– these are pathopsychological symptoms of impaired direction and selectivity mental activity. Narrowing of attention is manifested by the inability to perceive information from different sources, instability of attention - decreased concentration, increased distractibility to stimuli, insufficient switchability - difficulties in voluntarily moving concentration from one object (phenomenon) to another. Diagnosis is carried out using conversation, observation and specific pathopsychological tests. Treatment uses medications, psychotherapy and physiotherapy.
ICD-10
F90.0 F63
General information
Attention ensures activity and focus throughout cognitive activity. Its disorders often become the basis for the deterioration of other mental functions - mnestic, mental, volitional. Weakening of attention is accompanied by a deterioration in all types of activity, orientation and adaptation to the environment. It is difficult to determine the exact epidemiological indicators of attention disorders, since mild temporary symptoms occur in every person due to overwork or somatic diseases. Moderate and relatively persistent manifestations are diagnosed in preschoolers, primary schoolchildren (3-10%), as well as in older people due to natural involutive changes and age-related diseases of the central nervous system (12-17%).
Causes
The productivity of directed attention functions is influenced by external and internal factors: lifestyle, health status, tendency to various diseases, general adaptive capabilities of the body, experience stressful situations And psychological trauma. The most common causes of attention problems include:
- Psychopathological syndromes. Reduced focused attention is part of the structure of mental disorders. Increased distractibility is determined by mania and ADHD, confusion - by depression, delirium, and hallucinations. Dementia and delirium are accompanied by severe pathologies of attention.
- Organic lesions of the central nervous system. Attention is impaired due to dysfunction of nonspecific subcortical structures, specific cortical sections, with diffuse pathological processes in the brain. The cause of the disorder can be head injury, neuroinfections, brain tumors, degenerative diseases of the central nervous system, prenatal and natal lesions, epilepsy.
- Stress. Attentive processes change when exposed to unfavorable external factors– prolonged emotional, mental and physical stress, traumatic situations. A decrease in attention activity is determined in students during sessions, in young mothers after childbirth, in athletes during the period of intensive preparation for competitions.
- Somatic diseases. Pathologies of internal organs and systems, infections, and intoxications often provoke the development of asthenic syndrome. This condition is characterized by increased fatigue, deterioration in performance, decreased attention, memory and other cognitive functions.
Pathogenesis
Attention disorders can be modality-nonspecific, when all types and levels of attention are impaired, and modality-specific, manifested in one area - visual, auditory, motor or tactile. With modality-nonspecific symptoms, three pathogenesis options are possible. The first is damage or dysfunction of the medulla oblongata and midbrain region. At the same time, rapid exhaustion, lack of volume and concentration of attention are formed. The next option is represented by a disruption of the work of diencephalic structures and the limbic system. Symptoms are more severe, concentration and concentration are unstable.
The third mechanism is damage to the mediobasal regions of the frontal and temporal zones. The functions of voluntary attention decrease, involuntary attention becomes pathologically enhanced (easily distractible). People with specific disorders have difficulty understanding stimuli of the same modality when presented twice (two visual images, two sounds, two touches). Visual, auditory, sensory or motor inattention is based on disruption of the corresponding cortical analyzers brain systems, less often the functioning of the subcortical departments is pathologically altered.
Classification
Attention is the conscious selection of some objects (phenomena) and simultaneous distraction from others, less significant. According to this definition, attentive functions are classified into active, which are implemented voluntarily, and passive, due not to the person’s purposefulness, but external properties incentives. In disorders, active attention deteriorates, and involuntary operations decrease, remain the same, or increase. The following violations are identified:
- Reduced stability. This disorder is also called pathological distractibility, and in severe cases, hyperdistractibility (hypermetamorphosis). It manifests itself as a decrease in selectivity, involuntary switching to extraneous stimuli.
- Increased exhaustion. As a result of excessive fatigue, all basic parameters deteriorate during mental stress. Active and passive attention is weakened.
- Narrowing of volume. There is a high concentration on one (less often two) objects with complete disregard for others. An example of such a disorder is overvalued ideas and traumatic experiences.
- Decreased concentration. There is a weakening or complete loss of the ability to focus on specific phenomena and objects. Active forms of attention suffer, while passive ones remain at the same level.
- Increased inertia. Stiffness of attention is a violation of the ability to switch focus from the observed object or the action being performed. Characteristic of organic brain lesions, manifested by perseverations at various levels of the psyche.
Symptoms of attention disorders
The most common attention disorder is excessive exhaustion. The disorder occurs with somatic diseases, physical and mental stress, and mild neurological organic dysfunctions. It is expressed by a decrease in the ability to focus on activities for a long time due to increased fatigue. Patients, even after a short period of stress, become tired, they begin to get distracted, and lose interest in their main activity. There are frequent complaints about a feeling of heaviness in the head, the need for rest, drowsiness, and restlessness.
With neurotic disorders and organic diseases of the brain, a reduction in attention span often occurs. Patients cannot hold and purposefully operate with several objects (topics, ideas). They find it difficult to perform multicomponent activities; when performing them, important requirements and conditions are often missed, and changing circumstances are not taken into account. Patients look distracted, forgetful, and during a conversation they “lose” the thought they just wanted to express. Consciousness retains from 1 to 3-4 units of information (the norm is 7-10 units).
In children and with damage to the frontal areas of the cerebral cortex, a predominance of passive attention over active attention is observed. Clinically, this phenomenon is expressed by high distractibility, insufficient observation, instability and insufficient depth of concentration. Patients cannot maintain active attention on voluntary activities, do not complete what they start, being distracted by more intense stimuli - loud sound, light, movement. They listen inattentively to questions, answer inappropriately, ask again, slip from the main topic of conversation to random, but more interesting associations for them (they talk about situations in life, movies they have watched). With severe distractibility, characteristic of manic states, the ability to concentrate is completely lost, attention is distracted by side stimuli, without dwelling on any of them.
In patients with epilepsy and other organic pathologies, stiffness and inertia of attention are determined. Key Feature– decreased ability to switch concentration from an action or object. Patients are inert in their attitudes, “stuck” on one topic of conversation, describing it in detail for a long time and in detail. It is difficult for them to change goals, objectives, plans. People around them evaluate them as boring and clingy. To an extreme degree, inertia is manifested by perseverative repetition of words, phrases, and actions.
Impaired focus of attention develops with hypochondria, depression, psychotrauma, and schizophrenia. Patients are focused on certain phenomena, other aspects of life are ignored. A variant of the distortion is pathological reflection, in which patients are absorbed in introspection, thinking about the meaning of life, relationships with people. They keep diaries, describe experiences in detail, trying to understand themselves. Everyday aspects and family relationships remain outside the scope of attention.
With hypochondriacal syndrome, there is a fixation on the state of health, well-being, painful sensations. The attention of depressed patients is focused on negative experiences from the past and anxious pessimistic expectations for the future. Changes in the attention of schizophrenic patients are characterized by absent-mindedness, focusing on minor and latent details of what is happening. To those around him it seems unusual, eccentric, peculiar. For example, when communicating, they count the objects on the table, look at the wallpaper, distracted from the content of the conversation.
Complications
Attention disorders impair the ability of patients to perform complex activities associated with mental and physical stress, planning, control, and forecasting. Mild violations negatively affect the solution of professional tasks and the quality of study of schoolchildren and students. With severe disorders, the skill of conducting a conversation and orientation in space is lost. Patients find themselves maladapted socially and household level need care from family members. Timely diagnosis and treatment of diseases that provoke disturbances in the activity and focus of attention, allows one to avoid the development of gross defects and improve the adaptation of patients.
Diagnostics
Patients with attention disorders are examined by neurologists and psychiatrists. Difficulties in diagnosis are associated with the insufficient ability of patients to switch, fatigue, selective fixation on some aspects of the study and ignoring others. Absent-mindedness, forgetfulness, partial loss of communication skills due to impaired attentiveness must be differentiated from general intellectual disability. For this purpose, a survey and comprehensive pathopsychological testing of the cognitive sphere are carried out. If you suspect neurological disease a neurological examination is ordered and instrumental examinations brain. Attention disorders are directly studied using the following methods:
- Conversation and observation. A psychiatrist examines complaints, the presence of mental and neurological disorders, stress and psychological trauma, and collects family history. Patients ask again and again, are distracted by external stimuli, linger on a single aspect of the topic, or speak vaguely, in fragments, without focusing on any one discussion. They need organizing and guiding help.
- Double stimulation methods. These techniques are aimed at diagnosing modality-specific disorders. Their essence lies in the simultaneous presentation of stimuli of the same modality, assessing the ability to distribute and maintain attention. To detect visual inattention, two stimulus-objects are presented. Auditory inattention is determined by simultaneous exposure to different sounds in both ears; tactile inattention - touch of double localization, but of varying intensity/character; motor inattention – repetition of complex movements.
- Pathopsychological tests. Represent test tasks with structured stimulus material. Based on the success of execution and the nature of errors, the psychologist determines dysfunction. Common techniques are:
- Corrective test. Used to determine concentration and stability of attention. The pace of test execution, the number, nature and distribution of errors are assessed.
- Account according to Kraepelin. Used to study performance and attention switchability. Based on the results, workability, exhaustibility, and inertia are determined.
- Schulte tables. A test to find numbers reveals mobility of attention, fatigue, and concentration. The speed and accuracy of completing tasks is taken into account.
- Red and black tables. The main purpose of the technique is to evaluate the switching operation. The total time spent indicates the pace of cognitive activity.
- Countdown. The test allows you to assess focus, concentration and exhaustion. The experimenter records the nature of errors and adherence to instructions.
Treatment of attention disorders
The treatment tactics are determined by the underlying disease that provoked the deterioration of attention. In some cases, it is possible to restore function by eliminating etiological factor– asthenia, depression, consequences of traumatic brain injury, epileptic seizures. For most pathologies, the following types of therapeutic interventions are indicated:
- Drug treatment. The main group of drugs for correcting attention functions are nootropics. They improve metabolic processes in nerve cells, restore the direction and speed of neurotransmission. In some cases, a positive effect is observed when taking medications that stimulate the nervous system (psychostimulants, herbal remedies). For severe disorders with weakening of all types of attention, antidepressants are indicated.
- Psychocorrection. Classes with psychologists and special education teachers are most effective in childhood when formation occurs cognitive sphere, and during periods of recovery after TBI, strokes, neuroinfections. Educational games and tasks are used that are aimed at enhancing concentration, stability, and distribution of attention. Additionally, exercises are conducted to master relaxation, self-regulation of tension and relaxation.
- Physiotherapy. Currently, the method of electrical stimulation of the cerebral cortex and subcortical systems of the brain with direct and alternating low-frequency currents is often used to treat cognitive dysfunctions. The procedures are becoming more common due to their non-invasiveness and minimal risk side effects. In cases of cognitive dysfunction due to neurological asthenic syndrome patients are recommended general healing procedures - massage, balneotherapy, exercise therapy.
Prognosis and prevention
Mild to moderate attention disorders with properly selected drug therapy and active psychocorrection have a favorable prognosis. In case of severe disorders, the outcome depends entirely on the nature of the leading disease. Prevention is based on maintaining somatic and mental health, quitting smoking and drinking alcohol, preventing fatigue. It is necessary to rationally distribute the load throughout the day, alternating periods of work and rest. If there are risk factors for the development of neurological and mental illness You need to regularly undergo preventive diagnostics.
From pathological manifestations process of attention should be pointed out such as instability, insufficient concentration, disturbance of distribution, slowness of switching, absent-mindedness.
1. Increasing active attention is not mental pathology. It is observed with the dominant ideas among scientists. At the same time, the ability to switch to other types of stimuli is not lost.
- Stuck attention(slow switching) – observed with organic brain lesions, paranoid disorder personality and is expressed in the difficulty of switching from one type of activity to another.
- Increased distractibility– associated with weakness of active attention and inability to long time focus on one activity. Occurs in manic states.
- Distraction of attention(insufficient concentration of attention) – instability of active attention. Usually combined with exhaustion of attention and fatigue. Observed in asthenic conditions.
- Impaired distribution of attention – narrowing of attention span. In this case, attention is limited only to an object that has situational significance. A person is not able to control several processes simultaneously. Observed in cerebral atherosclerosis.
At the level clinical manifestations in children's practice stands out attention deficit disorder . It includes the following Clinical signs:
1. Restless movements in the hands and feet (sitting on a chair, writhing, “squirming”).
2. Inability to sit still when required.
3. Easily distracted by extraneous stimuli.
4. Impatience (has difficulty waiting for his turn during games and different situations a team).
5. The tendency to answer without thinking, without listening to the end of the question.
6. Difficulties in completing the proposed tasks (not related to insufficient understanding or negative behavior).
7. Difficulty maintaining attention when completing tasks or during games.
8. Frequent transition from one unfinished action to another.
9. Inability to play quietly and calmly.
10. Talkativeness.
11. Tendency to disturb others, to “molest” others (for example, to interfere with other children’s games).
12. External manifestations of lack of concentration on speech addressed to a person.
13. Tendency to lose things needed at school and at home (for example, toys, pencils, books, etc.).
14. Frequent commission dangerous actions(underestimation of consequences). At the same time, he does not seek adventure or thrills (for example, he runs across the street without looking around.
Considering the fact that many scientists question the allocation of attention to an independent cognitive process, among psychopathological and pathopsychological manifestations, symptoms and syndromes of attention disorders are presented rather poorly.
Lecture on psychiatry No. 4
Pathology of attention. Pathology of will. Pathology of emotions.
Attention is a cross-cutting, incomplete process that seems to permeate the entire mental sphere: the direction of mental activity towards an object. Attention can be passive (orienting reflex) and active (voluntary, with its help we communicate with environment). Attention is characterized by the ability to concentrate (the ability to work in noise) and the ability to switch.
Pathology of attention.
exhaustion - a person cannot maintain active attention for a long time; characteristic of all disorders of the asthenic circle, mainly asthenic syndrome, neurasthenia. This comes out in conversation.
Distraction of attention - observed in both asthenic and manic states(mild pathological switchability).
Difficulty switching - characteristic of epilepsy, limited brain lesions (stuckness). Attention span is the ability to do several things at once. It narrows in case of vascular diseases of the brain (atherosclerosis).
WILL - conscious, purposeful mental activity. Pathology of the will (using the example of the food instinct):
Bulimia - increased food instinct - is observed in idiocy, diabetes mellitus etc.
Anorexia is a weakening of the food instinct. Occurs with asthenia, depression.
A perversion of the food instinct - coprophagia - eating feces in schizophrenia.
Using the example of the instinct of self-preservation, weakening is often found, expressed in suicidal thoughts and attempts, which occur in depressive states.
Pathology of volitional behavior itself.
Strengthening - hyperbulia. Appears with overvalued ideas, certain types of delirium. For example, during delusions of jealousy, in order to prove his wife’s infidelity, the patient makes a lot of efforts: monitoring her around the clock, calling her at work, interrogating her, etc. also observed in all forms of painful addictions (alcoholism, drug addiction).
Hypobulia - decreased willpower, occurs with asthenia and depression. It can be constantly progressive up to abulia - a person has no motivation for activity; it occurs in patients with schizophrenia.
Parabulia is a perversion of volitional activity. Manifests itself in catatonic symptoms: Unmotivated opposition:
negativism - the patient is asked to give his hand, but he hides it behind his back.
mutism - unmotivated silence
refusal to eat
delay of physiological functions
Passive submission (echo - symptoms) - a person does something that others do:
echolalia - passive repetition of the words of others
echopraxia - repetition of the actions of others
echomiya - repetition of facial expressions
Waxy flexibility - a person holds the position given to him for a very long time. Now occurs as a symptom air cushion- the patient lies on his back, and his head is not on the pillow, but above it.
Stereotypes:
motor
All manifestations of catatonic symptoms can be combined into two syndromes:
catatonic stupor - a person lies motionless with phenomena of waxy flexibility, with negativism, with mutism.
catatonic arousal - chaotic, unfocused, with echosymptoms.
A person experiences emotions all the time: he is happy or dissatisfied, he is in a good mood or not in a very good mood. Emotions permeate a person’s entire personality, can speed up or slow down thinking, affect volitional processes, and the whole person as a whole. Emotions are involved in the pathogenesis of many diseases; It is difficult to somehow qualify them, you can only compare them among one person.
A person’s emotions can be judged by vegetative signs, biochemical (endocrinological) signs, blood pressure and pulse. What matters is the expression of the eyes, the folds of the eyelids, the face, and the patient’s posture.
Emotions are an expression of a person’s attitude towards something, a very subtle and sensitive mechanism of human self-regulation in his relationships with the external and internal world, that is, emotions are needed for a person’s adaptation to the constantly changing conditions of the external and internal environment, they guide our lives.
Emotions are characteristic not only of humans, but also of animals and even plants.
Emotions are divided by duration:
actual emotions or emotional response of a person
mood - the basic tone of emotions over a more or less long period of time
Here we can draw the following analogy: there are 2 concepts - climate and weather. Climate - on a certain area of land there is a constant value, but in this climate the sun shines today and rain tomorrow. So, climate is actually emotions and weather is mood.
Affects are violent emotions, accompanied by a motor discharge.
Hierarchical construction of emotions.
Lower ones, associated with instincts (hungry - bad, ate - good).
Needs are instincts passed through a social prism (a person is hungry, but he will not chew raw meat and raw cereals, but will cook, stew, fry everything). Here stage 2 is formed - egoistic emotions.
Higher emotions (ethnic, aesthetic, moral, ethical). For the most part, people neither rob, nor steal, nor kill, nor rape, not because they are afraid, but because higher emotions (feelings) exist.
Pathology of emotional response.
Gain
emotional lability - with asthenia
emotional weakness, characteristic of asthenia, cerebral atherosclerosis.
Both of these options for intensifying emotions can occur together with neurasthenia, then they speak of irritable weakness.
Weakening
emotional impoverishment is the very case when higher emotions disappear, and egoistic emotions come to the fore. A person is only interested in his own well-being; he is not interested in politics, art, painting, books, etc. a person becomes deceitful (can deceive for his own benefit). This is typical for alcoholism, organic diseases brain.
Emotional dullness is characteristic of schizophrenia, and only of it. IN in this case All three levels of the hierarchical structure of emotions suffer.
Lack of emotions - apathy. There is no emotional response. “How are you” - “Nothing.” Psychiatrists call apathy a waking coma, death with with open eyes. Apathy may be the initial state of schizophrenia.
Perversion of emotional response is characteristic only of schizophrenia:
emotional inadequacy. The patient is talking about an unpleasant topic, and there is a smile on his face
ambivalence is the simultaneous coexistence of different, opposing emotions: like - don't like, love - hate. “I love him, but he doesn’t love me. Therefore, I begin to hate him, my beloved, and in order for no one to get him, I will kill him, loving him.” Thus, for schizophrenia, three A’s can be distinguished: ataxia, abulia, apathy.
They call the direction and concentration of consciousness on certain objects or certain activities while being distracted from everything else. Attention is always highlighting something and focusing on it. In distinguishing an object from a mass of others, the so-called selectivity of attention is manifested: attention to one is at the same time inattention to another.
Attention is special shape human mental activity, necessary condition any activity.
- Attention activates the necessary ones and inhibits the unnecessary ones. this moment mental and physiological processes.
- Promotes organized and targeted selection of information entering the body in accordance with current processes.
- Provides selective and long-term concentration of mental activity on the same object or type of activity.
- Affects directionality and selectivity cognitive processes, their quality and performance results.
The physiological basis of attention is the mechanism of interaction between the nervous processes of excitation and inhibition occurring in the cerebral cortex. This interaction occurs, as you already know, on the basis of an established I. P. Pavlov law of induction of nervous processes, according to which excitation processes occurring in some areas of the cerebral cortex cause (induce) inhibitory processes in other areas of the brain. If a person focuses his attention on an object, this means that this object caused excitement in the corresponding part of the cerebral cortex, while the remaining parts of the cortex turned out to be inhibited, as a result of which the person does not notice anything except this object.
In addition, physiological mechanisms of attention include:
1. Mechanism of dominance. There is always a dominant focus of excitation in the brain, which not only suppresses newly emerging foci of excitation, but also attracts weak excitations to itself, intensifying due to them.
- Depending on the nature of the object to which a person’s attention is directed, a distinction is made between external and internal attention.
External attention- attention directed at the objects and phenomena around us.
Inner attention- attention directed to one’s own thoughts, feelings and experiences. This division, of course, is to a certain extent arbitrary, since in a number of cases we think intently in connection with the perception of an object or phenomenon, trying to understand it, to penetrate deeply into its essence. Depending on the level of volitional regulation, attention is divided into involuntary, voluntary, and post-voluntary.
Voluntary attention is most likely to occur in the following situations:
1) when a person clearly understands his responsibilities and specific tasks when performing an activity;
2) when the activity is performed under familiar conditions, for example: the habit of doing everything according to the schedule in advance creates an attitude towards voluntary attention;
3) when performing an activity concerns any indirect interests, for example: playing scales on the piano is not very exciting, but necessary if you want to be a good musician;
4) when favorable conditions are created when performing an activity, but this does not mean complete silence, since weak side stimuli (for example, quiet music) can even increase work efficiency.
Human attention has five main properties: stability, concentration, switchability, distribution and volume. Let's look at each of them.
Sustainability of attention- this is a long-term retention of attention on an object or any activity.
On a stationary, unchanging object, passive attention remains for about 5 seconds, after which it begins to be distracted.
If a person actively interacts with an object, then sustained attention can be maintained for 15-20 minutes.
Stability of attention can be determined by various reasons:
Individual physiological characteristics human (properties of the nervous system). For example, people with a weak nervous system or overexcited people quickly get tired;
The general condition of the body at a given time. For example, a person who is not feeling well physically is usually characterized by unstable attention;
Attention also has its drawbacks, the most common of which is absent-mindedness, expressed in two forms:
1) frequent involuntary distraction while performing an activity. They say about such people that they have “fluttering”, “sliding” attention. May arise as a consequence:
a) insufficient development of attention;
b) feeling unwell, fatigue;
c) for students - neglect of educational material;
d) lack of interests;
2) excessive concentration on any one object or activity, when attention is not paid to anything else. For example, a person, thinking about something important for himself, may, while crossing the road, not notice the red traffic light and end up under the wheels of a car.
Types of attention disorders.
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Attention deficit is one of the most important symptoms pathological state of the brain, and its study can provide important data in the diagnosis of brain lesions.
With massive damage to the deep parts of the brain (superior brainstem, walls of the third ventricle, limbic system), severe disorders may occur involuntary attention, manifested in the form general decline activity and pronounced violations of the mechanisms of the orienting reflex.
These violations can be of different nature:
1) the nature of the loss. The disorder manifests itself in the fact that the orientation reflex is unstable and quickly fades away;
2) the nature of the pathological irritation of the stem and limbic systems, as a result of which once the symptoms of the orientation reflex have arisen, they do not fade away and for a long time the stimuli continue to cause unquenchable electrophysiological and autonomic (vascular and motor) reactions.
Sometimes the usual signs of the orientation reflex can take on a paradoxical character; stimuli begin to cause exaltation of the alpha rhythm instead of depression, or instead of constriction of blood vessels in response to the presentation of signals, their paradoxical expansion.
IN clinical picture These disorders affect the fact that patients exhibit sharp signs lethargy, inactivity and either do not respond to stimuli at all, or respond to them only with constant additional stimuli. In the case of pathological overexcitation of the brain systems of the upper trunk and limbic region, patients, on the contrary, show signs of increased excitability, experience constant anxiety, and increased distractibility by any irritations and emotional arousals.
Violations of voluntary attention are of particular importance for the clinic. They manifest themselves in the fact that the patient is easily distracted by every side stimulus, but it turns out to be impossible to organize his attention by setting him a specific task or giving appropriate verbal instructions. In psychophysiological studies, this can be seen if, after the patient’s signs of the orienting reflex have faded, he is presented with an appropriate task, for example, counting signals, monitoring their changes, etc. If such an instruction is normal, as we have already seen above, leads to stabilization of the electrophysiological symptoms of the orienting reflex, then in case of brain lesions, the speech instruction addressed to the patient does not cause any strengthening of the orienting reaction.
Most typical examples violations of higher forms of attention are given by patients with defeat frontal lobes brain(especially their medial sections). In these patients, it is often impossible to observe any loss of the orienting reflex to external signals; sometimes their involuntary attention is even increased, and the patient is easily distracted by every side irritation (noise in the room, opening doors, etc.); however, it turns out to be impossible to concentrate him on performing any task, to raise the tone of the cerebral cortex with speech instructions, and the presentation of speech instructions (count signals, monitor changes) does not cause in such a patient any changes in electrophysiological and vegetative symptoms orientation reflex. Sometimes this type of violation, which is physiological basis for behavior change in patients with damage to the frontal lobes of the brain, it turns out to be fundamental for their diagnosis.
It is characteristic that this type of violation of speech regulation of the orienting reflex occurs only with lesions of the frontal lobes of the brain and does not occur with lesions of other parts. This speaks to the exceptional role that the frontal lobes of the human brain play in the process of forming strong intentions and in exercising control over the course of behavior.
Naturally, such forms of violation of voluntary attention lead to significant changes in all complex psychological processes. It is precisely because of these disorders that patients with damage to the frontal lobes of the brain differ in the following:
1) find themselves unable to concentrate on solving the problem proposed to them;
2) cannot create a strong system of electoral ties that corresponds to the program of action given to them;
3) they easily slip into side connections, replacing the systematic implementation of the program with impulsively arising reactions to any side stimulus or to the repetition of stereotypes that have arisen once, which have long lost their meaning, but easily disrupt the purposeful activity that has begun.
That is why a slight loss of selectivity in performing any intellectual operation is one of the significant signs of damage to the frontal lobes of the brain.
Significant impairments of attention can also occur in those brain diseases that are characterized by a pathological inhibitory (phase) state of the cortex.
In such states (characteristic of severe exhaustion or sleep-like - “oneiric” states), the “law of force” described by I. P. Pavlov, in which strong stimuli cause strong, and weak ones cause weakened reactions, is violated.
In relatively mild “phase” states of the cortex, both strong and weak stimuli begin to produce the same responses, and as these states deepen further, known as the “paradoxical phase,” weak stimuli begin to produce even stronger responses than strong stimuli.
Naturally, in such conditions, sustained attention to the task at hand becomes impossible, and attention begins to be easily distracted by all sorts of side stimuli.
The difference between the instability of voluntary attention and those gross forms of its violation that occur with lesions of the frontal lobes of the brain is that in these cases, mobilization of attention by strengthening motives, turning to supporting aids and strengthening speech instructions leads to compensation for its shortcomings. While with damage to the frontal lobes, which destroys the main mechanism for regulating voluntary attention, this pathway may not produce the desired effect. Instability of voluntary attention occurs not only with pronounced pathological conditions brain, but also in such conditions nervous system which are caused by exhaustion and neuroses, sometimes it reflects individual characteristics personality. Therefore, the study of attention stability using all objective psychophysiological and psychological methods may have great diagnostic value.
Luria A. R. Lectures on general psychology . - St. Petersburg: Peter, 2004. - 320 p. pp. 189-192.
