Distinct Attentional Control Profiles During Language Comprehension in Major Mental Health Disorders

The current study combined behavioral and electroencephalography (EEG) measures to investigate variations in attentional state during comprehension of spoken stories in a clinical sample that included participants with several major mental health disorders that often feature attentional control difficulties.

Participants with schizophrenia (SZ) (n = 62), bipolar disorder (BP) (n = 44), and major depressive disorder (MDD) (n = 51) and psychiatrically healthy control participants (HCs) (n = 82) completed a story-listening task and were periodically interrupted by attention probes. Attention probes assessed 3 different states of engagement via self-reports: on-task attention, partially off-task split-attention, and fully off-task lapsed attention. EEG was recorded to examine corresponding changes in periodic alpha band (8-13 Hz) power.

We found that all patient groups reported significantly less time fully on-task during story listening than HCs but that individual patient groups reported distinct patterns of off-task attention. Reports of fully lapsed attention dominated off-task reports for participants with SZ, whereas participants with MDD reported a higher incidence of experiencing a distracted or split attentional state. The EEG results provided additional evidence that the 3 self-report attention probe categories tapped into biologically distinguishable attentional states, with split attention and fully lapsed attention associated with distinct neural signatures compared with on-task attention. Periodic alpha power was modulated by attentional state in all groups, although there were significant group differences.

Our results demonstrate distinct behavioral and neurophysiological attentional control profiles in SZ and MDD compared with HCs during language comprehension.