Virtual Reality Attention Tasks in Attention Deficit Hyperactivity Disorder: I. Behavioural Responses

Differences in executive functioning associated with working memory and different components of attention including sustained, selective, divided and attentional switching have been reported in people with attention deficit hyperactivity disorder. Traditional laboratory tasks have limited ecological validity, whereas existing virtual reality studies have focused mainly on sustained attention, with multi-attention-form assessment remaining relatively unexplored. Sixty-four participants (34 people with self-reported attention deficit hyperactivity traits and 30 neurotypical participants) were included. Participants were tested for stuttering, attention deficit hyperactivity disorder traits and phonological working memory and then completed 10 virtual reality tasks that measured all four forms of attention. The self-reported attention deficit hyperactivity disorder group showed significantly lower attention scores, higher stuttering scores and lower phonological working memory scores. Behavioural results from the virtual reality tasks revealed that this group differed in sustained attention. Lower accuracy, higher omission error rates and reduced sensitivity occurred in this group in the traditionally formatted task based on the continuous performance test (Task 2). Logistic regression showed that all measures, except for sensitivity in Task 2, significantly predicted group membership. Results from the questionnaires indicated that overall, all participants felt present and immersed in the tasks. Findings suggest that attentional differences are form-specific and mostly observed under sustained attention tasks. Virtual reality can be used as an ecologically valid tool for detecting form-specific attentional differences under real-life scenarios.