What Characterises the Predominantly Hyperactive-Impulsive Presentation in DSM-5? 

The ADHD Hyperactive-Impulsive presentation is one of the three main types of ADHD defined in the DSM-5. This presentation is characterised by excessive movement, impulsive behaviours, and difficulty regulating emotions. Unlike the predominantly inattentive type, individuals with the hyperactive-impulsive presentation show more overt signs of hyperactivity and impulsivity, often making them more noticeable in settings such as school or social environments. 

According to the DSM-5 ADHD types, to be diagnosed with ADHD Hyperactive-Impulsive presentation, a person must exhibit at least six symptoms of hyperactivity and impulsivity that have persisted for at least six months. Common hyperactivity symptoms include fidgeting, difficulty staying seated, excessive talking, and an inability to relax. Impulsive symptoms may include interrupting others, speaking out of turn, and making hasty decisions without considering the consequences. 

The DSM-5 specifies that these symptoms must cause significant impairment in at least two different settings, such as at home and in school or work environments. These behaviours must also be inconsistent with the person’s developmental level, meaning they must be more intense than what would be expected for the individual’s age. 

How It Helps 

Recognising the ADHD Hyperactive-Impulsive presentation through the DSM-5 ADHD types allows clinicians to accurately diagnose and address the specific needs of individuals with this form of ADHD. By identifying hyperactivity and impulsivity early, appropriate interventions and treatments can be implemented to help manage symptoms and improve overall functioning. 

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.