Attention Fatigue Research Articles

Differences in Self-reported Attentional Fatigue Between Patients With Breast and Prostate Cancer at the Initiation of Radiation Therapy

Attentional fatigue is experienced as a decreased ability to concentrate, engage in purposeful activity, and maintain social relationships when there are competing demands on attention. Breast and prostate cancer are the 2 most common cancers in women and men, respectively. Most previous studies on self-reported attentional fatigue evaluated patients with breast cancer. The objectives of the study were to determine if self-reported attentional fatigue differed in patients with breast cancer and prostate cancer before radiation therapy (RT) and to determine the relationships between attentional fatigue and other symptoms in these 2 groups. Patients (n = 155) completed questionnaires before RT. Descriptive statistics, Pearson correlations, and analysis of covariance were used for data analyses. After controlling for age, patients with breast cancer reported significantly higher levels of attentional fatigue. In both groups, more attentional fatigue correlated significantly with more anxiety, depression, sleep disturbance, and physical fatigue. These correlations were stronger for patients with breast cancer. The present study is the first to identify differences in self-reported attentional fatigue between these 2 groups before RT. Additional research is warranted to determine factors that contribute to these differences, as well as mechanisms that underlie the development of attentional fatigue. Clinicians should consider the capacity of their patients to direct attention when learning about RT and other treatments. It is important to simplify confusing healthcare terminology and reinforce teaching that is most important both verbally and in writing. Appropriate interventions for anxiety and depression may decrease attentional fatigue in these patients.

Divided attention and childhood chronic fatigue syndrome (CCFS)

Divided attention and childhood chronic fatigue syndrome (CCFS)

Do we need to pay attention to fatigue in rehabilitation?

Do we need to pay attention to fatigue in rehabilitation?

Deficits in attentional control: cholinergic mechanisms and circuitry-based treatment approaches.

The cognitive control of attention involves maintaining task rules in working memory (or "online"), monitoring reward and error rates, filtering distractors, and suppressing prepotent, and competitive responses. Weak attentional control increases distractibility and causes attentional lapses, impulsivity, and attentional fatigue. Levels of tonic cholinergic activity (changes over tens of seconds or minutes) modulate cortical circuitry as a function of the demands on cognitive control. Increased cholinergic modulation enhances the representation of cues, by augmenting cue-evoked activity in thalamic glutamatergic afferents, thereby increasing the rate of detection. Such cholinergic modulation is mediated primarily via α4β2* nicotinic acetylcholine receptors. Animal experiments and clinical trials in adult patients with ADHD indicate that attentional symptoms and disorders may benefit from drugs that stimulate this receptor. Tonic cholinergic modulation of cue-evoked glutamatergic transients in prefrontal regions is an essential component of the brain's executive circuitry. This circuitry model guides the development of treatments of deficits in attentional control.

Walking in a Natural Winter Setting to Relieve Attention Fatigue: A Pilot Study

Previous research has suggested that exposure to outdoor surroundings is associated with improved attention and concentration among children with attention deficit hyperactivity disorder (AD/HD). This effect has been attributed to the impact of exposure to “green space” in restoring fatigued attention. Because of concerns about side effects and misuse of stimulant medication, there has been considerable interest in green space exposure as a possible alternative or complementary therapy for ADHD. In the current study, adults completed a 20 minute walk in three types of outdoor settings: a wooded trail, a residential neighborhood, and a parking lot. Participants completed subtests from the Wechsler Memory Scale assessing attention, concentration, and short-term memory as well as the Profile of Mood States, a self-report measure for assessing current emotional status. Based upon previous green space research, it was anticipated that participants in the wooded trail condition would perform better on the cognitive tasks. However, there was no difference between the three conditions in participants’ pre- and post-walk cognitive functioning. When data from the three groups were pooled, there was a significant benefit associated with the 20 minute walk for short-term memory as well in reducing tension, depression, anxiety, fatigue, and confusion. The results do suggest that relatively brief outdoor physical activity may be a useful complementary intervention for persons with conditions adversely affecting short-term memory

Incompatibility and Mental Fatigue

A straightforward prediction from attention restoration theory is that the level of incompatibility in a person’s life should be positively correlated with that person’s level of mental (or directed attention) fatigue. The authors tested this prediction by developing a new self-report measure of incompatibility in which they attempted to isolate all the six categories of incompatibility described by S. Kaplan: distraction, deficit of information, duty, deception, difficulty, and danger. Factor analysis revealed six factors that corresponded reasonably well to those six categories. This article found that a composite incompatibility score was positively correlated with a separate self-report measure of mental fatigue and so were all six of the subscale scores. With the exception of the score for duty, these positive correlations remained after partialing out a separate measure of the level of stress in the person’s life. The authors concluded that the proposed categories of incompatibility can be validly measured; that the constructs of incompatibility, mental fatigue, and stress are discriminable from each other; and that incompatibility is generally positively correlated with mental fatigue.

Predictors of the Trajectories of Self-Reported Attentional Fatigue in Women With Breast Cancer Undergoing Radiation Therapy

To examine how attentional fatigue changed from the time of simulation to four months after the completion of radiation therapy and to investigate whether specific variables predicted initial levels and trajectories of attentional fatigue. Descriptive, longitudinal study. Two radiation therapy departments. 73 women with breast cancer who received primary or adjuvant radiation therapy. Participants completed questionnaires prior to, during, and after radiation therapy. Descriptive statistics and hierarchical linear modeling were used for data analysis. Attentional fatigue; demographic, clinical, and symptom characteristics. Large amounts of interindividual variability were found in the trajectories of attentional fatigue. At baseline, higher levels of attentional fatigue were associated with younger age, not working, a higher number of comorbidities, and higher levels of trait anxiety. The trajectory of attentional fatigue improved over time for women with higher body mass index at baseline. This study is the first to identify predictors of interindividual variability in attentional fatigue in women with breast cancer undergoing radiation therapy. The predictors should be considered in the design of future correlational and interventional studies. Nurses could use knowledge of the predictors to identify patients at risk for higher levels of attentional fatigue. In addition, nurses could use the information to educate patients about how attentional fatigue may change during and following radiation therapy for breast cancer.

A nonlinear dynamics model for simulating long range correlations of cognitive bistability

Simulation results of bistable perception due to ambiguous visual stimuli are presented which are obtained with a behavioral nonlinear dynamics model using perception-attention-memory coupling. This model provides an explanation of recent experimental results of Gao et al. (Cogn Process 7:105-112, 2006a) and it supports their speculation that the fractal character of perceptual dominance time series may be understood in terms of nonlinear and reentrant dynamics of brain processing. Percept reversals are induced by attention fatigue and noise, with an attention bias which balances the relative percept duration. Dynamical coupling of the attention bias to the perception state introduces memory effects leading to significant long range correlations of perceptual duration times as quantified by the Hurst parameter H > 0.5 (Mandelbrot, The fractal geometry of nature, 1991), in agreement with Gao et al. (Cogn Process 7:105-112, 2006a).

The Benefit of Recreational Physical Activity to Restore Attentional Fatigue: The Effects of Running Intensity Level on Attention Scores

The primary aim of this study was to examine the effects of running intensity level and physical activity level on the recovery of attentional fatigue while controlling for duration, environment, and activity type in a sample of recreational runners. Attention Restoration Theory served as the theoretical frame for the study. Relationships among these and related variables were evaluated at the group level in an experimental, between subjects design. The data allowed hypothesis testing about differences between group means at four levels of intensity: self-regulated, low, high, and comparison to a resting control group on the dependent variable attention. High intensity running restored attention significantly more than the control group. Implications for theory, and recreation research and practice are discussed.

Preference for Restorative Situations: Interactive Effects of Attentional State, Activity-in-Environment, and Social Context

This study extends research on psychological restoration by encompassing a broad set of restorative situations available to urban residents. Preferences are assessed for mundane restorative situations comprising leisure activity, setting, and social context, given different levels of attentional fatigue. Attentional fatigue, activity-setting, and social context were experimentally manipulated. The settings for activities were home, park, city center, and transit. Participants (N = 70) read scenarios describing an attentional state and rated their preference for the situations. Results show interactive effects of attentional state with activity-setting and with social context. The park was most preferred given attentional fatigue. Results confirm that while residents may particularly value urban nature for restoration, their urban context also provides other mundane but attractive restorative situations.

An exploratory study of the effect of high and low fascination environments on attentional fatigue

According to attention restoration theory attentional fatigue can be renewed in environments where fascinating stimuli are present as they evoke effortless attention and allow directed attention to rest and be restored. The present study hypothesizes that performing an attention-orienting task in a state of attentional fatigue costs less in a high fascination than in a low fascination condition. In the former attentional shifts are expected to be facilitated because one can function in the involuntary mode. The high fascination condition is also expected to facilitate attention in the coding process and therefore to affect the likelihood of stimulus material to be remembered. To this end 31 subjects were mentally fatigued by performing a sustained attention test. Then they performed an ad hoc attention-orienting task inspired by Posner's paradigm and applied to 40 photographs of environments already assessed for their fascination value. Finally they performed an incidental memory task. As expected, only in the high fascination condition did participants show a significant benefit (reaction time reduction) in shifting attention between trials. The role of fascination on recall is less clear since it interacts with the naturalness of the scene.

Restorative servicescapes: restoring directed attention in third places

PurposeThe purpose of this paper is to introduce restorative servicescapes. The work demonstrates that younger‐aged consumers may remedy symptoms associated with directed attention fatigue, including adult attention deficit hyperactivity disorder (ADHD), by patronizing third places, such as video arcades and coffee shops.Design/methodology/approachThis paper evaluates a servicescape's restorative potential by drawing on established measures. Attention restoration theory (ART) has been explored in natural and environmental psychology, rather than marketing. The first study uses survey methodology to explore whether teenagers who patronize a video arcade sense its restorative potential. The second study uses survey methodology to explore the relationship between patronizing a restorative third place and being at risk for ADHD.FindingsStudy 1 reveals that video arcade patrons sense the arcade's restorative potential. Therefore, commercial servicescapes may possess restorative qualities. Study 2 reveals that college‐aged students, who patronize a restorative servicescape, are significantly less likely than other students to be at risk for experiencing ADHD.Research limitations/implicationsAlthough the data reveal a relationship between restorative servicescapes and ADHD risk, a diagnosis is not obtained. Furthermore, because survey methodology is employed, the causal influence of restorative servicescapes cannot be evaluated on their customers' health. However, commercial servicescapes can mimic the restorative properties found in nature. Thus, the health potential of public places on health may be profound.Practical implicationsEducational institutions, governmental agencies, and parents should consider publicly supporting third places for teenagers because doing so can remedy symptoms associated with mental fatigue.Originality/valueThe paper brings ART into the marketing discipline.

Where to take a study break on the college campus: An attention restoration theory perspective

College students spend much of their time on campus engaged in activities that require sustained directed attention, which may lead to attention fatigue. They would benefit from campus settings that provide effective restoration breaks and allow them to return to their work cognitively refreshed. Studies have found direct exposure to nature, viewing nature through windows, and viewing images of nature are restorative. In the present study, college students, instructed to imagine themselves cognitively fatigued, rated the perceived restorativeness of indoor campus settings that varied by view of nature: some had no views of nature, some had window views of nature with built structures present, and some had views of simulated nature depicted as large nature murals. Students rated settings with views of dramatic nature murals, especially those with water, more restorative than settings with window views of real, but mundane nature with built structures present. Students rated settings that lacked views of real or simulated nature least restorative. The findings suggest that large nature murals in indoor settings used for study breaks may provide attentionally fatigued students with opportunities for restoration when views of nature are unavailable or limited in restorative potential.

Perceived Danger and Judged Likelihood of Restoration

The authors investigated the impact of perceived danger on judged likelihood of restoration. Participants imagined that they were in a state of directed attention fatigue and then that they were taking a walk in a potentially restorative setting. The authors varied two properties of the setting in a factorial design. The setting was either a nature trail or a busy urban street, and it contained either no obvious source of danger or an ominous stalker. Measures of perceived danger and of judged likelihood of restoration were obtained. For both types of measures, in the low-danger condition the two setting categories differed, with the natural setting seen as less dangerous and more likely to be restorative. In the high-danger condition, the difference between the setting categories was eliminated. The authors conclude that the presence of a serious and potentially uncontrollable source of danger can damage the perceived restorative potential of a setting.

Are perceived soundscapes within urban parks restorative

The perceived quality of urban park soundscapes is starting to be explored, and attention restoration research has shown which environments are generally restorative. Yet the effect of perceived soundscapes on individuals' restorative experiences is hardly known. Natural environments, in general, provide restoration for people, including recovery from attentional fatigue and enabling reflection. Therefore the visually “natural” environment of urban parks provides a useful setting to explore the role of varying soundscapes in restoration. Four hundred park users within Sheffield, UK, were surveyed as they left two urban parks. Data were collected on aspects of their park visit, along with measures of their current perceived restoration. Participants' perceived soundscapes were described by the amount of time they heard certain sound types in the park, and the volume at which they heard them. Sound levels [LAeq, dB(A)] within the parks were also monitored on a number of days to provide contextual information. Results of the study will be discussed along with the importance of soundscape quality and individuals' restorative experiences in helping to provide a productive and positive quality of urban life.

The need for psychological restoration as a determinant of environmental preferences

Environmental preferences vary with the environments evaluated and the people who evaluated them. When research has considered the explanatory power of person variables, it has focused on traits or demographic characteristics. Little research has considered how environmental preferences vary with regularly occurring psychological states, such as attentional fatigue. In this experiment, we investigated the need for psychological restoration as a within-individual determinant of the common preference differential between natural and urban environments. We treated preference as an attitude, constituted of beliefs about the likelihood of restoration during a walk in a given environment and the evaluation of restoration given different restoration needs. College students ( N = 103 ) completed the procedure just before a morning lecture (less fatigue condition) or immediately after an afternoon lecture, which itself followed the passage of time and other activities over the day (more fatigue condition). In both fatigue conditions, participants reported more favorable attitudes toward a walk in a forest than a walk in a city center, but this difference was larger with the more fatigued. This result apparently owes to the more fatigued participants’ more positive evaluation of attentional recovery, and a greater judged likelihood of restoration when walking in the forest.

Vitamin G: effects of green space on health, well-being, and social safety

BackgroundLooking out on and being in the green elements of the landscape around us seem to affect health, well-being and feelings of social safety. This article discusses the design of a research program on the effects of green space in the living environment on health, well-being and social safety.Methods/designThe program consists of three projects at three different scales: at a macro scale using data on the Netherlands as a whole, at an intermediate scale looking into the specific effect of green space in the urban environment, and at micro scale investigating the effects of allotment gardens. The projects are observational studies, combining existing data on land use and health interview survey data, and collecting new data through questionnaires and interviews. Multilevel analysis and GIS techniques will be used to analyze the data.DiscussionPrevious (experimental) research in environmental psychology has shown that a natural environment has a positive effect on well-being through restoration of stress and attentional fatigue. Descriptive epidemiological research has shown a positive relationship between the amount of green space in the living environment and physical and mental health and longevity.The program has three aims. First, to document the relationship between the amount and type of green space in people's living environment and their health, well-being, and feelings of safety. Second, to investigate the mechanisms behind this relationship. Mechanisms relate to exposure (leading to stress reduction and attention restoration), healthy behavior and social integration, and selection. Third, to translate the results into policy on the crossroads of spatial planning, public health, and safety. Strong points of our program are: we study several interrelated dependent variables, in different ordinary settings (as opposed to experimental or extreme settings), focusing on different target groups, using appropriate multilevel methods.

Attention and Restoration in Post-RN Students

The impact of a restorative intervention using the natural environment on capacity to direct attention and issues that contribute to attention fatigue for diploma-prepared nursing students (Post-RN students) enrolled in a baccalaureate nursing program was examined. This study used a quasi-experimental comparison group design. Subjective (Attentional Functional Index) and objective (Finding A's Test and Symbol Digits Modalities Test) measures were employed. Thirty-two students at two universities participated. Results of the split-plot analysis revealed a within-subject effect on the Attentional Functional Index (p < .05), a significant within-subject effect on the Finding A's Test (p < .05), and a significant within- and between-subject effect on the Symbol Digits Modalities Test (p < .05). Recognizing and managing attention fatigue throughout the school year may enhance Post-RN students' abilities to direct attention and contribute to an enhanced academic experience.

The Effects of a Restorative Intervention on Undergraduate Nursing Students’ Capacity to Direct Attention

The purpose of this study was to examine the effects of a restorative intervention on undergraduate nursing students' capacity to direct attention. Kaplan and Kaplan's attention restoration theory, which describes and links concepts of directed attention, attention fatigue, and restorative environments, formed the theoretical basis for this research. A convenience sample consisted of 33 students randomly assigned to nonintervention and intervention groups. The intervention was a 1-hr walk in natural surroundings. Both groups completed study instruments prior to and following the intervention. Intervention group students scored higher on a measure of quality of life at posttest (p < .05). Differences in a measure of perceived attention were not observed between groups over time. Both groups improved on other measures of attention; however, the results did not provide support for the hypotheses. Students were a highly functioning group participating in many activities they considered restorative, prior to the study.

A Comparison of Leisure Time Spent in a Garden with Leisure Time Spent Indoors: On Measures of Restoration in Residents in Geriatric Care

During the past 20 years, findings have indicated that nature plays an active role in helping people recover from stress and fatigue. Two of the most cited theories in this field are Rachel and Stephen Kaplan's theory of recovery from Directed Attention Fatigue in nature and Roger Ulrich's theory of aesthetic and affective responses to natural environments and stress recovery. One aim of the present study is to test whether being outdoors in a green recreational environment causes people to be more focused, compared to being in a room indoors (in line with hypotheses suggested by the Kaplans). Another aim is to test whether people experience stress reduction, i.e. as evidenced by changes in blood pressure and heart rate, if they are placed in an environment with many green elements (in line with hypotheses suggested by Ulrich). The overall study design is that of an intervention study. Fifteen elderly persons living at a home for very elderly people participated. Their powers of concentration, blood pressure and heart rate were measured before and after an hour of rest in a garden or in an indoor setting. Seven elderly people were randomly chosen to have their first series of tests in a garden, while eight elderly people had their first series of tests indoors. The results indicate that powers of concentration increase for very elderly people after a visit to a garden outside the geriatric home in which they live, compared to that after resting indoors in their favourite room. The results did not show any effects on blood pressure or heart rate. It is suggested that having a one-hour rest outdoors in a garden setting plays a role in elderly people's powers of concentration, and could thereby affect their performance of activities of daily living. One important factor in this study was that both the outdoor environment and the indoor environment at the home were highly valued by participants.