# Is ADHD defined too loosely?

The criteria for the inattention part of ADHD from DSM-5. At least 6 of the behaviours for at least six months .

Fails to give close attention to detail, makes careless mistakes
Difficulty sustaining attention
Doesn’t listen when spoken to directly
Doesn’t follow through on instructions, doesn’t finish things
Often avoids, dislikes tasks that require sustained mental effort
Often loses things necessary for tasks/activities
Often easily distracted
forgetful


This are supposed to be the criteria for diagnosing somebody with an attention deficit. Almost everybody has this traits to some degree. Are the definitions too loose?

Is there any evidence of training for delayed gratification helping ADHD patients?

• What is your source? Could you link to it, reference it? The last question is a separate question. The recommended format on Stack Exchange is to stick to one question per post to keep answers focused. – Steven Jeuris May 20 at 15:35
• Even if you dropped the last line/question, which seems a different one, this is still probably too opinion-based and/or too broad. You're not even identifying which definition of ADHD you're talking about. It has changed over time somewhat, e.g. in the various editions of DSM. See psychiatrictimes.com/special-reports/… for some background. – Fizz May 20 at 15:36
• ncbi.nlm.nih.gov/pmc/articles/PMC3955126 has both more details on the DSM-5 changes as well as some criticism. – Fizz May 20 at 15:47
• Thank you for the comments, I shall read your paper. – Borut Flis May 21 at 12:33

People with ADHD show a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with functioning or development:

Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults;
symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
Often has trouble holding attention on tasks or play activities. Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
Often has trouble organizing tasks and activities.
Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
Is often easily distracted
Is often forgetful in daily activities.

Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
Often fidgets with or taps hands or feet, or squirms in seat.
Often leaves seat in situations when remaining seated is expected.
Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
Often unable to play or take part in leisure activities quietly.
Is often “on the go” acting as if “driven by a motor”.
Often talks excessively.
Often blurts out an answer before a question has been completed.
Often has trouble waiting his/her turn.
Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:

Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
Several symptoms are present in two or more setting, (such as at home, school or work; with friends or relatives; in other activities).
There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or
a personality disorder). The symptoms do not happen only during the
course of schizophrenia or another psychotic disorder.

The extent and degree of the symptoms matters. For example, some people can have ADHD traits, but an individual with a legitimate psychopathology may have a lifestyle that significantly suffers without treatment. Certain brain volumes are also smaller in ADHD subjects, see

Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention.

Malenka RC, Nestler EJ, Hyman SE (2009). "Chapters 10 and 13". In Sydor A, Brown RY (eds.). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 266, 315, 318–323. ISBN 978-0-07-148127-4.