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DIVA ADHD - Improving Adult ADHD Diagnosis
DIVA is a semi-structured interview that has been developed to improve ADHD assessments for adults. This study is designed to assess the reliability of the criteria used to determine DIVA 2.0 and its concomitant 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
The symptoms of ADD/ADHD impact every aspect of our lives from relationships and career advancement to the daily tasks that are part of our lives. That's why it is so crucial that our ADHD assessments are holistic by examining how symptoms impact all areas of life. Dr. Schilling will begin by evaluating your symptoms and medical history. She will then conduct a DIVA 5 assessment. This is a semi-structured, structured interview that examines both the primary symptoms and the impact of ADD/ADHD on your life.
The DIVA is an interviewing tool developed by psychiatrists and psychotherapists to evaluate the symptoms of adult ADHD. It has been demonstrated to have a high sensitivity to sound and specificity. It is highly effective at identifying people suffering from the disorder. It has the potential to increase awareness and diagnosis of the condition of adult ADHD in Korea, as it is the only validated semi-structured diagnostic test for adults with ADHD available in the country.
A trained clinician, usually psychiatrists will inquire about the most prominent symptoms of ADHD. These include hyperactivity, inattention, and impulsivity. The doctor will also dig into the background of the individual and examine their childhood experiences and how those may influence their present behavior. This is because the symptoms of ADHD do not just appear suddenly, they develop through the teenage years, and through adulthood.
The DIVA is able to effectively identify people suffering from ADHD by taking into consideration both the DSM-IV criteria for ADHD in adulthood and childhood and how the symptoms have affected an 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 CAADID, showed poor accuracy and negative predictive values.
Diagnosis
To diagnose ADHD in adults, it is important to determine the severity of the symptoms and their history. This can be done with an extensive interview regarding childhood symptoms and a neurological assessment. It is important to consider the impact that the symptoms have on the person's work and life. This can be evaluated conducting a structured interview, the DIVA and, in certain cases, getting information from relatives and friends.
The DIVA is a semi-structured interview that was initially developed to be used with adults in the Netherlands. It has been revised for use 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 will ask about ADHD symptoms during the early years and in adulthood. They will also ask the age at which symptoms first started to manifest symptoms and the level of impairment triggered by these symptoms. The doctor will also collect a variety of sociodemographic information and ask about any psychiatric co-morbidity.
The MINI-S and Version 5.0.0 and the Brief Alcohol Related Neuropsychological Impaired Screening Instrument (BEARNI) as well as the Frontal Assessment Battery were used to screen for psychiatric co-morbidity. Two psychiatrists who are experienced employed the structured diagnostic interview DIVA-5 in order to determine a clinical diagnosis of ADHD. They assessed symptoms in adulthood as well as childhood and determined the duration of symptoms.
The sensitivity and specificity of DIVA-5 was found to be high for both inattention and hyperactivity/impulsivity symptoms in childhood and adulthood. This diagnostic tool has good concurrent validity when compared to the WURS scale, and has fair validity when compared to 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 diagnosis was found to be similar to that of a clinical diagnoses made by two psychiatrists. This was in line with the sensitivity as well as specificity of earlier screening tools like ASRS and WURS.
Treatment
Undiagnosed ADHD can have a major impact on your life. It can impact your relationships, academic performance as well as your work. It can also affect the way you manage your day-to-day activities. A diagnosis can help you identify your strengths and weaknesses as well as provide treatment options to alleviate your symptoms and cope mechanisms.
A licensed professional (typically a psychiatrist or a psychologist) will have a structured conversation with you, using the DIVA-5 tool to assess your current symptoms. It will include standardised questions about your levels of hyperactivity, inattention and an impulsiveness. It will also look into your personal history, including your childhood experiences, to gain a complete understanding of your symptoms and their impact on your life.
This method is essential to ensure a complete diagnosis of adult ADHD. This allows us to better know your symptoms and help you with your treatment.
The DIVA assessment can be used to determine adult ADHD with high sensitivity and specificity. It has also been demonstrated to be valid as a criterion, when compared to self-report rating scales like the Wender Utah Rating Scale (WURS) and the ADHD-Rating Scale. It has good concordance validity with these scales and reasonable validity with Sheehan's Dysfunction Inventory.
The DIVA evaluation, unlike traditional methods for measuring ADHD in adulthood, focuses on identifying symptoms that manifest in childhood and into adulthood. This improves the accuracy of diagnosis and allows a more accurate comparison of the sociodemographic characteristics of the two groups. The DIVA evaluation also offers an opportunity to think about the effect of co-occurring disorders on the presentation of ADHD symptoms.
If your Psychologist is not able to recommend medication, it may be necessary to schedule an appointment with a Paediatrician or Psychiatrist to further assess and/or therapy. You may be referred to a specialist psychologist for a more in-depth assessment of your symptoms and to determine if there are co-occurring or different diagnoses. This includes assessing co-occurring conditions, such as depression or anxiety. This will enable your Psychologist determine the best treatment plan.
Getting Started
Getting diagnosed with ADHD can have a profound impact on your life providing explanations for long-standing difficulties and opening doors to effective treatment options. A thorough evaluation requires the expertise of trained healthcare professionals. The DIVA ADHD assessment is a standardized and extensive tool that assists to improve the accuracy of adult ADHD diagnosis by assessing symptoms across different life stages. It also detects patterns of behavior that are persistent and assists in determining the difference between ADHD symptoms and other disorders like anxiety or depression.
In the course of a DIVA ADHD evaluation, a clinician will use an organized interview to ask a series of questions regarding symptoms such as hyperactivity, inattention, and the tendency to be impulsive. The doctor evaluates the intensity, frequency and duration of symptoms to determine the extent to which they affect the person in various situations. This information can be used to determine an accurate diagnosis.
The DIVA assessment has been verified against other diagnostic tools and has shown high sensitivity when compared with the WURS-brief, CAA DID and the assessment of a psychiatrist. It has also excellent validity in it comes to assessing ADHD in five areas of daily function such as education and work, relationships with family and home, social contacts, and free time and hobby.
To be able to conduct an authentic DIVA assessment, the individual being evaluated, their family and friends need to be present. This will help establish trust and strengthen the therapeutic connection, which is essential to the success of your assessment.
A qualified psychologist or psychiatrist who has been skilled in the use of the DIVA ADHD assessment will be able to give a thorough report. This report will outline the findings of the assessment and recommend a treatment program based on the evidence.
Please contact us to schedule an appointment if you think you or someone you know might be suffering from ADHD. iampsychiatry.com has been trained in the use of DIVA ADHD assessments and is able to provide a thorough evaluation. She will then make an appointment with a specialist to create an effective treatment strategy. Please be aware that the treatment plan recommended is a combination of medication and psychotherapy.