Disorders of attention
Disorders of attention – patopsikhologichesky symptoms of violation of an orientation and selectivity of mental activity. Narrowing of attention is shown by inability to perceive information from different sources, instability of attention – decrease in the concentration increased by an otvlekayemost on irritants, an insufficient pereklyuchayemost – difficulties of any movement of concentration from one object (phenomenon) on another. Diagnostics is carried out by means of a conversation, observation and specific patopsikhologichesky tests. At treatment medicines, psychocorrection and physical therapy are used.
Disorders of attention
The attention provides activity and focus of all cognitive activity. Its frustration often become a basis for deterioration in other mental functions – mnestichesky, cogitative, strong-willed. Easing of attention is followed by deterioration in all kinds of activity, orientations and adaptations to the environment. It is difficult to define exact epidemiological indicators of disorders of attention as easy temporary symptoms arise at each person at overfatigue, somatic diseases. Moderate and rather permanent manifestations are diagnosed for preschool children, younger school students (3-10%), and also for elderly people in connection with natural involute changes and age diseases of TsNS (12-17%).
Reasons of disorders of attention
Efficiency of functions of the directed attention is influenced by external and internal factors: way of life, state of health, tendency to various diseases, general adaptation opportunities of an organism, experience of stressful situations and psychological injuries. Carry to the most common causes of violations of attention:
- Mental disorders. Decrease in purposeful attention is included into structure of psychopathological syndromes. Increase in an otvlekayemost is defined at manias and SDVG, confusion – at depressions, nonsense, hallucinations. Dementias and deliriya are followed by rough pathologies of attention.
- Organic defeats of TsNS. The attention is broken at dysfunction of nonspecific subcrustal structures, specific cortical departments, at diffusion pathological processes in a brain. ChMT, neuroinfections, brain tumors, degenerate diseases of TsNS, prenatal and natal defeats, epilepsy can become the reason of frustration.
- Stress. Attentivny processes change at influence of adverse external factors – long emotional, intellectual and physical activities, the psychoinjuring situations. Decrease of the activity of attention is defined at students during the sessions, at young mothers after the delivery, at athletes during intense training to competitions.
- Somatic diseases. Pathologies of internals and systems, infections, intoxications often provoke development of an asthenic syndrome. This state is characterized by increased fatigue, deterioration in working capacity, decrease in attention, memory and other cognitive functions.
Attentivny frustration happen modal and nonspecific when all types and levels of attention are broken, and modal and specific, shown in one sphere – visual, acoustical, motor or tactile. At modal and nonspecific symptoms three options of pathogenesis are possible. The first – defeat or dysfunction of area oblong and a midbrain. At the same time the bystry exhaustion, a lack of volume and concentration of attention is formed. The following option is presented by violation of work of dientsefalny structures and limbic system. Symptoms are more rough, concentration and concentration are unstable.
The third mechanism – defeat of mediobazalny departments of frontal and temporal zones. Functions of any attention decrease, involuntary becomes pathologically strengthened (an easy otvlekayemost). People with specific frustration have difficulties of understanding of incentives of one modality at double presentation (two visions, two sounds, two touches). The visual, acoustical, sensitive or motor inattention is based on violation of work of the corresponding cortical analizatorny brain systems, more rare functioning of subcrustal departments is pathologically changed.
Attention – conscious allocation of one objects (phenomena) and simultaneous derivation from others, less significant. According to this definition attentivny functions are classified on active which are implemented randomly, and passive, caused not by focus of the person, but external properties of incentives. At frustration there is a deterioration in active attention, and involuntary operations decrease, remain the same or amplify. Allocate the following violations:
- Decrease in stability. This frustration is called also pathological otvlekayemost, and in hard cases – a sverkhotvlekayemost (gipermetamorfozy). It is shown by decrease in selectivity, involuntary switching to foreign irritants.
- Increase in an exhaustion. As a result of excessive fatigue all key parameters at mental loading worsen. The active and passive attention is weakened.
- Narrowing of volume. High concentration on one (more rare than two) objects decides on full ignoring of others. An example of such frustration are the supervaluable ideas psychoinjuring experiences.
- Decrease in concentration. Easing or full loss of ability to concentrate on the concrete phenomena and objects is noted. Active forms of attention suffer, passive remain at the previous level.
- Increase in inertness. Rigidity of attention – violation of ability to switch focus from an observed object or the performed operation. It is characteristic of organic damages of a brain, it is shown by perseveration at various levels of mentality.
Symptoms of disorders of attention
The most widespread violation of attention – an excessive exhaustion. Frustration arises at somatic diseases, physical and intellectual activities, slight neurologic organic dysfunctions. It is expressed by decline in the ability it is long to be focused on activity because of increased fatigue. Patients even after the short period of tension have a fatigue, they begin to distract, lose interest in major activity. Complaints to heavy feeling in the head, the need for rest, drowsiness, restlessness are frequent.
At neurotic disorders, organic diseases of a brain quite often there is a reduction of volume of attention. Patients cannot hold and purposefully operate with several objects (subjects, representations). They difficult are given multicomponent activity, at its performance important requirements and conditions are often missed, the changing circumstances are not taken into consideration. Patients look scattered, forgetful, at a conversation "lose" a thought which was just wanted to be stated. Consciousness holds from 1 to 3-4 units of information (at norm of 7-10 units).
At children and at defeat of frontal zones of bark of a brain prevalence of passive attention over active is observed. Clinically such phenomenon is expressed by a high otvlekayemost, insufficient observation, instability and insufficient depth of concentration. Patients cannot keep active attention on any activity, do not finish begun, being distracted by more intensive incentives – a loud sound, light, the movement. They inattentively hear questions, answer inattentively, ask again, slide off the leading subject of a conversation on associations, casual, but more interesting to them (tell about situations from life, the watched movies). At the rough otvlekayemost characteristic of maniacal states, ability to concentration is completely lost, the attention blurs on collateral incentives, without lingering on one of them.
At patients rigidity and inertness of attention decides on epilepsy and other organic pathologies. A key sign – decrease in an opportunity to switch concentration from action or an object. Patients are inert in the installations, "get stuck" on one subject of a conversation, long and in detail describing it in trifles. It is difficult for them to replace the purposes, tasks, plans. People around estimate them as boring, catching. In extreme degree inertness is shown by perseverativny repetition of words, phrases, actions.
Violation of an orientation of attention develops at morbid depression, a depression, a psychotrauma, schizophrenia. Patients are concentrated on certain phenomena, other aspects of life are ignored. Option of distortion is the pathological reflection at which patients are absorbed by introspection, reflections about meaning of life, the relations with people. They keep diaries, in detail describe experiences, trying to understand themselves. Out of the field of attention there are household aspects, the family relations.
At an ipokhondrichesky syndrome there is a fixing on the state of health, health, painful feelings. The attention of depressive patients is concentrated on negative experiences from the past and disturbing pessimistic expectation of the future. Change of attention of schizophrenic patients is characterized by absent-mindedness, focusing on minor and latent details of the events. It seems to people around unusual, somewhat eccentric, peculiar. For example, at communication they recalculate objects on a table, consider the drawing of wall-paper, distracting from the content of a conversation.
Disorders of attention worsen ability of patients to carry out the difficult activity connected with intellectual and physical activities, planning, control, drawing up the forecast. Easy violations negatively affect the solution of professional tasks, quality of study of school students and students. At rough frustration the skill of conversation, orientation in space is lost. Patients are deadapted at the social and household level, need leaving from the party of family members. Timely diagnosis and treatment of the diseases provoking violation of activity and focus of attention allows to avoid development of rough defects, to improve adaptation of patients.
Patients with disorders of attention are examined neurologists and psychiatrists. Difficulties of diagnostics are connected with insufficient ability of patients to switching, bystry fatigue, selective fixing on one aspects of a research and ignoring of others. Absent-mindedness, forgetfulness, partial loss of communicative skill owing to violation of attentiveness have to be differentiated from the general intellectual insufficiency. Survey and complex patopsikhologichesky testing of the cognitive sphere is for this purpose held. At suspicion of a neurologic disease neurologic survey and tool inspections of a brain is appointed. Directly disorders of attention are studied by the following methods:
- Conversation and observation. The psychiatrist finds out complaints, existence of mental and neurologic disorders, stresses and psychoinjuries, collects the family anamnesis. Patients ask again, are distracted by external irritants, linger on single aspect of a subject or speak vaguely, scraps, without being fixed on any one discussion. The organizing and directing help is necessary for them.
- Methods of double stimulation. These technicians are directed to diagnostics of modal and specific violations. Their essence consists in simultaneous presentation of incentives of an identical modality, assessment of ability to distribute and keep attention. For identification of a visual inattention two incentives objects are shown. The acoustical inattention is defined by one-stage influence of different sounds in both ears; a tactile inattention – a touch of double localization, but various intensity / character; a motive inattention – repetition of difficult movements.
- Patopsikhologichesky tests. Represent test tasks with the structured stimulny material. The psychologist determines malfunction by success of performance and character of mistakes. Widespread techniques are:
- Proof test. It is used for definition of concentration and stability of attention. Rate of execution of the test, quantity, character and distribution of mistakes is estimated.
- Account on Krepelin. It is applied to a research of working capacity, an attention pereklyuchayemost. By results the vrabatyvayemost, an exhaustion, inertness is defined.
- Shulte's tables. Test on an otyskivaniye of numbers reveals mobility of attention, fatigue, concentration. Speed and correctness of performance of tasks is considered.
- Red-black tables. Basic purpose of a technique – switching operation assessment. The general spent time indicates rate of cognitive activity.
- Digitizing. Test allows to estimate concentration, concentration and an exhaustion. The experimenter registers character of mistakes, following of the instruction.
Treatment of disorders of attention
Tactics of therapy is defined by the main disease which provoked deterioration in attention. In some cases it is possible to restore function, having eliminated an etiologichesky factor – an adynamy, a depression, consequences of a craniocereberal trauma, epilepsy attacks. At the majority of pathologies the following types of therapeutic influence are shown:
- Drug treatment. The main group of medicines for correction of functions of attention are nootropa. They improve processes of metabolism in nervous cages, restore an orientation and speed of neurotransfer. In some cases the positive effect is observed at drug intake, stimulating nervous system (psychostimulators, vegetable means). At the expressed frustration with weakening of all types of attention antidepressants are shown.
- Psychocorrection. Occupations with psychologists and correctional teachers are most effective at children's age when there is a formation of the informative sphere, and during the restoration periods after ChMT, strokes, neuroinfections. The developing games and tasks focused on strengthening of concentration, stability, distribution of attention are applied. Exercises on development of a relaxation, self-control tension and relaxations are in addition carried out.
- Physical therapy. Now the method of electrostimulation of bark of big hemispheres and subcrustal systems of a brain by constants and alternating low-frequency currents is quite often applied to treatment of cognitive dysfunctions. Procedures gain ground thanks to not invasiveness and the minimum risk of side effects. At disorder of informative functions against the background of a neurotic syndrome the all-revitalizing procedures – massage, a balneoterapiya, LFK are shown to patients.
Forecast and prevention
Easy and moderate disorders of attention at correctly picked up medicamentous therapy and active psychocorrection have the favorable forecast. At heavy violations the outcome completely depends on character of a course of the leading disease. Prevention is based on maintenance of somatic and mental health, refusal of smoking and alcohol intake, the prevention of exhaustion. It is necessary to distribute rationally loading during the day, alternating the periods of work and rest. With risk factors on development of neurologic and mental diseases it is necessary to undergo preventive diagnostics regularly.