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Jasper/Goldberg Adult ADHD Questionnaire

Larry Jasper & Ivan Goldberg

Use this questionnaire to help determine if you need to see a mental health professional for diagnosis and treatment of ADD or ADHD in an adult.

Instructions: The 24 items below refer to how you have behaved and felt DURING MOST OF YOUR ADULT LIFE. If you have usually been one way and recently have changed, your responses should reflect HOW YOU HAVE USUALLY BEEN. For each item, indicate the extent to which it is true by checking the appropriate box next to the item.

1. At home, work, or school, I find my mind wandering from tasks that are uninteresting or difficult.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

2. I find it difficult to read written material unless it is very interesting or very easy.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

3. Especially in groups, I find it hard to stay focused on what is being said in conversations.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

4. I have a quick temper... a short fuse.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

5. I am irritable, and get upset by minor annoyances.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

6. I say things without thinking, and later regret having said them.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

7. I make quick decisions without thinking enough about their possible bad results.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

8. My relationships with people are made difficult by my tendency to talk first and think later.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

9. My moods have highs and lows.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

10. I have trouble planning in what order to do a series of tasks or activities.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

11. I easily become upset.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

12. I seem to be thin skinned and many things upset me.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

13. I almost always am on the go.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

14. I am more comfortable when moving than when sitting still.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

15. In conversations, I start to answer questions before the questions have been fully asked.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

16. I usually work on more than one project at a time, and fail to finish many of them.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

17. There is a lot of “static” or “chatter” in my head.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

18. Even when sitting quietly, I am usually moving my hands or feet.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

19. In group activities it is hard for me to wait my turn.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

20. My mind gets so cluttered that it is hard for it to function.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

21. My thoughts bounce around as if my mind is a pinball machine.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

22. My brain feels as if it is a television set with all the channels going at once.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

23. I am unable to stop daydreaming.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much

24. I am distressed by the disorganized way my brain works.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much


Copyright 1990, 1991, 1992, 1993 Larry Jasper & Ivan Goldberg. All rights reserved. Adopted from the printed edition of the Jasper/Goldberg Adult ADD Screening Examination for electronic distribution. For personal use only; other use may be prohibited by law.

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