J.J.S. Kooij, MD, PhD & M.H. Francken, MSc
2010, DIVA Foundation, The Netherlands
Diagnostic Interview for ADHD
in adults (DIVA)
D iagnostisch I nterview V oor A DHD bij volwassenen
DIVA
2.0
diagnostic interview
for ADHD
in adults
ENGLISH
2
DIVA 2.0 Diagnostic Interview for ADHD in adults
Colophon
The Diagnostic Interview for
ADHD in adults (DIVA) is a
publication of the DIVA
Foundation, The Hague,
The Netherlands, August
2010. The original English
translation by Vertaalbureau
Boot was supported by
Janssen-Cilag B.V. Back-
translation into Dutch by
Sietske Helder. Revison by
dr. J.J.S. Kooij, DIVA
Foundation and Prof. Philip
Asherson, Institute of
Psychiatry, London.
Reprinted with permission
from the Diagnostic and
Statistical Manual of Mental
Disorders, Text Revision,
Fourth Edition (Copyright
2000). American Psychiatric
Association.
This publication has been
put together with care.
However, over the course of
time, parts of this publication
might change. For that
reason, no rights may be
derived from this publica-
tion. For more information
and future updates of the
DIVA please visit
www.divacenter.eu.
Introduction
According to the DSM-IV, ascertaining the diagnosis of ADHD in adults
involves determining the presence of ADHD symptoms during both childhood
and adulthood.
The main requirements for the diagnosis are that the onset of ADHD symp-
toms occurred during childhood and that this was followed by a lifelong
persistence of the characteristic symptoms to the time of the current evalua-
tion. The symptoms need to be associated with significant clinical or psycho-
social impairments that affect the individual in two or more life situations
1
.
Because ADHD in adults is a lifelong condition that starts in childhood, it is
necessary to evaluate the symptoms, course and level of associated impair-
ment in childhood, using a retrospective interview for childhood behaviours.
Whenever possible the information should be gathered from the patient and
supplemented by information from informants that knew the person as a child
(usually parents or close relatives)
2
.
The Diagnostic Interview for ADHD in Adults (DIVA)
The DIVA is based on the DSM-IV criteria and is the first structured Dutch
interview for ADHD in adults. The DIVA has been developed by J.J.S. Kooij
and M.H. Francken and is the successor of the earlier Semi-Structured
Interview for ADHD in adults
2,3
.
In order to simplify the evaluation of each of the 18 symptom criteria for
ADHD, in childhood and adulthood, the interview provides a list of concrete
and realistic examples, for both current and retrospective (childhood) behav-
iour. The examples are based on the common descriptions provided by adult
patients in clinical practice. Examples are also provided of the types of
impairments that are commonly associated with the symptoms in five areas of
everyday life: work and education; relationships and family life; social con-
tacts; free time and hobbies; self-confidence and self-image.
Whenever possible the DIVA should be completed with adults in the presence
of a partner and/or family member, to enable retrospective and collateral
information to be ascertained at the same time. The DIVA usually takes
around one and a half hours to complete.
The DIVA only asks about the core symptoms of ADHD required to make the
DSM-IV diagnosis of ADHD, and does not ask about other co-occurring
psychiatric symptoms, syndromes or disorders. However comorbidity is
commonly seen in both children and adults with ADHD, in around 75% of
cases. For this reason, it is important to complete a general psychiatric
assessment to enquire about commonly co-occurring symptoms, syndromes
and disorders. The most common mental health problems that accompany
ADHD include anxiety, depression, bipolar disorder, substance abuse disor-
ders and addiction, sleep problems and personality disorders, and all these
should be investigated. This is needed to understand the full range of symp-
toms experienced by the individual with ADHD; and also for the differential
diagnosis, to exclude other major psychiatric disorders as the primary cause
of ‘ADHD symptoms’ in adults
2
.
DIVA 2.0 Diagnostic Interview for ADHD in adults
3
The DIVA is divided into three parts that are each applied
to both childhood and adulthood:
n The criteria for Attention Deficit (A1)
n The criteria for Hyperactivity-Impulsivity (A2)
n The Age of Onset and Impairment accounted for by
ADHD symptoms
Start with the first set of DSM-IV criteria for attention deficit
(A1), followed by the second set of criteria for hyperactiv-
ity/impulsivity (A2). Ask about each of the 18 criteria in
turn. For each item take the following approach:
First ask about adulthood (symptoms present in the last
6-months or more) and then ask about the same symptom
in childhood (symptoms between the ages of 5 to 12
years)
4-6
. Read each question fully and ask the person
being interviewed whether they recognise this problem
and to provide examples. Patients will often give the same
examples as those provided in the DIVA, which can then
be ticked off as present. If they do not recognise the
symptoms or you are not sure if their response is specific
to the item in question, then use the examples, asking
about each example in turn. For a problem behaviour or
symptom to be scored as present, the problem should
occur more frequently or at a more severe level than is
usual in an age and IQ matched peer group, or to be
closely associated with impairments. Tick off each of the
examples that are described by the patient. If alternative
examples that fit the criteria are given, make a note of
these under “other”. To score an item as present it is not
necessary to score all the examples as present, rather the
aim is for the investigator to obtain a clear picture of the
presence or absence of each criterion.
For each criterion, ask whether the partner or family
member agrees with this or can give further examples of
problems that relate to each item. As a rule, the partner
would report on adulthood and the family member (usually
parent or older relative) on childhood. The clinician has to
use clinical judgement in order to determine the most
accurate answer. If the answers conflict with one another,
the rule of thumb is that the patient is usually the best
informant
7
.
The information received from the partner and family is
mainly intended to supplement the information obtained
from the patient and to obtain an accurate account of both
current and childhood behaviour; the informant information
is particularly useful for childhood since many patients
have difficulty recalling their own behaviour retrospective-
ly. Many people have a good recall for behaviour from
around the age of 10-12 years of age, but have difficulty
for the pre-school years.
For each criterion, the researcher should make a decision
about the presence or absence in both stages of life,
taking into 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 available, these can help to give an
idea of the symptoms that were noticed in the classroom
during childhood and can be used to support the diagno-
sis. Symptoms are considered to be clinically relevant if
they occurred to a more severe degree and/or more
frequently than in the peer group or if they were impairing
to the individual.
Age of onset and impairment
The third section on Age of Onset and Impairment ac-
counted for by the symptoms is an essential part of the
diagnostic criteria. Find out whether the patient has always
had the symptoms and, if so, whether any symptoms were
present before 7-years of age. If the symptoms did not
commence till later in life, record the age of onset.
Then ask about the examples for the different situations in
which impairment can occur, first in adulthood then in
childhood. Place a tick next to the examples that the
patient recognises and indicate whether the impairment is
reported for two or more domains of functioning. For the
disorder to be present, it should cause impairment in at
least two situations, such as work and education; relation-
ships and family life; social contacts; free time and
hobbies; self-confidence and self-image, and be at least
moderately impairing.
Summary of symptoms
In the Summary of Symptoms of Attention Deficit (A) and
Hyperactivity-Impulsivity (HI), indicate which of the
18 symptom criteria are present in both stages of life; and
sum the number of criteria for inattention and hyperactivity/
impulsivity separately.
Finally, indicate on the Score Form whether six or more
criteria are scored for each of the symptom domains of
Attention Deficit (A) and Hyperactivity-Impulsivity (HI). For
each domain, indicate whether there was evidence of a
lifelong persistent course for the symptoms, whether the
symptoms were associated with impairment, whether
impairment occurred in at least two situations, and
whether the symptoms might be better explained by
another psychiatric disorder. Indicate the degree to which
Instructions for performing the DIVA
4
DIVA 2.0 Diagnostic Interview for ADHD in adults
References
1. American Psychiatric Association (APA):
Diagnostic and Statistical Manual of Mental
Disorders, Text Revision, Fourth Edition.
Washington DC, 2000.
2. Diagnostic Interview for ADHD in Adults 2.0
(DIVA 2.0), in: Kooij, JJS. Adult ADHD. Diagnos-
tic assessment and treatment. Pearson Assess-
ment and Information BV, Amsterdam, 2010.
3. Kooij JJS, Francken MH: Diagnostisch Interview
Voor ADHD (DIVA) bij volwassenen. Online
available at www.kenniscentrumadhdbijvolwas-
senen.nl, 2007 and published in English in
reference 2.
4. Applegate B, Lahey BB, Hart EL, Biederman J,
Hynd GW, Barkley RA, Ollendick T, Frick PJ,
Greenhill L, McBurnett K, Newcorn JH, Kerdyk
L, Garfinkel B, Waldman I, Shaffer D: Validity of
the age-of-onset criterion for ADHD: a report
from the DSM-IV field trials. J Am Acad Child
Adolesc Psychiatry 1997; 36(9):1211-21
5. Barkley RA, Biederman J: Toward a broader
definition of the age-of-onset criterion for
attention-deficit hyperactivity disorder. J Am
Acad Child Adolesc Psychiatry 1997;
36(9):1204-10
6. Faraone SV, Biederman J, Spencer T, Mick E,
Murray K, Petty C, Adamson JJ, Monuteaux
MC: Diagnosing adult attention deficit hyperac-
tivity disorder: are late onset and subthreshold
diagnoses valid? Am J Psychiatry
2006;163(10):1720-9
7. Kooij JJS, Boonstra AM, Willemsen-Swinkels
SHN, Bekker EM, Noord Id, Buitelaar JL:
Reliability, validity, and utility of instruments for
self-report and informant report regarding
symptoms of Attention-Deficit/Hyperactivity
Disorder (ADHD) in adult patients. J Atten
Disorders 2008; 11(4):445-458
Reprinted with permission from the Diagnostic and
Statistical Manual of Mental Disorders, Text Revi-
sion, Fourth Edition (Copyright 2000). American
Psychiatric Association.
the collateral information, and if applicable school reports,
support the diagnosis. Finally, conclude whether the
diagnosis of ADHD can be made and which subtype (with
DSM-IV code) applies.
Explanation to be given beforehand to the patient
This interview will be used to ask about the presence of
ADHD symptoms that you experienced during your
childhood and adulthood. The questions are based on the
official criteria for ADHD in the DSM-IV. For each question
I will ask you whether you recognise the problem. To help
you during the interview I will provide some examples of
each symptom, that describe the way that children and
adults often experience difficulties related to each of the
symptoms of ADHD. First of all, you will be asked the
questions, then your partner and family members (if
present) will be asked the same questions. Your partner
will most likely have known you only since adulthood and
will be asked questions about the period of your life that
he or she knew you for; your family will have a better idea
of your behaviour during childhood. Both stages of your
life need to be investigated in order to be able to establish
the diagnosis of ADHD.
DIVA 2.0 Diagnostic Interview for ADHD in adults
5
Name of the patient
Date of birth
Sex:
Date of interview
Name of researcher
Patient number
Part 1: Symptoms of attention-deficit (DSM-IV criterion A1)
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.
M / F
Do you often fail to give close attention to detail, or do you make careless mistakes in your work or
during other activities? And how was that during childhood?
A1
Examples during adulthood:
Makes careless mistakes
Works slowly to avoid mistakes
Does not read instructions carefully
Difficulty working in a detailed way
Too much time needed to complete detailed tasks
Gets easily bogged down by details
Works too quickly and therefore makes mistakes
Other:
Symptom present: Yes / No
Examples during childhood:
Careless mistakes in schoolwork
Mistakes made by not reading questions properly
Leaves questions unanswered by not reading them
properly
Leaves the reverse side of a test unanswered
Others comment about careless work
Not checking the answers in homework
Too much time needed to complete detailed tasks
Other:
Symptom present:
Yes / No
6
DIVA 2.0 Diagnostic Interview for ADHD in adults
Do you often find it difficult to sustain your attention on tasks? And how was that during childhood?
Does it often seem as though you are not listening when you are spoken to directly? And how was that
during childhood?
A2
A3
Examples during adulthood:
Not able to keep attention on tasks for long*
Quickly distracted by own thoughts or associations
Finds it difficult to watch a film through to the end, or to
read a book*
Quickly becomes bored with things*
Asks questions about subjects that have already been
discussed
Other:
*Unless the subject is found to be really interesting (e.g.
computer or hobby)
Symptom present:
Yes / No
Examples during adulthood:
Dreamy or preoccupied
Difficulty concentrating on a conversation
Afterwards, not knowing what a conversation was
about
Often changing the subject of the conversation
Others saying that your thoughts are somewhere else
Other:
Symptom present: Yes / No
Examples during childhood:
Difficulty keeping attention on schoolwork
Difficulty keeping attention on play*
Easily distracted
Difficulty concentrating*
Needing structure to avoid becoming distracted
Quickly becoming bored of activities*
Other:
*Unless the subject is found to be really interesting (e.g.
computer or hobby)
Symptom present:
Yes / No
Examples during childhood:
Not knowing what parents/teachers have said
Dreamy or preoccupied
Only listening during eye contact or when a voice is
raised
Often having to be addressed again
Questions having to be repeated
Other:
Symptom present: Yes / No
DIVA 2.0 Diagnostic Interview for ADHD in adults
7
Do you often fail to follow through on instructions and do you often fail to finish jobs or fail to meet obligations
at work? And how was that during childhood (when doing schoolwork as opposed to when at work)?
Do you often find it difficult to organise tasks and activities? And how was that during childhood?
A4
A5
Examples during adulthood:
Does things that are muddled up together without
completing them
Difficulty completing tasks once the novelty has worn off
Needing a time limit to complete tasks
Difficulty completing administrative tasks
Difficulty following instructions from a manual
Other:
Symptom present: Yes / No
Examples during adulthood:
Difficulty with planning activities of daily life
House and/or workplace are disorganised
Planning too many tasks or non-efficient planning
Regularly booking things to take place at the same
time (double-booking)
Arriving late
Not able to use an agenda or diary consistently
Inflexible because of the need to keep to schedules
Poor sense of time
Creating schedules but not using them
Needing other people to structure things
Other:
Symptom present: Yes / No
Examples during childhood:
Difficulty following instructions
Difficulty with instructions involving more than one step
Not completing things
Not completing homework or handing it in
Needing a lot of structure in order to complete tasks
Other:
Symptom present: Yes / No
Examples during childhood:
Difficulty being ready on time
Messy room or desk
Difficulty playing alone
Difficulty planning tasks or homework
Doing things in a muddled way
Arriving late
Poor sense of time
Difficulty keeping himself/herself entertained
Other:
Symptom present: Yes / No
8
DIVA 2.0 Diagnostic Interview for ADHD in adults
Do you often avoid (or do you have an aversion to, or are you unwilling to do) tasks which require
sustained mental effort? And how was that during childhood?
Do you often lose things that are needed for tasks or activities? And how was that during childhood?
A6
A7
Examples during adulthood:
Do the easiest or nicest things first of all
Often postpone boring or difficult tasks
Postpone tasks so that deadlines are missed
Avoid monotonous work, such as administration
Do not like reading due to mental effort
Avoidance of tasks that require a lot of concentration
Other:
Symptom present: Yes / No
Examples during adulthood:
Mislays wallet, keys, or agenda
Often leaves things behind
Loses papers for work
Loses a lot of time searching for things
Gets in a panic if other people move things around
Stores things away in the wrong place
Loses notes, lists or telephone numbers
Other:
Symptom present: Yes / No
Examples during childhood:
Avoidance of homework or has an aversion to this
Reads few books or does not feel like reading due to
mental effort
Avoidance of tasks that require a lot of concentration
Aversion to school subjects that require a lot of
concentration
Often postpones boring or difficult tasks.
Other:
Symptom present: Yes / No
Examples during childhood:
Loses diaries, pens, gym kit or other items
Mislays toys, clothing, or homework
Spends a lot of time searching for things
Gets in a panic if other people move things around
Comments from parents and/or teacher about things
being lost
Other:
Symptom present: Yes / No
DIVA 2.0 Diagnostic Interview for ADHD in adults
9
Are you often easily distracted by external stimuli? And how was that during childhood?
Are you often forgetful during daily activities? And how was that during childhood?
A8
A9
Supplement criterion A
Examples during adulthood:
Difficulty shutting off from external stimuli
After being distracted, difficult to pick up the thread again
Easily distracted by noises or events
Easily distracted by the conversations of others
Difficulty in filtering and/or selecting information
Other:
Symptom present: Yes / No
Examples during adulthood:
Forgets appointments or other obligations
Forgets keys, agenda etc.
Needs frequent reminders for appointments
Returning home to fetch forgotten things
Rigid use of lists to make sure things aren’t forgotten
Forgets to keep or look at daily agenda
Other:
Symptom present: Yes / No
Examples during childhood:
In the classroom, often looking outside
Easily distracted by noises or events
After being distracted, has difficulty picking up the
thread again
Other:
Symptom present: Yes / No
Examples during childhood:
Forgets appointments or instructions
Has to be frequently reminded of things
Half-way through a task, forgetting what has to be done
Forgets to take things to school
Leaving things behind at school or at friends’ houses
Other:
Symptom present: Yes / No
Adulthood:
Do you have more of these symptoms of attention deficit than other people, or do you experience these more frequently
than other people of your age?
Yes / No
Childhood:
Did you have more of these symptoms of attention deficit than other children of your age, or did you experience these
more frequently than other children of your age?
Yes / No
10
DIVA 2.0 Diagnostic Interview for ADHD in adults
Do you often move your hands or feet in a restless manner, or do you often fidget in your chair?
And how was that during childhood?
Do you often stand up in situations where the expectation is that you should remain in your seat?
And how was that during childhood?
H/I 1
H/I 2
Examples during adulthood:
Difficulty sitting still
Fidgets with the legs
Tapping with a pen or playing with something
Fiddling with hair or biting nails
Able to control restlessness, but feels stressed as a
result
Other:
Symptom present: Yes / No
Examples during adulthood:
Avoids symposiums, lectures, church etc.
Prefers to walk around rather than sit
Never sits still for long, always moving around
Stressed owing to the difficulty of sitting still
Makes excuses in order to be able to walk around
Other:
Symptom present: Yes / No
Examples during childhood:
Parents often said “sit still” or similar
Fidgets with the legs
Tapping with a pen or playing with something
Fiddling with hair or biting nails
Unable to remain seated in a chair in a relaxed manner
Able to control restlessness, but feels stressed as a result
Other:
Symptom present: Yes / No
Examples during childhood:
Often stands up while eating or in the classroom
Finds it very difficult to stay seated at school or during
meals
Being told to remain seated
Making excuses in order to walk around
Other:
Symptom present: Yes / No
Part 2: Symptoms of hyperactivity-impulsivity
(DSM-IV criterion A2)
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.
DIVA 2.0 Diagnostic Interview for ADHD in adults
11
Do you often feel restless? And how was that during childhood?
Do you often find it difficult to engage in leisure activities quietly? And how was that during
childhood?
H/I 3
H/I 4
Examples during adulthood:
Feeling restless or agitated inside
Constantly having the feeling that you have to be doing
something
Finding it hard to relax
Other:
Symptom present: Yes / No
Examples during adulthood:
Talks during activities when this is not appropriate
Becoming quickly too cocky in public
Being loud in all kinds of situations
Difficulty doing activities quietly
Difficulty in speaking softly
Other:
Symptom present: Yes / No
Examples during childhood:
Always running around
Climbing on furniture, or jumping on the sofa
Climbing in trees
Feeling restless inside
Other:
Symptom present: Yes / No
Examples during childhood:
Being loud-spoken during play or in the classroom
Unable to watch TV or films quietly
Asked to be quieter or calm down
Becoming quickly too cocky in public
Other:
Symptom present: Yes / No
12
DIVA 2.0 Diagnostic Interview for ADHD in adults
Are you often on the go or do you often act as if “driven by a motor”? And how was that during
childhood?
Do you often talk excessively? And how was that during childhood?
H/I 5
H/I 6
Examples during adulthood:
Always busy doing something
Has too much energy, always on the move
Stepping over own boundaries
Finds it difficult to let things go, excessively driven
Other:
Symptom present: Yes / No
Examples during adulthood:
So busy talking that other people find it tiring
Known to be an incessant talker
Finds it difficult to stop talking
Tendency to talk too much
Not giving others room to interject during a conversa-
tion
Needing a lot of words to say something
Other:
Symptom present: Yes / No
Examples during childhood:
Constantly busy
Excessively active at school and at home
Has lots of energy
Always on the go, excessively driven
Other:
Symptom present: Yes / No
Examples during childhood:
Known as a chatterbox
Teachers and parents often ask you to be quiet
Comments in school reports about talking too much
Being punished for talking too much
Keeping others from doing schoolwork by talking too
much
Not giving others room during a conversation
Other:
Symptom present: Yes / No
DIVA 2.0 Diagnostic Interview for ADHD in adults
13
Do you often give the answer before questions have been completed? And how was that during
childhood?
Do you often find it difficult to await your turn? And how was that during childhood?
H/I 7
H/I 8
Examples during adulthood:
Being a blabbermouth, saying what you think
Saying things without thinking first
Giving people answers before they have finished
speaking
Completing other people’s words
Being tactless
Other:
Symptom present: Yes / No
Examples during adulthood:
Difficulty waiting in a queue, jumping the queue
Difficulty in patiently waiting in the traffic/traffic jams
Difficulty waiting your turn during conversations
Being impatient
Quickly starting relationships/jobs, or ending/leaving
these because of impatience
Other:
Symptom present: Yes / No
Examples during childhood:
Being a blabbermouth, saying things without thinking
first
Wants to be the first to answer questions at school
Blurts out an answer even if it is wrong
Interrupts others before sentences are finished
Coming across as being tactless
Other:
Symptom present: Yes / No
Examples during childhood:
Difficulty waiting turn in group activities
Difficulty waiting turn in the classroom
Always being the first to talk or act
Becomes quickly impatient
Crosses the road without looking
Other:
Symptom present: Yes / No
14
DIVA 2.0 Diagnostic Interview for ADHD in adults
Do you often interrupt the activities of others, or intrude on others? And how was that during
childhood?
H/I 9
Examples during adulthood:
Being quick to interfere with others
Interrupts others
Disturbes other people’s activities without being asked
Comments from others about interference
Difficulty respecting the boundaries of others
Having an opinion about everything and immediately
expressing this
Other:
Symptom present: Yes / No
Examples during childhood:
Impinges on the games of others
Interrupts the conversations of others
Reacts to everything
Unable to wait
Other:
Symptom present: Yes / No
Supplement criterion A
Adulthood:
Do you have more of these symptoms of hyperactivity/impulsivity than other people, or do you experience these more
frequently than other people?
Yes / No
Childhood:
Did you have more of these symptoms of hyperactivity/impulsivity than other children of your age, or did you experience
these more frequently than other children of your age?
Yes / No
Part 3: Impairment on account of the symptoms
(DSM-IV criteria B, C and D)
Criterion B
Have you always had these symptoms of attention deficit and/or hyperactivity/impulsivity?
Yes (a number of symptoms were present prior to the 7th year of age).
No
If no is answered above, starting as from
year of age.
DIVA 2.0 Diagnostic Interview for ADHD in adults
15
Criterion C
In which areas do you have / have you had problems with these symptoms?
Adulthood
Work/education
Did not complete education/training needed for work
Work below level of education
Tire quickly of a workplace
Pattern of many short-lasting jobs
Difficulty with administrative work/planning
Not achieving promotions
Under-performing at work
Left work following arguments or dismissal
Sickness benefits/disability benefit as a result of
symptoms
Limited impairment through compensation of high IQ
Limited impairment through compensation of external
structure
Other
Relationship and/or family
Tire quickly of relationships
Impulsively commencing/ending relationships
Unequal partner relationship owing to symptoms
Relationship problems, lots of arguments, lack of
intimacy
Divorced owing to symptoms
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:
Childhood and adolescence
Education
Lower educational level than expected based on IQ
Staying back (repeating classes) as a result of
concentration problems
Education not completed / rejected from school
Took much longer to complete education than usual
Achieved education suited to IQ with a lot of effort
Difficulty doing homework
Followed special education on account of symptoms
Comments from teachers about behaviour or concen-
tration
Limited impairment through compensation of high IQ
Limited impairment through compensation of external
structure
Other:
Family
Frequent arguments with brothers or sisters
Frequent punishment or hiding
Little contact with family on account of conflicts
Required structure from parents for a longer period
than would normally be the case
Other:
16
DIVA 2.0 Diagnostic Interview for ADHD in adults
Social contacts
Tire quickly of social contacts
Difficulty maintaining social contacts
Conflicts as a result of communication problems
Difficulty initiating social contacts
Low self-assertiveness as a result of negative
experiences
Not being attentive (i.e. forget to send a card/
empathising/phoning, etc)
Other:
Free time / hobby
Unable to relax properly during free time
Having to play lots of sports in order to relax
Injuries as a result of excessive sport
Unable to finish a book or watch a film all the way
through
Being continually busy and therefore becoming
overtired
Tire quickly of hobbies
Accidents/loss of driving licence as a result of reckless
driving behaviour
Sensation seeking and/or taking too many risks
Contact with the police/the courts
Binge eating
Other:
Self-confidence / self-image
Uncertainty through negative comments of others
Negative self-image due to experiences of failure
Fear of failure in terms of starting new things
Excessive intense reaction to criticism
Perfectionism
Distressed by the symptoms of ADHD
Other:
Social contacts
Difficulty maintaining social contacts
Conflicts as a result of communication problems
Difficulty entering into social contacts
Low self-assertiveness as a result of negative
experiences
Few friends
Being teased
Shut out by, or not being allowed, to do things with a
group
Being a bully
Other:
Free time/hobby
Unable to relax properly during free time
Having to play lots of sport to be able to relax
Injuries as a result of excessive sport
Unable to finish a book or watch a film all the way
through
Being continually busy and therefore becoming
overtired
Tired quickly of hobbies
Sensation seeking and/or taking too many risks
Contact with the police/courts
Increased number of accidents
Other:
Self-confidence / self-image
Uncertainty through negative comments of others
Negative self-image due to experiences of failure
Fear of failure in terms of starting new things
Excessive intense reaction to criticism
Perfectionism
Other:
Adulthood (continuance) Childhood and adolescence (continuance)
DIVA 2.0 Diagnostic Interview for ADHD in adults
17
Adulthood: Evidence of impairment in two or more areas? Yes / No
Childhood and adolescence: Evidence of impairment in two or more areas? Yes / No
End of the interview. Please continue with the summary.
Potential details:
18
DIVA 2.0 Diagnostic Interview for ADHD in adults
Summary of symptoms A and H/I
Indicate which criteria were scored in parts 1 and 2 and add up
Criterion
DSM-IV
TR
Symptom Present
during
adulthood
Present
during
child-
hood
A1a A1. Often fails to pay close attention to details, or makes careless
mistakes in schoolwork, work or during other activities
A1b A2. Often has difficulty sustaining attention in tasks or play
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 (such as school of homework)
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 hands or feet or squirms in seat
A2b H/I 2. Often leaves seat in classroom or in other situations in which
remaining seated is expected
A2c H/I 3. Often runs about or climbs excessively in situations in which it
is inappropriate (in adolescents or adults this may be limited to
subjective feelings of restlessness)
A2d H/I 4. Often has difficulty playing or engaging in leisure activities
quietly
A2e H/I 5. Is often on the go or often acts as if ‘driven by a motor
A2f H/I 6. Often talks excessively
A2g H/I 7. Often blurts out answers before questions have been completed
A2h H/I 8. Often has difficulty awaiting turn
A2i H/I 9. Often interrupts or intrudes on others
Total number of criteria Hyperactivity/Impulsivity
/ 9 / 9
DIVA 2.0 Diagnostic Interview for ADHD in adults
19
Score form
* Research has indicated that at adult age, four or more characteristics of attention problems and/or hyperactivity-impulsivity are sufficient for
the diagnosis of ADHD to be made. Kooij e.a., Internal and external validity of Attention-Deficit Hyperactivity Disorder in a population-based
sample of adults. Psychological Medicine 2005; 35(6):817-827. Barkley RA: Age dependent decline in ADHD: True recovery or statistical
illusion? The ADHD Report 1997; 5:1-5.
** Indicate from whom the collateral information was taken.
*** If the established sub-types differ in childhood and adulthood, the current adult sub-type prevails for the diagnosis.
DSM-IV
criterion A
Childhood
Is the number of A characteristics ≥ 6?
Is the number of H/I characteristics ≥ 6?
Adulthood*
Is the number of A characteristics ≥ 6?
Is the number of H/I characteristics ≥ 6?
Yes / No
Yes / No
Yes / No
Yes / No
DSM-IV
criterion B
Are there signs of a lifelong pattern of symptoms and limita-
tions?
Yes / No
DSM-IV
criterion C
and D
The symptoms and the impairment are expressed in at least
two domains of functioning
Adulthood
Childhood
Yes / No
Yes / No
DSM-IV
criterion E
The symptoms cannot be (better) explained by the presence
of another psychiatric disorder
No
Yes, by
Is the diagnosis supported by collateral information?
Parent(s)/brother/sister/other, i.e.
**
Partner/good friend/other, i.e.
**
School reports
0 = none/little support
1 = some support
2 = clear support
N/A 0 1 2
N/A 0 1 2
N/A 0 1 2
Explanation:
Diagnosis ADHD***
No
Yes, subtype
314.01 Combined type
314.00 Predominantly inattentive
type
314.01 Predominantly
hyperactive-impulsive type
DIVA
2.0
diagnostic interview
for ADHD
in adults
ENGLISH