DIVA-5 Assessment for ADHD – With Clinical Interview

DIVA-5 Questionnaire

Part 1: Symptoms of Attention-Deficit

DSM-5-TR Criteria A1 — Inattention (five or more required)

A

James frequently makes careless errors in workplace documentation and has overlooked important details in client reports on multiple occasions. As a child, he regularly received feedback from teachers that his written work contained careless mistakes despite demonstrating strong verbal ability.

B

James reports significant difficulty sustaining attention during extended work meetings and while reading lengthy reports, often losing his place or needing to re-read material multiple times. In childhood, he struggled to remain focused during classroom instruction and frequently needed tasks broken into smaller steps.

C

James’s partner reports that he frequently appears distracted during conversations at home, often responding with answers that suggest he has not followed what was said. Similar observations were noted by teachers during primary school.

D

James consistently begins tasks at work but reports difficulty following through to completion, particularly when tasks involve multiple steps or administrative components. As a child, he regularly left school assignments incomplete and struggled to finish household chores without repeated prompting.

E

James describes his workspace as persistently disorganised, with difficulty prioritising tasks and frequently missing deadlines. He reports that time management has been a lifelong challenge. In childhood, his school bag and desk were consistently described by his parents as chaotic.

F

James actively avoids preparing written reports and completing administrative forms at work, often delegating these tasks to colleagues. As a child, he was described by his mother as resistant to homework, particularly written tasks.

G

James reports regularly misplacing his keys, wallet, and mobile phone, and has lost important work documents on several occasions. Similar difficulties with losing school materials and personal belongings were noted throughout his childhood.

H

James describes being easily pulled off task by background noise and unrelated thoughts during work, to the extent that he often requires a quiet environment to complete cognitively demanding tasks. His teachers noted similar difficulties with distractibility in the classroom.

I

James reports frequently forgetting appointments, failing to return phone calls, and missing bill payment deadlines. In childhood, he was described as forgetful with regard to chores and daily routines.

Part 2: Symptoms of Hyperactivity-Impulsivity

DSM-5-TR Criteria A2 — Hyperactivity and Impulsivity (five or more required)

A

James reports persistent leg bouncing and tapping during meetings and while seated at his desk. As a child, his teachers frequently noted that he fidgeted throughout class and had difficulty sitting still.

B

Information related to this diagnostic criterion not found in the transcript.

C

James describes a persistent internal sense of restlessness and discomfort when required to remain still for extended periods, such as during long flights or multi-hour meetings. As a child, he was frequently described as unable to sit at the dinner table for the duration of a family meal.

D

James reports difficulty engaging in quiet leisure activities and describes watching television or reading as frustrating unless highly stimulating content is involved. This was consistent with parental reports from his childhood.

E

James’s partner describes him as constantly “on the go” and notes that he becomes visibly uncomfortable and irritable when required to remain inactive. His mother reported similar observations throughout his childhood and adolescence.

F

James acknowledges that colleagues and his partner have commented that he talks excessively, particularly when discussing topics of interest. His parents noted that he was an unusually talkative child.

G

James reports frequently completing other people’s sentences and acknowledges difficulty waiting for others to finish speaking before responding. This was a consistent source of feedback in performance reviews at work.

H

James describes significant difficulty waiting in queues and reports leaving situations where waiting is required when possible. He recalls similar difficulties as a child, particularly in structured settings such as school assemblies.

I

James acknowledges a tendency to join conversations without being invited and to take over tasks from others when he perceives them to be progressing too slowly. His teachers noted similar intrusive behaviour in group activities during primary school.

Part 3: Impairment on Account of the Symptoms

DSM-5-TR Criteria B

James and his mother both report that the symptoms described above were clearly evident prior to the age of 12. Difficulties with attention, impulsivity, and restlessness were consistently documented across primary and secondary school settings.

DSM-5-TR Criteria C

Symptoms are present across multiple settings, including the workplace, the home environment, and social situations. James’s partner has corroborated the presence of inattentive and hyperactive-impulsive symptoms at home, and James has reported significant difficulties in occupational functioning.

DSM-5-TR Criteria D

James’s symptoms have resulted in clear functional impairment across occupational and interpersonal domains. He has received formal performance feedback regarding disorganisation and incomplete work, and his partner has expressed ongoing frustration regarding his distractibility and difficulty following through on household responsibilities.

DSM-5-TR Criteria E

Before applying a diagnosis of ADHD, the clinician must ensure that the symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder such as mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal.

Clinical Interview

Referral Reason

James Brown, a 34-year-old male, self-referred for an ADHD assessment following a conversation with his general practitioner, who suggested the evaluation after James described longstanding difficulties with concentration, organisation, and impulsivity that had increasingly affected his performance at work. James reports that these difficulties have been present throughout his life but have become more impairing over the past two years following a promotion to a senior role requiring greater organisational demands. He describes a pattern of starting tasks and failing to complete them, chronic lateness, and a persistent sense of underachievement relative to his perceived abilities.

People Present

James Brown (client, aged 34) attended the interview. James’s mother, Patricia Brown, attended for a portion of the session to provide collateral developmental history. James’s partner, Sarah Brown, provided a brief written account of her observations, which was reviewed by the clinician during the session.

Mental Status Examination

James presented as a well-groomed male of average build who established good rapport with the clinician. He demonstrated psychomotor restlessness throughout the session, including frequent leg bouncing and shifting in his seat, and his speech was rapid in rate with occasional tangential digressions. His mood was euthymic and his affect was broad and reactive, with periods of visible frustration when discussing occupational difficulties. Insight into the functional impact of his difficulties was good, and his judgment appeared intact.

Personal and Developmental History

James was born at full term following an uncomplicated pregnancy and delivery. His mother reported that developmental milestones were broadly within normal limits, though he was described as an active and challenging infant. Speech development was age-appropriate, though his mother noted that he was difficult to redirect from preferred activities from an early age. James attended three primary schools due to family relocations, and his academic performance was consistently described as “inconsistent” — performing well in areas of interest such as science and physical education, but poorly in tasks requiring sustained written output. He was never formally assessed during his schooling despite teacher concerns being raised on several occasions. James completed Year 12 and subsequently obtained a bachelor’s degree in engineering, which he described as “very hard work” and achieved with significant effort and support from peers.

James currently lives with his partner Sarah in Melbourne. He reports a small but stable social network and describes his relationship with Sarah as generally positive, though strained by his difficulties with follow-through and household organisation. He has no children. James is employed full-time as a senior project engineer.

James described a significant period of family instability during mid-adolescence following his parents’ separation. He reported that this period was stressful but did not describe any specific traumatic events. There is no known history of family trauma beyond this.

James’s mother disclosed that his father was diagnosed with ADHD in his late forties. A paternal uncle is known to have experienced significant difficulties with alcohol use. No other family psychiatric history was reported.

Medical History

James was diagnosed with mild asthma in childhood, which is currently well-managed. He reports no other significant medical history and has not previously received any psychiatric diagnosis.

Current Medications

James is currently taking salbutamol (Ventolin) as required for asthma management. He is not taking any psychotropic medications.

Strengths, Interests, and Hobbies

James was identified as having strong verbal reasoning abilities and an exceptional capacity for creative problem-solving in his occupational role. He is described by his partner as warm, generous, and highly empathic. James has a strong interest in trail running and rock climbing, which he engages in regularly and describes as important outlets for managing restlessness. He also has a longstanding interest in mechanical engineering projects, which he pursues as a hobby.

Client Goals

James expressed a desire to improve his organisational functioning and time management at work, reduce the interpersonal friction caused by his impulsivity and distractibility at home, and gain a clearer understanding of whether ADHD accounts for his lifelong difficulties. He stated that understanding the nature of his difficulties would be meaningful to him, regardless of the outcome of the assessment.

Clinician Observations, Notes, and Diagnostic Impressions

The clinician noted that James presented with a clear and consistent history of inattentive and hyperactive-impulsive symptoms with documented onset in childhood, present across multiple settings, and associated with meaningful functional impairment. The clinician noted the importance of ruling out anxiety as a primary explanation for the presenting difficulties, observing that while James does report some situational anxiety, this does not appear to account for the breadth or chronicity of his symptoms. A provisional diagnosis of ADHD, Combined Presentation (DSM-5-TR 314.01) was considered, pending review of collateral information and psychometric assessment results.

Risk

James denied any current suicidal ideation, self-harm, or thoughts of harm to others. No significant risk factors were identified at this time. Protective factors include stable employment, a supportive partner, a close relationship with his mother, and active engagement in physical leisure activities.

Next Steps

• The clinician recommended referral to a psychiatrist for medication assessment, noting that should ADHD be confirmed, stimulant medication may be an appropriate component of James’s management plan.
• Psychoeducation regarding ADHD in adults was provided, including information about the neurobiological basis of the condition and evidence-based treatment options. James indicated good understanding and expressed openness to both pharmacological and non-pharmacological approaches.
• The clinician recommended that James consider working with a psychologist experienced in ADHD to develop compensatory strategies for organisation and time management, referencing approaches such as CBT adapted for ADHD.
• A follow-up appointment to review psychometric assessment results and confirm diagnostic impressions was scheduled for Wednesday, 12 March 2025 at 10:00 AM.

Summary

James Brown, a 34-year-old male, presented for a DIVA-5 clinical interview to investigate a possible diagnosis of ADHD. He reported a longstanding history of inattentive and hyperactive-impulsive symptoms with clear childhood onset, present across occupational, domestic, and social settings, and associated with meaningful functional impairment. Collateral information from his mother and partner was broadly consistent with James’s self-report. A provisional diagnosis of ADHD, Combined Presentation was considered, with further assessment and psychiatric review recommended as next steps.