Home / Resources / Psychological Measures / ASRS-v1.1
Adult ADHD Self-Report Scale v1.1:
Scoring and Interpretation
The Adult ADHD Self-Report Scale v1.1 (ASRS-v1.1) is an 18-item self-report checklist of adult attention-deficit/hyperactivity symptoms over the past six months, whose six-item Part A screener is scored as a count of shaded endorsements, not as a sum (Kessler et al., 2005). What follows is ASRS v1.1 scoring as a count of six item-specific flags, why the four-of-six rule cannot be swapped for a raw sum or the ASRS-5, the 2005 screening accuracy figures, and screen-status code for SPSS and R.
What the ASRS-v1.1 Measures
The World Health Organization Adult ADHD Self-Report Scale v1.1 records how often an adult has experienced attention-deficit/hyperactivity symptoms over the prior six months. Its 18-item checklist maps to DSM-IV symptom criteria, while the six-item Part A screener was empirically selected to identify adults who warrant further assessment (Kessler et al., 2005).
The ASRS-v1.1 is common in US population research and in clinical case finding, where it gives a rapid indicator of reported symptoms rather than a clinical confirmation. A later DSM-5-oriented six-item version, the ASRS-5, has a different scoring method and must not be labeled or analyzed as the ASRS-v1.1 screener (Ustun et al., 2017). Most scoring problems with this instrument come from summing Part A as if it were a scale score or from mixing the two generations of the instrument.
Structure of the ASRS-v1.1
- Items: 18 frequency items in the symptom checklist. The first six form Part A and the remaining 12 form Part B.
- Response scale: five ordered frequency options coded 0 to 4 (never, rarely, sometimes, often, very often), referring to the preceding six months.
- Part A rule: shaded endorsements are counted item by item. For items 1 to 3, a response of sometimes or more counts. For items 4 to 6, a response of often or very often counts. Four or more shaded endorsements is a positive screen.
- Reverse-scored items: none in the standard symptom checklist.
- Not the Part A rule: a plain Part A sum (0 to 24), a full 18-item sum (0 to 72) and any ASRS-5 score. Kessler et al. (2007) did evaluate an unweighted 0 to 24 sum of the six screener items with a cut-off of 14 or more as an alternative continuous scoring. If you use it, cite that paper and label the rule explicitly.
The instrument itself is available from Harvard National Comorbidity Survey ASRS resources and NINDS Common Data Elements.
How to Score the ASRS-v1.1
- Verify that asrs1 to asrs18 follow the order of the ASRS-v1.1 symptom checklist and are coded never = 0, rarely = 1, sometimes = 2, often = 3 and very often = 4.
- For asrs_partA_flags (0 to 6), count whether asrs1 to asrs3 are 2 or higher, plus whether asrs4 to asrs6 are 3 or higher. Classify a positive Part A screen when the count is 4 or more.
- Do not treat optional raw frequency totals as interchangeable with the validated binary endorsement count. The full 18-item checklist can be described at item level or analyzed under a separately stated psychometric approach.
- The code below requires all six Part A answers before it classifies a respondent. Partial-score handling needs to be prespecified.
* ASRS-v1.1 Part A only. Source items must be 0,1,2,3,4 (never ... very often).
DO IF NVALID(asrs1, asrs2, asrs3, asrs4, asrs5, asrs6)=6.
COMPUTE asrs_partA_flags=(asrs1>=2)+(asrs2>=2)+(asrs3>=2)+
(asrs4>=3)+(asrs5>=3)+(asrs6>=3).
COMPUTE asrs_partA_positive=(asrs_partA_flags>=4).
END IF.
EXECUTE.# Six v1.1 Part A items; 0-4 frequency coding.
cols <- paste0("asrs",1:6)
x <- data[cols]
flags <- mapply(function(v,t) as.integer(v>=t), x, c(2,2,2,3,3,3))
flags <- as.matrix(flags)
data$asrs_partA_flags <- rowSums(flags,na.rm=FALSE)
data$asrs_partA_positive <- ifelse(is.na(data$asrs_partA_flags),
NA, data$asrs_partA_flags>=4)Interpreting ASRS-v1.1 Scores
| Score band | Interpretation |
|---|---|
| 0 to 3 shaded endorsements | Below the conventional Part A positive-screen threshold |
| 4 to 6 shaded endorsements | Positive ASRS-v1.1 Part A screening result |
Source: WHO ASRS-v1.1 Symptom Checklist scoring; Kessler et al. (2005).
A four-of-six positive screen indicates a symptom pattern that warrants clinical evaluation rather than verified ADHD. In a clinical reappraisal subsample from a US population survey, Kessler et al. (2005) reported sensitivity of 68.7% and specificity of 99.5% for the six-item screener. These performance values cannot be assumed in a different referral or community population.
ADHD assessment requires evaluation of onset, cross-setting impairment, alternative explanations and clinical history. Do not mix the ASRS-v1.1 Part A algorithm with the ASRS-5, and do not replace the threshold with an arbitrary raw-score sum.
Psychometric Properties
| Property | Published finding | Source |
|---|---|---|
| Screening sensitivity | 68.7% for the six-item screener in the NCS-R clinical reappraisal sample | Kessler et al. (2005) |
| Screening specificity | 99.5% in the same study | Kessler et al. (2005) |
| Classification agreement | Cohen’s κ = .76 for the six-item screener versus blind clinical classification | Kessler et al. (2005) |
| Full checklist comparison | 18-item dichotomized algorithm: sensitivity 56.3% and specificity 98.3% in the study | Kessler et al. (2005) |
| Updated versions | The ASRS-5 (DSM-5) is a different scoring instrument and does not share the Part A four-of-six rule | Ustun et al. (2017) |
These are source-specific results and cannot be assumed to hold as reliability or accuracy estimates in a new sample.
Using the ASRS-v1.1 in a Study
When the purpose is screening, use the 0 to 6 Part A shaded-endorsement count with a prespecified positive status at 4 or more, not a continuous six-item sum standing in for the clinical rule, and describe prevalence as “screen positive”, not as ADHD. A screen-positive indicator is a binary outcome or predictor, which Logistic Regression handles, and population estimates of screen positivity are the territory of Incidence & Prevalence Analysis. If you use all 18 items as a symptom burden construct, specify how that score and its validity were established.
Operating characteristics belong to the sample that produced them. Verification bias and the underlying ADHD prevalence strongly affect positive predictive value, so estimate sensitivity and specificity against a criterion interview, with confidence intervals, as set out in Sensitivity & Specificity (Diagnostic Accuracy). Cronbach’s alpha is not a replacement for validating a screening rule. Decide in advance how a respondent with a missing Part A answer is handled, using the principles in Missing Data Analysis, and report which ASRS generation and coding rule were used.
Related field: Neuropsychology & Neuroscience
Reporting the ASRS-v1.1
Adult ADHD symptoms were screened using the World Health Organization Adult ADHD Self-Report Scale v1.1 six-item Part A screener (Kessler et al., 2005). Responses referred to the preceding six months and were coded in five ordered frequency categories. Shaded endorsements were counted with item-specific thresholds (sometimes or more for items 1 to 3 and often or more for items 4 to 6), and a count of four or more denoted a positive screen, not a clinical ADHD diagnosis. Missing Part A responses were handled using [prespecified approach].
References
Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., Howes, M. J., Jin, R., Secnik, K., Spencer, T., Ustun, T. B., & Walters, E. E. (2005). The World Health Organization adult ADHD self-report scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35(2), 245-256. https://doi.org/10.1017/S0033291704002892
Kessler, R. C., Adler, L. A., Gruber, M. J., Sarawate, C. A., Spencer, T., & Van Brunt, D. L. (2007). Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members. International Journal of Methods in Psychiatric Research, 16(2), 52-65. https://doi.org/10.1002/mpr.208
National Institute of Neurological Disorders and Stroke. (n.d.). Adult ADHD Self-Report Scale: Common Data Element. https://cde.ninds.nih.gov/
Ustun, B., Adler, L. A., Rudin, C., Faraone, S. V., Spencer, T. J., Berglund, P., Gruber, M. J., & Kessler, R. C. (2017). The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5. JAMA Psychiatry, 74(5), 520-526. https://doi.org/10.1001/jamapsychiatry.2017.0298
Frequently Asked Questions
Is the ASRS-v1.1 six-item score the sum of six 0 to 4 ratings?
No. The conventional Part A screen counts six item-specific positive-response flags, and four or more indicates a positive screen. A raw sum of the six ratings is a different quantity and needs its own citation and label.
Are the first six items enough to diagnose adult ADHD?
No. The screen identifies respondents who may need a comprehensive clinical evaluation, and a positive result should be reported as a positive screen.
Can I substitute the 2017 ASRS-5 for the ASRS-v1.1?
No. They are different instruments with different scoring rules and validation samples, so record which one each participant completed and do not pool their screening results.
What if one Part A item is missing?
The algorithm shown here does not classify a respondent unless all six responses are available. Adopt and document an explicit missingness rule where relevant.
NEXT STEP
Need ASRS-v1.1 Screening
Flags Checked?
OnlineSPSS is a statistical consultancy for researchers. Share your design and dataset, and a statistically trained Research Coordinator reviews it. The scope and one fixed project fee are confirmed before work begins.
No Commitment Required
Strictly Confidential
Fixed Project Fee
In-House PhD-Level Statisticians
Same-Day Response
Serving Researchers Since 2014