Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
This retrospective analysis synthesized the results of existing studies examining sensory processing preferences of people with psychiatric conditions, including schizophrenia, high risk for psychosis, bipolar disorder, depression, posttraumatic stress and obsessive–compulsive disorder. A general pattern of increased sensory sensitivity, sensation avoiding, and low registration and less sensation seeking was identified; however, condition-specific preferences were also noted.
Primary Author and Speaker: Catana Brown
Additional Authors and Speakers: Megan Steuter
PURPOSE: Occupational therapists are interested in sensory processing as a client factor that affects occupational performance. People experience sensory processing challenges when their reactions do not match seemingly common stimuli. For example, Bailliard (2015) describes sensory dissonance as a phenomenon that occurs when one’s expectations for sensation are not congruent with the sensations one is experiencing. Some individuals overreact to sensory stimuli, others underreact, while still others vacillate between the two demonstrating problems in modulation. Although every person has a unique sensory profile (Brown, Steffan-Sanchez & Nicholson, 2019), different psychiatric conditions may be characterized by a tendency towards particular sensory preferences. Several studies using the Adolescent/Adult Sensory Profile (A/ASP) examined sensory processing preferences with psychiatric diagnoses making it easy to compare results across the studies. Therefore the purpose of this study is to address the question, ‘What are the sensory processing preferences as measured by the A/ASP that distinguish psychiatric conditions?’
DESIGN: A retrospective analysis described the results of existing studies and compared the results of each study with established norms.
METHOD: PubMed, PsycINFO, ERIC, CINAHL and OT seeker were searched for applicable studies. The retrospective analysis was completed by extracting the four sensory processing quadrant scores from each study and comparing these scores to the A/ASP norms using independent sample t-tests.
RESULTS: The five included studies revealed a general pattern of greater sensory sensitivity, sensation avoiding and low registration and less sensation seeking among individuals with a psychiatric condition. Even when conservative bonferroni corrections were applied to determine statistical significance (p < 0.000156), with all conditions (schizophrenia, high risk for psychosis, bipolar disorder, depression, post traumatic stress, and obsessive compulsive disorder) there was a statistically significant difference from the AASP normative scores in at least two of the four sensory processing quadrants. Variability in sensory processing preferences across the psychiatric conditions were most marked when examining those instances in which there was a large effect size (d > 0.80) differentiating those with a psychiatric condition from the normative sample. For schizophrenia there was a large effect with low registration (d = 0.83). Bipolar disorder and major depression were most different from the normative sample in terms of exceptionally low scores in sensation seeking (d = 1.46 and 1.72 respectively). In post traumatic stress there were large effects for sensory sensitivity (d = 1.70), low registration (d = .99), sensation avoiding (d = 1.58) and sensation seeking (d = 1.04). Similarly in obsessive compulsive disorder there were large effects for sensory sensitivity (d = 1.33), low registration (d = .83) and sensation avoiding (d = 1.0) but not sensation seeking.
CONCLUSION: Both general patterns and condition specific sensory processing preferences were identified.
IMPACT STATEMENT: This research is important to practice because it can lead to condition-specific sensory-based interventions targeting the person’s specific sensory needs (Scanlan & Novak, 2015). People with schizophrenia will be more likely to notice information when sensory features are enhanced, while individuals with mood disorders may benefit from strategies to increase comfort and motivation when exposed to sensations. Individuals with PTS and OCD present with more complex sensory processing patterns and require strategies that help with self regulation.
References
Baillard, A. L. (2015). Habits of the sensory system and mental health: Understanding sensory dissonance. American Journal of Occupational Therapy, 69, 6904250021. https://doi.org/10.5014/ajot.2015.014977
Brown, C. E., & Dunn, W. (2002). Adolescent/adult sensory profile: User’s manual. San Antonio, TX: Psychological Corporation.
Brown, C., Steffen-Sanchez, P., & Nicholson, R. (2019). Sensory Processing. In C. Brown, J. Munoz, and G. Stoffel (Eds). Occupational Therapy in Mental Health: A Vision for Participation (pp. 323-341). Philadelphia, PA: FA Davis.
Scanlan, J.N. & Novak, T. (2015). Sensory approaches in mental health: A scoping review. Australian Occupational Therapy Journal, 62, 277-285. https://doi.org/10.111/1440-1630.12224
