Redefining ADHD Using an Adult Population: Should Inattention be Viewed as a Separate Dimension From Cognitive and Physiological Activity Level?

Abstract

Hyperactivity and hypoactivity may be viewed as a continuum, rather than separate disorders. Inattention may have a U-shaped relationship with activity level. Linear analyses may be insufficient and inaccurate for studying ADHD.

Normal executive attention but abnormal orienting attention in individuals with sluggish cognitive tempo

“…Therefore, although the present research has not been able to address this issue satisfactorily, it can be inferred that there could be impairment in the orienting network due to less activity in the left superior parietal lobe among individuals with SCT. Second, according to the continuous model of activity, hyperactivity and hypoactivity could be explained as a single continuum of activity level, with a conjecture that attentional problems may have an inverted U-shaped relationship with the activity level ( Miller & Prevatt, 2017 ). SCT is characterized by hypoactivity, and a slower processing or motor speed has been linked to specifically hypoactivity ( Lundervold, Posserud et al, 2011 ).…”

“…In support of this hypothesis, a neuroimaging study found that an increase of SCT symptoms was related to less activity in the left superior parietal lobe, associated with reorientation or shifting of attention ( Becker et al, 2016 , Fassbender et al, 2015 ). Furthermore, the continuous model of activity suggests that hyperactivity and hypoactivity are better explained as a single continuum of the activity level, rather than separated symptoms, with a conjecture that inattention may have an inverted U-shape relationship with the activity level ( Miller & Prevatt, 2017 ). Therefore, individuals with SCT who have hypoactivity symptoms will show a poor performance of attention in relation to the low activity level.…”

The effect of feedback in virtual attention training on orienting attention in individuals with sluggish cognitive tempo

“…Studies have shown that low activity in the left superior parietal lobe, which is associated with orienting or shifting attention, is associated with increased SCT symptoms (Becker, Leopold et al, 2015c; Fassbender et al, 2015). In addition, according to the explanation of the continuous model of activity, hyperactivity and hypoactivity are on a continuous spectrum at the activity level rather than separate symptoms, and the degree of inattention appears as a U-shaped curve from hypoactivity to hyperactivity (Miller & Prevatt, 2020). SCT is characterized by hypoactivity, and a slow processing speed is related to low activity levels (Lundervold et al, 2011).…”