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Alterations of attention and its psychopathology

Alterations of attention and its psychopathology

June 11, 2024

Attention capacity it is one of the skills that most frequently becomes altered with the presence of psychopathology. Then we will see the various deviations that attention can suffer depending on some of the most common psychological disorders.

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The 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 that formed from a network of cortical connections that are responsible for orientation, alert and executive control functions .


More specifically, the care is composed of the following elements: arousal, focal attention, sustained attention, selective attention, alternating attention (change of attention focus depending on the information that needs to be processed at each moment) and divided care (ability to attend to two types of stimulation simultaneously).

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Alterations of attention 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) has differentiated in its classification aprosexias, hypoprosexias, pseudoprosexias, paraprosexias and hyperprosexias.


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

1. The Aprosexias

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

2. The Hypoprosexies

These are states of diminished attentional capacity of less intensity than aprosexia, and are divided into subgroups:


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

b) Intentive emotional lability linked to anxiogenic symptoms.

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

d) Negligence , an inability to orient after a focal-type brain accident.

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

3. The Pseudoprosexies

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

4. The Paraprosexias

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

5. The hyperprosexies

Its about an increased and transient attentional state present in moments of alteration of 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 to the aspect of attention that in each case is more altered. Thus, the following attentional skills are distinguished.

1. Attention as concentration or sustained attention

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

In this category can occur phenomena such as mental absence (exclusion of external information that is usually accessible, where attention is diminished for distractor stimuli or not closely related to the thought in question and there is an increase in the threshold necessary to enable attentional targeting) or the temporary gap (an absence of event registration while performing an automatic cognitive processing task, such as during the driving of a vehicle on a regular route).

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2. Attention as a selection

Consists of the ability to discriminate relevant information inhibiting other non-main stimulatory elements.That is, the ability to separate the determinant stimuli for the task in question from those secondary or irrelevant.

Given the limited nature of attentional capacity, a common phenomenon in this type of skill is the fact of "fine-tuning", which consists in following a source of information when other competing factors attract attention.

The alteration of this function is also known as "distractibility" and can appear in a wide variety of psychopathological disorders such as anxiety, manic episodes or twilight (symptoms similar to epilepsy).

3. Attention as activation or arousal

It is the state of general activation of the organism that allows to be on alert and is related to the attentional focus on when to 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. Care as surveillance

It is defined as the state of hypersensitivity or high receptivity to the environment, as well as a type of attention dedication in long-term tasks in which the subject must detect a low-frequency stimulus. In this type of capacity commission errors are of special relevance (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 high scores in the trait anxiety as in the TAG, or Generalized Anxiety Disorder. Among its most frequent manifestations, general hypervigilance can be differentiated (attending to any stimulus irrelevant to the task), specific hypervigilance (selectively attending to stimuli related to threatening information), widening 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 that allows the subject a greater effectiveness when performing a specific task. This ability is altered, for example, in the reaction time of schizophrenic individuals.

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

In conclusion

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

Bibliographic references:

  • García, J. (1997). Psychology of attention. Madrid: Synthesis.
  • Ríos, M., Muñoz, J. and Paúl, N. (2007). Alterations of attention after traumatic brain injury: evaluation and rehabilitation. Journal of Neurology, 44, 291-297.

Psychopaths (Crime Psychology Documentary) - Real Stories (June 2024).


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