ADHD
ASRS or DIVA-5: a screening test is not a diagnosis
A positive ASRS is not a diagnosis and a negative one does not rule ADHD out. What the scores mean and what the DIVA-5 interview adds.
The ASRS is a screening questionnaire, not a diagnosis. It can tell you that an assessment is worth doing, but only a clinical assessment, which in this practice is a structured interview called the DIVA-5, can confirm or rule out adult ADHD.
What the ASRS is
The ASRS (Adult ADHD Self-Report Scale) is a short questionnaire developed with the World Health Organization. You rate how often you notice certain attention, restlessness and impulsivity problems. It takes a few minutes and costs nothing, which is exactly why it is useful: ADHD in adults is under-diagnosed in many European countries, and simple tools help people take the first step [7]. You can try the questionnaire on the tests page.
But a screening tool answers a narrow question: “Is it worth looking further?” It does not answer “Do I have ADHD?”
What a score can and cannot tell you
Research on the scale itself shows why the result cannot be treated as a verdict:
A positive result is not a diagnosis. In the study that updated the ASRS for DSM-5 criteria, the six-question version had a positive predictive value of 67.3% in the general population. In plain terms, about one in three people who screened positive did not meet the criteria at a full diagnostic interview. In a clinic sample, where people are already seeking help, 74.0% specificity meant that about a quarter of those without ADHD still screened positive [3].
A negative result does not exclude ADHD. In the earlier validation study, the six-question screener had a sensitivity of 68.7%, so roughly three in ten people who met clinical criteria were missed [2]. In a study of 404 people in residential treatment for alcohol dependence, the ASRS picked up only 57.1% of those diagnosed after a structured interview, and the authors state that a negative screening result does not necessarily imply the absence of ADHD [4]. That group is specific, so do not read the number as a rate for everyone, but the lesson transfers: a self-report scale can under-report.
These studies measure different things in different groups, so I am not giving you one “accuracy figure”. The point is simpler. A questionnaire counts symptoms. It cannot ask why they happen, whether they began in childhood, or how much they interfere with your life.
What a diagnosis actually requires
NICE is clear that ADHD should be diagnosed by a specialist or a suitably qualified clinician after a full clinical and psychosocial assessment, a full developmental and psychiatric history, observer reports where possible and an assessment of mental state. It also states that a diagnosis should not be made solely on the basis of rating scale data. Symptoms must be often present, in two or more important settings, and cause at least moderate impairment [1].
A UK quality standard for adult ADHD assessment adds the same logic: assessment belongs inside a full psychiatric and neurodevelopmental review, uses a semi-structured interview that draws out real-life examples, and evaluates impairment [6].
What the DIVA-5 interview is
The DIVA-5 is a structured interview built on the 18 DSM-5 symptoms of ADHD. For each symptom we look at childhood and at adult life, with concrete examples, and at how it affects different areas of life [5]. In practice that means I ask you what a symptom looks like on an ordinary Tuesday, then what it looked like at school, and how it shows up at work and in relationships. When there is a parent, partner or old school report that helps with the early years, it adds to the picture.
The DIVA Foundation also notes that the interview is used alongside a general psychiatric assessment [5]. That matters because anxiety, depression, sleep problems and trauma can mimic ADHD or sit on top of it. When a score and a story do not match, the interview is where we find out why.
Questionnaires still have a place, but around the interview, not instead of it. Rating scales are given both to you and to someone who knows you, so that two views of the same behaviour can be compared, and further questionnaires look at mood and anxiety. They support the interview; they do not decide on its behalf.
Why a score alone can mislead you
When you score high and stop there, you risk the wrong explanation, because stress, poor sleep or low mood can raise the same answers. When you score low and stop there, you risk missing a real difficulty, because many adults have spent years compensating and they answer from the point of view of “that’s just me”. Both mistakes come from one habit: treating a number as a conclusion.
The thoughts below show up often around test results, and they are worth testing instead of believing:
All-or-nothing: “The test says yes, so I definitely have it” or “the test says no, so I’m just lazy.” A score is one piece of information.
Mind-reading: “A doctor will think I only want a label.” An assessment is there to find out what is true for you, including that the answer might be something else.
Catastrophising: “If it’s ADHD, then my whole past was wasted.” A diagnosis explains the past. It does not cancel it.
Ask yourself a concrete question: if you scored very high and your work, relationships and daily routines are running well, what does that tell you? And if you scored low but every week falls apart in the same way, is “no problem” the honest conclusion?
A score is a number. What matters is how your life actually works day to day.
A score also cannot hear the difference between two sentences that tick the same box. “I’m low” and “I’m not sad, I just can’t get started” can both mean that tasks stay undone, yet the first points towards depression and the second more towards ADHD. That difference only shows up in conversation.
What happens after the assessment
You receive a written report and a clear explanation. If a diagnosis is made, we talk through the options together, including psychological work and, where it fits, medical options, with the advantages and possible side effects discussed up front, a timeline and a trial period. If it is not ADHD, we say that plainly and look at what else could explain your difficulties. Whether any treatment is offered is decided after the assessment, never before it.
After the assessment you leave with a shared understanding of your profile, concrete next steps and a set date to review how they are working.
Sometimes the definitive diagnosis has to wait for one more piece: an account of your childhood from a third person, usually a parent, or from a partner. If that cannot happen, the decision rests on the clinical interview. Either way, you know in advance which route we are following and why.
When to get assessed
The question is not “do I have some of these traits?” Most people recognise a few. The question is whether the difficulties regularly get in the way of your work, studies, relationships or daily functioning, and whether they have been there since childhood. Discomfort alone is not the test. Repeated interference is.
If that sounds like you, take the next step instead of waiting to feel ready. Action comes before mood: book the first session, and in the meantime write down three real situations from the last month. They are more useful in the room than any score. The preparation guide lists what to bring.
I see adults in Trikala, Karditsa, Kalambaka and online anywhere in Greece, in English or Greek. The assessment is usually two 45-minute sessions at 130 € each. The adult ADHD service page explains how it works, this article walks through the process step by step, and you can book an appointment directly.
Educational information. It does not replace an individual assessment.
Sources
NICE. Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations 1.2.2, 1.3.1–1.3.4. https://www.nice.org.uk/guidance/ng87/chapter/recommendations (retrieved 29/10/2026)
Kessler RC, Adler L, Ames M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005;35(2):245-256. https://doi.org/10.1017/S0033291704002892
Ustun B, Adler LA, Rudin C, et al. The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5. JAMA Psychiatry 2017;74(5):520-527. https://doi.org/10.1001/jamapsychiatry.2017.0298
Luderer M, Kaplan-Wickel N, Richter A, et al. Screening for adult attention-deficit/hyperactivity disorder in alcohol dependent patients: Underreporting of ADHD symptoms in self-report scales. Drug Alcohol Depend 2019;195:52-58. https://doi.org/10.1016/j.drugalcdep.2018.11.020
DIVA Foundation. About DIVA-5. https://www.divacenter.eu/diva-5/about-diva-5/ (retrieved 29/10/2026)
Adamou M, Arif M, Asherson P, et al. The adult ADHD assessment quality assurance standard. Front Psychiatry 2024;15:1380410. https://doi.org/10.3389/fpsyt.2024.1380410
Kooij JJS, Bijlenga D, Salerno L, et al. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry 2019;56:14-34. https://doi.org/10.1016/j.eurpsy.2018.11.001
