ADHD does not look the same for everyone. One person may mainly struggle with focus, organisation and forgetfulness, while another may experience symptoms of restlessness, impulsivity or emotional dysregulation.
This variation is one reason ADHD can sometimes be misunderstood, missed or oversimplified and over-diagnosed. Although ADHD is commonly spoken about as a single condition, people diagnosed with ADHD can have very different symptoms, challenges and support needs.
New research published in JAMA Psychiatry (Pan et al.,2026) may help explain why ADHD can vary so much between people. The study used brain imaging and network modelling to explore whether children with ADHD showed different brain-based patterns that could be grouped into possible biotypes.
ADHD is not always a one size fits all condition
ADHD is usually diagnosed through a clinical assessment with a psychiatrist. This may involve exploring symptoms of inattention, hyperactivity and impulsivity, as well as a person’s developmental history, functioning at school by looking at old school reports, work or home, gathering extra history from a parent or sibling and any other mental health or learning concerns.
However, ADHD can present differently from person to person. Some people may mainly experience inattentive symptoms, such as difficulty concentrating, loosing track of tasks or feeling mentally scattered. Others may experience more hyperactive or impulsive symptoms, such as restlessness, interrupting, acting impulsively or struggling to slow down.
For some people, emotional regulation is also a significant part of their ADHD experience. This may include feeling easily overwhelmed, frustrated or emotionally reactive. These differences can affect how ADHD is recognised, diagnosed and managed.
ADHD is currently diagnosed through a comprehensive clinical psychiatric assessment, including symptoms of inattention, hyperactivity and impulsivity, as well as developmental history, daily functioning, schoolwork by looking at current and old school reports, and experiences of home difficulties.
However, symptoms alone may not fully explain why ADHD looks so different from person to person. Pan et al., (2026) describe ADHD as a heterogeneous condition meaning, the same diagnostic category may include people with different underlying brain-based patterns. This is the reasoning behind why the researchers explored whether brain imaging could hep identify ADHD “biotypes” within children.
What Did the New ADHD Brain Imaging Study Find?
The study examined brain imaging data from 446 children with ADHD and 708 typically developing children. Using normative modelling (comparing individual brain features against expected developmental patterns), researchers identified three possible ADHD biotypes.
Biotype 1: Severe Combined With Emotional Dysregulation
This group showed the most widespread brain network differences and had the highest level of both inattention and hyperactivity/impulsivity. Individuals with this biotype were also linked with more persistent difficulties with emotional self-regulation over time.
Biotype 2: Predominately Hyperactive/ Impulsive.
This group showed brain network differences that were closely associated with hyperactivity and impulsivity
Biotype 3: Predominately Inattentive
This group showed brain network differences that were more closely associated with attention related difficulties.
What does this mean for ADHD diagnosis?
These results are promising, but they do not mean that brain scans are currently used to diagnosed ADHD.
ADHD is still diagnosed through a comprehensive clinical assessment by a psychiatrist, which includes exploring symptoms of inattention, hyperactivity and impulsivity, developmental history, daily functioning, gathering extra history from a. Parent or sibling and any co-occurring mental health or learning concerns.
Brain imaging may eventually help improve scientific understanding and lead to more personalised treatment approaches, but clinical training, symptom history and functional assessment and a comprehensive corroborative history remain the foundation of diagnosis.
Why this research matters
This study helps explain why ADHD can present so differently from person to person. It also supports the idea that people with ADHD may not all respond to the same supports or treatment in the same way.
In the future, research like this may contribute to more personalised approaches to ADHD care, better matching support and treatments to individual needs and symptom profiles.
Why speaking to a psychiatrist still matters?
For those seeking a psychiatrist in Sydney, speaking directly with quality medical specialists remains the most reliable way to receive an accurate diagnosis and care plan. A thorough psychiatric assessment helps build a clear picture of the person behind the diagnosis, including their unique strength, challenged and support. Emerging research may eventually help psychiatrist better understand which supports are most helpful for different patients, but clinical assessments remain the foundation of ADHD diagnosis and care.
If you or your child is struggling with attention, hyperactivity or emotional regulation, a comprehensive psychiatric assessment can provide clarity and a tailored management plan.
To learn more about ADHD assessment, click here
Source
- Pan, N., Long, Y., Qin, K., Pope, I. Z., Chen, Q., Zhu, Z., … & Gong, Q. (2026). Mapping ADHD Heterogeneity and Biotypes by Topological Deviations in Morphometric Similarity Networks. JAMA psychiatry.