How Does DSM-5 Address Individuals Who Do Not Fit Neatly Into One ADHD Presentation? 

The DSM-5 recognises that not all individuals with ADHD fit neatly into one of the three main presentations — Inattentive, Hyperactive-Impulsive, or Combined. For those who display symptoms that do not clearly match any one category, the DSM-5 acknowledges the existence of an atypical ADHD presentation. This allows for a more flexible approach to diagnosis when symptoms are less straightforward. 

An atypical ADHD presentation can occur when an individual shows a mixture of symptoms from multiple presentations but does not meet the criteria for one specific category. For example, they might experience significant inattentive symptoms, but only mild signs of hyperactivity, or vice versa. The undefined presentation can also occur in cases where ADHD symptoms are less severe or where they only appear in specific settings, leading to diagnostic ambiguity. 

In these situations, the DSM-5 encourages clinicians to thoroughly evaluate all symptoms across different environments (for example, home, school, work) and consider the severity and impact of those symptoms. This ensures that a more accurate diagnosis is made, even if the individual’s presentation does not fit perfectly into the standard classifications. 

How It Helps 

By acknowledging atypical ADHD presentations, the DSM-5 ensures that individuals who do not fit traditional ADHD categories still receive the correct diagnosis and support. This approach helps in tailoring treatment plans to address the full range of symptoms, improving the effectiveness of interventions and overall care. 

Visit providers like ADHD Certify for personal consultations and expert advice tailored to your needs.   

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to DSM-5 Diagnostic Guidelines. 

Harriet Winslow, BSc

Author

Harriet Winslow is a clinical psychologist with a Bachelor’s in Clinical Psychology and extensive experience in behaviour therapy and developmental disorders. She has worked with children and adolescents with ADHD, autism spectrum disorder (ASD), learning disabilities, and behavioural challenges, providing individual and group therapy using evidence-based approaches such as CBT and DBT. Dr. Winslow has developed and implemented personalised treatment plans, conducted formal and informal assessments, and delivered crisis intervention for clients in need of urgent mental health care. Her expertise spans assessment, treatment planning, and behavioural intervention for both neurodevelopmental and mental health conditions.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.