A trans-diagnostic investigation of attention, hyper-focus, and monotropism in autism, attention dysregulation hyperactivity development, and the general population

The monotropism hypothesis posits that hyper-focus on interests is core to autistic cognition; moreover, hyper-focus is common in attention dysregulation hyperactivity development (ADHD). However, ADHD is partly defined by susceptibility to distraction, and research has found evidence of attention capture in autism. We investigated hyper-focus in autism and ADHD, its relationship to inattention, and whether it is related to quality of life, hypervigilance, negative repetitive thinking, and symptoms of anxiety and depression. 492 adults (122 ADHD-only, 130 autistic-only, 141 autistic + ADHD, and 99 comparison) completed questionnaires indexing hyper-focus in multiple domains, inattention, and the valence of their hyper-focus experiences. Hyper-focus and inattention were elevated in all neurodivergent groups, and were positively correlated, implying that atypical regulation of attention, sometimes manifesting in hyper-focus and sometimes in inattention, is a trans-diagnostic phenomenon. Hyper-focus predicted poorer global quality of life, more hypervigilance, more negative repetitive thinking, and more symptoms of anxiety and depression; however, positive experiences of hyper-focus mediated an indirect relationship between hyper-focus and greater quality of life, partially attenuating the overall negative association. Indeed, neurodivergent participants not only reported more negative experiences of hyper-focus than controls, but also more positive experiences. Further studies could explore contextual factors influencing whether hyper-focus has positive or negative impacts on daily life.