Paid attention1/31/2024 In the following review, we hone in on dysfunction in attention, which may encompass several sub-domains of patient experiences, from increased distractibility (selective attention impairment) to an inability to sustain focus (sustained attention impairment) or an inability to simultaneously monitor multiple channels of information (divided attention impairment). Therefore, we focus on parsing impairments in specific sub-domains of goal-directed attention, and outline directions for future research to parse individual cognitive impairments with further granularity. Although it is often assumed that group-level deficits in a variety of cognitive tasks 8 imply that depressed individuals experience a “general” cognitive deficit, there is not yet sufficient evidence to suggest that an individual with deficits on one cognitive task will necessarily exhibit deficits on other tasks. Thus, the RDoC matrix provides a framework from which to hone in on attentional impairments in MDD and to consider how attention may influence other domains of the cognitive and emotional systems. RDoC also includes both the negative and positive valence systems and associated constructs of emotional function and mood. The cognitive systems domain of RDoC comprises a construct of attention as well as constructs of perception, declarative memory, language, cognitive control, and working memory 7. Our focus on attention as a specific cognitive domain aligns with the matrix of cognitive neurobiological constructs within the Research Domain Criteria (RDoC) framework, intended to advance a precision medicine approach to psychiatry informed by neurobiology 6. Although cognitive dysfunction is a hallmark of MDD contributing to disability, it is not well understood, especially in comparison with the mood features of MDD. Attention impairments in particular are known to negatively impact daily function 3, 4 and are associated with poorer clinical outcome 5. These cognitive problems may include impairments in executive functions, learning and memory, processing speed, as well as in concentration and attention 2, and these are associated with a disproportionately poor prognosis in psychosocial and occupational domains. By synthesizing findings across disciplines and delineating avenues for future research, we aim to provide a clearer outline of how attention impairments may arise in the context of MDD and how, mechanistically, they may negatively impact daily functioning across various domains.Ĭognitive dysfunction is included as a diagnostic criterion for major depressive disorder (MDD), described as “Diminished ability to think or concentrate” 1. Finally, we discuss the failure of current first-line treatments to alleviate attention impairments in MDD and review evidence for more targeted pharmacological, brain stimulation, and behavioral interventions. We then review evidence for neurobiological mechanisms supporting attention, including the organization of large-scale neural networks and electrophysiological synchrony. We then discuss interactions between goal-directed attention and other aspects of cognition (cognitive control, perception, and decision-making) and emotional functioning (negative biases, internally-focused attention, and interactions of mood and attention). First, we characterize behavioral impairments in selective, sustained, and divided attention in depressed individuals. Here, we summarize the breadth and depth of findings from the cognitive neurosciences regarding the neural mechanisms supporting goal-directed attention in order to better understand how these might go awry in depression. In spite of attention’s influence on many aspects of cognitive and emotional functioning, and the inclusion of concentration difficulties in the diagnostic criteria for MDD, the focus of depression as a disease is typically on mood features, with attentional features considered less of an imperative for investigation. Oftentimes, patients with major depressive disorder (MDD) complain of concentration difficulties that negatively impact their day-to-day function, and these attention problems are not alleviated by current first-line treatments. Attention is the gate through which sensory information enters our conscious experiences.
0 Comments
Leave a Reply.AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |