Adult ADHD Self - Report Scale - V1.1 (ASRS - V1.1)
Symptoms Checklist
from WHO Composite International Diagnostic Interview
© World Health Organization 2012
All rights reserved. Based on the Composite International Diagnostic Interview © 2001 World Health Organization. All rights reserved. Used with permission. Requests for permission to reproduce or translate — whether for sale or for noncommercial distribution — should be addressed to Professor Ronald Kessler, PhD, Department of Health Care Policy, Harvard Medical School , (fax: +011 617 - 432 - 3588; email: ronkadm@hcp.med.harvard.edu).
Acknowledgements
Translation of this document was performed on behalf of the World Health Organization Composite International Diagnostic Interview Advisory Committee by Corporate Translations, Inc.,
Adult ADHD Self - Report Scale Symptom Checklist (ASRS - v1 . 1)
Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page. As you answer each question, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months. Please give this completed checklist to your health care professional to discuss during today’s appointment.
Never
Rarely
Sometimes
Often
Very often
Part A
- How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
- How often do you have difficulty getting things in order, when you have to do a task that requires organization?
- How often do you have problems remembering appointments or obligations?
- When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
- How often do you fidget with your hands or feet when you have sit down for a long time?
- How often do you feel overly active and compelled to things, like you were driven by a motor?
Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page. As you answer each question, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months. Please give this completed checklist to your health care professional to discuss during today’s appointment.
Part B
- How often do you make careless mistakes when working on a boring project?
- How often do you have difficulty keeping your attention when you are doing boring or repetitive work?
- How often do you have difficulty concentrating on what people say to you, even when they are speaking directly to you?
- How often do you misplace or have difficulty finding things at home or at work?
- How often are you distracted by activity or noise around you?
- How often do you leave your seat at meetings or other situations in which you are expected to remain seated?
This post is for informational purposes only. It should not be considered therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local doctor/psychologist or psychiatrist or the SADAG Mental Health Line on 011 234 4837. If necessary, please phone the Suicide Crisis Line on 0800 567 567 or sms 31393.