OBJECTIVE: We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener. METHOD: Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,627, 57% women, Mage=32.84; SDage=12.57). RESULTS: The ASRS Screener demonstrated good reliability and validity, along with partial invariance across different languages, countries, and genders. The occurrence of being at risk for adult ADHD was relatively high (21.4% for women, 18.1% for men). The highest scores were obtained in the US, Canada, and other English-speaking Western countries, with significantly lower scores among East Asian and non-English-speaking European countries. Moreover, ADHD symptom severity and occurrence were especially high among gender-diverse individuals. Significant associations between adult ADHD symptoms and age, mental and sexual health, and socioeconomic status were observed. CONCLUSIONS: Present results show significant cross-cultural variability in adult ADHD occurrence as well as highlight important factors related to adult ADHD. Moreover, the importance of further research on adult ADHD in previously understudied populations (non-Western countries) and minority groups (gender-diverse individuals) is stressed. Lastly, the present analysis is consistent with previous evidence showing low specificity of adult ADHD screening instruments and contributes to the current discussion on accurate adult ADHD screening and diagnosis.

All India Institute of Medical Sciences New Delhi India

Artois University Arras France

Auckland University of Technology New Zealand

Cardinal Stefan Wyszynski University Warsaw Poland

Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles Canada

Centre for Advanced Research Excellence in Public Health Savar Dhaka Bangladesh

Charles University Prague Czech Republic

Chuncheon Addiction Management Center South Korea

Connecticut Council on Problem Gambling Wethersfield CT USA

Connecticut Mental Health Center New Haven CT USA

Department of Health Services Srinagar India

ELTE Eötvös Loránd University Budapest Hungary

Florida State University Republic of Panama

Fuzhou University China

General University Hospital Prague Czech Republic

Grupo de Investigación Biomédica y de Patología Colombia

Hallym University Chuncheon Sacred Heart Hospital South Korea

HELP University Kuala Lumpur Malaysia

Institute of Psychology Polish Academy of Sciences Poland

Jahangirnagar University Savar Dhaka Bangladesh

James Cook University Australia

KU Leuven Belgium

Kyoto University Kyoto Japan

Lausanne University Hospitals Switzerland

Lawson Health Research Institute London Canada

Liverpool John Moores University UK

Macedonian Academy of Sciences and Arts Republic of North Macedonia

National Autonomous University of Mexico Mexico

National Cheng Kung University Tainan

National Taipei University of Education Taipei

Neuroscience Institute Lithuanian University of Health Sciences Lithuania

Nottingham Trent University UK

Pavol Jozef Safarik University in Kosice Slovakia

Psychosis Research Centre University of Social Welfare and Rehabilitation Sciences Tehran Iran

RIKEN Center for Advanced Intelligence Project Tokyo Japan

Sapienza University of Rome Italy

Sharda University Greater Noida India

Sigmund Freud University Vienna Austria

Sistema Nacional de Investigación SENACYT Panama

South African Medical Research Council South Africa

Stellenbosch University South Africa

The General Research Division Osaka University Research Center on Ethical Legal and Social Issues Osaka Japan

Universidad Científica del Sur Lima Perú

Universidad de Talca Chile

Universidad de Tarapacá Arica Chile

Universidad Pedagógica y Tecnológica de Colombia Colombia

Universidad Privada de Santa Cruz de la Sierra Bolivia

Universidad Privada del Norte Lima Perú

Universidade de Aveiro Portugal

Universidade de São Paulo Brazil

Université de Montréal Canada

Université du Québec à Trois Rivières Canada

University Jaume 1 of Castellón Spain

University Medical Centre Hamburg Eppendorf Germany

University of Baghdad Iraq

University of California San Diego USA

University of Cape Town Rondebosch South Africa

University of Cuenca Azuay Ecuador

University of Duisburg Essen Germany

University of Galway Ireland

University of Gibraltar Gibraltar

University of Haifa Israel

University of Hertfordshire UK

University of Lausanne Switzerland

University of Nevada Las Vegas USA

University of New Mexico Albuquerque USA

University of Religions and Denominations Qom Iran

University of Southampton UK

University of Ss Cyril and Methodius in Trnava Slovakia

University of Trento Italy

University of Valencia Spain

University of Zagreb Croatia

Western University St Joseph's Health Care London and London Health Sciences Centre London Canada

Yale University School of Medicine New Haven CT USA

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Identification and comprehensive characterization of moral disapproval and behavioral dysregulation-based pornography-use profiles across 42 countries