ENGLISH

DIVA-5
Diagnostic Interview for ADHD
in adults (3rd edition; DIVA-5)

D iagnostisch I nterview V oor A DHD bij volwassenen

J.J.S. Kooij, MD, PhD, M.H. Francken, MSc, & T.I. Bron, MSc
March 2019, DIVA Foundation, The Hague, The Netherlands
 Colophon Introduction
The Diagnostic Interview DIVA-5 is the third edition of the DIVA. This edition includes adjustments made to the DIVA 2.0
for ADHD in adults is a following the changes in the DSM-5 criteria for Attention-deficit/hyperactivity disorder.
publication of the DIVA According to the DSM-5, ascertaining the diagnosis of ADHD in adults involves determining
Foundation, The Hague, the presence of ADHD symptoms during both childhood and adulthood.
The Netherlands, August
2010. The original English The main requirements for the diagnosis are that the onset of ADHD symptoms occurred
translation by during childhood and that this was followed by a lifelong persistence of the characteristic
Vertaalbureau Boot was symptoms to the time of the current evaluation. The symptoms need to be associated with
supported by Janssen-Cilag significant clinical or psychosocial impairments that affect the individual in two or more life
B.V. Backtranslation into situations1. Because ADHD in adults is a lifelong condition that starts in childhood, it is
Dutch by Sietske Helder. necessary to evaluate the symptoms, course and level of associated impairment in childhood,
Final revisions and using a retrospective interview for childhood behaviours. Whenever possible the information
authorisation by dr. J.J.S. should be gathered from the patient and supplemented by information from informants that
Kooij DIVA Foundation and knew the person as a child (usually parents or close relatives)2.
prof. Philip Asherson,
Institute of Psychiatry, Changes in DSM-5 compared to DSM-IV-TR criteria for ADHD
London. The DSM-5 was published in the beginning of 2013, and several changes were made
regarding the diagnosis of ADHD in adulthood. According to these changes, the DIVA was
Adjustments based on the adjusted. The adjustments are summarised below:
DSM-5 criteria by prof. • Age of onset: The criterion for the age of onset in childhood was changed from ‘some
Philip Asherson, Institute of hyperactivity-impulsivity or inattentive symptoms that cause impairment were present
Psychiatry, London, dr. before the age of 7 years’ to ‘several inattentive or hyperactive/impulsive symptoms were
Josep Antoni Ramos- present prior to age 12’. Under DSM-5 there is no longer a requirement for impairments
Quiroga, Servicio de from the symptoms prior to age 12.
Psiquiatría. CIBERSAM. • Symptom count in childhood: the total number of symptoms for the childhood diagnosis
Hospital Universitari Vall has not changed (i.e. 6/9 Attention deficit (A) and/or Hyperactivity/impulsivity (HI)
d’Hebron Universitat symptoms). There needs to have been a period of six months or more with 6/9 symptoms
Autònoma de Barcelona, dr. interfering with functioning in one or both domains and several symptoms prior to age
J.J. Sandra Kooij, and drs. T.I. 12.
Annet Bron, DIVA • Symptom count in adulthood: The threshold for the number of symptoms needed for a
Foundation, 2016. diagnosis of ADHD in adulthood (from the age of 17 upwards) has been lowered from 6
to 5 symptoms on either the inattentive and/or hyperactive/impulsive symptom
Reprinted with permission domains.
from the Diagnostic and • Examples: Some examples of age-appropriate criteria were added in DSM-5. The
Statistical Manual of Mental adjustments concerned the criteria A1 to A9, HI2, HI3, HI5, HI7, and HI9.
Disorders, (5th ed.). • Subtypes have been renamed as ‘clinical presentation types’ as the DSM-IV subtypes were
American Psychiatric shown to be developmentally unstable. The DSM-5 presentation types refer to the
Publishing, 2013. predominance of one or both symptom domains.

This publication has been The DIVA-5 was changed to take account of these changes.
put together with care.
However, over the course of Although not mentioned in the DIVA-5, other DSM-5 changes with regards to ADHD are:
time, parts of this 1. ADHD is now categorised in the chapter ‘Neurodevelopmental disorders’, instead of
publication might change. ‘Disorders usually first diagnosed in infancy, childhood, or adolescence’.
For that reason, no rights 2. The new option to diagnose ADHD and autism spectrum disorder in the same patient.
may be derived from this 3. Also, more attention has been paid to associated features of ADHD which support the
publication. For more diagnosis, including mild delays in language, motor or social development; low
information and future frustration tolerance, irritability or mood lability; cognitive problems in tests of attention,
updates of the DIVA please executive function or memory.
visit www.divacenter.eu.
The Diagnostic Interview for ADHD in Adults (DIVA-5) is based on the DSM-5 criteria and is the
third edition of the first structured Dutch interview for ADHD in adults (DIVA). The DIVA-5 is

2 DIVA-5 Diagnostic Interview for ADHD in adults

the successor of the DIVA 2.0 that was developed by J.J.S. Kooij First ask about adulthood (symptoms present in the last
and M.H. Francken and was based on the DSM-IV-TR criteria2. 6-months or more) and then ask about the same symptom in
DIVA 2.0 has been validated in two studies3,4. childhood (symptoms between the ages of 5 to 12 years)5-7.
Read each question fully and ask the person being interviewed
In order to simplify the evaluation of each of the 18 symptom whether they recognise this problem and to provide examples.
criteria for ADHD, in childhood and adulthood, the interview Patients will often give the same examples as those provided in
provides a list of concrete and realistic examples, for both the DIVA, which can then be ticked off as present. If they do not
current and retrospective (childhood) behaviour. The examples recognise the symptoms or you are not sure if their response is
are based on the common descriptions provided by adult specific to the item in question, then use the examples, asking
patients in clinical practice. Examples are also provided of the about each example in turn. For a problem behaviour or
types of impairments that are commonly associated with the symptom to be scored as present, the problem should occur
symptoms in five areas of everyday life: work and education; more frequently or at a more severe level than is usual in an age
relationships and family life; social contacts; free time / hobbies; and IQ matched peer group, or to be closely associated with
self-confidence / self-image. impairments. Tick off each of the examples that are described by
the patient. If alternative examples that fit the criteria are given,
Whenever possible the DIVA should be completed with adults in make a note of these under “other”. To score an item as present it
the presence of a partner and/or family member, to enable is not necessary to score all the examples as present, rather the
retrospective and collateral information to be ascertained at the aim is for the investigator to obtain a clear picture of the
same time. The DIVA usually takes around one and a half hours presence or absence of each criterion.
to complete.
For each criterion, ask whether the partner or family member
The DIVA only asks about the core symptoms of ADHD required agrees with this or can give further examples of problems that
to make the DSM-5 diagnosis of ADHD, and does not ask about relate to each item. As a rule, the partner would report on
other co-occurring psychiatric symptoms, syndromes or adulthood and the family member (usually parent or older
disorders. However comorbidity is commonly seen in both relative) on childhood. The clinician has to use clinical
children and adults with ADHD, in around 75% of cases. For this judgement in order to determine the most accurate answer. If
reason, it is important to complete a general psychiatric the answers conflict with one another, the rule of thumb is that
assessment to enquire about commonly co-occurring the patient is usually the best informant8.
symptoms, syndromes and disorders. The most common mental
health problems that accompany ADHD include anxiety, The information received from the partner and family is mainly
depression, bipolar disorder, substance abuse disorders and intended to supplement the information obtained from the
addiction, sleep problems and personality disorders, and all patient and to obtain an accurate account of both current and
these should be investigated. This is needed to understand the childhood behaviour; the informant information is particularly
full range of symptoms experienced by the individual with useful for childhood since many patients have difficulty recalling
ADHD; and also for the differential diagnosis, to exclude other their own behaviour retrospectively. Many people have a good
major psychiatric disorders as the primary cause of ‘ADHD recall for behaviour from around the age of 10-12 years of age,
symptoms in adults’2. but have difficulty for the pre-school years.

For each criterion, the researcher should make a decision about

Instructions for performing the the presence or absence in both stages of life, taking into
DIVA account the information from all the parties involved. If
collateral information cannot be obtained, the diagnosis should
be based on the patient’s recall alone. If school reports are
The DIVA is divided into 3 parts that are each applied to both available, these can help to give an idea of the symptoms that
childhood and adulthood: were noticed in the classroom during childhood and can be
• The criteria for Attention Deficit (A1) used to support the diagnosis. Symptoms are considered to be
• The criteria for Hyperactivity-Impulsivity (A2) clinically relevant if they occurred to a more severe degree and/
• The Age of Onset and Impairment accounted for by ADHD or more frequently than in the peer group or if they were
symptoms impairing to the individual.

Start with the first set of DSM-5 criteria for Attention Deficit (A1), Age of onset and impairment
followed by the second set of criteria for Hyperactivity/ The third section on Age of Onset and Impairment accounted
Impulsivity (A2). Ask about each of the 18 criteria in turn. For for by the symptoms is an essential part of the diagnostic
each item take the following approach: criteria. Find out whether the patient has always had the

DIVA-5 Diagnostic Interview for ADHD in adults 3

symptoms and, if so, whether several symptoms were present before 12 References
years of age.
1. American Psychiatric Association (APA):
DIVA-5 defines ‘several’ as 3 or more symptoms in either domain before age Diagnostic and Statistical Manual of Mental
12. If 3 or more symptoms did not commence till later in life, record the age Disorders, (5th ed.). Arlington, VA: American
of onset. Psychiatric Publishing, 2013.
2. Diagnostisch interview voor ADHD bij
Then ask about the examples for the different situations in which volwassenen (DIVA 2.0), in: Kooij JJS. ADHD bij
impairment can occur, first in adulthood then in childhood. Place a tick volwassenen. Diagnostiek en behandeling.
next to the examples that the patient recognises and indicate whether the Springer, 2012. Online available in several
impairment is reported for two or more domains of functioning. For the languages at www.divacenter.eu.
disorder to be present, it should cause impairment in at least two 3. Pettersson R, Söderström S, Nilsson KW:
situations, such as work and education; relationships and family life; Diagnosing ADHD in Adults: An Examination of
social contacts; free time and hobbies; self-confidence and self-image, and the Discriminative Validity of Neuropsychological
be at least moderately impairing. Tests and Diagnostic Assessment Instruments. J
Atten Disord 2015; Dec 17:1-13.
Summary of symptoms 4. Ramos-Quiroga JA, Nasillo V, Richarte V, Corrales
In the Summary of Symptoms of Attention Deficit (A) and Hyperactivity/ M, Palma F, Ibáñez P, Michelsen M, Van de Glind
Impulsivity (HI), indicate which of the 18 symptom criteria were present in G, Casas M, Kooij JJ: Criteria and Concurrent
childhood and in adulthood separately. Sum the total number of Validity of DIVA 2.0: A Semi-Structured Diagnostic
symptoms in each domain in childhood and adulthood. Interview for Adult ADHD. J Atten Disord 2016;
Apr 28:1-10.
Indicate on the Score Form whether several symptoms (defined as 3 or 5. Applegate B, Lahey BB, Hart EL, Biederman J,
more) of A and/or HI were present before age 12. Hynd GW, Barkley RA, Ollendick T, Frick PJ,
Indicate whether in adulthood (> age 17) five or more symptoms are Greenhill L, McBurnett K, Newcorn JH, Kerdyk L,
present of A and/or HI. Indicate whether there was evidence of a lifelong Garfinkel B, Waldman I, Shaffer D: Validity of the
persistent course for the symptoms, whether the symptoms were age-of-onset criterion for ADHD: a report from
associated with impairment, whether impairment occurred in at least two the DSM-IV field trials. J Am Acad Child Adolesc
situations, and whether the symptoms might be better explained by Psychiatry 1997; 36(9):1211-21.
another psychiatric disorder. Indicate the degree to which the collateral 6. Barkley RA, Biederman J: Toward a broader
information, and if applicable school reports, support the diagnosis. Finally, definition of the age-of-onset criterion for
conclude whether the diagnosis of ADHD can be made and which attention-deficit hyperactivity disorder. J Am
presentation subtype (with DSM-5 code) applies. Acad Child Adolesc Psychiatry 1997; 36(9):1204-
10.
Explanation to be given beforehand to the patient 7. Faraone SV, Biederman J, Spencer T, Mick E,
This interview will be used to ask about the presence of ADHD symptoms Murray K, Petty C, Adamson JJ, Monuteaux MC:
that you experienced during your childhood and adulthood. The questions Diagnosing adult attention deficit hyperactivity
are based on the official criteria for ADHD in the DSM-5. For each question I disorder: are late onset and subthreshold
will ask you whether you recognise the problem. To help you during the diagnoses valid? Am J Psychiatry 2006;
interview I will provide some examples of each symptom, that describe the 163(10):1720-9.
way that children and adults often experience difficulties related to each of 8. Kooij JJS, Boonstra AM, Willemsen-Swinkels SHN,
the symptoms of ADHD. First of all, you will be asked the questions, then Bekker EM, De Noord I, Buitelaar JL: Reliability,
your partner and family members (if present) will be asked the same validity, and utility of instruments for self-report
questions. Your partner will most likely have known you only since and informant report regarding symptoms of
adulthood and will be asked questions about the period of your life that he Attention-Deficit/Hyperactivity Disorder (ADHD)
or she knew you for; your family will have a better idea of your behaviour in adult patients. J Atten Disorders 2008;
during childhood. Both stages of your life need to be investigated in order 11(4):445-458.
to be able to establish the diagnosis of ADHD.
Reprinted with permission from the Diagnostic and
Statistical Manual of Mental Disorders, (5th ed.).
American Psychiatric Publishing, 2013.

4 DIVA-5 Diagnostic Interview for ADHD in adults

Name of the patient

Date of birth

Sex M / F

Date of interview

Name of researcher

Patient number

Instructions: the symptoms in adulthood have to have been present for at least 6 months. The symptoms in childhood relate to the
age of 5-12 years. For a symptom to be ascribed to ADHD it should have a chronic trait-like course and should not be episodic.

A1 Do you often fail to give close attention to details, or do you make careless mistakes in your work or during other
activities? And how was that during childhood (in schoolwork or during other activities)?

Examples adulthood Examples childhood

Makes careless mistakes Careless mistakes in schoolwork

Works slowly to avoid mistakes Mistakes made by not reading questions properly
Work is inaccurate Overlooks or misses details
Does not read instructions carefully Work is inaccurate
Overlooks or misses details Leaves questions unanswered by not reading them
Too much time needed to complete detailed tasks properly
Gets easily bogged down by details Leaves the reverse side of a test unanswered
Works too quickly and therefore makes mistakes Others comment about careless work
Other: Not checking the answers in homework
Too much time needed to complete detailed tasks
Other:

Symptom present? Yes / No Symptom present? Yes / No

DIVA-5 Diagnostic Interview for ADHD in adults 5

 A2 Do you often have difficulty sustaining your attention in tasks? And how was that during childhood (in play
activities)?

Examples adulthood Examples childhood

Not able to keep attention on tasks for long* Difficulty keeping attention on schoolwork
Quickly distracted by own thoughts or associations Difficulty keeping attention on play*
Easily distracted by unrelated thoughts Difficulty remaining focused during lectures and/or
Difficulty remaining focused during lectures and/or conversations
conversations Easily distracted
Finds it difficult to watch a film through to the end, or to Difficulty concentrating*
read a book* Needing structure to avoid becoming distracted
Quickly becomes bored with things* Quickly becoming bored of activities*
Asks questions about subjects that have already been Other:
discussed
Other:

*Unless the subject is found to be really interesting (e.g.

computer or hobby)
*Unless the subject is found to be really interesting (e.g.
computer or hobby)

Symptom present? Yes / No Symptom present? Yes / No

A3 Does it often seem as though you are not listening when you are spoken to directly? And how was that during
childhood?

Examples adulthood Examples childhood

Dreamy or preoccupied Not knowing what parents/teachers have said

Difficulty concentrating on a conversation Dreamy or preoccupied
Afterwards, not knowing what a conversation was about Only listening during eye contact or when a voice is
Often changing the subject of the conversation raised
Others saying that your thoughts are somewhere else Mind seems elsewhere, even in the absence of any
Mind seems elsewhere, even in the absence of any obvious distraction
obvious distraction Often having to be addressed again
Other: Questions having to be repeated
Other:

Symptom present? Yes / No Symptom present? Yes / No

6 DIVA-5 Diagnostic Interview for ADHD in adults

 A4 Do you often not follow through on instructions and often fail to finish chores or duties in the workplace? And
how was that during childhood (in schoolwork)?

Examples adulthood Examples childhood

Does things that are muddled up together without Difficulty following instructions
completing them Difficulty with instructions involving more than one step
Starts tasks but quickly loses focus and is easily Starts tasks but quickly loses focus and is easily sidetracked
sidetracked Not completing things
Needing a time limit to complete tasks Not completing homework or handing it in
Difficulty completing administrative tasks Needing a lot of structure in order to complete tasks
Difficultly following instructions from a manual Other:
Other:

Symptom present? Yes / No Symptom present? Yes / No

A5 Do you often find it difficult to organise tasks and activities? And how was that during childhood?

Examples adulthood Examples childhood

Difficultly with planning activities of daily life Difficultly being ready on time
Difficulty managing sequential tasks Messy room / desk and/or work
House and/or workplace are disorganised Difficulty keeping materials and belongings in order
Difficulty keeping materials and belongings in order Difficultly playing alone
Works messy and disorganized Difficulty planning tasks or homework
Planning too many tasks or non-efficient planning Fails to meet deadlines
Regularly booking things to take place at the same time Doing things in a muddled way
(double-booking) Arriving late
Arriving late Poor sense of time
Fails to meet deadlines Difficulty keeping himself/herself entertained
Not able to use an agenda or diary consistently Other:
Inflexible because of the need to keep to schedules
Poor sense and management of time
Creating schedules but not using them
Needing other people to structure things
Other:

Symptom present? Yes / No Symptom present? Yes / No

DIVA-5 Diagnostic Interview for ADHD in adults 7

 A6 Do you often avoid (or do you dislike, or are you reluctant to engage in) tasks that require sustained mental
effort? And how was that during childhood?

Examples adulthood Examples childhood

Do the easiest or nicest things first of all Avoidance of homework or has an aversion to this
Often postpone boring or difficult tasks Reads few books or does not feel like reading due to
Postpone tasks so that deadlines are missed mental effort
Avoid monotonous work, such as administration Avoidance of tasks that require a lot of concentration
Avoids preparing reports, completing forms, or Aversion to school subjects that require a lot of
reviewing lengthy papers concentration
Do not like reading due to mental effort Often postpones boring or difficult tasks.
Avoidance of tasks that require a lot of concentration Other:
Other:

Symptom present? Yes / No Symptom present? Yes / No

A7 Do you often lose things that are necessary for tasks or activities? And how was that during childhood?

Examples adulthood Examples childhood

Mislays tools, paperwork, eyeglasses, mobile telephones, Loses school materials, pencils, books, or other items
wallet, keys, or agenda Mislays toys, clothing, or homework
Often leaves things behind Spends a lot of time searching for things
Loses papers for work Gets in a panic if other people move things around
Loses a lot of time searching for things Comments from parents and/or teacher about things
Gets in a panic if other people move things around being lost
Stores things away in the wrong place Other:
Loses notes, lists or telephone numbers
Other:

Symptom present? Yes / No Symptom present? Yes / No

8 DIVA-5 Diagnostic Interview for ADHD in adults

 A8 Are you often easily distracted by extraneous stimuli? And how was that during childhood?

Examples adulthood Examples childhood

Difficulty shutting off from external stimuli In the classroom, often looking outside
After being distracted, difficult to pick up the thread Easily distracted by noises or events
again After being distracted, has difficultly picking up the
Easily distracted by noises or events thread again
Easily distracted by the conversations of others Other:
Difficulty in filtering and/or selecting information
Other:

Symptom present? Yes / No Symptom present? Yes / No

A9 Are you often forgetful in daily activities? And how was that during childhood?

Examples adulthood Examples childhood

Forgets appointments or other obligations Forgets appointments or instructions

Forgets keys, agenda etc. Forgets to do chores or run errands
Needs frequent reminders for appointments Has to be frequently reminded of things
Forgets to pay bills or to return calls Half-way through a task, forgetting what has to be done
Returning home to fetch forgotten things Forgets to take things to school
Rigid use of lists to make sure things aren’t forgotten Leaving things behind at school or at friends’ houses
Forgets to keep or look at daily agenda Other:
Forgets to do chores or run errands
Other:

Symptom present? Yes / No Symptom present? Yes / No

DIVA-5 Diagnostic Interview for ADHD in adults 9

 Part 2: Symptoms of hyperactivity-impulsivity

Instructions: the symptoms in adulthood have to have been present for at least 6 months. The symptoms in childhood relate to the
age of 5-12 years. For a symptom to be ascribed to ADHD it should have a chronic trait-like course and should not be episodic.

H/I 1 Do you often fidget with or tap hands or feet, or do you often squirm in your seat? And how was that during
childhood?

Examples adulthood Examples childhood

Difficulty sitting still Parents often said “sit still” or similar

Fidgets with the legs Fidgets with the legs
Tapping with a pen or playing with something Tapping with a pen or playing with something
Fiddling with hair or biting nails Fiddling with hair or biting nails
Able to control restlessness, but feels stressed as a result Unable to remain seated in a chair in a relaxed manner
Other: Able to control restlessness, but feels stressed as a result
Other:

Symptom present? Yes / No Symptom present? Yes / No

H/I 2 Do you often leave your seat in situations where it is expected that you remain seated? And how was that
during childhood?

Examples adulthood Examples childhood

Often leaves his/her place in the office or in the Often stands up while eating or leaves his/her place in
workplace the classroom
Avoids symposiums, lectures, church etc. Finds it very difficult to stay seated at school or during
Prefers to walk around rather than sit meals
Never sits still for long, always moving around Being told to remain seated
Stressed owing to the difficulty of sitting still Making excuses in order to walk around
Makes excuses in order to be able to walk around Other:
Other:

Symptom present? Yes / No Symptom present? Yes / No

10 DIVA-5 Diagnostic Interview for ADHD in adults

 H/I 3 Do you often feel restless? And how was that during childhood?

Examples adulthood Examples childhood

Feeling restless or agitated inside Always running around where it is inappropriate

Constantly having the feeling that you have to be doing Climbing on furniture, or jumping on the sofa
something Climbing in trees
Finding it hard to relax Feeling restless inside
Other: Other:

Symptom present? Yes / No Symptom present? Yes / No

H/I 4 Do you often find it difficult to engage in leisure activities quietly? And how was that during childhood (in play
activities)?

Examples adulthood Examples childhood

Talks during activities when this is not appropriate Being loud-spoken during play or in the classroom
Becoming quickly too cocky in public Unable to watch TV or films quietly
Being loud in all kinds of situations Asked to be quieter or calm down
Difficulty doing activities quietly Becoming quickly too cocky in public
Difficultly in speaking softly Other:
Other:

Symptom present? Yes / No Symptom present? Yes / No

DIVA-5 Diagnostic Interview for ADHD in adults 11

 H/I 5 Are you often “on the go” or do you often act as if “driven by a motor”? And how was that during childhood?

Examples adulthood Examples childhood

Always busy doing something Constantly busy

Is uncomfortable being still for extended time, e.g. in Others find you restless or difficult to keep up with
restaurants or meetings Is uncomfortable being still for extended time
Has too much energy, always on the move Excessively active at school and at home
Others find you restless or difficult to keep up with Has lots of energy
Stepping over own boundaries Always on the go, excessively driven
Finds it difficult to let things go, excessively driven Other:
Other:

Symptom present? Yes / No Symptom present? Yes / No

H/I 6 Do you often talk excessively? And how was that during childhood?

Examples adulthood Examples childhood

So busy talking that other people find it tiring Known as a chatterbox

Known to be an incessant talker Teachers and parents often ask you to be quiet
Finds it difficult to stop talking Comments in school reports about talking too much
Tendency to talk too much Being punished for talking too much
Not giving others room to interject during a Keeping others from doing schoolwork by talking too
conversation much
Needing a lot of words to say something Not giving others room during a conversation
Other: Other:

Symptom present? Yes / No Symptom present? Yes / No

12 DIVA-5 Diagnostic Interview for ADHD in adults

 H/I 7 Do you often blurt out an answer before questions have been completed? And how was that during
childhood?

Examples adulthood Examples childhood

Being a blabbermouth, saying what you think Being a blabbermouth, saying things without thinking
Saying things without thinking first first
Giving people answers before they have finished Wants to be the first to answer questions at school
speaking Blurts out an answer even if it is wrong
Completing other people’s sentences Interrupts others before sentences are finished
Being tactless Difficulty waiting for turn during conversations
Other: Coming across as being tactless
Other:

Symptom present? Yes / No Symptom present? Yes / No

H/I 8 Do you often find it difficult to await your turn? And how was that during childhood?

Examples adulthood Examples childhood

Difficulty waiting in a queue, jumping the queue Difficultly waiting turn in group activities
Difficulty in patiently waiting in the traffic/traffic jams Difficultly waiting turn in the classroom
Being impatient Always being the first to talk or act
Quickly starting relationships/jobs, or ending/leaving Becomes quickly impatient
these because of impatience Crosses the road without looking
Other: Other:

Symptom present? Yes / No Symptom present? Yes / No

DIVA-5 Diagnostic Interview for ADHD in adults 13

 H/I 9 Do you often interrupt or intrude on others? And how was that during childhood?

Examples adulthood Examples childhood

Being quick to interfere with others Interrupts the games or activities of others
Intrudes on others Starts using people’s things without asking or permission
Disturbs other people’s activities without being asked, or Interrupts the conversations of others
takes over their tasks Reacts to everything
Comments from others about interference Unable to wait
Difficulty respecting the boundaries of others Other:
Having an opinion about everything and immediately
expressing this
Other:

Symptom present? Yes / No

Symptom present? Yes / No

Part 3: Impairment on account of the symptoms

Have you always had these symptoms of attention deficit and/or hyperactivity/impulsivity?

Yes (several symptoms were present prior to the 12th year of age)
No
If no is answered above, starting as from year of age

14 DIVA-5 Diagnostic Interview for ADHD in adults

In which areas do you have / have you had problems with these symptoms?

Adulthood Childhood and adolescence

Work/education Education
Did not complete education/training needed for work Lower educational level than expected based on IQ
Work below level of education Staying back (repeating classes) as a result of
Tire quickly of a workplace concentration problems
Pattern of many short-lasting jobs Education not completed / rejected from school
Difficulty with administrative work/planning Took much longer to complete education than usual
Not achieving promotions Achieved education suited to IQ with a lot of effort
Under-performing at work Difficulty doing homework
Left work following arguments or dismissal Followed special education on account of symptoms
Sickness benefits/disability benefit as a result of Comments from teachers about behaviour or
symptoms concentration
Limited impairment through compensation of high IQ Limited impairment through compensation of high IQ
Limited impairment through compensation of external Limited impairment through compensation of external
structure structure
Other: Other:

Relationship and/or family Family

Tire quickly of relationships Frequent arguments with brothers or sisters
Impulsively commencing/ending relationships Frequent punishment or hiding
Unequal partner relationship owing to symptoms Little contact with family on account of conflicts
Relationship problems, lots of arguments, lack of Required structure from parents for a longer period than
intimacy would normally be the case
Divorced owing to symptoms Other:
Problems with sexuality as a result of symptoms
Problems with upbringing as a result of symptoms
Difficulty with housekeeping and/or administration
Financial problems or gambling
Not daring to start a relationship
Other:

DIVA-5 Diagnostic Interview for ADHD in adults 15

Adulthood (continuance) Childhood and adolescence (continuance)

Social contacts Social contacts

Tire quickly of social contacts Difficultly maintaining social contacts
Difficultly maintaining social contacts Conflicts as a result of communication problems
Conflicts as a result of communication problems Difficultly entering into social contacts
Difficulty initiating social contacts Low self-assertiveness as a result of negative experiences
Low self-assertiveness as a result of negative experiences Few friends
Not being attentive (i.e. forget to send a card/ Being teased
empathising/phoning, etc) Shut out by, or not being allowed, to do things with a
Other: group
Being a bully
Other:

Free time / hobby Free time/hobby

Unable to relax properly during free time Unable to relax properly during free time
Having to play lots of sports in order to relax Having to play lots of sport to be able to relax
Injuries as a result of excessive sport Injuries as a result of excessive sport
Unable to finish a book or watch a film all the way Unable to finish a book or watch a film all the way
through through
Being continually busy and therefore becoming Being continually busy and therefore becoming
overtired overtired
Tire quickly of hobbies Tired quickly of hobbies
Accidents/loss of driving licence as a result of reckless Sensation seeking and/or taking too many risks
driving behaviour Contact with the police/courts
Sensation seeking and/or taking too many risks Increased number of accidents
Contact with the police/the courts Other:
Binge eating
Other:

Self-confidence / self-image Self-confidence / self-image

Uncertainty through negative comments of others Uncertainty through negative comments of others
Negative self-image due to experiences of failure Negative self-image due to experiences of failure
Fear of failure in terms of starting new things Fear of failure in terms of starting new things
Excessive intense reaction to criticism Excessive intense reaction to criticism
Perfectionism Perfectionism
Distressed by the symptoms of ADHD Other:
Other:

16 DIVA-5 Diagnostic Interview for ADHD in adults

 Adulthood: Evidence of impairment in ≥2 areas? Yes / No

Childhood: Evidence of impairment in ≥2 areas? Yes / No

End of the interview. Please continue with the summary.

Potential details:

DIVA-5 Diagnostic Interview for ADHD in adults 17

 Summary of symptoms A and H/I

Indicate which criteria were scored in parts 1 and 2 and add up

Criterion Symptom Present during Present

DSM-5 adulthood during
childhood

A1a A1. Often fails to give close attention to details, or makes careless mistakes in
schoolwork, work or during other activities

A1b A2. Often has difficultly sustaining attention in tasks or play activities

A1c A3. Often does not seem to listen when spoken to directly

A1d A4. Often does not follow through on instructions and fails to finish
schoolwork, chores, or duties in the workplace

A1e A5. Often has difficulty organizing tasks and activities

A1f A6. Often avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort

A1g A7. Often loses things necessary for tasks or activities

A1h A8. Often easily distracted by extraneous stimuli

A1i A9. Often forgetful in daily activities

Total number of criteria Attention Deficit

/9 /9

A2a H/I 1. Often fidgets with or taps hands or feet or squirms in seat

A2b H/I 2. Often leaves seat in situations when remaining seated is expected

A2c H/I 3. Often runs about or climbs in situations where it is inappropriate (in
adolescents or adults this may be limited to subjective feelings of restlessness)

A2d H/I 4. Often unable to play or take part in leisure activities quietly

A2e H/I 5. Is often “on the go” acting as if “driven by a motor”

A2f H/I 6. Often talks excessively

A2g H/I 7. Often blurts out an answer before a question has been completed

A2h H/I 8. Often has difficulty awaiting his or her turn

A2i H/I 9. Often interrupts or intrudes on others

Total number of criteria Hyperactivity/Impulsivity

/9 /9

18 DIVA-5 Diagnostic Interview for ADHD in adults

 Score form

DSM-5 Childhood
criterion A Are several (3 or more) symptoms present of A and/or HI? Yes / No

Adulthood
Is the number of A characteristics ≥ 5? Yes / No
Is the number of H/I characteristics ≥ 5? Yes / No
DSM-5 Are there signs of a lifelong pattern of symptoms, starting before Yes / No
criterion B the 12th year of age?
DSM-5 The symptoms and the impairment are expressed in at least two
criterion C domains of functioning
and D
Adulthood Yes / No
Childhood Yes / No
DSM-5 The symptoms cannot be (better) explained by the presence of No
criterion E another psychiatric disorder Yes, by

Is the diagnosis supported by collateral information?

Parent(s)/brother/sister/other, i.e. * N/A 0 1 2

Partner/good friend/other, i.e. * N/A 0 1 2

School reports N/A 0 1 2

0 = none/little support Explanation:

1 = some support
2 = clear support

Diagnosis No
ADHD** Yes:
314.01 Combined presentation type
314.00 Predominantly inattentive presentation type
314.01 Predominantly hyperactive-impulsive presentation type

314.01 Other specified attention-deficit/hyperactivity disorder

314.01 Not specified attention-deficit/hyperactivity disorder

Partly in remission
Severity mild
moderate
severe

* Indicate from whom the collateral information was taken.

** If the established presentation types differ in childhood and adulthood, the current adult presentation type prevails for the
diagnosis.

DIVA-5 Diagnostic Interview for ADHD in adults 19

 ENGLISH

DIVA-5