Understanding ADHD: How It Is Defined in the DSM-5

Discover tips, treatment options, and support strategies from the Finding Focus Care Team

Last Update: January 16, 2025 | Estimated Read Time: 6 min

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by patterns of inattention and/or hyperactivity-impulsivity that interfere with daily functioning. The DSM-5 provides criteria for diagnosing ADHD, ensuring accurate identification and effective support.

What Is ADHD?

ADHD affects individuals of all ages, genders, and cultural backgrounds. Symptoms often manifest differently across demographics; for example, women may experience more inattentive symptoms, while cultural norms can influence how ADHD is recognized and addressed. Recognizing symptoms early is critical for appropriate intervention.

DSM-5 Criteria for ADHD

The DSM-5 divides ADHD symptoms into two categories: inattention and hyperactivity-impulsivity. These symptoms must persist for at least six months, occur in multiple settings, and interfere with functioning.

Inattention Symptoms

Individuals with ADHD may exhibit symptoms that indicate difficulty with focus, organization, and memory. According to the DSM-5, inattentive symptoms include:

• Frequently making careless mistakes or overlooking details.
• Struggling to sustain attention in tasks.
• Not seeming to listen when spoken to directly.
• Failing to follow through on instructions and tasks.
• Displaying poor organization.
• Avoiding or disliking tasks requiring sustained mental effort.
• Losing important items needed for tasks and activities.
• Being easily distracted, including by unrelated thoughts.
• Being forgetful in daily activities.

Hyperactivity-Impulsivity Symptoms

The hyperactive and impulsive aspects of ADHD can make it difficult for individuals to remain still, take turns, or regulate their speech and behaviour. The DSM-5 identifies the following symptoms:

• Fidgeting with hands or feet or squirming in seat.
• Talking excessively.
• Blurting out answers before questions have been completed.
• Having difficulty waiting for their turn.
• Interrupting or intruding on others’ conversations or activities.
• Experiencing restlessness or difficulty staying still.
• Having difficulty engaging in quiet, leisurely activities.
• Acting as if “driven by a motor.”
• Leaving their seat in situations when remaining seated is expected.

Diagnostic Criteria for ADHD

For an ADHD diagnosis, an individual must meet all five of the DSM-5 criteria:

1. Number of Symptoms: Adults (age 18 and older) must exhibit at least five symptoms from either the inattention or hyperactivity-impulsivity categories for six months or more, to a degree that is inconsistent with developmental level and negatively impacts social and academic/occupational activities.
2. Early Onset: Several symptoms must have been present before the age of 12.
3. Multiple Settings: Symptoms must be observed in at least two settings (e.g., home, school, work, or social environments).
4. Functional Impairment: There must be clear evidence that symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
5. Exclusion of Other Conditions: Symptoms cannot be better explained by another mental disorder (e.g., mood disorders, anxiety disorders, personality disorders, or substance use disorders).

Presentations of ADHD

ADHD is not a one-size-fits-all diagnosis. The DSM-5 recognizes three primary ADHD presentations:

• Predominantly Inattentive Presentation: Individuals struggle primarily with focus, organization, and memory but may not exhibit significant hyperactivity.
• Predominantly Hyperactive-Impulsive Presentation: High energy, impulsivity, and difficulty sitting still dominate.
• Combined Presentation: Both inattentive and hyperactive-impulsive symptoms are present in significant amounts.

Experiencing Some ADHD Symptoms Does Not Necessarily Mean You Have ADHD

Many people experience difficulties with focus, restlessness, or impulsivity from time to time. However, occasional struggles do not equate to ADHD. A formal diagnosis requires the presence of persistent, impairing symptoms across multiple settings. It is important to seek a comprehensive evaluation from a qualified professional before assuming an ADHD diagnosis.

ADHD Across the Lifespan

ADHD is often diagnosed in childhood but frequently persists into adulthood. In children, it may appear as difficulty following instructions or staying seated. Adolescents often face academic struggles, while adults may experience chronic disorganization, difficulty managing responsibilities, and restlessness.

• Children: Common signs include hyperactivity, difficulty listening, trouble following rules, and excessive energy.
• Adolescents: Struggles with academic performance, forgetfulness, and impulsivity may emerge more clearly.
• Adults: Challenges in time management, maintaining relationships, staying organized, and sustaining attention can affect daily life and work performance.

Managing ADHD

While ADHD cannot be cured, it can be effectively managed through a combination of behavioural strategies, lifestyle modifications, and professional interventions.

• For Inattention: Utilize planners, to-do lists, and reminders. Break large tasks into smaller, manageable steps.
• For Hyperactivity: Engage in regular physical activity to reduce restlessness.
• For Impulsivity: Practice mindfulness, structured routines, and impulse-control strategies.
• Professional Support: Therapy (such as Cognitive Behavioural Therapy or ADHD coaching), educational accommodations, and medication may be beneficial.

Importance of Diagnosis and Early Intervention

A timely ADHD diagnosis is essential for accessing appropriate resources and support. Many individuals with ADHD benefit from therapy, medication, and personalized academic or workplace accommodations. By working with healthcare professionals, individuals with ADHD can develop strategies that help them thrive in different areas of life.

Finding Focus Care Team

We are a group of nurse practitioners, continuous care specialists, creators, and writers, all committed to excellence in patient care and expertise in ADHD. We share content that illuminates aspects of ADHD and broader health care topics. Each article is medically verified and approved by the Finding Focus Care Team. You can contact us at Finding Focus Support if you have any questions!

References

DSM-5 ADHD Criteria: Link  

CDC ADHD Symptoms and Diagnosis: Link

CHADD Understanding ADHD: Link