DSM-5 and Other Symptom Thresholds for ADHD: Which Is the Best Predictor of Impairment in College Students?

Cynthia M. Hartung, Elizabeth K. Lefler, Will H. Canu, Anne E. Stevens, Maryanne Jaconis, Patrick A. LaCount, Christopher R. Shelton, Daniel R. Leopold, Erik G. Willcutt

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective: Approximately 5% of adults have ADHD. Despite recommendations regarding the diagnosis of emerging adults, there is not a strong consensus regarding the ideal method for diagnosing ADHD in both emerging and mature adults. We were interested in determining whether a threshold of four, five, or six ADHD symptoms would be associated with significantly different levels of functional impairment and be more or less indicative of a potential ADHD diagnosis. Method: We examined the relation between functional impairment and these ADHD symptom thresholds in 2,577 college students. Results: Our findings suggest that none of these symptom thresholds are differentially better at predicting functional impairment. Conclusion: The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) threshold of five symptoms for ages 17 years and older is not necessarily predictive of ADHD-related impairment in college students and may not be preferable to other thresholds. Options for resolving this diagnostic dilemma are discussed.

Original languageEnglish (US)
Pages (from-to)1637-1646
Number of pages10
JournalJournal of Attention Disorders
Issue number13
StatePublished - Nov 1 2019

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology
  • Clinical Psychology


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