What your ADHD self-test results mean

You answered six questions, the tool counted your answers, and now you have a number. This page explains what that number can tell you, what it cannot, and what the published research on this screener actually found. It is written for the screener on this site's adult ADHD self-test, the Adult ADHD Self-Report Scale (ASRS) v1.1 Screener developed with the World Health Organization, but most of it applies to any ADHD questionnaire.

How the screener is scored

The ASRS v1.1 Screener is the six questions, out of an 18-question symptom checklist, that were selected in the original study to most closely match clinical diagnoses. Each question asks how often a recent symptom happens, on a scale from Never to Very Often. The scoring is fixed by the instrument's terms:

• For questions 1 to 3, an answer of Sometimes, Often or Very Often counts.
• For questions 4 to 6, an answer of Often or Very Often counts.
• Four or more counted answers means symptoms highly consistent with ADHD in adults, and further investigation is warranted.

So the result is a count, not a measure of severity. A 6 is not "more ADHD" than a 4. Both mean the same thing: an evaluation makes sense.

What the published accuracy figures say

Two numbers describe a screener. Sensitivity is the share of people who do have the condition who screen positive. Specificity is the share of people who do not have it who screen negative. A third number, the positive predictive value, is the share of positive screens that turn out to be the condition, and it depends heavily on who is taking the test.

Read together, these say three things.

1. In the general population, the screener rarely flags people who turn out not to have ADHD. Specificity of 99.5% in the 2005 sample is very high.
2. It does miss some people. Sensitivity of 68.7% means that in that sample, roughly three in ten adults whom clinicians rated as having ADHD did not reach the cutoff. The original study was small (154 people); the larger 2007 study supported the screener's overall accuracy.
3. The setting changes everything. Among adults entering substance use treatment, about one in four positive screens was confirmed as ADHD on a structured diagnostic interview. The authors concluded the ASRS is a sensitive screener with very few missed cases among those screening negative in that population, which is a different job from confirming a diagnosis.

A note on the DSM-5 version

If you have read that the ASRS catches more than 90% of adults with ADHD, that figure belongs to a different screener. In 2017 the same research group published a six-question screener written for DSM-5, with partly different questions and a different scoring method. In the general population it showed sensitivity of 91.4%, specificity of 96.0% and a positive predictive value of 67.3%. In a specialty clinic sample at NYU Langone, specificity fell to 74.0%, and the authors linked that to the many clinic patients who had a meaningful number of symptoms without meeting full criteria. Those numbers are useful for understanding screeners in general, but they are not the figures for the v1.1 screener on this site. The New York guide's explainer on screening tests covers that version in more detail.

If your result was 4 or more

A positive result means your recent experience includes several of the symptoms most closely linked to adult ADHD. It is a good reason to book an evaluation. It does not mean ADHD is the explanation, for reasons a questionnaire cannot reach:

• Onset. Adults must have shown symptoms starting before age 12, according to the National Institute of Mental Health (NIMH). The screener asks only about recent symptoms.
• Impairment and settings. NIMH describes ADHD as a pattern that makes it hard to function in at least two areas of life, such as home, school or work. The screener asks how often, not how much it costs you.
• Other explanations. The CDC lists sleep disorders, anxiety, depression and certain learning disabilities among conditions that can have symptoms like ADHD. Someone who is depressed or not sleeping can answer these six questions exactly as someone with ADHD would.

UK national guidance from NICE puts it plainly: a diagnosis should not be made solely on the basis of rating scale or observational data. Rating scales are helpful added tools inside a full clinical assessment.

If your result was under 4

A negative screen is reassuring but not a clearance. The 2005 sensitivity figure means some adults with ADHD score under the cutoff. People who have built strong workarounds, or who answered during an unusually good stretch, may undercount. If the problems that brought you to the test are real and persistent, they are still worth raising with a clinician, whatever the cause turns out to be. The guide to ADHD or ordinary distraction explains what separates a disorder from everyday lapses.

Making the result useful

A screener is most useful as a conversation starter. Before an appointment:

• Write down your count and which questions you answered in the counted range.
• Add one or two real examples for each: a missed deadline, a forgotten appointment, a project left at 90%.
• Note how long these problems have been going on, and whether anyone noticed them when you were a child. The guide on asking family about childhood symptoms explains why evaluators ask.
• List your sleep, mood, substances and medications. NIMH says providers ask about mood and medical conditions to rule out alternative diagnoses.

When to talk to a clinician

If you scored 4 or more, or if attention, organization or restlessness are causing real problems at work, at home or in relationships, an evaluation is the reasonable next step. There is no rush to decide anything today, and a screen result does not commit you to a diagnosis or to medication.

Dr. John C. Shershow, M.D. is a psychiatrist who focuses on adult ADHD and sees adults located in New York or New Jersey. His adult ADHD evaluation covers current symptoms, childhood, school and work history, health, sleep and substances, and other explanations, and ends with what it found and the treatment options that fit. See adult ADHD testing and evaluation in NYC or in New Jersey, or retake the self-test and bring your answers. To start, call the office or use the call-back form.