• Inattention: where a person often fails to give close attention to details or makes careless mistakes, often has difficulty sustaining attention in tasks, often does not seem to listen when spoken to directly, or often does not follow through on instructions.

• Tasks: Where a person often has difficulty organizing tasks and activities, often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort, often loses things necessary for tasks or activities, often easily gets distracted by extraneous stimuli, or is often forgetful in daily activities.

• Hyperactivity: Where a person often fidgets with hands or feet or squirms in seat, often feels restless, often has difficulty engaging in leisure activities quietly, or often talks excessively.

• Impulsivity: Where a person often blurts out answers before questions have been completed, or often interrupts or intrudes on others.

There is a growing consensus that the central feature of ADHD is disinhibition. Patients are unable to stop themselves from immediately responding, and they have deficits in their capacity for monitoring their own behavior.

Hyperactivity, while a common feature among children, is likely to be less overt in adults. Utah criteria may be called the imperative criteria for this.

For adults, it is used like this:

What is the childhood history consistent with ADHD?

What are the adult symptoms?

Does the adult have hyperactivity and poor concentration?

Is there any affective lability or hot temper?

Is there the inability to complete tasks and disorganization?

Is there any stress intolerance, or impulsivity? (Wender, 1998)

Wender developed these ADHD criteria, known as the Utah criteria, which reflect the distinct features of the disorder in adults. The diagnosis of ADHD in an adult requires a longstanding history of ADHD symptoms, dating back to at least age seven. In the absence of treatment, such symptoms should have been consistently present without remission. In addition, hyperactivity and poor concentration should be present in adulthood, along with two of the five additional symptoms: affective lability; hot temper; inability to complete tasks and disorganization; stress intolerance; and impulsivity.

The Utah criteria include the emotional aspects of the syndrome. Affective lability is characterized by brief, intense affective outbursts ranging from euphoria to despair to anger, and is experienced by the ADHD adult as being out of control. Under conditions of increased emotional arousal from external demands, the patient becomes more disorganized and distractible.

References

Wender, Paul (1998). Attention-Deficit Hyperactivity Disorder in Adults . Oxford University Press.

Weiss, Margaret (2001). Adhd in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment . Johns Hopkins University Press.

Goldstein, Sam; Ellison, Anne (2002). Clinicians' Guide to Adult ADHD: Assessment and Intervention . Academic Press.