A Six-Domain Clinical Framework for ADHD Assessment
In this video, Dr Sanil Rege, consultant psychiatrist, outlines a clinician-focused approach to ADHD diagnostic domains, extending assessment beyond the DSM-based emphasis on inattention and hyperactivity.
The video introduces a six-domain framework covering cognition, activity, reward sensitivity, behavioural activation, behavioural inhibition, and the fight/flight system—that clinicians can use as an ADHD assessment framework to structure history-taking and systematically rule out commonly overlooked functional impairments.
This provides clinicians with a practical method for organising ADHD assessments and identifying executive, motivational, and emotional dysregulation in clinical practice.
Develop Clinical Excellence in ADHD Assessment and Management
Strengthen your clinical skills in ADHD assessment, diagnosis and management through our comprehensive curriculum, covering neurobiology, psychopharmacology, comorbidities and practical case-based learning. Join Academy by Psych Scene to access the courses and earn CME/CPD points.
Get Access to the Course
KEY TAKEAWAYS
- DSM criteria may not capture the full functional complexity of ADHD presentations
- A six-domain hierarchy provides a structured method for ADHD assessment
- Executive function and cognition are central to diagnostic formulation
- Motivation, anticipation, and sustained activity represent a distinct clinical domain
- Reward sensitivity, behavioural activation/inhibition, and fight/flight responses reflect shared neurobiological circuits relevant to ADHD and trauma
To build on the diagnostic and neurobiological framework discussed in this video, clinicians may find value in the Clinical Excellence in Adult ADHD curriculum on The Academy by Psych Scene. This comprehensive program integrates ADHD neurobiology with structured approaches to assessment, executive dysfunction, motivation, and reward processing, supporting clinicians in applying mechanism-informed diagnostic reasoning in adult ADHD.
Subscribe to The Academy by Psych Scene on YouTube for clinician-focused videos on psychiatry, neuroscience, and evidence-based clinical practice.
Related Articles & Videos:
- Neurobiology of Attention Deficit Hyperactivity Disorder (ADHD) – A Primer
- Diagnosis and Management of Attention Deficit Hyperactivity Disorder – Focus on Adult ADHD
- ADHD and Comorbidities: An Evidence-Based Overview of Diagnosis, Treatment, and Clinical Integration
- Clinical Approach to Diagnosis of Adult ADHD (Attention Deficit Hyperactivity Disorder)
- The Overlooked Emotional Dynamics of ADHD
- Are There Similarities Between the Neurobiology of ADHD and Binge-Eating Disorder?-Prof Martin Katzman
Get Serious About Psychiatry Learning
Our courses offer practical knowledge and clinical expertise at exceptional value, plus CME & CPD points.
Go to Academy by Psych Scene