ASRS v1.1

The Adult ADHD Self-Report Scale (ASRS v1.1) is a self-report screening scale for attention deficit hyperactivity disorder (ADHD) in adults, consisting of two parts. Part A is the main test, while part B offers more information that can be discussed with your medical professional. For the latest version of this test, have a look at the ASRS-5.

Take the test here:

Who the test is designed for

• Adults (18+) with an IQ in the normal range (IQ >=80).

What it tests

The ASRS v1.1 identifies ADHD in adults, with questions that relate to the two subscales:^[1]The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population (Kessler et al., 2005)

• Inattention (questions 1–4, 7–11)
• Hyperactivity-impulsivity (questions 5–6, 12–18)

Note, however, that the ASRS v1.1 is only a screening scale, not a diagnostic test. So while it can give an indication of ADHD, a diagnostic assessment by a trained clinician is needed to follow up on patients who screen positive.^[2]Adult ADHD Self-Report Scale (ASRS) Version 1.1 Background Information | Harvard Medical School Sarah Gray et al. states:^[3]The Adult ADHD Self-Report Scale (ASRS): utility in college students with attention-deficit/hyperactivity disorder (Gray et al., 2014)

These two scales are not measuring ADHD symptomatology for diagnostic cut-off; rather, they measure functional impairment experienced by those with ADHD.

• Never
• Rarely
• Sometimes
• Often
• Very Often

If you decide to take the test, please consider the Discussion section below.

Scoring

Basics

• Scoring range: 0–6 (0–18 for the full test)
• Threshold score: 4+ (on part A)

Scoring

Although you get 5 choices per question, the scoring is binary; you get either a 0 or a 1. But which answers you get a 1 for can vary. For questions 1–3, 9, 12, 16, and 18, the scoring is as follows:^[4]Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist | Harvard Medical School

• Never – 0
• Rarely – 0
• Sometimes – 1
• Often – 1
• Very often – 1

But for questions 4–8, 10, 11, 13–15, and 17 the scoring is:^[5]Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist | Harvard Medical School

• Never – 0
• Rarely – 0
• Sometimes – 0
• Often – 1
• Very often – 1

Threshold

If you score 4 or more on part A, then the test shows you have symptoms highly consistent with ADHD in adults, and further investigation is warranted.^[6]Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist | Harvard Medical School

Validity

Although the ASRS v1.1 screener can effectively diagnose ADHD in adults, it cannot rule out other medical conditions that may impact the diagnosis of ADHD.

The validity of the ASRS v1.1 varies depending on whether you take the screening (first 6 questions) or the full test (18 questions), as the screening part was found to be more reliable.^[7]The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population (Kessler et al., 2005)

Here is what the terms mean:

• Sensitivity — The ability of a test to correctly identify patients with a condition (true positive rate).
• Specificity — The test’s ability to correctly identify those without the condition (true negative rate).
• Classification accuracy — The ratio of the number of correct predictions to the total number of input samples (correct classifications rate).
• Kappa — The extent of agreement between different measures or reviewers’ interpretations. In this case, there is moderate to substantial agreement.^[8]Week 14: kappa (Dr. James Degnan) | The University of New Mexico – Department of Mathematics & Statistics

So as you can see, the ASRS v1.1 is much better at identifying when someone doesn’t have ADHD than when they do, but the 6 first questions of the test can identify almost 70% of people with ADHD. Note, however, that the ASRS-5 correctly identifies more than 90% of cases. So you may want to do that test instead.

Discussion

Martin:

The ASRS v1.1 seems to be a fair, short screening tool, but it isn’t a comprehensive measure of ADHD, so you might have to manage your expectations.

The lack of a threshold score bothers me, because it renders the output score close to useless. The fact that the scoring is done in a binary way also makes ADHD seem binary, like either it describes your neurology and cognition or it doesn’t. But while the clinical diagnosis may be binary (i.e. either you’re diagnosed with ADHD or you’re not), ADHD constitutes a constellation of traits. So I would have liked to see that reflected in the scoring as well.

I also don’t think this test offers a lot of insight, but to be fair, I’m not sure if I should expect a screening instrument to be. I scored 5 in total (4 on part A, and 1 on part B). What this tells me is that I scored mostly (4/6) for ADHD on the inattention scale, but just about nothing (1/12) on the hyperactivity-impulsivity scale. That makes a lot of sense to me, but I still find myself wondering if this is any indication that I might have ADHD. As it happens I do; I’m not diagnosed, but I take medication for it. But this test wouldn’t have offered me the clarity I would have needed to pursue a diagnosis.

Since this is a screening tool, it only needs to give an indication of ADHD so you can follow it up with a clinical professional. But considering this screening detects less than 70% of people with ADHD (less than 60% for the 18-part version), it might actually overlook a substantial number of people in the screening process. For a more reliable ADHD screening tool, have a look at the ASRS-5.

ASRS v1.1

Below is the ASRS v1.1. Officially, only part A (questions 1–6) is scored, but we decided to include the extended test in the scoring.

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