Difficulty with concentration is a common occurrence in university students. Assessing concentration requires attention to multiple aspects of a student’s life. Probably the most common causes of attention difficulties are related to lifestyle issues. Serious concentration problems are usually caused by anxiety or depression. Attention Deficit Disorder is relatively rare in university, especially as students have had to achieve high standards in pre-university education. It is a diagnosis that requires the exclusion of other diagnoses, as well as a clear childhood history. Childhood histories can be difficult to ascertain. A high percentage of young boys will show some degree of attention difficulties. Family stress, or lack of adequate family structure can accentuate normal childhood restlessness. The attention problems in ADHD should be consistent and pervasive.
Lifestyle Issues
There are a few basic requirements that most people need in order to have optimal concentration, such as proper sleep, regular meals, and a reasonably comfortable and distraction free environment. These aspects are frequently missing from a student’s life. Often away from home to study for the first time, students may be lax in providing a reasonably structured lifestyle for themselves. Many students get inadequate sleep, and their living arrangements may make a reasonably quiet atmosphere difficult. Substance abuse can also significantly interfere with concentration. It is important to take a clear history of all these aspects in assessing a concentration problem, though it is often difficult to get an accurate reporting of these issues on history alone. The standard psychiatric mental status exam is of little use in students, as very few will have concentration problems of pathological proportions.
Expectations
It is not unusual for a student to complain about concentration difficulties when their concentration is totally within normal limits. A normal concentration span where one can fully focus on a subject is 20-30 minutes. Most people need to take a break after this time before being able to refocus their attention. When students try to push their attention span longer than their normal ability, they both waste time, and will get anxious and distressed about their lack of productivity, further increasing their difficulty in learning. Another issue involving students’ expectations is the level of academic achievement they expect. They may feel pressured to get higher marks than is reasonable for them. Throughout North America, there is considerable mark inflation in high schools. This can lead to difficulty in adapting to the higher standards in university.
Most people need to be physically and psychologically comfortable in order to be able to concentrate. The ability to settle oneself down to work will certainly be effected by stress or moods. It can also be affected by relatively simple life changes. For example, a student may have had certain habits at home that helped in settling, but may have been unable to replicate those conditions at school. Exploring past study habits may help in discovering the conditions that are most conducive to a student’s needs.
Biological Traits
Individual’s natural ability to concentrate tend to fall on a continuum from those who can focus well despite major disruptions, to those who may be natural multi-taskers and can quickly switch from one focus to another, but can’t just focus on one thing for very long. At this end of the biological continuum are those with true ADHD. Students with concentration difficulties may fall within the lower end of the continuum, but are able to concentrate well enough, as long as the other elements of their lives are intact. However, when they don’t take care of their lifestyle elements, or when they are stressed, their concentration will suffer. These students will respond fairly well to psycho-stimulants in the short term, but prescribing medication will usually result in their not attending to the other areas of difficulty in their lives. Reliance in stimulants may actually lead to a worsening of their ability to recognize their lifestyle and emotional needs, as they are then able to ignore these elements and still function.
Mood
Studies have indicated that over 70% of serious concentration problems in students are due to depressed or anxious moods. There are various aspects to the interference with concentration due to these moods. The sleep disturbance that frequently accompanies anxiety or depression can have a direct effect on concentration. Both the psychological and physiological roots of these mood disorders can influence one’s ability to concentrate. The stressed placed on an individual due to these disorders and their effects on concentration, can lead to further deterioration in one’s attention span.
The assessment of concentration problems requires an in-depth clinical assessment. All aspects
of life, both present and past that can contribute to stress need to be investigated. Present lifestyle issues are important. Childhood
history, including academic records, need to be assessed. Learning styles also need to be assessed, as many students’ academic
problems are secondary to inadequate study habits. Significant trauma, frequent changes of environment, or emotional turmoil
in childhood and adolescence can lead directly to concentration difficulties. Emotional difficulties need to be stabilized before
a diagnosis of a primary attention problem can be firmly established. Testing can be helpful in establishing a diagnosis of ADHD,
but does not replace a proper clinical evaluation. At the present time, there is no test that will confirm a diagnosis of ADHD. Testing can pick up concentration difficulties, as well as learning disabilities. In the presence of significant depression
or anxiety, testing is may be less useful.
