All of the following are the core symptoms of ADHD EXCEPT:

Appeared in: BTSC 3 August 2025

Explanation

Social anxiety is not a core symptom of ADHD as defined by the DSM-5.
While social difficulties and anxiety can be associated with or result from ADHD, they are considered separate conditions or consequences, not primary diagnostic criteria.
The core, defining symptoms of ADHD are specifically categorized as inattention, hyperactivity, and impulsivity.

Why Other Options Were Wrong

Option A: This is incorrect because inattention is one of the primary, core symptom clusters of ADHD.
Option B: This is incorrect because hyperactivity is a core symptom of ADHD, particularly in the hyperactive/impulsive and combined presentations.
Option D: This is incorrect because impulsivity is a key diagnostic criterion and a core symptom of ADHD.

Related Visual

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) as background academic context rather than a clinical decision trigger.
For nurses, accurately identifying the core symptoms of ADHD is crucial for proper assessment, patient education, and developing an effective care plan.
Misattributing comorbid symptoms like anxiety as core features of ADHD can lead to ineffective treatment strategies. A comprehensive assessment should screen for co-existing conditions.
What if? If a patient with ADHD presents with significant social withdrawal, the nurse should not assume it's just part of the ADHD. Instead, they should assess for a comorbid social anxiety disorder, which would require a different therapeutic approach, such as cognitive-behavioral therapy (CBT) for anxiety, in addition to ADHD management.

How to Approach the Question

First, identify the keywords in the question stem. Here, the key terms are 'core symptoms of ADHD' and the negative word 'EXCEPT'.
The word 'EXCEPT' signals that three of the options are correct (they are core symptoms), and one is the outlier.
Recall the three primary clusters of ADHD symptoms: inattention, hyperactivity, and impulsivity.
Evaluate each option against this knowledge: 'inattention' (core symptom), 'hyperactivity' (core symptom), 'impulsivity' (core symptom).
The remaining option, 'social anxiety', is not on the list of core symptoms. While it can be related or co-occur, it is not a defining feature.
Therefore, 'social anxiety' is the correct answer because it is the exception.

Concept Tested & Keywords

Concept Tested: Core symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD)
Stem keywords: ADHD, core symptoms
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks for the option that is NOT a core symptom of ADHD.

Question ID

QvSZIdGxo7TA7n2OvYbjLC

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 12108-12110, 12098-12100

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 421-423

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