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[Distributed attention and focused attention: different modalities of use].

In the present experiments two different attention modalities were investigated: focused and distributed attention. In Experiment 1 manual choice reaction times to lateralized visual stimuli were measured. Visual stimuli (rectangles or squares) were presented in one of six positions along the horizontal axis. In between each position a digit 1 to 5 was permanently displayed. The subjects were instructed to switch their attention to one of the five digits and to respond as fast as possible to the stimulus target flashed either on the right or on the left of the focus of attention. The only difference in Experiment 2 was that the digit stayed on 100 msec only. The results show the importance of a visual cue (Exp. 1) for focused attention. In the absence of a permanent visual cue (Exp. 2) only distributed attention can be employed.

Adult↗

The influence of risperidone on attentional functions in children and adolescents with attention-deficit/hyperactivity disorder and co-morbid disruptive behavior disorder.

This study aims to examine the influence of risperidone on various attentional functions, including intensity and selectivity aspects of attention plus inhibitory control in children with attention deficit/hyperactivity disorder (ADHD) with co-morbid Disruptive Behavior Disorders (DBD) and normal IQ. Children with ADHD and DBD, aged 8-15 years, were treated with risperidone (mean daily dose: 1.5 mg; n = 23) and examined with three attentional paradigms before and after a 4-week treatment period. Age- and IQ-matched normal controls (n = 23) were also tested without medication on the same two occasions. No influence of the medication could be detected for any neuropsychological variable, neither as a positive enhancement nor as adverse side effects. However, clinical symptoms of ADHD and DBD assessed on the IOWA Conners Scale significantly improved after the 4-week treatment period. Divergent behavioral and cognitive effects of risperidone on ADHD symptoms were observed, with a significant reduction in behavioral symptoms, whereas no positive treatment effects were found on laboratory tasks of impulsivity. Thus, the cognitive effects of risperidone seem to differ from the cognitive effects of stimulant treatments in children with ADHD + DBD. However, no negative impact of risperidone was observed on attentional functions either, i.e., there was no slowing of cognitive speed.

Adolescent↗

Attention to bodily sensations: a test of the cognitive-attentional model of panic.

This paper describes a study designed to test the cognitive-attentional model of panic. This model suggests that attention to internal sensations is likely to increase misinterpretation of them as representing a serious threat to health, which in turn might increase anxiety. In the present study, instructions for internal attentional focus were predicted to increase symptom reporting, anxiety, and catastrophic symptom attributions. Two groups, patients diagnosed with panic disorder with agoraphobia (PDA) and normal controls, watched a stressful film; half of each group was asked to attend to their internal sensations while watching, and the other half to focus on the film. In the normal controls, the manipulation was effective in modifying attentional focus, and the self-focused attention group became more anxious, reported more symptoms, and made more negative symptom attributions. However, in the PDA group, attentional focus was high in both conditions, and perhaps for this reason the intervention had no effect on mood, symptoms, catastrophic cognitions, or symptom attribution.

Adaptation, Psychological↗

Sources of auditory selective attention and the effects of methylphenidate in children with attention-deficit/hyperactivity disorder.

BACKGROUND: The aim of this study was to determine 1) whether abnormal auditory selective attention in children with attention-deficit/hyperactivity disorder (ADHD), as reflected in the processing negativity (PN) of the event-related potential, is related to impaired frontal functioning; and 2) how methylphenidate (MPh) affects attentional functioning in ADHD. METHODS: Sources of electrical brain activity were estimated in healthy control children, in ADHD children without medication, and in children with ADHD during a placebo-controlled medication trial involving MPh. RESULTS: The source models showed that the PN is generated in the auditory cortex. Children with ADHD showed less activity related to selective attention in this brain region. Administration of MPh resulted in more frontally located sources. CONCLUSIONS: The results showed no evidence for an important role of the frontal cortex in abnormalities in selective attention in children with ADHD. Also, the data did not indicate that MPh normalizes brain activity in these children.

Attention↗

Neuroelectrical signs of selective attention to color in boys with attention-deficit hyperactivity disorder.

In order to gain insight into the functional and macroanatomical loci of visual selective processing deficits that may be basic to attention-deficit hyperactivity disorder (ADHD), the present study examined multi-channel event-related potentials (ERPs) recorded from 7- to 11-year-old boys clinically diagnosed as having ADHD (n=24) and age-matched healthy control boys (n=24) while they performed a visual (color) selective attention task. The spatio-temporal dynamics of several ERP components related to attention to color were characterized using topographic profile analysis, topographic mapping of the ERP and associated scalp current density distributions, and spatio-temporal source potential modeling. Boys with ADHD showed a lower target hit rate, a higher false-alarm rate, and a lower perceptual sensitivity than controls. Also, whereas color attention induced in the ERPs from controls a characteristic early frontally maximal selection positivity (FSP), ADHD boys displayed little or no FSP. Similarly, ADHD boys manifested P3b amplitude decrements that were partially lateralized (i.e., maximal at left temporal scalp locations) as well as affected by maturation. These results indicate that ADHD boys suffer from deficits at both relatively early (sensory) and late (semantic) levels of visual selective information processing. The data also support the hypothesis that the visual selective processing deficits observed in the ADHD boys originate from deficits in the strength of activation of a neural network comprising prefrontal and occipito-temporal brain regions. This network seems to be actively engaged during attention to color and may contain the major intracerebral generating sources of the associated scalp-recorded ERP components.

Attention↗

Attentional versus motor inhibition in adults with attention-deficit/hyperactivity disorder.

Faulty inhibition is theorized to be a central feature in attention-deficit/hyperactivity disorder (ADHD), but it remains unclear whether inhibitory impairments encompass both motoric and attentional domains. Further, characterization of inhibitory deficits in adults with ADHD is needed. We experimentally assessed adults who met diagnostic criteria for ADHD and a subgroup who had partially remitted. Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) subtype effects were also examined. Motoric inhibition was assessed with the antisaccade task, and attentional inhibition was assessed with the attentional blink (AB) task. Antisaccade results replicated prior findings of extended latencies and increased anticipatory saccades in ADHD. Errors, however, appeared to be epiphenomenal to ADHD as they were absent when symptoms had partially remitted. Anticipatory saccades appeared as potential core problems that remained even when symptoms had improved. Differential response patterns were found for predominantly inattentive and combined subtypes, with the latter showing increasing anticipatory movements with increasing fixation time. In the AB task, ADHD groups committed more errors but showed no convincing evidence of an abnormal blink. These results demonstrate clear effects on motoric inhibition but not attentional inhibition in adults with ADHD.

Adolescent↗

Deaf adults without attention deficit hyperactivity disorder display reduced perceptual sensitivity and elevated impulsivity on the Test of Variables of Attention (T.O.V.A.).

The Test of Variables of Attention (T.O.V.A.; R. A. Leark, T. R. Dupuy, L. M. Greenberg, C. L. Corman, & C. L. Kindeschi, 1996) is a continuous performance test used widely to help diagnose attention deficit hyperactivity disorder (ADHD) in both hearing and deaf people. The T.O.V.A. previously has been normed only on the hearing population. The T.O.V.A. performance of 38 prelingually and severely-to-profoundly deaf young adults and 34 hearing young adults who did not have ADHD was examined in this study. Deaf and hearing participants did not differ on the T.O.V.A. omission variables. However, deaf participants had significantly lower d' scores than hearing participants, indicating reduced perceptual sensitivity to the distinction between target and distractor stimuli. Consistent with the existing literature on attentional reorganization in the deaf population, this result was interpreted as indicating a deafness-related reduction in attention to centrally presented stimuli. Deaf participants also showed 2 to 3 times more commission errors than hearing participants and displayed a higher incidence of anticipatory errors. These results suggest a deafness-related increase in impulsivity at the time of response initiation. Beta score analysis confirmed that deaf participants adopted an overall less conservative (more impulsive) response criterion that contributed to their total elevated commission errors. However, a portion of the commission errors was secondary to their reduced d', not to increased behavioral impulsivity. Separate factor analyses of the standard T.O.V.A. variables revealed highly similar factor structures for deaf and hearing participants, indicating similar construct validity of the T.O.V.A. for both groups. The evidence for increased inattention and impulsivity in a non-ADHD deaf sample are interpreted in the context of an adaptive attentional reorganization due to deafness. Along with the factor analytic results, these considerations suggest that separate T.O.V.A. norms must be developed for the deaf population to avoid overdiagnosis of ADHD in deaf individuals.

Adult↗

Motor preparation, motor execution, attention, and executive functions in attention deficit/hyperactivity disorder (ADHD).

Attention and executive functions were investigated in medicated and unmedicated children with ADHD combined type using a novel selective reaching task. This task involved responding as rapidly as possible to a target while at times having to ignore a distractor. Results indicated that unmedicated children with ADHD showed slow and inaccurate responding. Slow responding reflected problems at the stage of movement preparation but not movement execution. An attentional impairment, rather than a motor planning problem per se, appeared to underlie the slow movement preparation. Inaccurate responding reflected problems with response inhibition and selective attention, impulsivity, set-shifting, and difficulties in maintaining vigilance. Although medicated children with ADHD did not show slow movement preparation, they did show some response inaccuracy, resulting especially from impulsive responding. These findings suggest that ADHD is characterized by slow motor preparation (but not motor execution), and deficits in selective attention, vigilance, and executive functions. Preliminary results suggest that stimulant medication may resolve some of these motor, attentional and executive function deficits.

Attention↗

Remediation of attention deficits in children: a focus on childhood cancer, traumatic brain injury and attention deficit disorder.

The purpose of this review is to examine the status of attention training in children. This body of literature is very small so the review examines available efficacy studies in three paediatric groups: children who have survived cancer affecting the central nervous system (CNS) or whose treatment has impacted the CNS, children with traumatic brain injury (TBI) and children with attention deficit disorder (ADD). Seven studies/case reports are reviewed. The results are encouraging, with six of seven describing some improvement on attention measures. An original case study is presented using Pay Attention! materials with a 6 year old survivor of acute lymphoblastic leukaemia (ALL). This represents only the third report of the use of attention training materials with a survivor of childhood cancer and the first case report of the use of these materials with a very young child (6 years of age).

Attention↗

Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) has been associated with structural alterations in brain networks influencing cognitive and motor behaviors. Volumetric studies in children identify abnormalities in cortical, striatal, callosal, and cerebellar regions. In a prior volumetric study, we found that ADHD adults had significantly smaller overall cortical gray matter, prefrontal, and anterior cingulate volumes than matched controls. Thickness and surface area are additional indicators of integrity of cytoarchitecture in the cortex. To expand upon our earlier results and further refine the regions of structural abnormality, we carried out a structural magnetic resonance imaging study of cortical thickness in the same sample of adults with ADHD (n = 24) and controls (n = 18), hypothesizing that the cortical networks underlying attention and executive function (EF) would be most affected. Compared with healthy adults, adults with ADHD showed selective thinning of cerebral cortex in the networks that subserve attention and EF. In the present study, we found significant cortical thinning in ADHD in a distinct cortical network supporting attention especially in the right hemisphere involving the inferior parietal lobule, the dorsolateral prefrontal, and the anterior cingulate cortices. This is the first documentation that ADHD in adults is associated with thinner cortex in the cortical networks that modulate attention and EF.

Adolescent↗

Effects of methylphenidate on selective and sustained attention in hyperactive, reading-disabled, and presumably attention-disordered boys.

Performance on a visual search task was contrasted for hyperactive boys and nonhyperactive reading-disabled and presumably attention-disordered boys participating in a double blind, crossover study (methylphenidate vs. placebo). Mean dosage levels, individually titrated by the team psychiatrist, were highest for the reading-disabled group, lowest for those with suspected attention disorders. All three groups were seen by teachers and parents as significantly improved while on medication, and all groups dramatically reduced extraneous responses and attention lapses on the laboratory task. On a composite measure of performance and behavior, the nonhyperactive subjects improved significantly more than the hyperactive subjects. Although given rather high average dosage levels (about 37.5 mg/day or 1.25 mg/kg.day), the subjects did not deteriorate in search behavior, which entails short term memory. It is argued that the cerebral stimulants may be as beneficial for nonhyperactive reading-disabled and attention-disordered children as for hyperactive patients, for the former have just as great difficulty sustaining attention as the latter.

Attention↗

Insights into the control of attentional set in ADHD using the attentional blink paradigm.

BACKGROUND: Previous work on visual selective attention in Attention Deficit Hyperactivity Disorder (ADHD) has utilised spatial search paradigms. This study compared ADHD to control children on a temporal search task using Rapid Serial Visual Presentation (RSVP). In addition, the effects of irrelevant singleton distractors on search performance were examined. METHOD: In each condition, subjects reported the identity of a red letter 'probe' in a sequence of white letters which appeared one after the other at a central fixation point. The temporal position of the probe varied from an initial target, which was distinguished by surrounding asterisks. The target was reported in addition to the probe in condition 2, but not in the baseline condition 1. In a third condition, the initial target was not reported, but one of the asterisks appeared as a colour singleton on some trials. RESULTS: All children displayed an 'attentional blink' with probe detection reduced when it appeared at close temporal relations relative to the target. This 'blink' reduced over time, and there were no group differences in the recovery of performance, although ADHD children made more errors overall. The ADHD group were also more vulnerable than controls to distraction from irrelevant singletons in condition 3. CONCLUSION: Although the basic mechanisms of selective attention were not impaired in children with ADHD, these children appeared to require more resources to execute the task and were more vulnerable to distraction by irrelevant singletons, indicating deficits in the maintenance of attentional control.

Adolescent↗

Infrequent, but not frequent, reinforcers produce more variable responding and deficient sustained attention in young children with attention-deficit/hyperactivity disorder (ADHD).

BACKGROUND: The underlying behavioral/psychological processes of attention-deficit/hyperactivity disorder are unclear. Motivational factors, related to dopamine dysfunction, may play an important role in the development of the behavioral symptoms. Particularly, infrequent, but not frequent, reinforcers have been suggested to be associated with altered responding and deviant behavior in children with ADHD. The present study was designed to analyze the influence of reinforcement frequency on operationalized measures of hyperactivity, impulsiveness, sustained attention, and response variability. METHODS: Fifty-six boys, half of whom were diagnosed with ADHD, completed a computerized task presented as a game with two squares on the screen. One square was associated with reinforcement. The task required responses by the computer mouse under contingencies alternating between variable interval schedules of short (mean 2 s) and long (mean 20 s) durations. Reinforcers were cartoon pictures and small trinkets. RESULTS: Overall, there was no difference between children with ADHD and comparison children when reinforcers were given frequently. Statistically significant differences on measures of sustained attention and variability, but not hyperactivity and impulsiveness, were found during infrequent reinforcement only. Age effects interacted with group effects on sustained attention, showing that group differences were found in the young children only. Surprisingly, older comparison children showed increased response variability and no learning. CONCLUSIONS: When reinforcers are infrequent, children with ADHD show deficient sustained attention and increased variability in responding. Computer experience may have interfered with measures of hyperactivity and impulsiveness. The unexpectedly poor performance of the older comparison children may have been due to inefficient reinforcers or to verbally governed behavior overruling reinforcer effects. Reinforcer characteristics and experimental procedures are important factors influencing findings in studies investigating motivational factors. The study provides some support for the dynamic developmental theory of ADHD predicting relationships between neurobiological deficits, altered reinforcement mechanisms, and treatment recommendations.

Age Factors↗

Temporal allocation of visual attention in adult attention deficit hyperactivity disorder.

In two experiments, we examined the ability of adults with attention deficit hyperactivity disorder (ADHD) to process multiple targets appearing in a rapid serial visual presentation (RSVP) stream. Using a standard attentional blink (AB) task, subjects were required to both identify a target in the RSVP stream and detect a probe appearing in one of several posttarget serial positions. In Experiment 1, ADHD adults exhibited a protracted AB compared to controls, in that their probe detection did not improve as a function of increasing probe-to-target intervals (450-720 msec). In Experiment 2, the ADHD group performed as well as controls in detecting probes appearing immediately (i.e., 90 msec) after the target. Taken together, the results demonstrate that adults with ADHD exhibit a selective deficit in rapidly shifting attention between the target and the probe, when the two appear several hundred milliseconds apart. These results suggest that adults with ADHD can use automatic (reflexive) attention to detect items in close temporal proximity in the RSVP stream, but have difficulty allocating controlled attention to multiple stimuli separated by several hundred milliseconds.

Adolescent↗

The effects of methylphenidate on neural systems of attention in attention deficit hyperactivity disorder.

OBJECTIVE: Recent studies have suggested that attention deficit hyperactivity disorder (ADHD) is associated with abnormalities in basal ganglia and prefrontal cortical functioning. However, these studies have primarily relied upon cognitive tasks that reflect impulse control rather than attentional mechanisms. METHOD: The authors used functional magnetic resonance imaging to investigate the neural correlates of selective and divided attention in a randomized, double-blind, placebo-controlled pharmacological challenge with methylphenidate in 15 adolescents with ADHD (ages 14-17), eight adolescents with reading disorder (ages 12-17), and four adolescents with both reading disorder and ADHD (ages 14-18) who were scanned during both a methylphenidate and a placebo session. Fourteen healthy comparison subjects (ages 12-20) who were not given methylphenidate served as the primary comparison group. RESULTS: During the divided attention task, unmedicated subjects with ADHD or reading disorder recruited the left ventral basal ganglia significantly less than the healthy comparison subjects. Methylphenidate led to an increase in activation in this region but had no effect on task performance. Subjects with ADHD also recruited the middle temporal gyrus significantly less than the comparison subjects, but methylphenidate did not have a direct effect on activation in this region. CONCLUSIONS: These results suggest that ADHD is associated with abnormal processing in attentional networks, with specific dysfunction in striatal circuitry. Methylphenidate may act to normalize activity within this network.

Adolescent↗

DRD4 gene variants and sustained attention in attention deficit hyperactivity disorder (ADHD): effects of associated alleles at the VNTR and -521 SNP.

Associations between attention deficit hyperactivity disorder (ADHD) and genetic variants within the dopamine D4 receptor gene have been much reported. Variants investigated include the 7-repeat allele of a VNTR within the third exon, and two SNPs (-521 and -616) located with the promoter region. We investigated the relationship between the VNTR, -521, and -616 SNPs and sustained attention performance in 54 ADHD probands, relative to a non-genotyped control group. Participants performed the Sustained Attention to Response Task (SART) in which the response to an unpredictably occurring target digit must be inhibited. This task, therefore, challenged sustained attention and included a response inhibition component. Consistent with previous reports, ADHD participants possessing the 7-repeat allele of the VNTR outperformed those children not possessing this allele, both in terms of errors and response variability. In family based analyses, better performance on the SART tended to predict biased transmission of the 7-repeat allele from heterozygous parents. For the -521 SNP, A allele homozygotes showed greater impairment than heterozygotes or those not possessing this allele, both in terms of total errors and response variability. Family based analysis showed that higher total errors on the SART predicted transmission of the A allele from heterozygous parents. There were no effects of the -616 SNP. Our results suggest dissociable effects of the "associated alleles" of DRD4 gene variants on sustained attention: while the 7-repeat allele of the VNTR is associated with relatively better performance, the A allele of the -521 SNP is associated with poorer performance.

Adolescent↗

Unilateral attention deficits and hemispheric asymmetries in the control of visual attention.

The present study sought to determine the roles of the two hemispheres in arousal and the selective components of attention. Ten patients with left and right parietal lesions and ten with left and right temporal lesions participated in the experiment. The hypothesis that posterior parietal lesions, whether left or right, cause two selective attentional deficits, namely, a reduced reactivity to stimuli in the visual field contralateral to the lesion, and a reduced reactivity to any stimulus which occupies a relative contralateral spatial position, was tested by asking the patient to tilt their head either to the left or to the right by 90 degrees and to respond to two stimuli displayed above and on either side of fixation mark. The arousal component of attention was studied by analysing the overall RT to visual stimuli independent of their spatial positions. The results showed that (1) patients with either left or right parietal damage are impaired in shifting attention from the ipsilateral to the contralateral visual field, and, within each visual field, in a direction contraversive to the lesion and (2) these two attentional deficits are more severe after right than after left parietal damage. Furthermore, the results show that the difficulty in maintaining a high level of alertness is a specific deficit of patients with right hemispheric lesion and not of patients with an extinction syndrome, insofar as there is no significant difference in overall RT between patients with parietal and temporal lesions.

Adult↗

Attention processes in the maintenance and treatment of social phobia: hypervigilance, avoidance and self-focused attention.

Four domains of evidence regarding the relationship between attention and social phobia are reviewed: (1) possible maintaining factor, (2) causal relationship, (3) specific relationship and (4) mediator of change during treatment. Two areas of research are covered and integrated: vigilance-avoidance of social threat stimuli and self-focused attention. There is empirical support for these processes as possible maintaining factors that are specific to patients and non-clinical samples with high levels of social anxiety. There is reasonable evidence to promote the use of attentional strategies in the treatment of social phobia, although better controlled studies are required. We propose six overlapping mechanisms that could be responsible for change: reduced vigilance; reduced avoidance; reduced self-focused attention; mindfulness; increased attentional control; increased self-esteem.

Arousal↗