Note to SCZ team: Deficits in Attention: Reasons Why?

Suppose you receive data on an individual showing that he performs poorly on all 17 tests that were administered (Citation). Let us go through the logical steps in finding an answer regarding the reason for the poor performance.

  1. Could it be Dementia? In cases like this Kraepelin believed that the attentional problem was due to Dementia praecox. Answer: You find clinically and on testing that the individual does not fit the clinical or psychometric pattern of Dementia.
  2. You consider Attention Deficit Disorder. Answer: You find that the individual does not fit the qualifications for this disorder clinically or psychometrically.
  3. You consider the hypothesis that the individual simply has the attenuation of the attentional capacity. Answer: This seems unlikely for two reasons. First, the individual is able to engage in activities that demand optimal utilization of capacities such as attention, memory, and flexibility. These activities can include driving in traffic, participating in a play or talent show, or teaching someone how to use the computer. Second, when the individuals improve clinically they show the same degree of improvement on the test ( Note: the individuals are able to demonstrate improved performance on the tasks of daily living as well as in social, academic, and vocational performance.)
  4. An alternative hypothesis is that the individuals perform poorly on these tests because of factors related to self-concept and motivation. Indeed a number of factors related to these two components of personality have been shown to influence performance on these tests. An experiment to distinguish between these two hypotheses: administer the Self-concept Test, Dysfunctional Attitude Scale (Defeatist Attitude Subscale), the Optimism Scale, etc. when the individual is in a generally withdrawn state. Then, re-administer the tests after the individual has become engaged in a meaningful activity. Provide encouragement about taking the test. Re-administer the self-concept test, the Defeatist Attitude scale, the Optimism Scale, etc. Determine whether the improvement in the subjective factors correlates with performance.

Please send me your feedback regarding whether this Socratic questioning makes sense!

-ATB