Discrepancy between self-reported and performance-based attention

Subjective and objective assessments of attention often yield discrepant results, yet little is known about whether such discrepancies vary across attention subdomains or are influenced by depressive symptoms. This study examined the agreement and correlation between self-reported attentional complaints and performance-based measures of attention and explored the impact of Major Depressive Episode (MDE) on these discrepancies.

cross-sectional study, 475 employees and medical students (aged 20-70 years) from a university hospital in Brazil completed the Patient Health Questionnaire-9 (PHQ-9) and the Continuous Visual Attention Test (CVAT), that measures focused attention, inhibitory control, intrinsic alertness, and sustained attention. Discrepancy scores between subjective and objective attention assessments were computed (range: -3 to +3). Participants were classified as MDE (PHQ-9 ≥ 10) or no MDE. Agreement was assessed with Cohen's κ, correlations with Spearman's ρ, and predictors of discrepancy with multiple quantile regression.

There was no agreement between subjective and objective attention measures (κ = 0.027, p = .487) and no significant correlations across subdomains (all p > .05). MDE participants (32 % of the sample) showed significantly higher discrepancy scores than no MDE participants (p < .001), with 73 % classified as overestimators of subjective complaints. Depression severity was the strongest independent predictor of greater overestimation (β = 0.100, p < .001), while sex and education were non- significant.

Depressive symptoms are strongly associated with a negatively biased self- evaluation of attentional functioning, characterized by overestimation of difficulties despite objective performance.