Toward a Spectrum of Attention Disorders

When we conceptualized the writing of this book, we identified several main ideas or hypotheses that we thought were important to discuss. The first idea was that all deficits of attention do not represent aspects of attention deficit hyperactivity disorder (ADHD); that there were problems of attention associated with other clinical conditions that arise independently of attention deficit hyperactivity disorder. These other attentional issues were poorly articulated, and perhaps often mislabeled and frequently overlooked. The second idea was that the classification of ADHD, as far as the DSM-5 defines it, was overly broad and too heterogeneous to be of scientific value going forward. A related idea was that grouping all types of attentional deficiencies under the rubric of ADHD resulted in dilution of certain characteristics and research findings, making the utility of findings based on heterogeneous samples less clinically utilitarian. Finally, the idea that attention deficit hyperactivity disorder-inattentive type was probably a separate disorder with unique neural network underpinnings. While researching and writing this book, some additional ideas presented themselves and provided the opportunity to think about things quite differently. Foremost among these was the idea that attentional functioning (and poor functioning) could provide a meaningful, and empirically valid, way to understand the difference between traditional disorders of mental health and pave the way for a new nosology. Another was that there were commonalities of poor attentional allocation that underpinned certain disorders of mental health and differentiated them from other groups of mental health disorders. Finally, there is the idea that in many instances, attention per se is not disordered at all, but rather it is misapplied or less than maximally efficiently utilized. We review each of the above ideas.