Adult ADHD Self-Report Scale (ASRS) 成人ADHD自评量表
synopsis（简介）
The Adult ADHD Self-Report Scale (ASRS v1.1) is an 18-item self-report questionnaire designed to assess Attention Deficit Hyperactivity Disorder (ADHD) symptoms in adults (18+). This scale is based on the World Health Organization Composite International Diagnostic Interview (2001), and the questions are consistent with DSM criteria, but reworded to better reflect symptom manifestation in adults. This scale is useful for screening and diagnosis of ADHD among adults 18+ and should be used in conjunction with a clinical interview to provide additional clinical information.
Part A contains 6 items and it has been found that these questions are the most predictive of ADHD and are best for use as a screening instrument. Part-B contains 12 additional questions based on DSM criteria that provide additional cues and can serve as further probes into the patient’s symptoms. For a client’s symptoms to be considered consistent with an ADHD diagnosis, they require 4 or more responses at specific severity levels in Part A of the ASRS.
成人多动症自我报告量表（ASRS v1.1）是一份包含 18 个项目的自我报告问卷，旨在评估成人（18 岁以上）的注意力缺陷多动障碍（ADHD）症状。该量表以世界卫生组织的国际综合诊断访谈（2001 年）为基础，问题与 DSM 标准一致，但进行了重新措辞，以更好地反映成人的症状表现。该量表适用于 18 岁以上成年人多动症的筛查和诊断，应与临床访谈结合使用，以提供更多临床信息。
A 部分包含 6 个项目，这些问题对多动症的预测性最强，最适合作为筛查工具使用。B 部分包含 12 个基于 DSM 标准的附加问题，可提供更多线索并进一步探究患者的症状。客户的症状需要在《ASRS》A 部分的特定严重程度中回答 4 个或 4 个以上的问题，才能被认为符合多动症的诊断标准。
The ASRS has high internal consistency (Cronbach’s alpha = 0.88) and concurrent validity (r = 0.84) (Adler et al., 2006).
For a client’s symptoms to be considered consistent with an ADHD diagnosis, they require 4 or more responses in the criterion boxes of Part A (the first 6 questions) of the ASRS. Using this scoring convention, previous studies (e.g., Hines, King & Curry, 2012) report high sensitivity (1.0) and moderate positive predictive power (0.52), suggesting that the ASRS would rarely miss ADHD in an adult who has ADHD. Moreover, the ASRS has moderate specificity (.71) and high negative predictive power (1.0), indicating that this tool is quite successful in not identifying someone with ADHD when they do not have the disorder (Hines, King & Curry, 2012).
Adler et al. (2018) found that in a sample of 22,397 randomly selected adults in the USA that the mean total score was 2.0 (SD = 3.2). Of note, ASRS total scores where significantly related to age:
– Age 18-29: mean = 2.99, stdev = 4.1
– Age 30-39: mean = 2.59, stdev = 3.1
– Age 40-49: mean = 2.26, stdev = 3.1
– Age 50-64: mean = 1.82, stdev = 3.1
– Age > 65: mean = 1.23, stdev = 2.1
This age specific normative data is used to compute percentiles.
Stanton, Forbes and Zimmerman (2018) determined, by using CFA with over 1,000 adult subjects, that the ASRS had three factors:
Inattentive subscale
Motor Hyperactive/Impulsive subscale
Verbal Hyperactive/Impulsive subscale
These factors are used to compute subscale scores. It is noted that the DSM specifies two subtypes (Inattentive and Hyperactive/Impulsive) however analysis of this scale indicates three distinct symptom clusters.
ASRS 具有较高的内部一致性（Cronbach's alpha = 0.88）和并行效度（r = 0.84）（Adler et al., 2006）。
客户的症状需要在 ASRS A 部分（前 6 个问题）的标准方框中回答 4 个或更多问题，才能被认为符合多动症诊断。使用这种评分方法，以往的研究（e.g., Hines, King & Curry, 2012）报告了较高的灵敏度（1.0）和中等的阳性预测能力（0.52），表明 ASRS 很少会漏掉患有 ADHD 的成年人。此外，ASRS 具有中等的特异性（0.71）和较高的阴性预测能力（1.0），这表明该工具能成功地避免在不患有 ADHD 的人身上发现 ADHD（Hines, King & Curry, 2012）。
Adler等人（2018）发现，在美国随机抽取的22397名成年人样本中，总分的平均值为2.0（SD = 3.2）。值得注意的是，ASRS 总分与年龄有显著关系：
- 18-29 岁：平均 = 2.99，标准差 = 4.1
- 30-39 岁：平均值 = 2.59，标准差 = 3.1
- 40-49 岁：平均值 = 2.26，差异值 = 3.1
- 50-64 岁：平均值 = 1.82，差异值 = 3.1
- 年龄大于 65 岁：平均值 = 1.23，差异值 = 2.1
该年龄段常模数据用于计算百分位数。
Stanton、Forbes 和 Zimmerman（2018 年）通过对 1000 多名成年受试者进行 CFA 分析，确定 ASRS 有三个因子：
注意力不集中子量表
运动过动/冲动子量表
言语多动/冲动子量表
这些因子用于计算子量表得分。值得注意的是，DSM 规定了两个亚型（注意力不集中和多动/冲动），但对该量表的分析表明有三个不同的症状群。
Three seperate metrics are computed:
–Part A (items 1-6. Scores range from 0 to 6)
If the respondent scores 4 or more in Part-A, then the symptom profile of the individual is considered to be highly consistent with an ADHD diagnosis in adults (Adler et al., 2006; Kessler et al., 2007).
–Part B (items 7-18. Scores range from 0 to 12)
The frequency scores on Part B provide additional cues and can serve as further probes into the patient’s symptom severity and the impact that inattention or hyperactivity has on their life.
– Total Score (and percentile) (scores range from 0 to 18)
Over and above the key interpretation metrics from Part A and Part B, the total score (sum of part A and B) is converted into a percentile to contextualise responses in comparison to normative data (22,397 adults; Adler et al., 2018). For example, a percentile of 90 represents that the respondent scored higher than 90 percent of other typical adults in their age range in the community.
These percentiles compare total scores to age related peers, so it is imperative to ensure the correct client date of birth is entered for the client.
While Part A contains the items that have been found to be most predictive of ADHD, looking at the total score (and percentile) can also be informative about diagnosis in cases where the Part A score was only 3. This scale should always be used in conjunction with a clinical interview to provide additional clinical information important for diagnosis.
Three ADHD subscales are presented according to factors identified by Stanton et al. (2018). Raw scores as well as the percentage of items endorsed are presented, providing more specific information about difficulties:
Inattentive subscale (Items 1, 2, 3, 4, 7, 8, 9, 10, 11, range 0 to 9)): measuring an adult’s difficulty in focussing on details, being organised, remembering appointments, making careless mistakes, and concentrating.
Hyperactive/Impulsive subscale (Motor) (Items 5, 6, 12, 13, 14, range 0 to 5): measuring an adult’s difficulty in sitting still, staying seated, and ability to relax.
Hyperactive/Impulsive subscale (Verbal) (Items 15, 16, 17, 18, range 0 to 4): measuring an adult’s difficulty in controlling how much they are talking, interrupting others, and waiting their turn.
Considering the percentage of items endorsed for each of the subscales can be helpful in determining the ADHD subtype defined in DSM-V: Combined, Hyperactivity-Impulsivity or Inattentive. Note that the DSM-V does not make a distinction between verbal and motor hyperactive subtypes.
Depending on the question, responses are either scored as 0 or 1. On items 1-3, 9, 12, 16, and 18 ratings of sometimes, often, or very often are assigned one point (ratings of never or rarely are assigned zero points). For the remaining 11 items, ratings of often or very often are assigned one point (ratings of never, rarely, or sometimes are assigned zero points).
分别计算三个指标：
–A 部分（项目 1-6，得分范围为 0-6 分）
如果受访者在 A 部分得分达到或超过 4 分，则认为其症状特征与成人多动症诊断高度一致（Adler 等人，2006 年；Kessler 等人，2007 年）。
–B 部分（项目 7-18，分值范围 0 至 12）
B 部分的频率得分提供了额外的线索，可以进一步探究患者症状的严重程度以及注意力不集中或多动对其生活的影响。
–总分（和百分位数）（分数范围从 0 到 18）
除了 A 部分和 B 部分的关键解释指标外，总分（A 部分和 B 部分的总和）还被转换成百分位数，以便与常模数据（22,397 adults; Adler et al., 2018）进行比较，从而确定反应的背景情况。例如，百分位数为 90 代表受访者的得分高于社区中其年龄段其他典型成年人的 90%。
这些百分位数将总分与年龄相关的同龄人进行比较，因此必须确保为客户输入正确的客户出生日期。
虽然 A 部分包含的项目被认为最能预测多动症，但在 A 部分得分仅为 3 分的情况下，查看总分（和百分位数）也能为诊断提供信息。
根据 Stanton 等人（2018 年）确定的因素，列出了三个 ADHD 分量表。该量表显示了原始分数以及所认可项目的百分比，从而提供了有关困难的更具体信息：
注意力不集中分量表（项目 1、2、3、4、7、8、9、10、11，范围 0 至 9）：测量成年人在关注细节、有条理、记住约会、粗心出错和集中注意力方面的困难。
多动/冲动分量表（运动）（项目 5、6、12、13、14，范围 0 至 5）：测量成年人在静坐、保持坐姿和放松能力方面的困难。
多动/冲动分量表（言语）（项目 15、16、17、18，范围 0-4）：测量成年人在控制自己说话的程度、打断他人说话和等待轮到自己时的困难程度。
考虑每个分量表中认可项目的百分比有助于确定 DSM-V 中定义的 ADHD 亚型： 综合型、过度活跃-冲动型或注意力不集中型。请注意，DSM-V 没有区分言语过动亚型和运动过动亚型。
根据问题的不同，回答要么记为 0 分，要么记为 1 分。在项目 1-3、9、12、16 和 18 中，对 "有时"、"经常 "或 "非常经常 "的评分为 1 分（对 "从不 "或 "很少 "的评分为 0 分）。在其余 11 个项目中，经常或非常经常得 1 分（从不、很少或有时得 0 分）。