Abstract
Do neuropsychological tests commonly used to assess attention in clinical populations measure the same construct as experimental attention tests? We followed up a factor analysis by Huang et al. (2012), who proposed that many visual cognition attention paradigms load on a “general attention factor”, a. Adult participants (N = 488) completed a comprehensive 90-minute on-line battery (TestMyBrain.org). Five visual cognition paradigms (Multiple Object Tracking (MOT), Flanker Interference, Visual Change Detection (VCD), Approximate Number Sense (ANS), L/T Visual Search Task) were selected to match the general attention factor. We included the Gradual Onset Continuous Performance Task (Grad CPT), hypothesizing that some neuropsychological tests might be measuring sustained rather than selective attention. Neuropsychological tests, selected according to popularity in the domain of cancer-related cognitive impairments (Horowitz et al. 2019), comprised Trail Making Test versions A & B (TMT), Digit Symbol Substitution (DSS), Forward and Backward Digit Span, Letter Cancellation, Spatial Span, and Arithmetic.
We obtained a four-factor solution: (1) GradCPT, MOT, VCD, and ANS, along with Spatial Span and DSS; (2) Digit Span Forward and Backward; (3) TMT A & B, Letter Cancellation, and Visual Search; (4) Arithmetic. Flanker Interference did not load on any factor.
These results do not fully replicate a, as Visual Search and Flanker Interference were not related to other attentional paradigms. Of neuropsychological measures, Spatial Span and DSS were related to the main attention factor, while those with a search component (e.g., TMT) were related to Visual Search.
These results help us to understand the structure of our visual attention paradigms, and to connect visual cognition to neuropsychology. We recommend that clinical studies should be cautious about attributing attention deficits; Digit Span, for example, should not be characterized as an attention measure. Visual search may be distinct from other attentional paradigms.