impact that inattention or hyperactivity has on their life. A descriptor in the high or very high range (27 or above) is clinically significant:
Over and above the key interpretation metrics from Part A and Part B, the total score (sum of part A and B) is converted into a percentile to contextualise responses in comparison to normative data of adults (Adler et al., 2018). For example, a percentile of 90 represents that the respondent scored higher than 90 percent of typical adults in their age range in the community. In most cases, someone with ADHD will score higher than the 79th percentile (raw score of 40). The total score is described as:
While Part A contains the items that have been found to be most predictive of ADHD (Kessler et al., 2007), looking at both the Part B score and description (and percentile) can also be informative about diagnosis in cases where the Part A score doesn’t reach the threshold. This scale should always be used in conjunction with a clinical interview to provide additional clinical information important for diagnosis. A WURS-25 could also be useful to retrospectively evaluate the presence and severity of childhood symptoms of ADHD.
Three ADHD subscales are presented according to factors identified by Stanton et al. (2018). Raw scores (as determined by the original ASRS dichotomous scoring method where each score is assigned as either 0 or 1) as well as the percentage of items endorsed are presented, providing more specific information about the focus of difficulties:
Considering the percentage of items endorsed (as determined by the original ASRS dichotomous scoring method) for each of the subscales can be helpful in determining the ADHD presentation defined in DSM-V-TR: Combined, Hyperactivity-Impulsivity or Inattentive. Note that the DSM-V-TR does not make a distinction between verbal and motor hyperactivity subtypes.
The ASRS has demonstrated strong psychometric properties in its original validation studies, showing high internal consistency (Cronbach’s alpha = 0.88) and concurrent validity (r = 0.84) (Adler et al., 2006). Using the previous scoring convention, studies reported high sensitivity (1.0) and moderate positive predictive power (0.52), suggesting that the ASRS would rarely miss ADHD in an adult who has ADHD. Moreover, the ASRS showed moderate specificity (.71) and high negative predictive power (1.0), indicating success in not identifying someone with ADHD when they do not have it (Hines, King & Curry, 2012).
Stanton et al. (2018) determined, by using CFA with over 1,000 adult subjects, that the ASRS had three factors:
These factors are used to compute subscale scores. It is noted that the DSM-5-TR specifies two subtypes (Inattentiveness and Hyperactivity/Impulsivity) however analysis of this scale indicates three distinct symptom clusters. For ease of understanding for clinicians, the subscales are presented in a manner that is consistent with the DSM but allows for breaking up the hyperactivity/impulsivity subscale into motor and verbal components.
NovoPsych calculated ASRS percentiles using summed scores and their standard deviations for Part A (items 1-6), Part B (items 7-18), and the Total Score (items 1-18) using the data from Adler et al. (2018). The Adler et al. (2018) sample included 22,397 adults, of whom 465 (2.1%) self-reported a physician diagnosis of ADHD. Compared to those without ADHD (n=21,932; the Community Sample), participants with ADHD were more likely to be male (51.0% vs 45.5%, p=0.02) and younger (mean age 42.0 vs 51.3 years, p<0.001). Of those with ADHD, 174 (37.4%) reported current use of prescription ADHD medication. The ADHD group reported significantly higher rates of psychiatric comorbidities, including depression (58.1% vs 18.0%), anxiety (53.1% vs 16.0%), and sleep difficulties (37.0% vs 14.0%) (all p<0.001). NovoPsych calculations used individual item-level means and standard deviations to determine summed score means (based on likert scoring) and standard deviations for the ADHD group (n = 465) of:
For the Community Sample (n = 21,932), the values were:
Although the ASRS was developed for DSM-IV criteria, the core symptoms of adult ADHD in the DSM-IV and DSM-5-TR are essentially the same (Adler et al., 2018) and the only substantive differences in the DSM-5 criteria for ADHD are (Alarachi et al., 2024):
Therefore, it is appropriate to use the ASRS v1.1 for assessing ADHD with regard to the DSM-5-TR diagnostic criteria.
Further details on the scoring methodology and the calculation of percentiles can be found in the attached article:
The ASRS demonstrates excellent diagnostic accuracy for adult ADHD. In a validation study by Brevik et al. (2020) comparing 646 clinically diagnosed ADHD adults with 908 controls, the ASRS achieved an Area Under the Curve (AUC) of 0.904, with the 6-item Part A screener performing equally well (AUC 0.903). Using NovoPsych’s recommended Part A cutoff of 14+ provides optimal sensitivity of 90% with 88% specificity, meaning it correctly identifies 9 out of 10 adults with ADHD while maintaining good specificity. The full scale showed high internal consistency (Cronbach’s alpha = 0.952), confirming its reliability as a screening instrument.
For optimal diagnostic accuracy, NovoPsych recommends using the ASRS alongside the WURS – the ASRS for current symptoms and the WURS for childhood history. When combined, these tools achieved an AUC of 0.964, providing clinicians with complementary perspectives that enhance diagnostic confidence.
The ASRS scoring was updated in 2024 at the suggestion of Harvard Medical School authors to enhance clinical utility and diagnostic accuracy. The key change is moving from a dichotomous scoring system (0 or 1) to a 5-point Likert scale (0 to 4). This provides more nuanced assessment of symptom severity. The updated scoring maintains the Part A cutoff of 14+ for ADHD diagnosis but offers better gradation of symptoms. The original dichotomous scoring is still used for calculating percentage of items endorsed for subtype determination.
Part A (items 1-6) contains the most predictive items for ADHD diagnosis with a cutoff of 14+, showing high sensitivity and high negative predictive power. Part B provides additional symptom severity information with scores of 27+ being clinically significant. Even if Part A doesn’t reach threshold, a high Part B score and total score percentile above the 79th percentile (raw score of 40) can be diagnostically informative.
While DSM-5-TR specifies two subtypes (Inattentiveness and Hyperactivity/Impulsivity), factor analysis by Stanton et al. (2018) identified three distinct symptom clusters: Inattentiveness, Motor Hyperactivity/Impulsivity, and Verbal Hyperactivity. The subscales help clinicians identify more specific symptom patterns – for example, distinguishing between clients who struggle primarily with motor restlessness versus those with verbal impulsivity, which can inform treatment planning.
The updated ASRS uses normative data from Adler et al. (2018) based on 22,397 adults, including 465 with self-reported ADHD diagnosis. NovoPsych has recalculated the means and standard deviations using a methodology that accounts for inter-item correlations (r = 0.32 within parts and r = 0.74 between Parts A and B).
ADHD group reference values:
Community sample reference values:
A total score at the 79th percentile or above (raw score ≥40) typically indicates ADHD. The percentile tables use descriptors (Low, Mild to Moderate, High, Very High) that maintain consistent meaning across all parts of the scale relative to the general population distribution. These calculations provide more accurate variance estimates than earlier versions, though clinicians should note they assume uniform correlations within each part for computational efficiency.
Yes, the ASRS v1.1 remains appropriate for DSM-5-TR assessment. The core adult ADHD symptoms are essentially unchanged between DSM-IV and DSM-5-TR (Adler et al., 2018). The main DSM-5 changes were: reducing the number of required symptoms for adults and changing age of onset from 7 to 12 years (Alarachi et al., 2024). The ASRS questions already incorporated adult-specific wording and remain consistent with current diagnostic criteria.
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): a short screening scale for use in the general population. Psychological Medicine, 35(2), 245–256. https://doi.org/10.1017/s0033291704002892
Adler, L. A., Faraone, S. V., Sarocco, P., Atkins, N., & Khachatryan, A. (2019). Establishing US norms for the Adult ADHD Self-Report Scale (ASRS-v1.1) and characterising symptom burden among adults with self-reported ADHD. International Journal of Clinical Practice, 73(1), e13260. https://doi.org/10.1111/ijcp.13260
Adler, L. A., Spencer, T., Faraone, S. V., Kessler, R. C., Howes, M. J., Biederman, J., & Secnik, K. (2006). Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 18(3), 145–148. https://doi.org/10.1080/10401230600801077
Alarachi, A., Merrifield, C., Rowa, K., & McCabe, R. E. (2024). Are We Measuring ADHD or Anxiety? Examining the Factor Structure and Discriminant Validity of the Adult ADHD Self-Report Scale in an Adult Anxiety Disorder Population. Assessment, 31(7), 1508-1524. https://doi.org/10.1177/10731911231225190
Brevik, E. J., Lundervold, A. J., Haavik, J., & Posserud, M. B. (2020). Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD. Brain and behavior, 10(6), e01605. https://doi.org/10.1002/brb3.1605
Harvard Medical School. (2024, February 28). ASRS v1.1 screener (6Q) scoring update [PDF]. https://www.hcp.med.harvard.edu/ncs/ftpdir/adhd/ASRS_v1.1_screener(6Q)_scoring_update.pdf
Hines, J. L., King, T. S., & Curry, W. J. (2012). The adult ADHD self-report scale for screening for adult attention deficit-hyperactivity disorder (ADHD). Journal of the American Board of Family Medicine: JABFM, 25(6), 847–853. https://doi.org/10.3122/jabfm.2012.06.120065
Kessler, R. C., Adler, L. A., Gruber, M. J., Sarawate, C. A., Spencer, T., & Van Brunt, D. L. (2007). Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. International Journal of Methods in Psychiatric Research, 16(2), 52–65. https://doi.org/10.1002/mpr.208
Stanton, K., Forbes, M. K., & Zimmerman, M. (2018). Distinct dimensions defining the Adult ADHD Self-Report Scale: Implications for assessing inattentive and hyperactive/impulsive symptoms. Psychological Assessment, 30(12), 1549–1559. https://doi.org/10.1037/pas0000604
