Diseases

Attention Disorders – Causes, Symptoms & Treatment

Attention disorders

Attention disorders can occur in the context of mental and neurological diseases. An attention disorder is one of the central features of attention deficit hyperactivity disorder (ADHD or ADD).

What are attention deficit disorders?

Attention is a cognitive performance that consists of different parts. In the case of an attention disorder, at least one of these functions is disturbed. Vigilance or alertness is also referred to as sustained attention.

It is not aimed at a specific task, but describes a basic state of the nervous system. In the case of a vigilance disorder, the person concerned cannot maintain their attention for a long period of time. Vigilance also plays an important role in connection with other aspects of attention.

The alertness or activation of attention serves to put the psyche into a general “state of alarm” in which the person can react quickly to relevant stimuli. Another facet is executive attention. It is consciously controlled and serves, for example, to block out unimportant stimuli or to direct attention to a specific object.

In everyday life, many people understand attention deficit disorder to mean that the person affected is easily distracted. This is a disorder of selective attention. With the help of selective attention, a person selects relevant stimuli and responds to them appropriately.

If, on the other hand, the divided attention is disturbed, the person concerned can only work on one task at a time. However, if he is confronted with at least two tasks, his performance drops significantly.

causes

Disturbances in attention can be traced back to neurological diseases. They may appear after a stroke or be caused by a brain tumor . Attention disorders can also occur in the event of a craniocerebral trauma , an inflammation of the central nervous system or a dementia syndrome.

Many mental illnesses are accompanied by attention and concentration disorders . This applies, for example, to depression , schizophrenia and autism .

Various causes are discussed for Attention Deficit Hyperactivity Disorder ( ADHD ). It is likely that genetic factors influence the development of ADHD. Researchers also found structural differences in the brain that distinguish people with ADHD from others. There are also differences in measurements of brain activity.

Psychological and social factors also play a role in the development of ADHD. However, there is controversy among experts as to whether the family and social environment actually cause ADHD or whether they merely aggravate the symptoms. ADHD affects boys more often than girls. The gender difference is greater in the predominantly hyperactive and impulsive type of ADHD.

Symptoms, Ailments & Signs

Attention disorders typically affect many cognitive functions. The patient often has the feeling of being unable to concentrate. He may appear “cuddled” and distracted. Tasks that require attention cause the individual trouble and perform less than expected. This also applies if the intelligence is unchanged. In the case of a stroke in particular, however, other partial performances of intelligence can also be impaired.

A disturbance in vigilance is characterized by the patient being unable to maintain their attention for less than half an hour. Other attention disorders may have trouble following conversations or driving.

ADHD is characterized by three central symptoms: inattention, impulsivity, and hyperactivity . For attention-deficit hyperactivity disorder to be diagnosed, symptoms must last longer than six months. In addition, they must not be due to another cause. The symptoms of ADHD appear before the age of seven. If the symptoms only start with school enrollment and there were no signs of ADHD beforehand, explanations other than the syndrome must be considered.

In ADHD, the cardinal symptoms are not only present qualitatively, but also quantitatively. Every child is occasionally inattentive and hyperactive. Since children have yet to learn to control themselves, they are more impulsive than adults. However, these signs are much more pronounced in ADHD than in other children of the same age and intellectual development.

complications

Attention disorders affect all areas of life. The ability to work can also suffer. People with attention deficit disorders are often underestimated by other people or labeled as “stupid”. As a result, various psychological complications can develop: Depression is a common response to continuous depression. The attention disorders can also make the patient feel inferior. He may even blame himself for his lack of performance. Anxiety is another possible complication.

If the attention deficit is due to a neurological disorder or an event such as a stroke, other cognitive functions may also be affected. Then, among other things , speech disorders , memory problems , perception disorders and orientation disorders are possible.

ADHD can coexist with other mental illnesses and problems. Oppositional behavioral disorder or aggressive-dissocial behavioral disorder is common in children. One-third to one-half of children with ADHD exhibit such a behavioral disorder. Learning disabilities are less common.

Children with ADHD are more likely than other children to have dyslexia or dyscalculia . They often suffer from tic disorders such as Tourette’s syndrome . Other possible complications include anxiety disorders and depression. In some cases, an eating disorder can develop as a complication .

Some adolescents and adults with ADHD use drugs and alcohol as self-medication. This can lead to substance dependency. Harmful use of drugs and alcohol is also above average in this group of people. Possible complications are poisoning, delirium or accidents in road traffic.

When should you go to the doctor?

Slight attention deficits are not always a reason to go to the doctor. They can also occur as a result of a cold or another mild infection. In addition, alertness fluctuates throughout the day, which is perfectly normal.

However, a visit to the doctor is advisable if the alertness deteriorates and no cause can be identified. If symptoms occur that indicate a stroke, a doctor should be consulted immediately or an ambulance should be called.

If the symptoms are unclear, a general practitioner or pediatrician is often the first point of contact. Depending on the cause, further treatment can be taken on by a neurologist , psychiatrist , psychotherapist or child and youth therapist. ADHD should always be diagnosed by a specialist.

Some patients suffer predominantly from psychological complaints, while the attention disorder accounts for only a small proportion. This can apply to depression, for example. In this case, those affected can also contact a psychotherapist directly. A transfer is not necessary in Germany.

Diagnose

Attention can be measured with neurocognitive tests. Such tests are usually conducted and scored by a psychologist , psychotherapist, or psychiatrist. Different aspects of attention should be recorded. The everyday complaints that the patient describes are also included in the diagnosis.

A well-known test that measures concentration is the “d2” from Brickenkamp. The patient receives a worksheet on which rows of letters with and without dashes can be seen. Within a given time, he ticks all “d”s that have two dashes. The worksheet also contains other letters such as “b” and letters with different numbers of strokes.

To make a neurological diagnosis or to rule out such a cause, an EEG , CT or MRI is often performed. These procedures show brain activity or visualize the structure of the brain. Doctors can use this to assess whether there are any abnormalities. A brain tumor or an advanced dementia syndrome can usually be recognized on these images.

ADHD diagnosis is very complex. Different perspectives should be considered for children and young people, e.g. B. from parents and teachers, if possible from different teachers. The behavior of the child is recorded in standardized questionnaires. An example of this is the “Questionnaire on Strengths and Weaknesses” by Klasen, Woerner, Rothenberger and Goodmann.

For adults, there is the “ADHD Screening for Adults” by Schmidt and Petermann or the “Adult Self-Report Scale” from the World Health Organization. In this questionnaire, the person concerned indicates which of the symptoms described he or she recognizes. The “ADHD screening for adults” only represents the beginning of the diagnosis. Screening basically only records general characteristics. This allows a doctor or psychologist to decide whether a detailed ADHD diagnosis is worthwhile or whether the cause of the attention disorder is probably something else.

Necessary differential diagnoses of ADHD are childhood behavioral disorders, impulse control disorders, tic disorders, epilepsy and other neurological disorders. In adolescents and adults, it is also necessary to differentiate it from emotionally unstable personality disorder.

Treatment & Therapy

Treatment for attention deficit disorder depends on the underlying cause. A stroke must be treated promptly to increase the chance of survival and minimize the consequences. This is often followed by neurological rehabilitation.

Surgery is an option after a traumatic brain injury or a brain tumor. Radiation and/or chemotherapy can also be used for brain tumors. The treatment is always individually tailored to the patient.

Neurological and psychiatric disorders may be treated with medication. A well-known drug used in ADHD is methylphenidate. However, AHSD and ADD should also be treated psychotherapeutically. In children in particular, socio-therapeutic or (professional) educational concepts can also come into play. It is important that the parents are also involved in the treatment. Various attempts at neurofeedback have also been successful in ADHD.

Co-therapies such as occupational therapy can be useful for attention disorders, as they train attention and contribute to comprehensive treatment. Occupational therapy is part of neurological rehabilitation after a stroke and can also be considered for dementia or ADHD.

Outlook & Forecast

The prognosis for attention deficit disorder is particularly favorable when the cause is treatable. In other cases, the symptoms can be alleviated. There are big differences between different diseases, but also between individuals.

Scientific studies have shown the best effects for ADHD therapy with drug treatment and cognitive behavioral therapy . Both can also be used together. In most cases, symptoms diminish in adulthood. Adults with ADHD tend to have non-specific symptoms, which is why it is controversial whether these cases are still ADHD in the sense of the disease.

prevention

In the case of attention disorders that are caused by neurological factors, only indirect prevention is possible. A healthy lifestyle helps reduce the risk of stroke. Obese individuals should reduce their weight to a normal level. Elevated cholesterol levels and smoking increase the risk of stroke and should therefore be avoided. Sufficient physical activity is also suitable for preventing a stroke.

Lifestyle factors could also play a role in the development of brain tumors and other cancers . Various studies, for example, point to the importance of a healthy diet with lots of vegetables and fruit.

Targeted ADHD prevention is not possible because psychosocial factors are probably not the cause of the disease. They just seem to make the symptoms worse. However, good parenting behavior on the part of parents can reduce the intensity of ADHD.

You can do that yourself

Being easily distracted is a fundamental problem in many attention disorders. It can be taken into account when designing the environment. Workspaces such as the office, home office or the seat at school should be free of distracting stimuli. A tidy desk and a low noise level also help people without attention deficit disorder to concentrate better on their tasks.

In many cases, attention can be trained by repeatedly challenging themselves and being challenged by those around them. However, this is not always possible. In any case, excessive demands should be avoided, as this leads to frustration.

Attention can be trained in many everyday activities:

  • reading (calms, organizes and structures thoughts and nerves)
  • watch a movie and then summarize
  • have a longer conversation (also trains social skills, argumentation skills and logical thinking)
  • Solve puzzles (e.g. Sudoku or crossword puzzles)
  • put together a puzzle
  • handicrafts
  • write a letter
  • … and much more

It often helps people with ADHD to give themselves more space. Some do a lot of sport to live out the increased urge to move, while others meditate consciously or practice deep relaxation. Both together is also possible.

However, the measures are not a substitute for medical or psychotherapeutic treatment. In particular, neurological diseases such as tumors, strokes or dementia must be treated by a doctor.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.