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Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun.
| DSM-IV | DSM-5 |
|---|---|
| Disorder Class: Disorders Usually Diagnosed in Infancy, Childhood, and Adolescence | Disorder Class: Neurodevelopmental Disorders |
| A. Either (1) or (2): | A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2): |
| 1. Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: | 1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: |
| Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 or older), at least five symptoms are required. | |
| Inattention | |
| a. often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities | a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate). |
| b. often has difficulty sustaining attention in tasks or play activity | b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading). |
| c. often does not seem to listen when spoken to directly | c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction). |
| d. often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace (not due to oppositional behavior or failure to understand instructions) | d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked). |
| e. often has difficulty organizing tasks and activities | e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines). |
| f. often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) | f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers). |
| g. often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books or tools) | g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). |
| h. is often easily distracted by extraneous stimuli | h. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts). |
| i. is often forgetful in daily activities | i. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments). |
| 2. Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: | 2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities: |
| Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or a failure to understand tasks or instructions. For older adolescents and adults (age 17 or older), at least five symptoms are required. | |
| Hyperactivity | |
| a. Often fidgets with hands or feet or squirms in seat | a. Often fidgets with or taps hands or feet or squirms in seat. |
| b. Often leaves seat in classroom or in other situations in which remaining seated is expected | b. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place). |
| c. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) | c. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless). |
| d. Often has difficulty playing or engaging in leisure activities quietly | d. Often unable to play or take part in leisure activities quietly. |
| e. Is often “on the go” or often acts as if “driven by a motor” | e. Is often “on the go” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with). |
| f. Often talks excessively | f. Often talks excessively. |
| Impulsivity | |
| g. Often blurts out answers before questions have been completed | g. Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation). |
| h. Often has difficulty awaiting turn | h. Often has trouble waiting his/her turn (e.g., while waiting in line). |
| i. Often interrupts or intrudes on others (e.g., butts into conversations or games) | i. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing). |
| B. Some hyperactive-impulsive or inattentive symptoms must have been present before age 7 years. | B. Several inattentive or hyperactive-impulsive symptoms were present before age 12 years. |
| C. Some impairment from the symptoms is present in at least two settings (e.g., at school [or work] and at home). | C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings, (e.g., at home, school or work; with friends or relatives; in other activities). |
| D. There must be clear evidence of clinically significant impairment in social, academic or occupational functioning. | D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning. |
| E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorders and is not better accounted for by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). | E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal). |
Code based on type:
| Specify whether:
|
From: 3, DSM-5 Child Mental Disorder Classification
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