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Effects of surgery type and attention focus on children's coping.

BACKGROUND: How children cope with minor or major surgery is influenced by their attention focus appraisals. Although factors that predict children's coping with surgery have been identified (i.e., age, locus of control, parent-doctor information, worry), it still is not known whether the type of surgery per se affects the coping strategies used and influences previously established predictors of coping. Furthermore, questions remain concerning the relation among type of surgery, attention focus, and coping. OBJECTIVES: The purpose of this study was to determine whether the type of surgery (minor vs. major) would have a differential effect on coping, and whether coping can be predicted better if it is known what type of attention focus (appraisal) the child has. METHODS: Data from three studies of children (n = 189) undergoing minor or major surgery were combined to examine the effects that type of surgery and attention have on coping. Measures included the Preoperative Mode of Coping Interview, Locus of Control Scale for Children, Parent-Doctor Information Interview, and a measure for worry. RESULTS: The results showed that the factors previously found to predict coping were upheld in the combined sample and accounted for 50% of the variance in coping. Type of surgery was significantly associated with coping: Children undergoing minor surgery were somewhat more vigilant than children undergoing major surgery. The inclusion of attention in the analysis significantly improved the variance explained in coping (66%), and children who had a concrete-objective focus of attention were found to be more vigilant. Significant interactions were found between attention focus and type of surgery, locus of control, and age. Type of surgery also had a significant interaction with worry. Children who focused on the concrete-objective aspects of the situation were more vigilant if they were having minor rather than major surgery. Also, children who had an internal locus of control and a concrete-objective focus of attention were more vigilant in coping. Regardless of age, children who had a concrete-objective focus of attention were more vigilant. Furthermore, at low levels of worry, children undergoing major surgery were more vigilant than children undergoing minor surgery. CONCLUSIONS: Coping with surgery is influenced by multiple factors. Children's ability to focus attention on the concrete-objective aspects of surgery may help to reduce feelings of threat that could impede their use of vigilant coping.

Adaptation, Psychological↗
PubMed2006

Neural mechanisms of joint attention in infancy.

One of the key transitions in early cognitive development is from participating in face-to-face interactions to engaging in joint attention exchanges. It is known that the ability to jointly attend with another person to an object is essential for the development of abilities such as language in later life. Strikingly, little is known about the function of joint attention in infants in the first year. We developed a novel interactive-live paradigm to assess the neural mechanisms of joint attention in 9-month-old infants. An adult interacted with each infant, and infants' electrical brain activity was measured in two contexts. In the joint attention context, a live adult gazed at the infants' face and then to a computer displayed novel object. In the non-joint attention context the adult gazed only to the novel object. We found that the negative component of the infant event-related potential (ERP), a neural correlate indexing attentional processes, was enhanced in amplitude during the processing of objects when infants were engaged in a joint attention interaction compared to a non-joint attention interaction. These results suggest that infants benefit from joint attention interactions by focusing their limited attentional resources to specific aspects of the surrounding environment.

Adult↗
PubMed2004

Modulation of associative human motor cortical plasticity by attention.

The role of attention in generating motor memories remains controversial principally because it is difficult to separate the effects of attention from changes in kinematics of motor performance. We attempted to disentangle attention from performance effects by varying attention while plasticity was induced in human primary motor cortex by external stimulation in the absence of voluntary movement. A paired associative stimulation (PAS) protocol was employed consisting of repetitive application of single afferent electric stimuli, delivered to the right median nerve, paired with single-pulse transcranial magnetic stimulation (TMS) over the optimal site for activation of the right abductor pollicis brevis muscle (APB) to generate near-synchronous events in the left primary motor cortex. In experiment 1, the spatial location of attention was varied. PAS failed to induce plasticity when the subject's attention was directed to their left hand, away from the right target hand the cortical representation of which was being stimulated by PAS. In experiment 2, the grade of attention to the target hand was manipulated. PAS-induced plasticity was maximal when the subject viewed their target hand, and its magnitude was slightly reduced when the subject could only feel their hand. Conversely, plasticity was completely blocked when the subject's attention was diverted from the target hand by a competing cognitive task. A similar modulation by attention was observed for PAS-induced changes in the duration of the silent period evoked by TMS in voluntarily contracted muscle. Associative plasticity in the human motor cortex depends decisively on attention.

Adult↗
PubMed2002

Cross-modal interactions between audition, touch, and vision in endogenous spatial attention: ERP evidence on preparatory states and sensory modulations.

Recent behavioral and event-related brain potential (ERP) studies have revealed cross-modal interactions in endogenous spatial attention between vision and audition, plus vision and touch. The present ERP study investigated whether these interactions reflect supramodal attentional control mechanisms, and whether similar cross-modal interactions also exist between audition and touch. Participants directed attention to the side indicated by a cue to detect infrequent auditory or tactile targets at the cued side. The relevant modality (audition or touch) was blocked. Attentional control processes were reflected in systematic ERP modulations elicited during cued shifts of attention. An anterior negativity contralateral to the cued side was followed by a contralateral positivity at posterior sites. These effects were similar whether the cue signaled which side was relevant for audition or for touch. They also resembled previously observed ERP modulations for shifts of visual attention, thus implicating supramodal mechanisms in the control of spatial attention. Following each cue, single auditory, tactile, or visual stimuli were presented at the cued or uncued side. Although stimuli in task-irrelevant modalities could be completely ignored, visual and auditory ERPs were nevertheless affected by spatial attention when touch was relevant, revealing cross-modal interactions. When audition was relevant, visual ERPs, but not tactile ERPs, were affected by spatial attention, indicating that touch can be decoupled from cross-modal attention when task-irrelevant.

Adult↗
PubMed2004

Visual search and attention: an overview.

This special feature issue is devoted to attention and visual search. Attention is a central topic in psychology and visual search is both a versatile paradigm for the study of visual attention and a topic of study in itself. Visual search depends on sensory, perceptual, and cognitive processes. As a result, the search paradigm has been used to investigate a diverse range of phenomena. Manipulating the search task can vary the demands on attention. In turn, attention modulates visual search by selecting and limiting the information available at various levels of processing. Focusing on the intersection of attention and search provides a relatively structured window into the wide world of attentional phenomena. In particular, the effects of divided attention are illustrated by the effects of set size (the number of stimuli in a display) and the effects of selective attention are illustrated by cueing subsets of stimuli within the display. These two phenomena provide the starting point for the articles in this special issue. The articles are organized into four general topics to help structure the issues of attention and search.

Attention↗
PubMed2000

Visual attention impairments in Alzheimer's disease.

BACKGROUND: Impaired attention can hinder information processing at multiple levels and may explain aspects of functional decline in aging and dementia. Impairments of attention in early AD may contribute to performance reductions in other cognitive domains, including memory and executive functions. METHOD: - The authors analyzed the scores on a battery of tests of attention and cognitive abilities in 64 older individuals: 42 with mild AD and 22 control subjects without dementia. The authors tested the hypotheses that patients with AD would have impairments of visual attention, and that these impairments would correlate with dysfunction in other key cognitive domains. RESULTS: Patients with AD performed significantly worse than control subjects on measures of sustained attention, divided attention, selective attention, and visual processing speed. The differences were not due to differences in age, education, or basic visual function. Strong relationships were identified between reduced attention skills and overall cognitive impairment. CONCLUSIONS: Deterioration of attention abilities occurs in early stages of AD, and likely contributes to functional decline in these patients. More routine assessment of visual attention deficits could give a more accurate measure of functionally useful perception in patients with AD who show normal visual acuity and visual fields, perhaps providing useful clues to diagnosis and staging.

Aged↗
PubMed1994

Visual motion and attentional capture.

Previous work has shown that abrupt visual onsets capture attention. This occurs even with stimuli that are equiluminant with the background, which suggests that the appearance of a new perceptual object, not merely a change in luminance, captures attention. Three experiments are reported in which this work was extended by investigating the possible role of visual motion in attentional capture. Experiment 1 revealed that motion can efficiently guide attention when it is perfectly informative about the location of a visual search target, but that it does not draw attention when it does not predict the target's position. This result was obtained with several forms of motion, including oscillation, looming, and nearby moving contours. To account for these and other results, we tested a new-object account of attentional capture in Experiment 2 by using a global/local paradigm. When motion segregated a local letter from its perceptual group, the local letter captured attention as indexed by an effect on latency of response to the task-relevant global configuration. Experiment 3 ruled out the possibility that the motion in Experiment 2 captured attention merely by increasing the salience of the moving object. We argue instead that when motion segregates a perceptual element from a perceptual group, a new perceptual object is created, and this event captures attention. Together, the results suggest that motion as such does not capture attention but that the appearance of a new perceptual object does.

Attention↗
PubMed1999

Time course of attention effects with abrupt-onset and offset single- and multiple-element precues.

Large differences between the time course of attentional responsiveness to onset single-element precues (onset singles) and to onset multiple-element precues (onset multiples) have suggested differences in the way attention is controlled. In five experiments here, singles presented as offsets produced rapid attention buildup, attentional decay across longer precue-to-target delays, and attentional capture, as do onset singles, suggesting exogenous attentional control; both offset and onset multiples produced gradual onset of attentional effects without subsequent attentional decay, suggesting endogenous attentional control; and onset and offset singles produced higher accuracy than onset and offset multiples. Thus, the dynamic quality of a sudden onset is not sufficient explanation for the exogenous attentional control produced by a single-element peripheral precue.

Adult↗
PubMed1991

Selective and divided attention during visual discriminations of shape, color, and speed: functional anatomy by positron emission tomography.

Positron emission tomography (PET) was used to identify the neural systems involved in discriminating the shape, color, and speed of a visual stimulus under conditions of selective and divided attention. Psychophysical evidence indicated that the sensitivity for discriminating subtle stimulus changes in a same-different matching task was higher when subjects selectively attended to one attribute than when they divided attention among the attributes. PET measurements of brain activity indicated that modulations of extrastriate visual activity were primarily produced by task conditions of selective attention. Attention to speed activated a region in the left inferior parietal lobule. Attention to color activated a region in the collateral sulcus and dorsolateral occipital cortex, while attention to shape activated collateral sulcus (similarly to color), fusiform and parahippocampal gyri, and temporal cortex along the superior temporal sulcus. Outside the visual system, selective and divided attention activated nonoverlapping sets of brain regions. Selective conditions activated globus pallidus, caudate nucleus, lateral orbitofrontal cortex, posterior thalamus/colliculus, and insular-premotor regions, while the divided condition activated the anterior cingulate and dorsolateral prefrontal cortex. The results in the visual system demonstrate that selective attention to different features modulates activity in distinct regions of extrastriate cortex that appear to be specialized for processing the selected feature. The disjoint pattern of activations in extravisual brain regions during selective- and divided-attention conditions also suggests that preceptual judgements involve different neural systems, depending on attentional strategies.

Adult↗
PubMed1998

[Electrophysiologic evaluation of passive and active attentions--I. Topographic analysis of somatosensory event-related potentials].

We studied the topography of somatosensory event-related potentials (SERP) in two different attentive conditions: passive and active. Seventeen healthy right-handed young men, aged 19 to 28 years old (average age; 22.9 years), were requested to perform the following four paradigms in turn. In the passive attentive paradigm, participants were given no specific task when 0.3 Hz electrical stimuli were at random delivered to the right median nerve. In the active attentive paradigm, subjects were required to direct their attention to the regular 0.3 Hz stimuli with all their might. In the control paradigm. 2.0 Hz stimuli were delivered as they listened to their favorite music. Finally, in the oddball paradigm, subjects were instructed to push a button whenever they detected rare stimuli. SERP was recorded at 13 electrodes Grand average topographic amplitude maps from the individual data of the seventeen subjects were made at the latencies of N 60, P 90, N 130 and P 250 for each of the four paradigms. The topographic maps of P 250, the largest positive peak between 200 and 300 msec after the stimuli, showed a significant difference in the distribution of amplitude in the passive and active attentive paradigms compared to the control paradigm. A statistically significant enhancement was noted at the central region in the passive attention, and at the central and frontal regions in the active attention. These results suggest that P 250 consists of two attentive components distinct from selective or discriminative attention. The enhanced positivity at the frontal region during active attention may be associated with expecting the next stimulus and maintaining awareness.

Adult↗
PubMed1998

The synchronization principle in modelling of binding and attention.

The paper presents some mathematical models in support of the hypothesis that there is a general principle of information processing at the levels of both preattention and attention. It is claimed that at both levels, information processing is based on the coherent (synchronous) activity of neurons, neural populations, and brain structures. The difference between the two levels is presumed to relate to how synchronization is realized. At the level of preattention, synchronization results from the self-organization of the cortical activity, while at the level of attention, synchronous activity is controlled by special structures that act as a central executive. Two types of oscillatory neural networks are developed to model preattention and attention phenomena. In the preattention modelling, we concentrate on the binding problem. To solve this problem, a two-layer network of neural oscillators is developed. The network is able to generate two-frequency envelope oscillations, in which the amplitude of high-frequency oscillations is modulated by a lower frequency. This network synchronizes regions of oscillatory activity at high and low frequencies according to the type of stimulation. Such a synchronization gives feature binding for both simple and complex stimuli. Networks of phase oscillators with a central element are used to described different dynamic behaviour associated with the attention focus formation and switching. For the input to the attention system represented by two stimuli, we give a complete description of conditions when a specific attention focus can be formed. The results are interpreted and discussed in terms of attention modelling. This includes the interpretation of psychological experiments on visual selective attention, the problem of attention focus formation and the possibility of spontaneous attention switching .

Attention↗
PubMed2001

The Test of Everyday Attention for Children (TEA-Ch): patterns of performance in children with ADHD and clinical controls.

The present study explores the utility of the Test of Everyday Attention for Children (TEA-Ch) as a measure of the attentional impairments displayed by children with Attention Deficit Hyperactivity Disorder (ADHD). Sixty-three children with ADHD and 23 non-ADHD Clinical Control children were compared on subtests of the TEA-Ch reflecting three attentional domains: sustained, selective, and attentional control. Results show that children with ADHD performed significantly worse than clinical controls on subtests of sustained attention and attentional control. The groups did not differ, however, on subtests of selective attention. These findings suggest that the TEA-Ch is sensitive to attentional deficits unique to ADHD and holds promise as a useful tool in the assessment of ADHD. Performance patterns and future directions are discussed.

Adjustment Disorders↗
PubMed1998

Transdermal nicotine effects on attention.

Nicotine has been shown to improve attentiveness in smokers and attenuate attentional deficits in Alzheimer's disease patients, schizophrenics and adults with attention-deficit/hyperactivity disorder (ADHD). The current study was conducted to determine whether nicotine administered via transdermal patches would improve attentiveness in non-smoking adults without attentional deficits. The subjects underwent the nicotine and placebo exposure in a counterbalanced double-blind manner. Measures of treatment effect included the Profile of Mood States (POMS), Conners' computerized Continuous Performance Test (CPT) of attentiveness and a computerized interval-timing task. The subjects were administered a 7 mg/day nicotine transdermal patch for 4.5 h during a morning session. Nicotine significantly increased self-perceived vigor as measured by the POMS test. On the CPT, nicotine significantly decreased the number of errors of omission without causing increases in either errors of commission or correct hit reaction time. Nicotine also significantly decreased the variance of hit reaction time and the composite measure of attentiveness. This study shows that, in addition to reducing attentional impairment, nicotine administered via transdermal patches can improve attentiveness in normal adult non-smokers.

Administration, Cutaneous↗
PubMed2007

Attention and executive functions profile in drug naive ADHD subtypes.

Attention deficit hyperactivity disorder (ADHD) has been associated with executive functioning and sustained and divided attention deficits. In order to clarify the questions on neurocognitive impairment in ADHD, we investigated the presence of specific executive functions (EFs) and attention deficit patterns in ADHD clinical subtypes. 50 patients with ADHD and 44 controls were evaluated. All subjects were boys and performed a clinical-psychopathological and neuropsychological battery. Five main domains of EFs and attention were studied. Executive functions-related neurocognitive abilities were used as control tasks. ADHD patients, inattentive and combined subtypes differ from controls on response inhibition, divided attention, phonological, and visual object working memory and on variability of reaction times measured with CPT. Comparison of ADHD subtypes, in five main domains of EFs, did not show evidence of different executive functioning profiles. Response inhibition can predict performance on working memory tests but it cannot predict performance on divided attention/set shifting and on sustained attention. ADHD boys exhibit a selective impairment on executive functions and attention tasks. These data suggest the involvement of partially independent neural circuits which control inhibition and divided attention in ADHD. Since right prefrontal cortex seems to be crucial in controlling response inhibition, while left dorsolateral prefrontal cortex seems important in modulating divided attention, these areas are deputated to be involved in the pathogenesis of neuropsychological deficits in ADHD subtypes. In addition, this study candidates the impairment in phonological and visual-object working memory as a possible neuropsychological trait in ADHD males with inattentive or combined subtypes.

Attention↗
PubMed2004

Prevalence of stimulant use for attentional dysfunction in children with phenylketonuria.

Recent data suggest that children with phenylketonuria (PKU) and poor metabolic control may have an increased prevalence of attentional dysfunction. However, few formal studies have addressed this topic in detail. We reviewed the medical records of 38 school-aged children with early and continuously treated PKU to determine the prevalence of stimulant use for attentional dysfunction, and to determine the relationship between metabolic control and attentional symptoms. Twenty-six per cent of the PKU children used a stimulant medication for attentional dysfunction. This is significantly higher than in an age- and sex-matched control group consisting of children with type I diabetes mellitus (6.5%, p <0.006), and also considerably higher than population norms for attention deficit hyperactivity disorder (ADHD) (5%). We also found a significant relationship between phenylalanine levels and stimulant use or attentional symptoms. Mean plasma phenylalanine concentration was 486 micromol/L in the non-stimulant-using group and 792 micromol/L in the stimulant-using group (p <0.02). Mean phenylalanine concentration was 462 micromol/L in the group not reporting attentional symptoms, and was 702 micromol/L in the symptomatic group (p <0.05). Parents of the stimulant-using children felt that the stimulants were efficacious in treating their child's attentional symptoms. Stimulant use and parent reports of attentional dysfunction are quite common in our PKU patients and appear to be strongly related to higher phenylalanine concentrations.

Adolescent↗
PubMed1999

Impairments of attention following childhood traumatic brain injury.

Attentional deficits are commonly reported following traumatic brain injury (TBI) in adults, although the occurrence of such problems is less well documented in young children. This study aimed to investigate residual attentional abilities associated with TBI during childhood, by examining a number of aspects of attention including sustained, focussed, and divided attention, attentional shift, and response inhibition. Eighteen children with a history of TBI, aged between 8 and 14 years and 18 non-injured matched controls participated in the study. Results show that attentional skills may be differentially impaired after TBI, with children who have sustained moderate-to-severe TBI exhibiting significant deficits on the following attentional domains: sustain, focus, and response inhibition. These findings support the view that attentional impairments following pediatric TBI, while not global, may be more generalized than those reported for adult samples, perhaps reflecting the relative immaturity of attentional skills at the time of injury.

Adolescent↗
PubMed2006

Training attention-switching ability in adults with ADHD.

OBJECTIVE: Children with ADHD show attention-switching impairment. The present study assessed attention-switching ability in adults with ADHD, the extent to which this ability can be improved via targeted training, and the degree to which training extends to novel tasks of attention-switching. METHOD: Adults with ADHD (n = 16) and adults without ADHD (n = 18) were divided into training and non-training groups. Training groups performed six blocks of four different attention-switching tasks, while non-training groups completed non-switching, "filler" tasks. Lastly, the four groups were tested on two novel attention-switching tasks. RESULTS: Adults with ADHD showed impaired attention-switching, relative to non-ADHD adults, but training significantly improved attention-switching in both ADHD and non-ADHD training groups. Finally, training effects transferred to new tasks of attention-switching. CONCLUSION: Adults with ADHD show attention-switching impairments, but deficits may be ameliorated with short-term, targeted training. Research has implications for cognitive training in ADHD.

Adult↗
PubMed1994

Impairment of spatially directed attention in patients with probable Alzheimer's disease as measured by eye movements.

OBJECTIVE: To investigate changes in spatially directed attention in patients with a diagnosis of probable Alzheimer's disease (AD). BACKGROUND: Impaired attention in patients with probable AD has not been the subject of extensive research. Yet recent reports suggest that attentional deficits may be an important early feature of the disease in a subset of patients. SETTING: University hospital center studying dementia and aging. SUBJECTS: Ten mild to moderately impaired patients diagnosed as having probable AD, by National Institute of Neurologic and Communicative Diseases and Stroke criteria, and 11 healthy age- and education-matched controls. MEASURES: Eye movements were recorded as subjects participated in two experiments designed to measure spatially directed attention. Subjects were instructed to (1) attend to and fixate a target appearing randomly to the right or left of a central marker and (2) direct attention to and fixate a target appearing randomly in one of four peripheral locations. RESULTS: Patients with probable AD exhibited fewer accurate trials and longer saccade latencies in both tasks. As a group, patients performed worse in the second task that placed increased demands on attention. However, the performance of patients in this second experiment varied. Four patients performed significantly worse than all other patients, while three patients performed as well as controls. Errors in the second task were reviewed to identify specific types of attentional deficits. Six empirically derived error patterns were classified into one of two major categories: perseveration and impersistence. Seven of 10 patients made greater than 50% errors of perseveration, and three of 10 made greater than 50% errors of impersistence. CONCLUSIONS: Impairment of attention may be an early feature of AD and a prominent clinical characteristic of some patients. The differences observed in error types made by patients may reflect the varied distribution of neuropathologic changes affecting structures that mediate aspects of attention. The architecture of eye movements can be used as a physiologic measure that should provide useful information for the diagnosis and clinicopathologic subtyping of patients with AD.

Aged↗