Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK.
CNS Spectr. 2023 Jun;28(3):357-360. doi: 10.1017/S1092852922000785. Epub 2022 May 20.
Attentional problems are common and have been associated with multiple psychiatric disorders. This study examined problems of sustained attention across a range of psychiatric disorders using a validated computerized trans-diagnostic attentional paradigm (a continuous performance task). We hypothesized that multiple psychiatric disorders, particularly attention deficit hyperactivity disorder (ADHD), would be associated with pronounced attentional problems.
Totally, 576 non-treatment seeking participants (aged 18-29 years) were enrolled from general community settings, provided demographic variables, and underwent clinical assessments to detect mental health disorders. Each participant underwent the rapid visual information processing task, a validated computerized test measuring sustained attention. The two measures of sustained attention were the sensitivity index and target detection (proportion of targets detected). The profile of attentional deficits was examined across different disorders using -scores relative to controls.
Participants with social phobia, obsessive-compulsive disorder (OCD), bulimia nervosa, and intermittent explosive disorder showed the greater impairment in target sensitivity, all with effect sizes of at least 0.8. Target detection was impaired across multiple disorders, with OCD and binge eating disorder exhibiting the most pronounced impairment. Post-traumatic stress disorder (PTSD) and compulsive sexual behavior were associated with particularly spared performance on both measures.
These data indicate that impaired attention is non-specific for ADHD and in fact several other disorders are associated with markedly larger deficits. Instead of clinicians assuming sustained attention problems are due to ADHD, a variety of disorders should be screened for when people report attentional problems. Future work should examine the contribution of comorbidities and psychoactive substances (prescribed or illicit) to the profiles identified.
注意力问题很常见，与多种精神障碍有关。本研究使用经过验证的计算机跨诊断注意力范式（连续表现任务）检查了一系列精神障碍中的持续性注意力问题。我们假设多种精神障碍，特别是注意缺陷多动障碍（ADHD），与明显的注意力问题有关。
总共招募了 576 名非治疗性寻求者（年龄在 18-29 岁之间），他们来自一般社区环境，提供人口统计学变量，并接受临床评估以检测精神健康障碍。每位参与者都接受了快速视觉信息处理任务，这是一种经过验证的计算机测试，用于测量持续性注意力。持续性注意力的两个衡量标准是敏感性指数和目标检测（检测到的目标比例）。使用相对于对照组的 -分数来检查不同疾病的注意力缺陷特征。
社交恐惧症、强迫症（OCD）、贪食症和间歇性爆发障碍的参与者在目标敏感性方面表现出更大的损伤，所有这些损伤的效应大小均至少为 0.8。多个障碍都会损害目标检测，而 OCD 和暴食障碍则表现出最明显的损伤。创伤后应激障碍（PTSD）和强迫性行为与这两个衡量标准的表现特别好相关。
这些数据表明，注意力受损并非 ADHD 所特有，实际上其他几种疾病与明显更大的缺陷有关。当人们报告注意力问题时，临床医生不应假设持续性注意力问题是由于 ADHD 引起的，而应该筛查多种疾病。未来的工作应该检查合并症和精神活性物质（规定或非法）对所确定的特征的贡献。
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