DIVA ADHD - Improving Adult ADHD Diagnosis
DIVA is a semi-structured, structured interview that has been developed to improve ADHD assessments in adults. This study aims to evaluate the reliability of the criteria used to determine DIVA 2.0 and its concurrent validity in comparison with Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID) criteria.
Compared to the top 20 attributes, DIVA attributes that correlate strongest with diagnosis are attention deficit for both childhood and adulthood and hyperactivity/impulsivity for adults, followed by CAARS ADHD TT1 score and IOWA personality disorders evaluation.
Symptoms
ADD/ADHD symptoms impact all aspects of our lives from relationships to career advancement and the daily tasks we do. That's why it is so important that our ADHD assessments are holistic by examining how symptoms affect every aspect of our lives. Dr. Schilling will begin by evaluating your symptoms and medical history. She will then conduct an DIVA 5 assessment. This is a semi-structured interview which evaluates both the main symptoms and the impact of ADD/ADHD your life.
The DIVA is an interviewing tool designed by psychiatrists and psychotherapists to assess symptoms of adult ADHD. It has been shown to have high sensitivity and a high degree of specificity. It is also highly effective in identifying those with the disorder. It can increase awareness and help diagnose adult ADHD in Korea because it is the only validated semistructured diagnostic interview available in the country.
A trained and experienced clinician, typically psychiatrists will inquire about the most prominent symptoms of ADHD. These include hyperactivity, inattention and an impulsive nature. The doctor will also dig into the individual's history, looking at their childhood experiences and how those may have influenced their behavior. This is because the symptoms of ADHD don't just emerge in a flash, they manifest throughout the teen years, and even into adulthood.
The DIVA can effectively identify those with ADHD because it takes into account both the DSM-IV criteria for ADHD in adulthood and childhood and how the symptoms have impacted the person's daily functioning in five distinct areas of life - education work, family/partner relationships, family social activities/leisure time and self-esteem and self-confidence. As a contrast other screening tools, such as the WURS-brief which was compared to the CAADID, showed poor sensitivity and negative predictive values.
Diagnosis
To determine ADHD in adults it is essential to evaluate the signs and symptoms along with their background. This can be done through an extensive interview regarding childhood symptoms as well as a neurocognitive assessment. It is important to consider the impact that the symptoms can have on a person's work and life. This can be evaluated using a structured clinical interview, the DIVA, and in some cases, obtaining information from friends and family members.
The DIVA is a semi-structured interview that was first developed for use with adults in the Netherlands. It has been revised for use with adult patients in other countries including Korea. This study looked at the validity of the Korean version of DIVA (DIVA-5) in a clinical sample of adults with ADHD.
During the DIVA, the clinician asks about the presence of ADHD symptoms in childhood and into adulthood, the time at which the symptoms onset, and the extent of impairment caused by those symptoms. The clinician also collects wide range of sociodemographic data and inquires about any psychiatric or comorbidity.
Patients were screened for psychiatric comorbidity using the MINI-S plus version 5.0.0 and the Brief Alcohol Related Neuropsychological Impairment Screening Instrument (BEARNI) and the Frontal Assessment Battery (FAB). A clinical diagnosis of ADHD was established by two psychiatrists with years of experience who used the structured diagnostic interview DIVA-5 to evaluate symptoms in both adulthood and childhood and determine the duration of these symptoms.
The sensitivity and specificity of DIVA-5 was found to be high for both inattention and hyperactivity/impulsivity symptoms in childhood and adulthood. assessment adhd has good concurrent validity when compared with the WURS scale, and fair validity when compared with three self-report ratings instruments which include the ASRS (self-report rating), FAB (self-report rating) and Sheehan's Dysfunction Inventory.
The sensitivity and specificity of the DIVA-5 was found to be high for all subtypes of ADHD in both inattention and hyperactivity/impulsivity in adulthood and during childhood. The accuracy of the DIVA-5's diagnostics was found to be comparable to the accuracy of a clinical diagnoses made by two psychiatrists. This was in line with the specificity and sensitivity of earlier screening tools such as the ASRS and the WURS.
Treatment
If you are not diagnosed with ADHD it can greatly affect your life. This can be in many aspects, from relationships to work and academic progress to the basic tasks of organising daily living. A diagnosis can help you determine your strengths and weaknesses and also provide treatment options that help you manage your symptoms and mechanisms.
A trained clinician, usually psychologist or psychiatrist will conduct a structured discussion with you about your symptoms currently using the DIVA-5 assessment tool. This will involve standardised questions regarding your levels of hyperactivity, inattention, and an impulsiveness. It will also delve into your personal history, including your childhood experiences, in order to obtain a complete picture of your symptoms and their impacts on your life.
This approach is crucial to ensure a thorough diagnosis of adult ADHD. This allows us to better understand your symptoms and inform your treatment.
The DIVA assessment can be used to determine adult ADHD with high sensitivity and specificity. It has also been shown to have sound criterion validity when compared with self-report scales for rating such as the Wender Utah Rating Scale (WURS) and the ADHD-Rating Scale. It has a good concordance with these scales and fair validity with Sheehan’s Dysfunction Inventory.
Contrary to the more conventional methods for assessing ADHD in adults, the DIVA evaluation focuses on identifying and discussing the symptoms that occur both during the teen years and into adulthood, increasing the accuracy of the diagnosis and enabling an accurate comparison between sociodemographic characteristics of the two groups. The DIVA evaluation also provides an opportunity to consider the effects of co-occurring disorders on appearance of ADHD symptoms.
If your Psychologist is unable to prescribe medication, it could be necessary to schedule an appointment with a pediatrician or Psychiatrist for further assessment and/or therapy. You can be referred to psychologists who specialize in more thorough evaluation of your symptoms and to determine if there are co-occurring or differential diagnoses. This includes assessing any comorbid conditions, like depression or anxiety. This will enable your Psychologist an appropriate treatment plan.
Getting Started
Being diagnosed with ADHD can have a profound impact on your life, offering explanations for long-standing difficulties and opening doors to effective treatment options. A good evaluation does require the expertise of qualified healthcare providers. The DIVA ADHD assessment is a structured and extensive tool that assists to improve the accuracy of an adult ADHD diagnosis by evaluating symptoms across different life stages. It also helps identify patterns of behavior and differentiates between ADHD symptoms and those of other conditions that may present similar symptoms for adults, such as depression or anxiety.
In the course of a DIVA ADHD evaluation, a clinician will use an organized interview to ask a series questions about the symptoms like hyperactivity, inattention, and an impulsiveness. The doctor evaluates the frequency, severity and duration of these symptoms to determine how they impact on the person's life and performance in a variety of settings. This information can be used to determine an accurate diagnosis.
The DIVA assessment has been validated against other diagnostic tools and has shown high sensitivity when compared with the WURS-brief, CAA-DID and the assessment of a psychiatrist. It also has a high degree of validity when assessing ADHD in five areas of daily functioning: work and education, relationships with family and home social interactions, leisure time and hobbies.
A well-validated DIVA assessment requires participation from the person being evaluated and their close family members and close friends. This helps to establish trust and a therapeutic bond that will be crucial to the success of the assessment.
A psychiatrist or psychologist with expertise in the DIVA ADHD assessment can write an in-depth, professional report. The report will detail the results of the assessment and provide a treatment strategy that is based upon evidence.
If you suspect that you or someone you love might be suffering from ADHD, please contact us to make an appointment. Our doctor Kate Schilling has been trained in the use of DIVA ADHD assessments and is able to provide a thorough evaluation. She will then make a referral to a specialist to develop an effective treatment strategy. Be aware that the recommended treatment approach is a combination of medications and psychotherapy.