Do Aversive Sounds Influence the Performance of Adult Females With Sensory Modulation Disorders (SMD) on a Sustained Attention Task?

PURPOSE: The goals of this study were to examine the effects of sensory modulation (SMD) and attention deficit hyperactivity disorder (ADHD) on sustained attention of young adult women and to assess the effects of aversive auditory conditions on their performance in a sustained attention task.

RATIONALE: The overlap of symptoms in children with SMD and ADHD makes it difficult to differentiate the two disorders. Furthermore, there is evidence that a high percentage of children with ADHD also have SMD. Research on adults with SMD is scarce.

In a recent study, we succeeded to dissociate between SMD and ADHD using an executive attention task. Here, we aimed at further testing the attentional profile of adult women with SMD and women with ADHD in a sustained attention task.

DESIGN: Quasi-experimental study with a 2 × 2 factorial design

PARTICIPANTS: The participants were 66 young adult women, mostly university students, in four groups: 20 with SMD and without ADHD; 20 with ADHD and SMD; 6 with ADHD and without SMD; and 20 controls. Mean age was 25.03 yr (standard deviation [SD] = 3.47). The diagnosis of SMD was made using the Sensory Responsiveness Questionnaire, and ADHD was diagnosed by a qualified psychiatrist or neurologist using Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria.

METHOD: The experimental measures were the Battery of Aversiveness to Sounds (BAS), a standardized measure of 10 sound presentations and the Conjunctive–Continuous Performance Task–Visual (CCPT–V) to measure sustained attention. The BAS was administered during the initial stage of the experimental procedure, from which the three most aversive sounds specific to each participant were chosen. Afterward, participants’ performance on the CCPT–V was measured under two conditions: with aversive sounds and without sounds.

ANALYSIS: Analyses were performed using a 2 × 2 × 2 × 2 (ADHD × SMD × sound order × sound) analysis of variance (ANOVA) with repeated measures on sound.

RESULTS: ANOVA found a main effect for ADHD, F(1, 58) = 4.330, p = .042, η² = .069. The mean (M) and standard error (SE) of reaction time (RT) for participants with ADHD was higher (M = 89.254, SE = 8.437), indicating more variability than the mean SD of RT for those without ADHD (M = 68.326, SE = 5.475). No interaction effect for ADHD and sound was found, F(1, 58) = 3.506, p > .05.

Another main effect was found for SMD, F(1, 58) = 5.262, p = .025, η² = .083. The mean SD of RT for SMD was significantly higher (M = 90, SE = 5), indicating more variability than the mean SD of RT for those without SMD (M = 67, SE = 8). No interaction effect was found for SMD and sound, F(1, 58) = 0.082, p > .05. This sustained attention task yielded a main effect for both ADHD (in the SD of RT and omission errors) and SMD (in the SD of RT and commission errors), indicating more variability in performance when the ADHD or SMD factors were present, more misses of the target for participants with ADHD, and more false alarms for participants with SMD.

DISCUSSION: The results obtained in sustained attention for participants with SMD are similar to those obtained for participants with ADHD, indicating that both factors, SMD and ADHD, contribute to poorer performance on this task. Both factors also did not differentiate participants when aversive sounds were present, possibly because this relatively easy task does not place a high cognitive load.

IMPACT STATEMENT: This study represents another step in the characterization of the attentional profile of adults with SMD. Findings stress the arguable use of a sustained attention task as measure that can differentiate SMD from ADHD, even when aversive sounds are present. Findings from this study potentially contribute to the assessment and intervention process for each diagnosis and to the allocation of economic and professional resources.