The clock as a focus of selective attention in those with primary insomnia: An experimental study using a modified Posner paradigm

Espie and colleagues [(2006). The attention-intention-effort pathway in the development of psychophysiological insomnia: a theoretical review. Sleep Medicine Reviews, 10, 215-245] propose a route into psychophysiological insomnia along the attention-intention-effort pathway which focuses on the inhibition of sleep-wake automaticity. A contributing factor to this is selective attention to sleep (alongside explicit intention to sleep and effort in the sleep engagement process). Following on from previous work on selective attention to sleep [Marchetti, L. M., Biello, S. M., Broomfield, N. M., MacMahon, K. M. A., & Espie, C. A. (2006). Who is pre-occupied with sleep?. A comparison of attention bias in people with psychphysiological insomnia, delayed sleep phase syndrome and good sleepers using the induced change blindness paradigm. Journal of Sleep Research, 15, 212-221; MacMahon, K., Broomfield, N., Macphee, L., & Espie, C. A. (2006). Attention bias for sleep related stimuli in primary insomnia and delayed sleep phase syndrome using the dot-probe task. Sleep, 29, 11] and considering the importance of monitoring both internal and external cues in the maintenance of insomnia, as highlighted in the cognitive model of insomnia [Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869-893], a cognitive probe task was employed to investigate further the role of the clock as a focus of selective attention in those with primary insomnia.A 2 × 2 between participants design comparing reaction time of individuals with primary insomnia (n = 22) and normal sleepers (n = 22) on a modified Posner paradigm. Responses obtained from a computer task presenting times which fall within a normal sleep period were analysed.Individuals with primary insomnia demonstrated delayed disengagement to the clock (F(1,84) = 6.9, p < 0.05) which is taken as further support for previous research demonstrating that individuals with primary insomnia exhibit an attentional bias to sleep related stimuli.These results lend support to the attention-intention-effort model (Espie et al., 2006) and the cognitive model (Harvey, 2002) both of which recognise the importance of selective attention towards salient stimuli in the maintenance of insomnia. Possible clinical implications of attentional bias to sleep as a marker of psychopathology progression and treatment efficacy are discussed.     

A presentation of Attentional Semantics

The paper presents the two main assumptions of Attentional Semantics—(A) and (B), and its main aim (C). (A) Conscious experience is determined by attention: there cannot be consciousness without attention. Consciousness is explained as the product of attentional activity. Attentional activity can be performed thanks to a special kind of energy: nervous energy. This energy is supplied by the organ of attention. When we perform attentional activity, we use our nervous energy. This activity directly affects the organ of attention, causing a variation in the state of the nervous energy. This variation constitutes the phenomenal aspect of consciousness. (B) Words are tools to pilot attention. The meanings of words isolate, de-contextualize, “freeze” and classify in an articulated system the ever-changing and multiform stream of our conscious experiences. Each meaning is composed of the sequence of invariable elements that, independently of any individual occurrence of a given conscious experience, are responsible for the production of any instance of that conscious experience. The elements composing the meanings of words are attentional operations: each word conveys the condensed instructions on the attentional operations one has to perform if one wants to consciously experience what is expressed through and by it. (C) Attentional Semantics aims at finding the attentional instruction conveyed by the meanings of words. To achieve this goal, it tries: (1) to identify the sequence of the elementary conscious experiences that invariably accompany, and are prompted by, the use of the word being analyzed; (2) to describe these conscious experiences in terms of the attentional operations that are responsible for their production; and (3) to identify the unconscious and non-conscious operations that, directly or indirectly, serve either as the support that makes it possible for the attentional operations to take place, be completed, and occur in a certain way, or as the necessary complement that makes it possible to execute and implement the activities determined and triggered by the conscious experiences. The origins of Attentional Semantics are also presented, and the methodological problems researchers encounter when analyzing meanings in attentional terms are discussed. Finally, a brief comparison with the other kinds of semantics is made.