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. 2022 Apr 25;19(9):5216.
doi: 10.3390/ijerph19095216.

It Takes Time: Vigilance and Sustained Attention Assessment in Adults with ADHD

Anselm B M Fuermaier  1 , Lara Tucha  1   2 , Nana Guo  1 , Christian Mette  3   4 , Bernhard W Müller  4   5 , Norbert Scherbaum  4 , Oliver Tucha  2   6
Affiliations

It Takes Time: Vigilance and Sustained Attention Assessment in Adults with ADHD

Anselm B M Fuermaier et al. Int J Environ Res Public Health. .

Abstract

Objectives: The present study compares the utility of eight different tests of vigilance and sustained attention in the neuropsychological examination of adults with Attention-deficit/hyperactivity disorder (ADHD). Methods: Thirty-one adults diagnosed with ADHD performed eight tests for vigilance and sustained attention, spread over three assessment days. Results: Adults with ADHD showed cognitive impairments in most tests and test variables, even though their sensitivity differed greatly. No specific type of test variable stands out to be the most sensitive, and no evidence for a differential deterioration of performance over time was observed. Conclusion: This study underscores the role of vigilance and sustained attention tests in the assessment of adult ADHD. It is further concluded that summary scores over the entire test duration are sufficient, but that all variables of a test should be considered. Finally, we hypothesize that reassessment on a different day may benefit a more accurate clinical assessment of adults with ADHD, in order to adequately take intraindividual fluctuations and limitations regarding test reliability into account.

Keywords: adult ADHD; impairment; neuropsychology; sustained attention; vigilance.

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Conflict of interest statement

A.B.M.F., L.T. and O.T. have contracts with Schuhfried GmbH, Mödling, Austria for the development and evaluation of neuropsychological test and training tools.

Figures

Figure 1
Figure 1
Graphical depiction of vigilance and sustained attention test performance (T-scores) and number of patients with ADHD showing impairment (T ≤ 40) in each of the test variables. Note: All raw scores were converted to T-scores based on test norms. Test performance scores were converted, if applicable, such that lower T-scores indicate worse performance for all test variables. Data labels indicate the number of patients impaired in each test variable (T ≤ 40). VIGIL = VIGIL of the Vienna Test System (VTS). WAFV = Perception and Attention Functions—Vigilance of the VTS. TAP = Test Battery for Attention Performance. TOVA = Test Of Variables of Attention. CPT = Conners’ Continuous Performance Test. CANTAB = Cambridge Neuropsychological Test Automated Battery—Rapid Visual Processing. IVA-2 = Integrated Visual and Auditory Continuous Performance Test. CR = Correct responses. Com = Commissions. RT = Reaction time. Om = Omissions. SDRT = Standard deviation of reaction times. P(hit) = Probability of a hit. Omi-A = Omissions, Auditory. Omi-V = Omissions, Visual. Com-A = Commissions, Auditory. Com-V = Commissions-Visual. RT-A = Reaction time, Auditory. RT-V = Reaction time, Visual. SDRT-A = Standard deviation of reaction times, Auditory. SDRT-V = Standard deviation of reaction times, Visual.
Figure 2
Figure 2
Percentage of patients showing impairment in each test variable. Note: A test variable is defined as impaired if T-score ≤ 40. TEA = Test of Everyday Attention. VIGIL = VIGIL of the Vienna Test System (VTS). WAFV = Perception and Attention Functions—Vigilance of the VTS. TAP = Test Battery for Attention Performance. TOVA = Test Of Variables of Attention. CPT = Conners’ Continuous Performance Test. CANTAB = Cambridge Neuropsychological Test Automated Battery—Rapid Visual Processing. IVA-2 = Integrated Visual and Auditory Continuous Performance Test. CR = Correct responses. Com = Commissions. RT = Reaction time. Om = Omissions. SDRT = Standard deviation of reaction times. P(hit) = Probability of a hit. Omi-A = Omissions, Auditory. Omi-V = Omissions, Visual. Com-A = Commissions, Auditory. Com-V = Commissions, Visual. RT-A = Reaction time, Auditory. RT-V = Reaction time, Visual. SDRT-A = Standard deviation of reaction times, Auditory. SDRT-V = Standard deviation of reaction times, Visual.
Figure 3
Figure 3
Proportion of patients with ADHD showing impairment in the various tests. Note: A test is defined as impaired if at least one test variable showing impairment. A test variable is defined as impaired when T-score ≤ 40. TEA = Test of Everyday Attention. VIGIL = VIGIL of the Vienna Test System (VTS). WAFV = Perception and Attention Functions—Vigilance of the VTS. TAP = Test Battery for Attention Performance. TOVA = Test Of Variables of Attention. CPT = Conners’ Continuous Performance Test. CANTAB = Cambridge Neuropsychological Test Automated Battery—Rapid Visual Processing. IVA-2 = Integrated Visual and Auditory Continuous Performance Test.
Figure 4
Figure 4
Cumulative percentage of patients with ADHD showing impairment in vigilance and sustained attention tests. Note: A test is defined as impaired if at least one test variable shows impairment. A test variable is defined as impaired when T-score ≤ 40.
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