Attention Disorders: The Main Characteristics
Attention is a cognitive function that allows us to tend to the different stimuli in the environment for a certain amount of time (sustained attention), in addition to selecting the information that interests us and ignoring the information that doesn’t. But attention can be altered or diminished; when that happens, then we’re talking about attention disorders.
In this article, we’ll discover what attention disorders exist according to two criteria: Quantitative (having more or less attention) and Qualitative (when attention is altered for some reason). In addition, we’ll tell you in which psychological disorders or conditions these disorders appear more frequently.
What is attention?
Attention is a cognitive function; it’s a behavioral and cognitive process of selective concentration on a discrete aspect of information while ignoring other perceptible aspects. However, there’s no single type of attention, but several of them (sustained attention, selective attention, divided attention, etc.).
Attention and awareness
Attention was defined by Bleuler as “a manifestation of affectivity, the impressions or ideas that arouse interest being strengthened, and all others being inhibited”. In addition, the relationship between attention and consciousness is very close, as attention involves the ability to mobilize and focus the field of consciousness on certain objects.
The history of attention disorders
Classically, attention disorders have been called hypoprosexias and aprosexias, to refer, respectively, to the decrease in attentional capacity or its practically complete abolition (lack of attention).
Baños and Belloch (1995), cited in the CEDE Manual of Psychopathology (2018), describe the basic assumptions of the classic approaches to care.
These include the identification of attention and concentration, the consideration of alertness, and clarity of consciousness as prerequisites for the proper functioning of attention, and the assimilation of alertness and concentration to wakefulness.
According to these authors, these assumptions make the psychopathology of attention extremely simplified. Therefore, numerous aspects or properties of attention are left out, focusing only on the faculty of attention as concentration or, at best, adding the property of sustained attention.
Therefore, the only attention disorders that can be conceived from these assumptions involve quantitative variations in the degree of focus of attention on a stimulus or a task; tending to little or nothing, tending to few things, or constantly varying the object of attention.
All this can be conceived as hypo or hyper-concentration, that is, the extremes of the concentration continuum would give rise to the same effects.
Attention disorders involve a reduction or alteration of attention. Next, we’ll describe the disorders included in the classic categories of attention disorders, as well as the so-called pseudoaprosexias, paraprosexias, and hyperprosexias.
We’re also going to talk about which psychological (or other) disorders are typically associated with the appearance of each of these attentional disorders, according to the data of Higueras et al. (1996), cited in the CEDE Manual already mentioned.
Finally, we’ll talk about some of the disorders that are suggested from cognitive psychopathology, according to the division proposed by Reed (1988) (cited in the CEDE Manual ), and that would be better collected in the aforementioned proposal by Baños and Belloch.
One of the attention disorders is aprosexia. These disorders involve the maximum reduction in attentional capacity (that is, the person’s unable to tend to any stimulus).
They can be seen in situations of agitation and in a stupor. In these cases, it may be impossible to mobilize care.
This category of attention disorders includes a wide variety of disorders, depending on the degree of impairment of the attentive or attentive capacity. Let’s get to know them below:
Distractibility implies sudden changes of attention and marked instability of the same. Attention is focused for a short time and on multiple stimuli. Distractability is typical of ADHD (attention deficit hyperactivity disorder), twilight state, and manic states (eg, bipolar disorder ).
Emotional attentive lability
Emotional attentive lability implies inconstancy and oscillation of attentional performance. It appears especially in situations of high levels of stress or anxiety.
Attention inhibition is defined as “the inability to mobilize attention”. Therefore, there’s a certain degree of attention, but this is insufficient. It’s typical of depression and schizophrenia.
Neglect syndrome is defined by the presence of inattention, akinesia, and hemispatial neglect. In people with focal lesions in the non-dominant cerebral hemisphere, what’s known as unilateral inattention appears, characterized by the tendency to ignore half of the extrapersonal space.
It manifests itself in tasks that require a symmetrical perception of space, such as writing or drawing.
Attention fatigability is defined as “an easy exhaustion of attention, secondary to brain compromise factors”. It appears in people with brain tumors, dementia, or post-traumatic neurasthenia.
Apathy is considered another of the attention disorders and is defined as the “difficulty in maintaining attention on certain stimuli”. It’s typical of asthenic-apathetic states, depression, and serious personality disorders.
In this case, the classical psychopathology of attention (described at the beginning of the article) considers the perplexity of attention as a qualitative alteration of attention (and not as a quantitative alteration, which goes from less to greater attention). In this state, it’s said that the person doesn’t achieve the synthesis of the content of attention.
It’s a somewhat complex phenomenon, and it implies that the person “cannot grasp the concrete significance of the phenomena and their effective relationships, so they’re not able to understand their actions and the circumstances that surround them.”
Pseudoaprosexias, paraprosexias, and hyperprosexias
In another category of attention disorders, we find pseudoaprosexias, paraprosexias, and hyperprosexias. But does each phenomenon involve?
- Pseudoaprosexias: These are situations that appear to be aprosexia (lack of attention), but in which attention is preserved and especially directed to the reactions of the environment.
- Paraprosexias: These imply an abnormal direction of attention. They’re typical of hypochondria, for example, where attention is focused on symptoms.
- Hyperprosexias: These are excessive or transitory focalizations of attention. For example, in a hyperlucid state (trance).
Cognitive psychopathology of attention
From the cognitive model in the study of psychopathology, the perspective is somewhat different from what has been mentioned so far, as the objective is the study of the functioning of abnormal knowledge processes (both in natural and artificial situations).
According to approaches closer to psychological research on attention, Reed (1988) divides attentional disorders according to the aspect of attention with which they’re most related.
Attention as concentration
This section includes alterations related to the fixation of attention on stimuli, present in many psychiatric disorders and conditions such as extreme fatigue, the need to sleep, states of malnutrition, etc. Within this group, we find two attention disorders:
- Mental absence: This occurs when the individual is so preoccupied with their own thoughts that they exclude external information that’s usually accessible to them, and, therefore don’t respond to external feedback regarding changes in their habit.
- Temporal gap: This occurs when a person “doesn’t remember” a sequence of behavior that has necessarily taken place.
Attention as selection
Selective attention is the capacity of attention to separate relevant stimuli from irrelevant stimluli, based on the limited capacity of attention. Within this category, Reed highlights the phenomenon of “tuning in”, which is related to the ability to follow one source of information when many others compete at the same time to attract attention.
When there’s an alteration in this function, people can’t fix their attention. It appears in disorders such as manic episodes, anxiety disorders, twilight symptoms, or in schizophrenia.
Attention as activation
In this category, we find the attentional disorder of “tunnel vision”. It appears in highly stressful situations; At the attentional level, the focus is extreme and restricted.
Thus, the activation of the body produces a narrowing of the selective attention focus, and there’s a tendency to abandon the indexes of peripheral information (the details) in favor of the central information, causing this “tunnel vision”.
Attention as vigilance
This term describes a state of high receptivity or sensitivity towards environmental stimulation, as well as a type of attention dedication defined by certain tasks.
Attention deficits such as vigilance appear in people with schizophrenia, in people with generalized anxiety disorder (GAD), or in normal subjects with elevated anxiety trait scores.
Attention as expectations/”set”/or anticipation
Finally, we find attention as expectations. Based on our knowledge and our previous experiences, we anticipate certain outcomes from the environment. But in people with schizophrenia, for example, they don’t benefit from preparatory cues in cognitive tasks.
Why? Because they fail to maintain the state of predisposition to respond quickly and appropriately to the stimulus of whose appearance they’re previously informed.
The psychopathology of attention encompasses different attention disorders. Here, we’ve looked at them from a quantitative point of view (understanding attention as a continuum where there are different degrees of it) and qualitative. As we’ve seen, there are certain disorders that are more typical of some disorders than others.
However, each and every one of us can suffer from a disorder of this type at some point in our life, whether or not we have a psychological disorder. Fortunately, these are usually reversible processes, and, in addition, attention can be trained and improved over time (to some degree).
“In life, the things we fix our attention on grow.”