A 32-year-old female graduate student requests evaluation for ADHD. She reports difficulty concentrating on her dissertation, procrastination, forgetfulness, and feeling overwhelmed by tasks. She states these problems began about 18 months ago when she started her doctoral program. She performed well academically through college with no behavioral or attention concerns. She sleeps 4-5 hours per night due to anxiety about her program, drinks 6 cups of coffee daily, and reports persistent worry about academic performance, finances, and her relationship. There is no family history of ADHD.