Attention disturbances and their psychopathology

attentional capacity It is one of the abilities that most frequently becomes altered with the presence of psychopathology. Next we will see the various deviations that attention can suffer depending on some of the most common psychological disorders.

• Related article: "The 6 levels of loss of consciousness and associated disorders"

Attention and its types

Although there are many authors who have proposed different definitions of the concept of attention, one of the recent contributions (Rios, 2007) states that attention is a neurocognitive state of preparation, which precedes perceptive capacity and action, and which is formed from a network of cortical connections that are responsible for orienting, alerting, and executive control functions.

More specifically, attention is made up of the following elements: arousal, focal attention, sustained attention, selective attention, alternating attention (change of focus based on the information that needs to be processed at each moment) and divided attention (ability to attend to two types of stimulation in a simultaneous).

• You may be interested in: "The 16 most common mental disorders"

Attention disorders and psychopathologies

In an attempt to describe the relationship between alteration of the attentional capacity and its presence in certain psychopathologies, Higueras et al. (1996) have differentiated in their classification aprosexias, hypoprosexias, pseudoprosexias, paraprosexias and hyperprosexias.

This taxonomy orders the categories understanding attention as a unidimensional variable in which the extremes (aprosexia and hyperprosexia) correspond to a total absence and an increased ability to focus attention and concentration, respectively. Thus, more specifically, each of them is defined as follows:

1. The Aprosexias

Total absence of attention is usually found associated with symptoms of intense agitation or stupor, a severe alteration of the level of consciousness in which alertness is highly compromised. This state can be caused by organic factors (diffuse brain dysfunction, for example) or psychiatric (melancholic, catatonic and hysterical states).

2. The Hypoprosexias 

They are states of decreased attentional capacity of less intensity than aprosexia, and are divided into subgroups:

to) distractibility: present in the ADHD or the twilight state, a disorder of the narrowing of the field of consciousness.

b) emotional attentional lability linked to anxiety symptoms.

c) inhibition of attention attributed to depressive and schizophrenic states.

d) Negligence, an inability to orientate after a focal-type stroke.

and) attention fatigue, a state characterized by exhaustion of attention (characteristic of dementia and the presence of tumors) and apathy associated with certain personality disorders.

3. The Pseudoprosexias

They can be confused with superficial aprosexias because apparently attention span seems absent due to the patient's pretense, although it is really preserved. It is common in states of hysteria or in Gánser syndrome (a type of dissociative disorder) with the aim of attracting the attention of relatives and relatives of the individual.

4. The Paraprosexias

is defined as an altered direction of attentional focus, related to hypochondriac behaviors.

5. The Hyperprosexias

Its about a transient heightened attentional state present in moments of altered consciousness such as hyperlucency or extreme vigilance.

Attention as a cognitive process

Derived from scientific research at the end of the last century, Reed (1988) has related some psychopathologies to the aspect of attention that is most altered in each case. Thus, the following attentional skills are distinguished.

1. Attention as concentration or sustained attention

It is defined as the maintenance of attention for a long time. This ability is related to the task of attention fixation and its most frequent alteration occurs in cases of extreme fatigue, sleep disturbance or states of malnutrition.

In this category there may be phenomena such as mental absence (exclusion of external information that is usually accessible, where attention to stimuli is decreased distracting or not closely related to the thought in question itself and there is also an increase in the threshold necessary to enable attentional focus) or the gap temporary (a lack of recording of events while performing an automatic cognitive processing task, such as while driving a vehicle on a commute usual).

• You may be interested in: "Selective Attention: Definition and Theories"

2. attention as selection

It consists of the ability to discriminate relevant information inhibiting other non-primary stimulatory elements. That is, the ability to separate the determining stimuli for the task in question from those that are secondary or irrelevant.

Given the limited nature of attentional capacity, a common phenomenon in this type of ability is the fact that “tune in”, which consists of following one source of information when other different ones compete to attract said information attention.

The alteration of this function is also known as “distractibility”. and it can appear in a great diversity of psychopathological disorders such as anxiety, manic episodes or twilight episodes (with symptoms similar to epilepsy).

3. Attention as activation or arousal

It is the state of general activation of the organism that allows it to be alert and is related to attentional focus in terms of degree or intensity. This ability is compromised in a state of high stress or anxiety, where there is a greater orientation of attention to threatening stimuli. These deviations are known as the “tunnel vision” phenomenon.

4. attention as surveillance

It is defined as the state of hypersensitivity or high responsiveness to the environment, as well as a type of attentional dedication in tasks of long duration in which the subject must detect a stimulus of low frequency. In this kind of capacity commission errors are particularly relevant (detection of a stimulus when it is not present) and omission (inadequate processing of non-detection of present information).

This ability is mainly altered in schizophrenic subjects, in individuals with a high score in the anxiety trait as in the GAD, or Generalized Anxiety Disorder. Among its most frequent manifestations, general hypervigilance (attend to any irrelevant stimulus for the task) can be distinguished. specific hypervigilance (selectively attending to stimuli related to threatening information), broadening of attention (in a prior to the detection of stressful stimulation or narrowing of attention (in the processing of a threatening stimulus, as occurs in subjects paranoid).

5. Attention as expectation

The ability to anticipate is a characteristic based on previous experience that allows the subject greater efficiency when performing a specific task. This ability is altered, for example, in the reaction time of individuals schizophrenics.

According to research by Shakow (1962), the latter have a "segmental set" that prevents you from taking advantage of preparatory time intervals in tasks that measure the time of reaction. On the other hand, subjects without psychopathology are characterized by having a "general set", which makes it possible to perceive the situation stimulate globally and allow the individual to respond without regard to irrelevant elements of the activity.

In conclusion

How can the alteration of the attentional capacity be verified? is present in a high comorbidity with anxiogenic or schizophrenic psychopathology. A cognitive level enhancement of this ability can become an important component in the intervention in this type of clinical disorders.

Bibliographic references:

• Garcia, J. (1997). Psychology of attention. Madrid: Synthesis.

• Rios, M., Muñoz, J. and Paul, N. (2007). Disturbances of attention after traumatic brain injury: evaluation and rehabilitation. Journal of Neurology, 44, 291-297.