Attention is often markedly impaired in patients across various psychiatric disorders. Methods to evaluate attentional impairment involve behavioral measures such as continuous performance tasks of sustained attention as well as physiological measures of cortical processing. These methods, however, have not been consistently combined and consequently their relationship to one another is not clearly defined. This study examined impaired attention in a group of neuropsychiatric patients by combining the Integrated Visual and Auditory Continuous Performance Tasks (IVA+Plus) with auditory P300. Results were analyzed to elucidate brain-behavior relationships of attention in psychiatric populations.

Hypothesis: Delayed latency and reduced amplitude on auditory P300 will significantly correlate with impaired attentional performance in auditory domains of IVA+Plus.

Methods: In a community-based neuropsychiatric outpatient clinic, archival auditory P300 and IVA+Plus data were analyzed for (n=73) patients. Patients were referred for evaluation due to a wide variety of psychiatric symptoms ranging from depression and anxiety to concentration and memory impairments. Most patients presented with complex and comborbid symptomatology. Cluster analysis was used to determine subgroups of patients based on performance in auditory domains of IVA+Plus. Independent t-tests were then utilized to compare auditory P300 amplitudes and latencies between subgroups.

Results: Cluster analysis revealed two subgroups of patients on the IVA+Plus Auditory Attention Quotient (AAQ) separated by average (n= 52) and below average performance (n=21). These subgroups were similar in both gender and age distribution. The below-average subgroup demonstrated significantly lower scores on AAQ by at least 1 standard deviation. Independent t-tests comparing P300 values between AAQ groups revealed significantly delayed latencies at Cz (p=0.0725) and reduced amplitudes at both Cz (p =.0012) and Pz (p=0.0005) associated with below-average AAQ scores.

Conclusions: Data supports the hypothesis in that auditory P300 impairments marked by delayed latency and reduced amplitude correspond to impairments in behavioral performance on tasks of auditory attention. This study is the first of its kind to directly link physiology to behavior using the IVA+Plus Continuous Performance Task. Findings of this study offer implications for brain-behavior relationships involved in attention and can enhance clinical assessment attention-related symptoms across a variety of psychiatric disorders. This study supports a combined approach to evaluation of attention utilizing both performance-based and physiological measures.