Attention deficit-hyperactivity disorder (ADHD) consists of symptoms of both inattention and hyperactivity/impulsivity that cause significant functional impairment (APA, 1994). Approximately 4.7% of adults are diagnosed with ADHD; however, there are few empirically-informed interventions that are specifically designed for adults. Instead, many of the common interventions for adults are derived from work done with children with ADHD and may not be appropriate for their particular needs (Weiss & Weiss, 2004). Given that adults with ADHD typically experience more symptoms of inattention rather than hyperactivity, an investigation of the effectiveness of an intervention that specifically targets their inattentive symptoms is warranted (Weiss & Weiss, 2004; Weiss et al., 2002). Therefore, the goal of this study was to evaluate the efficacy of an attention-specific intervention for adults with ADHD. The intervention used in this study, Attention Process Training (APT; Sohlberg & Mateer, 1987), has never been applied to adults with ADHD. The underlying assumption behind this intervention is that attentional functioning can be improved through the use of tasks that are designed to re-train various aspects of attention. More specifically, this study addressed sustained, alternating, and selective/divided attention during the intervention. A non-concurrent multiple baseline design was used in order to assess the effectiveness of the APT among a sample of adults with ADHD. A sample of four adults, aged 21-37 years (M = 27.75) participated in this study and demonstrated minimal changes in their attentional ability after the intervention. In addition, the findings suggest that the different components of attention addressed in this intervention are not distinct and likely have a reciprocal affect on one another. / Ph. D.

This study proposed that new insights about attention, including its phenomenon and pathology, would be provided by combining perspectives of the neurobiological discourse about attention with analyses of artworks that exploit the constraints of the attentional system. To advance the central argument that art offers a training ground for the attentional system, a wide range of contemporary art was analysed in light of specific tasks invoked. The kinds of cognitive tasks these works initiate with respect to the attentional system have been particularly critical to this research. Attention was explored within the context of transdisciplinary art practices, varied circumstances of viewing, new neuroscientific findings, and new approaches towards learning. Research for this dissertation required practical investigations in a gallery setting, and this original work was contextualised and correlated with pertinent neuroscientific approaches. It was also concluded that art can enhance public awareness of attention disorders and assist the public in discriminating between medical and social factors through questioning how norms of behaviour are defined and measured. This territory was examined through the comparative analysis of several diagnostic tests for attention deficit hyperactivity disorder (ADHD), through the adaptation of a methodology from economics involving patent citation in order to show market incentives, and through examples of data visualisation. The construction of an installation and collaborative animation allowed participants to experience first-hand the constraints on the attentional system, provoking awareness of our own “normal” physiological limitations. The embodied knowledge of images, emotion, and social context that are deeply embedded in art practices appeared to be capable of supplementing neuroscience’s understanding of attention and its disorders.

Paper 1 provides a systematic review on the association between children over-rating their competence, termed Positive Illusory Bias (PIB), and Attention deficit hyperactivity disorder (ADHD). The evidence towards this construct was examined, in addition to its environmental specificity and modifiability. Findings confirmed an association between PIB and ADHD, with most studies evidencing higher discrepancies between self and adult ratings of competence in children with ADHD compared to controls. The nature and magnitude of this association was less clear however, with some of these studies showing absolute ratings of children to be similar to controls, and a PIB only evidenced when adults were used as objective evaluators, not actual performance. Thus the review was unable to discount the idea that the PIB may, in part, be a function of the system around children with ADHD under-estimating their abilities. Clinical implications are discussed. Paper 2 presents an investigation into the efficacy and feasibility of a metacognitive therapy technique, Attention Training (ATT) in children with ADHD. A novel intervention in this population, the study employed a single case series design, followed by an uncontrolled trial, both with a 6-week follow up. A total of 16 children aged 7-11 under the care of a children and adolescent mental health service received 5 sessions of the ATT. Findings revealed that children rated their attention as significantly improved, despite no statistical improvement found on parent ratings. Significant improvements were also shown in working memory and other aspects of executive functioning. Adherence to home practice of the ATT was generally poor, but session attendance was good and the treatment was well-liked by parents. Clinical implications and directions for future research are indicated. Paper 3 is a critical reflection of the research process. Reflections on paper 1 and 2 are given, including limitations and clinical implications. The impact of the research process on my personal development and learning is also discussed.

Attention training (AT) is a therapeutic intervention developed by Adrian Wells that involves the training of attentional skills to treat emotional disorders (Wells, 1990). This study investigated whether the AT technique works as theorised to reduce anxiety and other symptoms by reducing self-focus. In a laboratory setting, seventy-one student participants were exposed to a single session of either an AT analogue or a control treatment to see if AT would reduce their self-focus and vulnerability to a subsequent stressor task. AT was not found to decrease self-focus or reduce vulnerability to the stressor. In addition, self-esteem (SE) and social anxiety were investigated as potential moderators of the relationship between AT and/or self-focus on vulnerability to the stressor. Prior research has shown that SE level and self-focus interact such that self-focus predicts vulnerability to anxiety in people with low SE, but not in those with high SE. In this study we also examined SE range, a measure we developed here to reflect the range within which a person’s state SE fluctuates over time. The results indicated that self-focus is related to increased vulnerability in those with low SE or a large SE range, but decreased vulnerability in those with high SE or a small SE range. This supports theorising that self-focus activates people’s self-beliefs, which then influence how they respond during potentially threatening experiences. The findings also support the recommendation that SE range be subjected to further evaluation.

Tato práce je shrnutím existujících přístupů pro zpracování EEG signálu za účelem EEG biofeedbacku a dále popisuje návrh a implementaci vlastní aplikace pro EEG biofeedback se zaměřením na trénink pozornosti. Dále obsahuje případovou studii provedenou na neurotypickém studentovi a studentovi s ADHD, která zkoumá vliv implementované aplikace na měřený EEG signál subjektů.

Deficits in cognitive control are associated with problems disengaging from ruminative thought, a significant risk factor for depression. Cognitive control refers to higher order cognitive processes used for goal-directed behavior, including emotion regulation. The current study examined associations between the switching component of cognitive control and rumination and tested the effects of two interventions used to improve cognitive control and thereby decrease ruminative thought. Undergraduate participants completed self-report measures to assess symptoms and an internal shift task to assess shifting ability. Participants completed a mood and rumination induction and were randomly assigned to one session of the Attention Training Technique (ATT), (n = 69), mindfulness meditation (n = 70), or an attention filler control task (n = 72). Switching deficits and rumination were not associated. The ATT moved participants’ focus of attention externally, and this outward shift in attention predicted lower state rumination. Decentering, however, was not impacted by attention training or mindfulness. Focus of attention did not impact mood recovery despite significant improvement in sad mood across all conditions. Overall, one session of attention training and mindfulness appears to have an impact on sad mood, but this effect is not superior to a simple distraction task. More than one session may be necessary to observe substantial benefits from the ATT or mindfulness. Implications and future research are discussed.

The use of attention training protocols for the treatment of generalized social anxiety disorder (SAD) is undergoing increased examination. Initial investigations were positive but more recent investigations have been less supportive of the treatment paradigm. One significant limitation of current investigations may be over-reliance on self-report. In this investigation, we expanded on initial investigations by using a multimodal assessment of patient functioning (i.e., including behavioral assessment). Patients with a primary diagnosis of SAD (n = 31) were randomly assigned to eight sessions of attention training (n = 15) or placebo/control (n = 16). Participants were assessed at pre- and post-treatment via self- and clinician-report of social anxiety as well as anxious and behavioral response to two in vivo social interactions. Results revealed no differences between groups at post-treatment for all study outcome variables, suggesting a lack of effect for the attention training condition. The results are concordant with recent investigations finding a lack of support for the use of attention training as an efficacious treatment for patients with SAD.

Attentional bias (AB) refers to the tendency to selectively attend to (orientation towards) and/or hold attention on (slowed disengagment from) disorder-relevant stimuli. Females with eating-related concerns are thought to preferentially process threatening stimuli, which in turn is thought to maintain and exacerbate eating concerns. The aim of the present thesis was to explore AB for threatening stimuli in females characterised by restrained, external or emotional eating, and those with high levels of (non-clinical) eating psychopathology. This was carried out with the intention of identifying cognitive processes that contribute to eating behaviours in females, in order to assess the relevance of an attention training (AT) programme for reducing such biases. A pilot study assessed orientation/slowed disengagement, for mood and food words amongst females with high/low levels of restraint. Forty females completed a modified Stroop task with three conditions. Food and mood conditions included sequences of five words ( target food/mood followed by four neutral). The neutral condition consisted of all neutral words. Performance did not significantly differ according to high/low restraint groups. All participants took longest to colour-name word position 2 (demonstrating slowed disengagement lasting one consecutive trial). However, this pattern was also found in the neutral condition. Methodological limitations were then addressed in study one. High/low restrained eaters (n=48) completed a modified Stroop where targets (food, interpersonal threat, animal) were presented prior to four neutral words. Participants were slow to disengage from targets (slowest for word position 2) in all conditions. Patterns of responding indicated that restrained eaters might take longer to disengage (i.e. the carry-over effect from the food word seemed to last longer than one trial). However, more neutral words in the sequence were needed to assess this. As slowed disengagement from animals also arose, a categorical effect may have occurred. Study two explored attention processing of food using modified Stroop and dot probe tasks. In the Stroop task targets (food, interpersonal threat, household objects) were presented prior to six matched neutral words. This task revealed no evidence of AB. No significant pattern of differences between restrained (n=29)/unrestrained eaters (n=31) emerged; however, binge eating scores were significantly negatively correlated with response times. A dot probe task with food/neutral picture pairs also revealed no evidence of AB. Both restrained/unrestrained eaters had negative mean interference scores indicating avoidance of food. None of the following eating behaviours significantly correlated with AB: restraint, disinhibition, external eating, emotional eating and non-clinical eating psychopathology. Study three employed a further modified dot probe task based on image ratings. There was no evidence of AB, and no significant relation between task performance and restrained, emotional or external eating. 2000ms bias scores (assessing disengagement) were significantly negatively correlated with eating psychopathology and age, suggesting that those with high levels of non-clinical eating psychopathology attentionally avoid food stimuli and that younger females are slower to disengage attention from food (although found within a limited age range). Study four employed further modified Stroop and dot probe tasks, and assessed whether AB mediates the negative mood-eating relationship. Participants were allocated to negative or neutral mood conditions. No evidence of AB was found with the dot probe, but greater levels of emotional eating were associated with slower responding. In the Stroop task, all participants displayed an orientation bias towards food. Emotional eating and drive for thinness (DFT) scores were significantly positively correlated with food word colour-naming times but only amongst participants in a negative mood. However, those with high levels of external eating showed greater AB towards food when in a neutral mood. Highly emotional eaters in a negative mood showed a greater desire to eat than those in a neutral mood but did not increase in food intake. Furthermore, those with a high DFT (in a negative mood) showed no evidence of increased desire to eat or food intake. AB was not significantly related to subjective appetite or food intake. Therefore, AB does not seem to mediate the negative-mood eating relationship. The present thesis provides important suggestions for modifications of Stroop and dot probe tasks targeting orientation and disengagement. A modified Stroop has been more sensitive at detecting food AB than the dot probe. Implications of biased attention processing are discussed in relation to the development of harmful eating behaviours, and the present findings have important implications for developing programmes to prevent eating disorders amongst at-risk females (e.g. through AT or training at-risk females how to effectively cope with negative mood).

O sistema colinérgico está sabidamente envolvido com processos cognitivos. Em trabalho recente mostramos que a infusão do peptídeo A promoveu neurodegeneração e redução da memória de ratos. O treino semanal dos animais em equipamento de esquiva ativa recuperou o desempenho na tarefa e aumentou a densidade de receptores nicotínicos α7 em áreas relacionadas à memória. No presente trabalho, o antagonismo de α7 com metilicaconitina (MLA), em camundongos, promoveu perda cognitiva, porém a recuperação com o treino foi parcial. A infusão conjunta de βA e MLA causou perda da memória, mas essa não foi revertida com o treino semanal. Os animais com MLA apresentaram aumento da atividade da acetilcolinesterase (AChE) e aumento de BDNF, que poderia ser relacionado à resiliência a injúrias. Porém, animais com A e MLA apresentaram aumento da atividade da AChE e redução de BDNF, sugerindo perda dos mecanismos de neuroproteção deflagrados por α7. Com isso, sugere-se que α7 tenha um papel determinante na recuperação da memória e resiliência tecidual, frente à neurodegeneração. / Cholinergic system plays an important role in cognitive processes. In a recent work we showed that infusion of Aβ promoted neurodegeneration and reduction of memory of rats. Week training of animals in active avoidance shuttle box recovered their performance and increased the density of α7 nicotinic receptors in brain areas related to memory. In the present work, infusion of the α7 antagonist methyllycaconitine (MLA), in mice, caused cognitive impairment, but memory recover with week training was partial. Infusion of βA together with MLA promoted memory loss, but this was not recovered with the week training. MLA infused mice presented increase in acetylcholinesterase (AChE) activity and increase in BDNF, which could be related to resilience to tissue injuries. However, animals infused with βA and MLA showed increase in AChE activity and reduction of BDNF, suggesting loss of neuroprotection mechanisms triggered by α7. It is suggested that α7 has a determinant role in memory recover and brain resilience, in neurodegenerative processes.

O sistema colinérgico está sabidamente envolvido com processos cognitivos. Em trabalho recente mostramos que a infusão do peptídeo A promoveu neurodegeneração e redução da memória de ratos. O treino semanal dos animais em equipamento de esquiva ativa recuperou o desempenho na tarefa e aumentou a densidade de receptores nicotínicos α7 em áreas relacionadas à memória. No presente trabalho, o antagonismo de α7 com metilicaconitina (MLA), em camundongos, promoveu perda cognitiva, porém a recuperação com o treino foi parcial. A infusão conjunta de βA e MLA causou perda da memória, mas essa não foi revertida com o treino semanal. Os animais com MLA apresentaram aumento da atividade da acetilcolinesterase (AChE) e aumento de BDNF, que poderia ser relacionado à resiliência a injúrias. Porém, animais com A e MLA apresentaram aumento da atividade da AChE e redução de BDNF, sugerindo perda dos mecanismos de neuroproteção deflagrados por α7. Com isso, sugere-se que α7 tenha um papel determinante na recuperação da memória e resiliência tecidual, frente à neurodegeneração. / Cholinergic system plays an important role in cognitive processes. In a recent work we showed that infusion of Aβ promoted neurodegeneration and reduction of memory of rats. Week training of animals in active avoidance shuttle box recovered their performance and increased the density of α7 nicotinic receptors in brain areas related to memory. In the present work, infusion of the α7 antagonist methyllycaconitine (MLA), in mice, caused cognitive impairment, but memory recover with week training was partial. Infusion of βA together with MLA promoted memory loss, but this was not recovered with the week training. MLA infused mice presented increase in acetylcholinesterase (AChE) activity and increase in BDNF, which could be related to resilience to tissue injuries. However, animals infused with βA and MLA showed increase in AChE activity and reduction of BDNF, suggesting loss of neuroprotection mechanisms triggered by α7. It is suggested that α7 has a determinant role in memory recover and brain resilience, in neurodegenerative processes.