Attention Disorders And Their Psychopathology

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

    Attention and its typologies

    Although many authors 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 the perceptive capacity and action, and which is It is made up of a network of cortical connections that are responsible for orientation, alert 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 attentional focus depending on the information that needs to be processed at each moment) and divided attention (ability to attend to two types of stimulation simultaneously).

      Alterations in attention and psychopathologies

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

      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 are defined as follows:

      1. Aprosexias

      The total absence of attention is usually found associated with symptoms of intense agitation or stupor, a serious alteration in the level of consciousness in which the alertness capacity is greatly compromised. This state can be caused by organic factors (diffuse brain dysfunctions, for example) or psychiatric factors (melancholic, catatonic and hysteria-related states).

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      2. Hypoprosexies

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

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

      b) emotional attention lability linked to anxiety symptoms.

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

      d) Negligencean inability to orient yourself after a focal type of brain accident.

      and) Fatigue of attentiona state characterized by exhaustion of attention (typical of dementia and the presence of tumors) and apathy associated with certain personality disorders.

      3. Pseudoprosexias

      They can be confused with aprosexias in a superficial way because apparently attentional capacity seems absent due to the patient’s pretense, although it is really preserved. It is common in states of hysteria or in Ganser syndrome (a type of dissociative disorder) with the aim of drawing the attention of family members and close friends of the individual.

      4. Paraprosexies

      is defined as an altered direction of attentional focusrelated to hypochondriacal behaviors.

      5. Hyperprosexias

      Its about an increased and transient state of attention present in moments of altered consciousness such as hyperlucidity 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 with 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..

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      In this category, phenomena such as mental absence may occur (exclusion of external information that is usually accessible, where attention is decreased for distracting stimuli or stimuli not closely related to the thought in question and in addition there is an increase in the threshold necessary to enable attentional focusing) or the temporal gap (an absence of recording events while performing an automatic cognitive processing task, such as while driving a vehicle on a regular route).

        2. Attention as selection

        It consists of the ability to discriminate relevant information inhibiting other non-primary stimulating 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 skill is “tuning in,” which consists of following one source of information when other sources compete for attention.

        The alteration of this function is also known as “distractibility.” and it can appear in a wide variety of psychopathological disorders such as anxiety, manic episodes or twilight symptoms (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 focusing in terms of degree or intensity. This ability is compromised in a state of high stress or anxiety, where a greater orientation of attention to threatening stimuli occurs. These deviations are known as the “tunnel vision” phenomenon.

        4. Attention as surveillance

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

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

        5. Attention as expectation

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

        According to the research of Shakow (1962), the latter have a “segmental set” that prevents them from benefiting from preparatory time intervals in tasks that measure reaction time. In contrast, subjects without psychopathology are characterized by having a “general set,” which makes it possible to perceive the stimulating situation globally and allows the individual to respond without taking into account the irrelevant elements of the activity.

        In conclusion

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

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