Om koncentra,on och uppmärksamhet

Transkript

1 Om koncentra,on och uppmärksamhet Siegbert Warken,n Professor i Psykologi/Neurokogni,on Linnéuniversitetet siegbert.warken,n@lnu.se

2 William James ( ) Everyone knows what aoen,on is. It is the taking possession by the mind in clear and vivid form, of one out of what seem several simultaneously possible objects or trains of thought It implies withdraw from things in order to deal efficiently with others, and is a condi,on which has a real opposite in the confused, dazed, scaoerbrained state (p.403).

3 Defini,oner av begreppen Psykologilexikon (Henry Egidius) Uppmärksamhet (attention) Medvetandets fokusering på något samtidigt som andra intryck, tankar o.s.v. hålls utanför det fokuserade. Uppmärksamhet är en funktion eller egenskap i djurs och människors beteende och själsliv som gör att en psykisk aktivitet inriktas mot ett visst fenomen, t.ex. något som försiggår i individens omgivning, i den egna organismen eller i det egna medvetandet. Begreppet koncentration likställs ofta med uppmärksamhet (ffa i engelsk litt.).

4 Inom psykiatrin och klinisk psykologi skiljer vi vanligen mellan fem olika typer av uppmärksamhetsfunk,oner 1. Fokuserad uppmärksamhet (focused aoen,on) 2. Fasthållen uppmärksamhet (sustained aoen,on) 3. Selek,v uppmärksamhet (selec,ve aoen,on) 4. Ski^ande uppmärksamhet (alterna,ng aoen,on) 5. Delad uppmärksamhet (divided aoen,on)

5 Uppmärksamhetsstörning är ospecifik! Demenssjukdomar Skallskador Sociala problem Trauma,ska upplevelser Utvecklingsstörning Neuropsykiatriska funk,onshinder (ADHD, ADD etc.) Toxiska skador och missbruk Sömnsvårigheter etc.

6 A framework for understanding the rela,onship between externally and internally directed cogni,on. Dixon, Fox, Christoff Neuropsychologia. (2014),

7 EDC IDC Matthew L. Dixon, Kieran C.R. Fox, Kalina Christoff A framework for understanding the relationship between externally and internally directed cognition Neuropsychologia, Volume 62, 2014,

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9 A Taxonomy of External and Internal AOen,on. Marvin M. Chun, Julie D. Golomb, Nicholas B. Turk- Browne The Annual Review of Psychology :

10 Internal A.en/on (top- down, goal directed, frontal neurons) Task rules Responses Long- term memory Working memory Features Objects Spa/al loca/ons Sensory modality Time points External A.en/on (bo.om- up, s/mulus driven parietal areas)

11 Typical performance Stimuli are re-randomized between measurements Mean: Hertz Attentional difficulties No loss of information. Stimuli are re-randomized between measurements Mean: o,xxx Hertz Mean xx.x % loss of information.

12 Ljudspektrum Betänke,d = Paus Paus BUP- Malmö S. Warken,n

13 Normal ADHD

14 Internal A.en/on (top- down, goal directed, frontal neurons) Task rules Responses Long- term memory Working memory Features Objects Spa/al loca/ons Sensory modality Time points External A.en/on (bo.om- up, s/mulus driven parietal areas)

15 Normal Pa,ent

16 Table 1. Sensitivity and specificity for controls (n=313) and NP-diagnoses (n=24) MCS Criterion Sensitivity (95% CI) Specificity (95% CI) + LR - LR PPV NPV AUC (95% CI) Means Frequency of aberrant pause times (Herz) a) % ( ) 96.3 % ( ) ( ) Number of word loss of text (%) b) % ( ) 97.5 % ( ) ( ) Note: a) and b) denote the mean of 2 measurements, LR=likelyhood ratio, PPV=positive predictive value, NPV=negative predictive value, AUC=area under the curve.

17 Primär svårighet med koncentra,on och uppmärksamhet leder,ll sekundär minnessvårighet. Datoranalogi: Har man inte fåo in det kan man inte heller plocka fram det.

18 MG, kap 7, sid 276

19 A.en/on to memory (AtoM) modellen (Cabeza et al., Nature Reviews Neuroscience, 2008) MCS DPC AOen,on B VPC Memory Röd Svart Blå stjärna kub pil Svart pil DPC = dorsal parietal cortex VPC = ventral parietal cortex B = Broca s area

20 Dopamine Supports Coupling of AOen,on- Related Networks Linh C. Dang, James P. O Neil, and William J. Jagust University of California, Berkeley, California AOen,onal processing has been associated with the dorsal aoen,on, default mode, and frontoparietal control networks. The dorsal aoen,on network is involved in externally focused aoen,on whereas the default mode network is involved in internally directed aoen,on. The frontopa- rietal control network has been proposed to mediate the transi,on between external and internal aoen,on by coupling its ac,vity to either the dorsal aoen,on network or the default mode network, depending on the aoen,onal demand. Dopamine is hypothesized to modulate aoen,on and has been linked to the integrity of these three aoen,on- related networks. We used PET with 6- [ 18F]fluoro- L- m- tyrosine to quan,fy dopa- mine synthesis capacity in vivo and fmri to acquire s,mulus- independent brain ac,vity in cogni,vely healthy human subjects. We found that in the res,ng state where internal cogni,on dominates, dopamine enhances the coupling between the frontoparietal control network and the default mode network while reducing the coupling between the frontoparietal control network and the dorsal aoen,on network. These results add a neurochemical perspec,ve to the role of network interac,on in modula,ng aoen,on.

21 Förändringar med Concerta (1-1.5,m) n.s. Ak,vitet Uppmärksamhet Impulsivitet MCS Qb- Test BUP- Malmö S. Warken,n

22 Betänke,d = Paus BUP- Malmö S. Warken,n

23 Rt och MCS mäter inte samma sak! Hz 1 1 Hz 1 Hz 2 Text 1 Text 2 Rt ljus Rt ljud Rt flerval Hz *** 1 Text **** ** 1 Text ** **** *** 1 Rt ljus n.s n.s n.s n.s. 1 Rt ljud n.s n.s n.s n.s ** 1 Rt flerval n.s n.s n.s n.s n.s n.s. 1 Spearman (n=24), psykologstudenter.

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25 MCS- ET