DSM-IV-TR

The DSM-IV-TR was the diagnostic manual used by mental health professionals to diagnose ADHD from 1994 to 2013. The DSM-IV-TR defined ADHD as a mental disorder characterized by six symptoms:

• Inattention: Difficulty paying attention to details, making careless mistakes, not following through on instructions, difficulty sustaining attention in tasks or play, not seeming to listen when spoken to directly, easily distracted by extraneous stimuli, and forgetful in daily activities.
• Hyperactivity: Fidgeting or squirming in seat, leaving seat in situations where remaining seated is expected, running or climbing in situations where it is not appropriate (in adolescents or adults, may be limited to feeling restless), difficulty playing or engaging in leisure activities quietly, excessive talking, and difficulty engaging in activities quietly.
• Impulsivity: Acting without thinking, blurting out answers before questions have been completed, difficulty waiting in line, interrupting or intruding on others.

To be diagnosed with ADHD, a child had to have six or more symptoms of inattention and/or hyperactivity-impulsivity for at least six months, and the symptoms had to cause significant impairment in social, academic, or occupational functioning.

DSM-5

The DSM-5 was published in 2013 and is the current diagnostic manual used by mental health professionals to diagnose ADHD. The DSM-5 made a number of changes to the diagnostic criteria for ADHD, including:

• Redefining inattention and hyperactivity-impulsivity: The DSM-5 redefined inattention and hyperactivity-impulsivity as two separate dimensions, rather than as two components of a single disorder. This change was made because research has shown that inattention and hyperactivity-impulsivity can occur independently of each other.
• Reducing the number of symptoms required for diagnosis: The DSM-5 reduced the number of symptoms required for diagnosis from six to five for inattention and six to four for hyperactivity-impulsivity. This change was made to make the diagnosis of ADHD more accurate and to reduce the number of false positives.
• Adding a specifier for ‘Combined Presentation’: The DSM-5 added a specifier for ‘Combined Presentation’ to indicate that a child meets the criteria for both inattention and hyperactivity-impulsivity. This specifier was added to make it easier to diagnose children who have both inattention and hyperactivity-impulsivity.

Changes in Discrepancy Regarding Proper Diagnosis

The changes to the diagnostic criteria in the DSM-5 have led to some reduction in discrepancy regarding proper diagnosis of ADHD. This is because the DSM-5 criteria are more specific and less subjective than the DSM-IV-TR criteria. However, there is still some controversy regarding the diagnosis and treatment of ADHD. Some people believe that the DSM-5 criteria are too lenient and that too many children are being diagnosed with ADHD. Others believe that the DSM-5 criteria are too strict and that some children with ADHD are not being diagnosed.

Overall, the changes to the diagnostic criteria in the DSM-5 have led to some improvement in the accuracy of diagnosis of ADHD. However, there is still some controversy regarding the diagnosis and treatment of this disorder. More research is needed to determine the best way to diagnose and treat ADHD.