Inattention & ADHD | Thriving with ADHD

 

ADHD & Inattention

 

Attention is a cognitive (mental) process that enables an individual to choose what they focus and concentrate on, and to maintain their focus and concentration over a period of time.

Being able to pay self-directed and selective attention protects an individual from experiencing sensory overload. It also enables an individual to accurately complete tasks in a timely manner and to maintain their interest and perseverance whilst working towards long-term goals.

Individuals rely on their executive functions when paying attention. These self-regulatory mental processes enable them to:

  • wilfully direct and maintain their attention 
  • filter information for relevance
  • block out irrelevant or distracting information (both internal and external) 
  • accurately absorb and remember information in full
  • protect and process information 
  • pay attention to detail
  • redirect their attention back to the task at hand should they experience interruption
  • maintain interest over a period of time
  • reserve energy and sustain effort.

 

ADHD and inattention

ADHD robs individuals of the ability to regulate their attention in the same manner and to the same degree as neurotypical individuals. To individuals with ADHD, this can feel like their brain has a mind of its own. As a result, individuals with ADHD tend to:

  • struggle to wilfully focus and concentrate on information or tasks they find boring or tedious 
  • experience mind wandering and are often interrupted by unrelated thoughts
  • are easily distracted by external stimuli
  • often miss instructions or relevant information
  • may have trouble remembering information
  • struggle to pay close attention to detail and make careless mistakes
  • require more frequent redirection
  • fail to finish tasks or to achieve their goals
  • loose items
  • avoid or seem reluctant to engage in tasks requiring sustained effort.

 

Hyperfocus

Difficulties paying self-directed attention also contributes to individuals with ADHD becoming hyperfocused. 

Hyperfocus occurs when an individual becomes so intensely fixated on an activity or topic that they are interested in, that they become over absorbed in it. Whilst hyperfocused, the individual is able to screen out any internal and external distractions that may impede their focus and concentration. However, they also struggle to disengage their focus and redirect their attention away from the task or topic that is holding their interest in order to attend to more pressing or important tasks.

Hyperfocus is often viewed as a strength individuals with ADHD can harness in order to complete an important task such as a university assignment or an artistic endeavour. However, this is only the case if an individual can put boundaries around their hyperfocus so that they only use it with intent and without compromising other parts of their life. They also need to be able to identify and reign in their hyperfocus should it become unhealthy or put them at risk of adverse outcomes.

Sadly, it is not uncommon for individuals with ADHD to become hyperfocused on unproductive tasks or topics that distract them way from attending to more important or urgent tasks. As you can imagine, missing meetings, forgetting to pick your child up from school or forgetting to pay your bills, all because you were hyperfocused on social media, a computer game, cleaning your house or another task, will have a profoundly negative affect on your ability to achieve your long-term goals, maintain your relationships and sustain your quality of life. 

Here are some examples of how hyperfocus can affect individuals with ADHD:

  • When hyperfocused on their Lego project, a child may fail to follow their usual morning routine and get dressed for school. When asked by mum to get ready they may become frustrated and act out due to difficulties disengaging from the activity.
  • A teenager may become so engaged in a computer game that they forget to do their homework or their chores.
  • An adult may become so engrossed in a hobby or reading social media posts that they forget to attend an important appointment or to pick up children from school. Or they may forget to eat which affects their health or stay up late and wake up tired the next day.

 

Resultant impact

Due to their inattentiveness, individuals with ADHD are “less able to persist at getting things done over time, in time and on time” when the task does not result in an instant and satisfying reward. They struggle to pay attention to what they need to do to get ready for a future event or to achieve a distant task. When they do persist, they are much more likely to get distracted, and once distracted they may struggle to get back on track and instead veer off course as they may forget what they were doing, the steps involved in carrying out a task or why a goal was important to them (Barkley, 2015).

Difficulty regulating one’s attention can compromise an individuals:

  • academic performance and achievement
  • occupational success and job performance
  • personal relationships (i.e. with parents, siblings, friends, work colleagues, community members, etc.)
  • romantic relationships and marriage
  • social success and inclusion
  • motor vehicle use
  • self-esteem and self-worth
  • health and quality of life.

 

Presentation

The DSM-5 (American Psychiatric Association, 2013) a handbook used by clinicians to diagnose mental conditions including ADHD. As per DSM-5, the inattentive symptoms indicative of ADHD includes:

  • often fail to give close attention to details or make careless mistakes in schoolwork, at work, or with other activities
  • often have trouble holding attention on tasks or play activities
  • often do not seem to listen when spoken to directly
  • often do not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked)
  • often have trouble organising tasks and activities
  • often avoid, dislike, or are reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework)
  • often lose things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones)
  • are often easily distracted
  • are often forgetful in daily activities.

 

 

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC.

Barkley, R.A. (2015). Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 4th ed. New York: Guilford Publications.

Chen, A. J-W., Novakovid-Agopianm T., Nycum, T. J.,Song, S., Turner, G. R., Hills, N. K., Rome, S., Abrams, G. M. & D’Esposito, M. (2001). Training of goal-directed attention regulation enhances control over neural processing for individuals with brain injury. Brain: A Journal of Neurology, 134; 1541–1554.

Milliken, B. & Tipper, S.P. (1999). Attention and Inhibition. In Attention. Edited by Pashler, H. Psychology Press; New York.

Tiego, J., Testa, R., Bellgrove, M. A., Pantelis, C., & Whittle, S. (2017, April 7). A three-component, hierarchical model of executive attention. Retrieved from Open Science Framework io/preprints/psyarxiv/b4gds