Is Attentional Filtering Impaired in Schizophrenia?

Recent evidence suggests that schizophrenia involves hyperfocusing, an unusually narrow but intense focusing of processing resources. This appears to contradict the classic idea that schizophrenia involves an impairment in the ability to focus on relevant information and filter irrelevant information. Here, we review one set of studies suggesting that attentional filtering is impaired in people with schizophrenia and another set of studies suggesting that attentional filtering is unimpaired or even enhanced in these individuals. Considerable evidence supports both conclusions, and we propose 3 potential ways of reconciling the conflicting evidence. First, impaired attentional filtering may occur primarily during periods of active psychosis, with hyperfocusing being a part of the broad pattern of cognitive impairment that persists independent of the level of positive symptoms. Second, schizophrenia may involve hyperfocusing in the visual modality and impaired attentional filtering in the auditory modality. Third, attention may be directed toward irrelevant inputs as a result of impaired executive control, and hyperfocusing on those inputs may be functionally equivalent to a failure of attentional filtering. Given the widespread clinical observations and first-person reports of impaired attentional filtering in schizophrenia, it will be important for future research to test these possibilities.

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© The Author(s) 2019. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: [e-mail].