{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:53:04Z","timestamp":1791413584037,"version":"4.3.3"},"reference-count":59,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"unspecified","delay-in-days":141,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Acta Neuropsychiatr."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Defined by DSM-5-TR as a neurodevelopmental disorder, attention-deficit\/hyperactivity disorder (ADHD) has attracted ever-mounting attention from the public, coupled with a growing interest from clinicians, researchers, and patients. This is reflected in significantly higher demand for clinical assessments and frequent media reports of a surge in ADHD cases across the lifespan. These trends are puzzling as it is unknown what they truly reflect: an improvement in clinical detection or a concerning degree of overdiagnosis? A key reason for this uncertainty is our limited understanding of the disorder and imprecision of the diagnosis \u2013 a long-running subject of criticism. To better understand these issues, in this article, we\n                    <jats:italic>deconstruct<\/jats:italic>\n                    ADHD through the lens of its DSM-5-TR diagnostic criteria \u2013 the basis upon which the diagnosis is routinely made. Our in-depth analysis reveals major problems associated with the diagnostic criteria with respect to their\n                    <jats:italic>arbitrariness<\/jats:italic>\n                    ,\n                    <jats:italic>vagueness<\/jats:italic>\n                    ,\n                    <jats:italic>redundancy<\/jats:italic>\n                    , and\n                    <jats:italic>context-dependent normality<\/jats:italic>\n                    , which together substantially undermine the validity and reliability of the diagnosis, and the ADHD construct itself, blunting the precision of ADHD research, clinical decisions, and the effectiveness of treatment \u2013 all of which are contingent on having a robust diagnosis in the first place. Hence, our detailed\n                    <jats:italic>deconstruction<\/jats:italic>\n                    of the diagnosis of ADHD is critical as it provides the necessary groundwork for its accurate\n                    <jats:italic>reconstruction<\/jats:italic>\n                    \u2013 an essential step towards developing a valid, reliable, and clinically meaningful diagnostic foundation that will inform research and improve clinical care for patients with attentional and hyperactivity\u2013impulsivity problems.\n                  <\/jats:p>","DOI":"10.1017\/neu.2026.10086","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T03:07:09Z","timestamp":1779419229000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Breaking down the attention-deficit\/hyperactivity disorder construct to build a valid diagnosis"],"prefix":"10.1017","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5887-9028","authenticated-orcid":false,"given":"Kinga","family":"Szymaniak","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0384j8v12","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Sydney"},{"id":[{"id":"https:\/\/ror.org\/02hmf0879","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Sydney Local Health District"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8483-8497","authenticated-orcid":false,"given":"Erica","family":"Bell","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0384j8v12","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Sydney"},{"id":[{"id":"https:\/\/ror.org\/02hmf0879","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Sydney Local Health District"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7449-5490","authenticated-orcid":false,"given":"Gurubhaskar","family":"Shivakumar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0384j8v12","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Sydney"},{"id":[{"id":"https:\/\/ror.org\/02hmf0879","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Sydney Local Health District"},{"name":"Hornsby and Ku-ring-gai Hospital, Northern Sydney Local Health District"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gin S.","family":"Malhi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0384j8v12","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Sydney"},{"id":[{"id":"https:\/\/ror.org\/02hmf0879","id-type":"ROR","asserted-by":"publisher"}],"name":"Northern Sydney Local Health District"},{"name":"University of 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Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"S0924270826100866_ref39","doi-asserted-by":"publisher","DOI":"10.1142\/12752"},{"key":"S0924270826100866_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10912-014-9324-2"},{"key":"S0924270826100866_ref59","doi-asserted-by":"publisher","DOI":"10.1177\/070674371305801104"},{"key":"S0924270826100866_ref38","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-65974-8"},{"key":"S0924270826100866_ref54","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2025.2447"},{"key":"S0924270826100866_ref37","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.14101266"},{"key":"S0924270826100866_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(24)00360-2"},{"key":"S0924270826100866_ref16","doi-asserted-by":"publisher","DOI":"10.1177\/1087054708315137"},{"key":"S0924270826100866_ref55","first-page":"1","article-title":"ADHD: 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Published by Cambridge University Press on behalf of Scandinavian College of Neuropsychopharmacology","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e44"}}