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Attention

What is attention? 

Selective attention is the ability to focus on relevant stimuli and ignore irrelevant stimuli. Sustained attention is the ability to maintain a consistent focus. Several tasks have been developed to assess attention performance. Examples include the Continuous Performance Test (CPT), which uses both visual and auditory stimuli and requires participants to respond to targets and ignore distractors. Other examples include the Trail Making Test (TMT), which requires participants to connect, in order, letters and/or numbers as quickly as possible, and the Wisconsin Card Sorting Test (WCST) that tests the ability to display flexibility during changing schedules. The Stroop Colour Word Test (SCWT) presents the name of a colour printed in an ink congruent to the colour name (e.g. blue), or incongruent to the colour name (e.g. blue), and participants are asked to either read the word or name the ink colour. Attention tasks may also measure other cognitive constructs, such as processing speed and memory.

What is the evidence for attention?

Moderate to high quality evidence shows medium to large-sized effects of poorer performance on the SCWT, the CPT, the TMT, and on vigilance tasks in people with schizophrenia than people without schizophrenia. Moderate to low quality evidence suggests poorer visual and verbal attention in people with youth-onset schizophrenia (< 19 years), and in people with late-onset schizophrenia (> 40 years). Compared to people with bipolar disorder, high quality evidence shows people with schizophrenia have poorer performance on the TMT and the WCST, with small-sized effects. High quality evidence suggests people at clinical high risk and people at familial high risk for psychosis are similarly impaired on attention tasks, with small to medium-sized effects when compared to controls.

High quality evidence shows people taking olanzapine or quetiapine show medium to large-sized improvements on attention tasks after treatment compared with before treatment. People taking haloperidol show a small improvement on the CPT, but not on the TMT post-treatment. People taking clozapine or risperidone show no improvement in attention post-treatment. High quality evidence shows small to medium-sized associations between poorer attention and more severe symptoms, worse community functioning, and poorer social skills.

 

April 2016

Page last updated: 3:41  6 September 2017

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