Psychiatry Shelf Exam Sample Questions

The correct answer is C. The onset criterion has been changed from symptoms presenting before age 7-years-old to 12-years-old for the diagnosis in children.

Explanation: “The onset criterion has been changed from ‘symptoms that caused impairment were present before age 7 years’ to ‘several inattentive or hyperactive-impulsive symptoms were present prior to age 12’.” (A) The same 18 symptoms are used in DSM-IV-TR as in DSM-5, and continue to be divided into 2 symptom domains (inattention and hyperactivity/impulsivity), of which at least 6 symptoms in 1 domain are required for diagnosis. (B) Subtypes have been replaced with presentation specifiers that map directly to the prior subtypes. Authors felt that subtypes were too rigid and allowed flexibility in allowing the diagnosis of specifiers when necessary. (D) For adults, the cutoff threshold for ADHD is 5 symptoms instead of 6 symptoms, both for inattention and hyperactivity/impulsivity, to reflect the substantial evidence of clinically significant ADHD impairment in older persons. (E) A comorbid diagnosis of ADHD and Autism Spectrum Disorder is now allowed.